Protecting Gun Owners from Pediatricians: Free Speech Redefined

by Maggie Kozel, M.D.

Why would a gun owner not want to talk to their child's doctor about gun safety?

One year ago I wrote an article about how Florida's state legislature had passed a law prohibiting doctors from discussing gun safety at pediatric visits. The law drew immediate and strong objection from all the major medical organizations, including my own, the American Academy of Pediatrics. Reason seemed to prevail, as the US District Court quickly handed down an injunction against the gag law. Reason however does not sell guns or bankroll politicians in wingnut states.
On July 25, 2014 the US Court of Appeals for the 11th Circuit upheld the original legislation, imposing harsh penalties on any physician who discusses gun safety with his or her patients (or in this case, of course, the minor's parents.) The Court's majority held that a state legislature can in fact prohibit a doctor from discussing with a patient any medical issue that it (the state) finds politically distasteful. The ruling asserts that there is no First Amendment protection for physicians who provide their best medical advice to patients. Appeals court Judge Gerald Tjoflat wrote that the law "simply acknowledges that the practice of good medicine does not require interrogation about irrelevant, private matters."
Why would a gun owner not want to talk to their child's doctor about gun safety? The answer is: that's the wrong question. They do want to talk about it.
I work in a rural area where gun ownership is common. I routinely ask families about guns at every well child visit and I have never had a parent -- gun owner or not -- raise an objection. I am pleased to say that most gun owning parents answer readily that yes, their guns are hidden and locked up. If they do not take these measures, I encourage them to do so. Even among parents who don't own guns, I am struck by the number of times an unexpected light bulb goes on, when a mother's forehead will furrow, and she'll turn to her child asking "Does Grandpa keep his guns locked up? We'll have to ask him the next time we're over there." Mission accomplished. Freedom still reigns.
Parents can even lie if they want to. Just the other day I asked the mother of a five year old if there were guns in the house. She said no, but the little guy chimed in "What about the one on the shelf?" The shelf? Really? I offered my safe storage advice to a very sour looking lady. As the AAP made clear in a recent statement, pediatricians are being urged to continue these conversations even as the legal battle rages on.
I apparently need to point out here that I don't -- excuse the expression -- hold a gun to anyone's head. I have no more clout in making parents take my advice about guns than in getting them to stop serving Pop Tarts for breakfast. They are completely free to reject my advice -- something parents do on a regular basis. But at least we had the conversation. Yet the NRA argued successfully that when doctors raise the issue of gun ownership, we are "forcing" patients to divulge private information that is medically irrelevant to their health care.
We routinely screen all the adolescents in my practice for depression. Irrelevant? Too private? One of the most crucial questions I need to ask in the context of any mood concern is "Is there a gun in the house?" I ask this because the association between guns in the house and increased fatal suicide risk has been well documented. The risk when the gun is kept loaded is even higher. What could be a very impulsive move following a breakup with his girlfriend will allow no second chances for a heartbroken boy. Parents need and want this information. They are often in my office because they are worried sick about their teen. They are looking for all the help they can get, and the stakes are too high to mince words. Considering what might be "politically distasteful" is the last thing on anyone's mind.
So the real question is: Who exactly is the Florida state legislature trying to protect? Not responsible parents and their children. The lawmakers are protecting the gun manufacturing industry that bankrolls their campaigns and they hope they are protecting the votes they crave from their most conservative base. These groups would have us believe that only gun owners should be allowed to speak about guns, and helpless, tongue-tied gun-owning parents need to be constitutionally protected from their subversive pediatricians. This mindset, perversely, has become not only the new definition of free speech, but the new legal standard of medical practice in Florida.