Vernick Jon S, Teret Stephen P, Smith Gary A, Webster Daniel W
Johns Hopkins Center for Gun Policy and Research, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205, USA.
Pediatrics. 2006 Nov;118(5):2168-72. doi: 10.1542/peds.2006-1120.
In early 2006, 2 separate but virtually identical bills were introduced in the Virginia and West Virginia legislatures that would have profoundly affected the relationship between a physician and his or her patients. Each bill would have prohibited a physician from asking a patient if he or she owned firearms for the purpose of counseling that patient about ways to reduce risks associated with firearms. Penalties for violation of the bills included revocation of a physician's license to practice. The Virginia bill was initially approved by its state House of Delegates by a vote of 88 to 11. It was ultimately defeated in a Virginia Senate committee. The West Virginia bill did not receive a vote during the 2006 legislative session. Although neither bill became law this year, this type of bill is likely to reappear in future legislative sessions. The Virginia and West Virginia bills were contrary to the best-practices recommendations of medical societies, including the American Academy of Pediatrics. Anticipatory guidance regarding firearms can indeed reduce risks to patients. Yet, the bills would have preferred the judgment of legislators over physicians regarding this aspect of the practice of medicine. In addition, the 2 bills raise legal issues regarding both medical malpractice and the First Amendment protection of the freedom of speech. The Virginia and West Virginia bills would have treated risks associated with firearms differently from other hazards and interfered with a physician's ability to protect his or her patients. The Virginia bill was defeated, in part, through the efforts of physicians to educate legislators. However, physicians must remain prepared to respond to similar state legislative initiatives in the future.
2006年初，弗吉尼亚州和西弗吉尼亚州的立法机构分别提出了两项几乎完全相同的法案，这些法案将对医生与患者之间的关系产生深远影响。每项法案都将禁止医生询问患者是否拥有枪支，以便就降低与枪支相关风险的方法为患者提供咨询。违反这些法案的处罚包括吊销医生的执业执照。弗吉尼亚州的法案最初在其州众议院以88票对11票获得通过。但最终在弗吉尼亚州参议院委员会被否决。西弗吉尼亚州的法案在2006年立法会议期间未进行表决。尽管今年这两项法案都未成为法律，但此类法案很可能在未来的立法会议中再次出现。弗吉尼亚州和西弗吉尼亚州的法案与包括美国儿科学会在内的医学协会的最佳实践建议背道而驰。关于枪支的预期性指导确实可以降低患者面临的风险。然而，在医学实践的这一方面，这些法案更倾向于立法者的判断而非医生的判断。此外，这两项法案还引发了关于医疗事故和第一修正案对言论自由保护的法律问题。弗吉尼亚州和西弗吉尼亚州的法案将与枪支相关的风险与其他危害区别对待，并干扰了医生保护其患者的能力。弗吉尼亚州的法案部分是通过医生努力教育立法者而被否决的。然而，医生必须做好准备，以应对未来类似的州立法举措。
