Wednesday, July 10, 2013

Physicians Urged to Talk to Elderly Patients About Guns

In a recent issue of the Annals of Internal Medicine, researchers highlight the importance of talking about elderly patients' access to firearms.  Older adults are more likely than younger people to suffer self-inflicted (either accidental or intentional) gunshot wounds. Firearms have recently emerged as the leading cause of suicide death among the elderly, and it is estimated that 75% of elderly suicide victims had visited their physician less than a month prior to their death.

However, there has been significant debate in recent years on the role of physicians to discuss firearm access with their patients. As the author points out,
Physicians have a legal right to engage in firearm-related inquiries. Although the issue of physicians asking patients or family members about the presence of firearms in the home has generated some heated discussion, no federal law (including the Patient Protection and Affordable Care Act) or state statute or regulation forbids such questioning. Moreover, such a legal provision would probably be invalidated by the courts as a violation of the physician's right to freedom of speech as guaranteed under the First Amendment. Even the 2012 Florida statute... expressly provides that a physician... who believes that information about firearm ownership or presence in the home is relevant to the safety of the patient or others may inquire accordingly.

In Colorado, 76% of firearm deaths are suicides. Males over the age of 85 complete suicide at a rate more than 5 times higher than the general population. Additionally, older adults account for 14.2% of the suicides in the state but only make up 10.1% of the population.

Physicians have a unique opportunity to intervene on behalf of older adults, helping patients to recognize that depression is not simply a normal part of aging, and that firearms pose a risk to patients during depressive episodes.