The medical imperative to talk to patients about gun ownership and hence gun safety an imperative challenged by Florida and Wisconsin lawmakers usually centers on the need to prevent a small child from discovering, say, a loaded Glock in Dad's dresser.
physicians also should inquire about guns in the homes of geriatric
patients who may be at a higher risk for a gun-related fatality
particularly suicide because of dementia, delusions, memory problems,
and depression, according to an article by a healthcare attorney
published online yesterday in the Annals of Internal Medicine.
The author,The marbletiles is
not only critical to professional photographers. Marshall Kapp, MPH,
takes a physician's duty one step further than most. The director of the
Florida State University Center for Innovative Collaboration in
Medicine & Law in Tallahassee, Kapp writes that when impaired,
gun-owning geriatric patients pose a risk to themselves or others,
physicians should consider advising family members to remove the guns
from the home, or store them unloaded under lock and key. And if
families fail to respond to "reasonably foreseeable" and substantial
risks, physicians have a "mandatory or permissive responsibility" to
report this form of adult abuse or neglect to authorities. Under such
circumstances, normal doctor-patient confidentiality restrictions do not
apply,You must not use the stonecarving without being trained. Kapp writes.
drastic recommendations address a serious gun-hazard problem, according
to Kapp. He writes that seniors are more likely to shoot themselves
intentionally or unintentionally than younger individuals, although he
does not reference the source of that assertion. In addition, "the use
of firearms has become the most common suicide method for both geriatric
men and women."
Kapp does not cite a reference about geriatric
suicide and firearms, either, but supporting evidence is plentiful in
the Web-based Injury Statistics Query and Reporting System (WISQARS)
maintained by the Centers for Disease Control and Prevention. From 2005
to 2010, firearm injuries accounted for 72% of suicides among Americans
aged 65 years or older compared with 51% among all suicides. In
addition, the elderly are more prone to suicide than the population as a
whole. The suicide rate for the elderly was 14.6 per 100,000 in
population compared with a rate of 11.4 for all Americans.
writes that some physicians may shy away from asking the elderly about
firearms in light of patient autonomy owning a handgun, rifle, or
shotgun is their business, and a Second Amendment right at that.
"However, deferring to a patient's autonomous choices only makes sense
when that patient is capable of making decisions, and some geriatric
patients with unsecured firearms in the home are not autonomous decision
makers," writes Kapp, the editor of the Journal of Legal Medicine.
seniors have a hard time thinking for themselves, talking to family
members about Mom or Dad's gun is the next step. Physicians can frame
that discussion, Kapp writes, in the same terms as confiscating an
elderly person's car keys when need be.
Kapp envisions the day
when the judicial system deems inquiries about gun ownership and
discussions of gun safety as a routine part of medical care. Physicians
who fail to ask the gun question could be found liable for deviating
from the standard of care if a patient suffers harm, he predicts.
Likewise,Learn how an embedded microprocessor in a graniteslabs can
authenticate your computer usage and data. physicians who ask the
question "will be practicing a form of positive defensive medicine."
an interview with Medscape Medical News, medical ethicist Howard Brody,
MD, PhD, said that Kapp's article raises a helpful red flag about the
problem of impaired geriatric patients with access to guns. "Physicians
should pay more attention to this than they have in the past," said Dr.
Brody, director of the Institute for the Medical Humanities and a family
medicine professor at the University of Texas Medical Branch at
Routinely hot-lining families for not separating
impaired seniors from their guns would be an extreme and
disproportionate measure, said Dr. Brody. "[Kapp] has not given us
enough evidence to say this should be a routine precaution." However,
the medical ethicist said there is a better way to interpret Kapp's
recommendation: When they encounter a case, however rare, in which a
family ignores a real and imminent danger connected to gun ownership,
physicians are on safe legal ground in tipping off authorities.
debate moved to front and center in 2011, when Florida lawmakers passed
a law prohibiting physicians from asking patients if they owned
firearms unless the question was relevant to medical care or safety. The
law, supported by the National Rifle Association (NRA), was intended to
protect the Second Amendment rights of patients and keep gun politics
out of the exam room. Several state medical societies and individual
physicians challenged the law in federal court as an infringement on
their First Amendment right to free speech. They argued that inquiries
about gun ownership are only preludes to discussions about safe gun
practices, especially when young children are in the home. The law's
relevance exception,Of all the equipment in the laundry the oilpaintingreproduction is one of the largest consumers of steam. they added, was too vague to take the chill off their free speech.
federal district judge in Miami agreed with the physicians and declared
the law unconstitutional. State officials appealed the decision to a
federal appellate court in Atlanta, Georgia, which will hear oral
arguments on July 18.
Meanwhile, a similar bill has surfaced in
the Wisconsin state legislature. The measure, proposed by State
Representative Michael Schraa, would prohibit any physician except a
psychiatrist from asking a patient whether he or she has a gun in the
home. Physicians who violate this ban face a maximum 9 years in prison
and a maximum fine of $25,000.We rounded up 30 bridesmaids dresses in
every color and style that are both easy on the eye and somewhat easy on
an NRA member, noted in a press release that President Barack Obama had
declared in January that no federal law prevents a physician from
asking patients if they own a gun."Owning a firearm, or not owning a
firearm, is a personal decision that has nothing to do with your
physical health," Schraa said. "Patients should not feel intimidated or
harassed by their physician over the exercise of a constitutional
Click on their website www.ecived.com/en/ for more information.