Docs' Role in Gauging Fitness for Concealed Weapons Queried
Standards, guidelines needed for ethical, legal, policy issues related to assessment of competency
MONDAY, April 22 (HealthDay News) -- Given the ethical, legal, and policy issues relating to the role of physicians in assessing competency for concealed-weapons permits, standards should be issued, according to a perspective piece published online April 17 in the New England Journal of Medicine.
Adam O. Goldstein, M.D., M.P.H., from the University of North Carolina School of Medicine in Chapel Hill, and colleagues explored the ethical, legal, and policy considerations regarding physician involvement in assessing competency for concealed-weapons permits.
The authors note that there are no training programs or standards for physicians asked to attest to the physical and mental health of applicants for concealed weapons, nor any evidence that physicians can accurately assess patients' ability to use a gun safely. In addition, there may be considerable variation between physicians about what constitutes mental and physical competence for carrying a concealed weapon and what needs to be disclosed on the permit. Ethical questions that may be raised by the request to sign off on a concealed-weapons permit include what personal information is relevant and how to protect the physician-patient relationship if the physician is unwilling to sign the permit because of religious or other beliefs. Finally, legal issues need clarification, including whether physicians can be liable to claims under the Health Insurance Portability and Accountability Act by releasing records about their patients' health to the state, as well as the threat of tort liability.
"Policymakers and professional organizations should consider modifying legislation to prohibit carrying concealed weapons in clinical settings and should examine ways of limiting the liability of physicians who follow appropriate standards, once such standards exist," the authors write.
Full Text (http://www.nejm.org/doi/full/10.1056/NEJMp1302795 )