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Docs and Glocks

By Douglas Steenblock, MD DFAPA

Firearms are an integral part of our cultural and historical identity. This country was founded and settled by an armed citizenry. The Second Amendment specifically addresses the right to bear arms. Many politicians have discovered just how sensitive this issue is. It is also a vexing problem for healthcare providers. Numerous studies have confirmed that a gun in the home substantially raises the risk that a member of the household will die of a gunshot wound (1). The gun ownership rate in the United States is far higher than any other country in the world (2). And per capita, many more people die in America from gunshot wounds (suicide, homicide and accidental) than in any other developed nation (3). These are scientific facts, not political rhetoric.

Most physicians consider firearm deaths to be a public safety issue on par with car accidents, drownings, poisonings, etc. But this can put us at odds with gun advocates who see our concerns as an intrusion. Iowa has had its share of horrific gun violence through the years (most notably the recent shooting of Ed Thomas in Parkersburg and the University of Iowa incident in 1991). Time and time again, we have seen one terrible shooting after another in the news, and each time we have hoped that it was not that patient who we just saw the other day in the office. Gun laws in Iowa have been a source of controversy, and there has been considerable public debate over the process for obtaining weapon carry permits.

Psychiatric physicians are trained to perform detailed safety assessments that often include inquiries about firearms. But the political climate is making that more difficult in some parts of the country. Last year in Florida, a bill strongly supported by the NRA (dubbed "Docs and Glocks") was passed that made it a criminal offense for a healthcare provider to ask a patient whether they have a gun at home unless they could establish that there was immediate danger to the patient or family members. If convicted, physicians could have faced stiff fines or even jail time. A recent editorial in JAMA was bitterly critical of this law and physician groups in Florida worked successfully through the courts to oppose it on the grounds that it stifled freedom of speech.

In my discussions with psychiatric physicians, I have found that many are uncertain about the laws that govern the purchase, possession and use of firearms in Iowa by those who have a history of mental illness. Thus, it seemed prudent to review these laws. There are numerous offenses and conditions that result in the loss of the right to possess or receive firearms, including a felony conviction, a misdemeanor domestic violence conviction, certain domestic related protection orders, and mental health adjudication/commitment.