Published online November 1, 2006
PEDIATRICS Vol. 118 No. 5 November 2006, pp. 2168-2172 (doi:10.1542/peds.2006-1120)
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SPECIAL ARTICLE

Counseling About Firearms: Proposed Legislation Is a Threat to Physicians and Their Patients

Jon S. Vernick, JD, MPHa, Stephen P. Teret, JD, MPHa, Gary A. Smith, MD, DrPHb and Daniel W. Webster, ScD, MPHa

a Johns Hopkins Center for Gun Policy and Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
b Ohio State University College of Medicine and Public Health, Center for Injury Research and Policy, Columbus Children's Research Institute, Children's Hospital, Columbus, Ohio

In early 2006, 2 separate but virtually identical bills were introduced in the Virginia and West Virginia legislatures that would have profoundly affected the relationship between a physician and his or her patients. Each bill would have prohibited a physician from asking a patient if he or she owned firearms for the purpose of counseling that patient about ways to reduce risks associated with firearms. Penalties for violation of the bills included revocation of a physician's license to practice. The Virginia bill was initially approved by its state House of Delegates by a vote of 88 to 11. It was ultimately defeated in a Virginia Senate committee. The West Virginia bill did not receive a vote during the 2006 legislative session. Although neither bill became law this year, this type of bill is likely to reappear in future legislative sessions.

The Virginia and West Virginia bills were contrary to the best-practices recommendations of medical societies, including the American Academy of Pediatrics. Anticipatory guidance regarding firearms can indeed reduce risks to patients. Yet, the bills would have preferred the judgment of legislators over physicians regarding this aspect of the practice of medicine. In addition, the 2 bills raise legal issues regarding both medical malpractice and the First Amendment protection of the freedom of speech.

The Virginia and West Virginia bills would have treated risks associated with firearms differently from other hazards and interfered with a physician's ability to protect his or her patients. The Virginia bill was defeated, in part, through the efforts of physicians to educate legislators. However, physicians must remain prepared to respond to similar state legislative initiatives in the future.

Key Words: anticipatory guidance • firearms • injury control • policy

Abbreviations: HB—House Bill • NRA—National Rifle Association • AAP—American Academy of Pediatrics

Accepted Jun 20, 2006.




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