In the first few years of a child’s life, a pediatrician will ask parents a series of questions about household safety: Do you have a pool? Where do you keep cleaning supplies? Do you smoke? Do you have pets? What is the temperature setting on your water heater? Do you own a gun? Such inquiries appropriately explore patient safety at home.
Only the last question provoked the ire of pro-gun legislators, activists and legal scholars, creating a legal showdown between the First and Second Amendments in the Eleventh Circuit, stemming from Florida’s Privacy of Firearms Owner’s Act. As the current Congress and executive administration act to repeal gun control measures, including the repeal of restrictions barring certain mentally ill individuals from owning guns, the roles of the physician as health care provider and mandatory reporter of abuse and neglect rely unconditionally on the physician’s First Amendment rights.
Many physicians in Florida rightly saw the Firearms Owner’s Act as a violation of their First Amendment rights and a group brought suit against the state (Wollschlaeger v. Governor of the State of Florida). The U.S. District Court for the Southern District of Florida agreed with the physicians, noting that the physicians’ questioning does not interfere with the right to keep and bear arms, but that the law directly interferes with a physician’s First Amendment right to free speech. On appeal, the Eleventh Circuit sided with Florida and the same three-judge panel ruled three times on the issue, offering multiple reasons why the law was reasonable and constitutional (noting at first that the law was a valid restriction on physicians’ speech, then applying the same argument under a slightly more strenuous level of review, again finding in Florida’s favor, and finally stating that even under a strict scrutiny review, the government would have a compelling interest in protecting the right to keep and bear arms under the Second Amendment). Thankfully, the full panel of the Eleventh Circuit has recently ruled in a 10-1 decision that the law violates the First Amendment rights of physicians and other medical care providers.
Florida’s law, and similar legislation proposed in other jurisdictions, is a clear violation of a physician’s freedom of speech and also thwarts the professional ethics of physicians to care for patients and do no harm. In many jurisdictions, including Connecticut, physicians are mandatory reporters for abuse and neglect. As restrictions on gun control are further loosened, including both federally and with proposed legislation in Connecticut, the role of physicians to help protect the health and well-being of their patients grows, especially where mental illness of both the patients and their guardians come into play. If pediatricians cannot inquire as to the presence of guns in the home, they would not know if there is a risk to their patient, both in terms of that patient’s mental health status and access to firearms in the home or as to a broader risk of abuse or neglect which they are mandatorily obligated to report. While mere ownership of a firearm does not impart abuse or neglect on a parent or guardian, it is one important factor physicians ought to consider when seeking to ascertain the health and well-being of their patients. Without the ability to ask simple questions about guns in the home, they would certainly not be able to make this assessment and would fail in their ethical and legal obligations to protect patient safety and do no harm.