Last month a three-judge panel of the 11 Federal Circuit reinstated Florida's gag law that prevented physicians from talking to patients about guns, a law that had been initially struck down at the Circuit Court level in 2011. Now the physicians have asked for an en banc rehearing of that decision by the entire 11 Circuit which, if the panel decision is affirmed, may move this case one step closer to a hearing before the Supreme Court.
The plaintiff's brief, whose amici reads like a who's who of virtually every medical association beginning with the AMA, notes that "there is no disagreement within the medical community that providing patients with information about firearm safety is a valid aspect of preventive care and thus beneficial to public health." They contend that the state's gag order not only prevents physicians from delivering proper medical care, but opens the door for other limitations on physician-patient discussions because "once it is known that physician communications can be compromised in one area, then politically empowered interests will be emboldened to compromise it in others." Florida's legislature, for example, could use a similar justification to limit whether a physician can ask a patient about whether they smoke cigarettes, drink alcohol or consume red meat.
The gun lobby's answer to this problem, which was echoed by the panel decision majority, was that physicians are always free to hand out gun safety pamphlets which, of course, the NRA is always happy to provide. But the NRA's support of gun safety information is disingenuous at best and consciously deceptive at worst, because this same organization is on record as opposing laws that would really increase gun safety by requiring that guns either be locked or locked away. Arizona was the 50 and last state to legislate protective barriers around backyard pools in homes where minor children live. Want to guess why there are still 22 states that do not mandate any kind of safe storage of guns at all? Last year in Kentucky a 5-year-old boy shot and killed his 2-year-old sister and the County Judge drily observed that "there's probably not a household in this county without a gun."
I'm not surprised nor really upset that the gun lobby would try to keep physicians from talking to patients about guns. After all, if the medical associations are on record as believing that gun ownership is a health risk, then they will line up some way or another as being against guns. And the fact is that physicians have reams of peer-reviewed studies that link higher levels of gun mortality and morbidity to ownership of guns. Even without the studies, you don't have to be a rocket scientist to figure out that the more guns there are in everyone's homes, the greater are the odds that more of them will be left around unlocked, and as the novelist Walter Mosley says, "If you carry a gun, it's bound to go off sooner or later."
But even though virtually every medical association acknowledges that guns constitute a risk to health, somehow this message still hasn't gotten back to the feds. In response to a call from President Obama after Sandy Hook, the Institute of Medicine published a report listing the major gun violence issues that needed further research over the next 3-5 years, including the influence of video games, interventions and strategies, risk and protective factors, safe guns and, most important, "characteristics of firearm violence."
With all due respect, I would like someone to explain to me why we need more research on the characteristics of gun violence to understand why 100,000 deaths and injuries from guns each year constitutes a risk to health. I don't believe there would be such unanimity among the national medical societies on this issue if it were just because most doctors don't like guns. But as long as the federal government can pretend that the "jury is still out" on the medical risks of gun violence, jurors like the panel majority of the 11 District can tell physicians not to talk to their patients about guns.