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When does a gun become a personal health issue? (iStockphoto.com)

Doctors' Questions About Guns Spark A Constitutional Fight

by Scott Hensley
Jul 19, 2013

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To pediatricians, guns are a health issue.

Firearms remain a leading cause of death and injury for young people. The doctors say the evidence shows that homes are safer for kids, and adults for that matter, when guns aren't around.

Pediatricians say doctors should ask their patients — or their parents, in the case of very young children — if there is a gun in the house.

That seemingly simple question has proved controversial, though pediatricians say it shouldn't be. "We ask patients about all kinds of things," Dr. Thomas McInerny, president of the American Academy of Pediatrics, tells Shots. Doctors ask about the setting on the water heater (turn it down to prevent burns) and whether family cyclists wear bike helmets, he says.

When it comes to guns, McInerny says, "We know it's important to ask." Pediatricians aren't looking to take people's guns away, he says, and the information will stay confidential. "We're not going to tell anyone," he says.

Instead, the question could lead to a teachable moment. "If you have a gun, at least keep it safe," he says. He says guns should be stored unloaded and locked up. Ammunition should be stored separately and locked up, too.

Pediatricians aren't the only ones asking. A Colorado doctor, for instance, told NPR earlier this year about how an elderly patient's suicide using a gun made him more likely to ask patients about firearms. For years, the leading professional group for internists has recommended that its doctors talk about guns and safety with patients.

Still, guns are unique. The right to bear them is constitutionally protected, and some people consider their ownership to be a private matter that should be off-limits, even in a doctor's office.

In Florida, a law to restrict doctors from asking about guns passed in 2011. Doctors asserted their constitutionally protected right to free speech and challenged the law in court. A federal judge's injunction has blocked it so far, but the state of Florida has appealed. Arguments in the case were heard Thursday in Miami.

We wondered how Americans view the issue and what their experience has been. So we asked in a nationwide telephone poll conducted with our partner Truven Health Analytics.

What did we find out? Well, about a third of respondents said there is at least one gun at home. Not many had been asked about guns by their doctors, though — only 7 percent. Overall, a third of respondents believe that providers of health care should ask patients about the presence of guns at home.

Now, what about banning a doctor's question to a patient about that kind of conversation? That question turned out to be divisive. About 44 percent of people either support or strongly support a ban. On the other hand, 37 percent oppose or strongly oppose blocking a doctor from asking about guns.

"It's stunning to me that people would feel that strongly that physicians should be prohibited from asking about a gun — and across all ages," says Dr. Michael Taylor, chief medical officer at Truven. "Gun violence is a safety issue as much as seat belts are a safety issue." For that reason, he says, doctors have a responsibility to know what's going on in the homes of patients.

We asked Daniel Webster, head of the Johns Hopkins Center for Gun Policy and Research, for his take on the results. He notes that very few people in the poll had direct experience with this sort of conversation with a doctor.

"Asking people hypothetical questions, you sort of have to take the responses with a grain of salt," he says. "If a doctor actually speaks to them and explains why it's relevant to their health and safety — and did so in a respectful, thoughtful way — I suspect a number of people who said no would be perfectly fine with it."

People are free to disregard the advice of doctors, and often do. But Webster says parents may store guns more safely, even if they aren't willing to remove firearms from the home when counseled about the risks to kids, after talking with a doctor.

The poll, conducted during the first half of April, gathered responses from 3,009 people across the country. The margin of error was plus or minus 1.8 percentage points. You can find the questions and full results here. Past polls can be found here.

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