News
President’s Blog: Can doctors predict gun violence?
Friday June 14, 2024
The public discourse around the horrifying shooting deaths of a mother and daughter in Floreat by an estranged family friend took an unexpected turn last week, as claimed details of the shooter’s medical history were leaked to the media. According to the reports, he had experienced two transient ischaemic attacks earlier in the year, and had acted aggressively towards staff during his admission. Claims were made by anonymous health workers that if they had known he possessed firearms, they might have delayed his discharge from hospital. The unfortunate and misleading headline in The West? “Health workers could have stopped Floreat killer.”
In response, the Premier reportedly stated that access to firearms was not in itself a consideration for health professionals in these circumstances, but that we should “inform the police” about patients who “present in an emotional or cognitive state which suggests that they may be a danger to themselves or a danger to someone else.” He acknowledged the need to “balance that out” with privacy considerations.
The Premier accused me of “responding to headlines” when I went to the media to put things into proper context: that it is unfair and unreasonable to expect health workers to alert police to every patient who might pose a risk to the community. Cognitive and emotional disturbance is, as we all know, extremely common in healthcare settings, and there is no validated tool to determine which patients might act violently in the future. In the extremely rare instance that a patient makes a specific threat of violence to someone else in the presence of a doctor, of course a doctor might have a duty to breach confidentiality and report the threat.
Whilst it could be the case that the Premier’s comments were out of context, there is a broader agenda at play that should concern us: the Firearms Act 1973 (WA) is currently under review, with new requirements under consideration for mandatory health assessments to be completed by medical practitioners for all new and existing firearms licence holders. Whilst no doubt we will be assured that protections will be afforded for medical practitioners who do not flag any health-related impediments to a firearms licence being granted or renewed in the event that the licence holder subsequently commits a violent act, we will need to exercise extreme caution in how we take those assurances. We must also ensure that politicians and the public understand that doctors do not have crystal balls to predict patients’ future behaviour, and seeking to blame doctors for a patient’s violent behaviour will not be reasonable.
Beyond that, the crisis of domestic violence we are currently experiencing requires a whole of community approach. Doctors have a significant role in identifying, treating and supporting victims of domestic violence, so we must be part of that approach.
