Weiss Ryan T
Duke Law J. 2016 Jan;65(4):801-42.
The physician-patient relationship rests on a bedrock of trust. Without trust, patients--and for that matter, physicians--are less willing to divulge information critical to providing accurate medical diagnoses and treatments. The state of Florida seemingly ignored this when its legislature, with support from the National Rifle Association and other pro-gun advocates, enacted the Firearm Owners Privacy Act (FOPA), a statute that restricts physicians from questioning their patients about firearm ownership. In Wollschlaeger v. Governor of Florida, the United States Court of Appeals for the Eleventh Circuit held that FOPA did not regulate physician speech but, instead, regulated physician conduct. As such, the law was exempted from First Amendment scrutiny. But almost one year to the day after publishing its first Wollschlaeger opinion, the Eleventh Circuit sua sponte vacated its original opinion and substituted in its place a brand new opinion--one holding that FOPA was subject to First Amendment scrutiny, but nonetheless passed constitutional muster. This Note uses the diverging Wollschlaeger opinions as a vehicle to analyze the First Amendment's coverage and protection of physician speech. Specifically, it argues that an uninhibited line of communication is required to protect the trust necessary for an effective physician-patient relationship. This logical underpinning leads to the conclusion that the First Amendment presumptively covers physician speech and, furthermore, that physician speech should be subject to intermediate scrutiny--a level of scrutiny that FOPA cannot meet.
医患关系建立在信任的基石之上。没有信任,患者(就此而言,还有医生)就不太愿意透露对提供准确医疗诊断和治疗至关重要的信息。佛罗里达州在其立法机构在全国步枪协会和其他支持枪支的倡导者的支持下颁布了《枪支所有者隐私法》(FOPA)时,似乎忽略了这一点。该法规限制医生询问患者的枪支拥有情况。在“沃尔施莱格诉佛罗里达州州长”一案中,美国第十一巡回上诉法院裁定,FOPA并未规范医生的言论,而是规范了医生的行为。因此,该法律不受第一修正案审查的约束。但在发布其首份关于“沃尔施莱格”案的意见近一年后的同一天,第十一巡回上诉法院自行撤销了其原意见,取而代之的是一份全新的意见——该意见认为FOPA应接受第一修正案审查,但尽管如此仍通过了合宪性审查。本评论以不同的“沃尔施莱格”案意见为切入点,分析第一修正案对医生言论的涵盖范围和保护。具体而言,它认为需要畅通无阻的沟通渠道来保护有效医患关系所需的信任。这一逻辑基础得出的结论是,第一修正案推定涵盖医生言论,此外,医生言论应接受中级审查——而FOPA无法通过这一审查标准。