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Abstract
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Early in his career, Louis B. St. Petery Jr, MD, a pediatrician in Tallahassee, Florida, attended the funeral of a young patient from his practice who was shot and killed after the child’s sibling found a loaded gun in a bedside drawer.
“It should never happen,” said St. Petery, who is also executive vice president of the Florida chapter of the American Academy of Pediatrics (AAP). With that memory not far from mind, St. Petery, like many physicians across the country, routinely asks his patients’ parents whether they have guns in their home. If they do, he advises them to take safety measures like using gun locks, storing the gun separately from bullets, or keeping the gun in a locked cabinet.
But whether St. Petery and colleagues across Florida will be able to continue such routine inquiries without fear of being reported to the state medical board now rests in the hands of the US Court of Appeals 11th Circuit. The circuit court is considering whether to uphold a Florida law signed by the governor in 2011 that medical groups argue infringes on physicians’ freedom of speech.
The law takes aim at physician-led discussions about firearm safety, discouraging physicians from routinely asking about gun ownership. Exceptions include circumstances in which the physician “in good faith believes this information is relevant to the patient’s medical care or safety or to the safety of others.” Patients can report physicians believed to be violating the law to the state medical board to determine if they acted in good faith.
St. Petery said he is not comfortable with the “good faith” loophole. “If a parent is upset I asked, they could report me,” he said....
The AAP joined a coalition of physicians, including state chapters of the ACP and American Academy of Family Physicians, and the Brady Center to Prevent Gun Violence to file a lawsuit in June 2011 blocking enactment of the Florida gun bill, which they argue infringes on physicians’ and patients’ freedom of speech (Schaechter J et al. JAMA Pediatr. 2013;167[4]:317-318). Three months later, Marcia Cooke, a federal district judge in Atlanta, awarded them a preliminary injunction and put the law’s implementation on hold.
The State of Florida appealed to the US Court of Appeals 11th Circuit, with organizations such as the National Rifle Association submitting amicus briefs in support of the law. The state and its backers argued that the law was necessary to protect gun owners’ privacy “by restricting irrelevant inquiry and record-keeping by physicians regarding firearms.”
Many organizations, including the American Medical Association and American Bar Association, filed amicus briefs supporting the American Academy of Pediatrics and its fellow plaintiffs in the appeal, arguing that gun safety counseling is a legal and ethical obligation of physicians and that failure to inquire about gun safety would be a breach of the current standard of care.
“I’m not antigun,” said St. Petery, who raised 3 children with a safely stored gun in his home. “I’m pro-child and preventing senseless death and injury.”
However, 3-judge panel of the 11th Circuit judges ruled (http://1.usa.gov/1nDn4kv) against the AAP and its fellow plaintiffs in July 2014, arguing that contrary to Judge Cooke’s decision, the Florida law is “a valid regulation of professional conduct that has only an incidental effect on physicians’ speech.”
The AAP and its fellow plaintiffs have asked all 9 judges of the 11th Circuit to review the decision. In the meantime, the original injunction against enforcing the law remains in place, St. Petery said.
Meanwhile, similar legislation continues to pop up in states around the country. In fact, Indiana’s legislature is currently considering a comparable bill (http://bit.ly/1FTfZFa). Most states that have considered such legislation haven’t adopted it....
Language: en |