Gun Violence

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Nurses Edition Commentary

Mizuho Spangler, DO, Lisa Chavez, RN, and Kathy Garvin, RN
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Dr. Vandelay -

Dr Barsotti
What if a patient is assaulted and tells me she has guns? I then have them removed because the patient is upset and seems unstable. She returns home and perpetrator kills her because she has no protection. Does that make me liable for her death.

Christopher B., M.D. -

I assume that a clinician would seek to have a patient's firearms removed only if s/he believed a patient was at reasonable risk of self-directed or interpersonal violence, i.e., is dangerous. Perhaps you're thinking she's at risk of suicide, or homicidal retaliation after her assault, which is why she needs to have her access to firearms restricted?

Liability determinations require proximate cause. In the hypothetical situation posed, the proximate cause of death is homicide by another person. You are asking if a physician may have vicarious liability for the patient's homicide because she did not have her firearm to protect herself - due to the physician's clinical judgement that she was dangerous. This argument seems infeasible, and additionally would require evidence that an individual's access to, and use of firearms prevents morbidity and mortality. I don't believe such evidence exists.

Mike J., M.D. -

Thank you for your reasoned discussion. Too rare a thing when the topic of guns comes up

Mike

Pierre M., M.D. -

I found the topic deeply depressing. As a Canadian I am left asking a simple question: Why does American society insist on having guns. Haven't enough of your children died already?

Christopher B., M.D. -

There are literally hundreds of millions of privately owned firearms in the US, and this statistic is not going to change. As physicians working in the front line of health care and violence in the US, however, we are in a position to recognize and treat individuals at elevated risk of (gun) violence, and by doing so may diminish firearm morbidity/mortality. The real question is, how?

Gannon D -

Hey Chris-

Great Talk. Anyway I could get a copy of the audio file to share with my ED mental health workers.

Christopher B., M.D. -

Surely! This is the download link: https://d140vvwqovffrf.cloudfront.net/media/segment/original/63bd5c436110f1a943882fab83d0343e689430a1.mp3

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