The purpose of this memo is to discuss prevention of gun violence and whether New Mexico should adopt a law that allows for certain individuals to petition the court for help when someone poses an imminent risk of harm to themselves or others and whether emergency physicians should also be authorized in these situations. There is rising controversy on both sides of the argument of gun control but it is important to look at the direct impact of a Gun Violence Restraining Order (GVRO) law as well as the role of physicians in regards to prevention to see if this law should be implemented in New Mexico.
In 2016, New Mexico had 18.2 gun deaths for every 100,000 people which was 51% higher than the overall US rate making it the 8th worst state for gun deaths with 243 suicides and 113 homicides1. The homicide firearm rate increased by 35.7% from 2011 to 2016 and death from firearm was the third leading cause of injury death in New Mexico in 20162. The current laws allow civilians to possess machine guns, assault weapons, .50 caliber rifles and large capacity ammunition magazines. Private possession of semiautomatic assault weapons and handguns are permitted without a license3. Additionally, firearms are allowed to be in plain view in a public place without a permit3.
Currently, if a physician suspects a patient might be exhibiting early warning signs of self harm, they are encouraged to report, counsel, or recommend involuntary commitment to their patients4. However, they can not ultimately decide whether a person’s liberty to own a gun should be legally restricted. The argument to limit a physician’s involvement is that there is no biomedical test for firearm ownership fitness5. Even in regards to mental health, there is not a clear clinical indicator for dangerous mental illness. Additionally, there are no objective measures to determine fitness and no standard specific enough for a doctor to follow5. The police department reports an extensive combination of surveying, questioning and testing of applicants to see if the person meets the basic criteria.
A GVRO is a civil court order signed by a judge that temporarily prohibits someone at risk of hurting themselves or others from possessing or purchasing any guns or ammunition6. It can be filed by family members, household members and law enforcement and gives them a way to temporarily prevent access to firearms6. It creates a safer situation for the individual to see treatment to address dangerous behaviors.
Currently, physicians do not have a legal role to prospectively determine if someone is fit for gun ownership. It is thought that physicians should not have the responsibility of being gatekeeper and that the legal determination of gun ownership should not be given to physicians. In fact, the majority of doctors felt they could not accurately give an assessment as to whether their patients were fit to own a gun5. In contrast, some believe that doctors are capable but just not trained to accurately assess patients and that a criterion would need to be created upon implementation of the law. However, there are many ethical consequences that could hurt the doctor patient relationship in regards to confidentiality and trust that would be compromised as a result of physician involvement.
Two major stakeholders are pro and anti gun advocacy groups. The New Mexicans to Stop Gun Violence is a group that was formed in response to the Sandy Hook shooting. Their main argument would be that gun control, specifically a GVRO bill, could potentially stop another Sandy Hook from happening in New Mexico. Their main priority is gun safety and they are constantly advocating for legislation that supports limiting guns in public spaces and restricting access of guns to people with a history of violence.
The New Mexico Shooting Sport Association is allied with the NRA and highly supports the second amendment. There would argue that there is a lack of due process and a potential for abuse of the law. Additionally, they believe that gun control laws attack civil rights and that a GVRO law is not an adequate solution to the current problem. Also, if law enforcement got a report, the affected person does not have the opportunity to contest the report.
There are valid points on either side of the conversation and stricter gun laws have shown to be beneficial for the community. As for emergency physicians, the level of involvement they should have in the matter is debatable. Asking physicians to report patients in a legal manner leads to the distrust of physicians and since most physicians believe they are not qualified or not in the position to report their patients to the law, incorporating physicians into the legal narrative does not seem necessary. Based on the overwhelming evidence, gun safety is a major issue in New Mexico and legislative action is needed in order to diminish the problem.
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