AMA Tackles Gun Violence, Physician Free Speech

The American Medical Association's House of Delegates discussed the collision of physicians' free speech rights with patients' rights to privacy Monday. They also weighed whether to support universal background checks for gun purchases and distributing NRA gun safety literature to patients.

The American Medical Association’s House of Delegates waded into the thorny issue of a physician’s role in preventing gun violence during the association’s annual meeting Monday in Chicago.

During the debate about gun safety, several members endorsed the idea of distributing firearms safety materials written by the National Rifle Association--a way of reaching a new group of patients, those who support the NRA.

The delegates passed a resolution “strongly” opposing “any attempt by local, state, or federal governments to interfere with a physician’s right to free speech as a means to improve the health and wellness of patients across the United States.”

On its face, the resolution is a First Amendment issue, rather than a Second Amendment matter. However, in Florida, those 2 constitutional rights have collided recently. The AMA filed an amicus brief in support of physicians challenging a Florida law that prevents physicians from asking patients about gun ownership as part of their routine examinations. The law was upheld by the 11th Circuit federal appeals court last July.

In its report to the delegates, the AMA’s reference committee on federal legislation said such laws limit physicians’ free speech rights, but also could potentially create “real harm” by interfering with doctors’ abilities to access the most current medical information available.

While that resolution passed as part of the consent agenda, other items proved more controversial. For instance, the House of Delegates approved—after considerable debate—an amended resolution that called for the AMA to “identify and support the distribution of firearm safety materials that are appropriate for the clinical setting.”

An earlier draft of the resolution called for the AMA to collaborate with firearms owners and other groups to develop and distribute its own material.

During the floor debate, some raised concerns that distributing pro-gun groups’ safety materials could cause reputation problems for the AMA.

Paul Pukerdpol, a member of the AMA’s Medical Student Section (MSS), said he’s heard many concerns from MSS members about the “political perils” of engaging directly with pro-gun groups, such as the National Rifle Association.

However, other delegates argued that collaboration, even with groups with different agendas, was more important than reputational concerns. Pukerdpol’s motion to refer the matter back to committee was voted down. The resolution was then approved.

Shortly thereafter came another controversial gun question: whether to officially support legislation requiring background checks for all purchasers of firearms. This time, the body voted to refer the matter to committee. In doing so, the House of Delegates followed the recommendation of the legislation committee, which had said the matter required additional consideration due to the various points of view and complexities.

During debate on the House of Delegates’ floor, opponents noted that many gun sales come from private sales or even family inheritances, in the case of heirloom firearms. It would be difficult, if not impossible, to require background checks on those transfers, they said.

Richard Stennes, MD, an emergency physician, was among those skeptical of the enforceability of a universal background check policy.

“I understand the intent of this,” he said. “I don’t think it will change anything.”

The House of Delegates took up one final gun-related matter before adjourning for the night. This time, it dealt with the non-lethal variety of “guns.” The group approved a resolution encouraging toy gun manufacturers to take further steps to reduce the similarity of toy guns to real guns. The resolution says the addition of an orange tip at the end of the barrel of toy guns is insufficient to distinguish toys from actual guns. The resolution also voices support for legislation to strengthen differentiation traits in toy guns.