Issue 19 / 23 May 2016

AGEING or impaired drivers are required to requalify for their licence regularly, but gun owners can continue to hold their firearms licence indefinitely regardless of their mental state, physical condition or capacity to make decisions, a situation described by one expert as “incredible” and “crazy”.

Dr Anne Wand, conjoint senior lecturer in psychiatry at the University of New South Wales, and a practising psychiatrist in the public health system, was commenting on an article published today by the MJA on the legacy of the Port Arthur massacre and the National Firearms Agreement (NFA).

The MJA report by Dudley and colleagues reflected on the 20 years since the signing of the NFA and the need to revisit gun control legislation in Australia.

“The national weapons stockpile has now returned to pre-1996 levels, highlighting the need to maintain and strengthen the national regulatory regime,” Dudley et al wrote.

“Complacency has somewhat eroded the NFA. For example, in New South Wales, the pro-gun lobby succeeded in weakening the regulation of pistol clubs — arguably causing at least one homicide. NFA opponents hope to overturn the ban on semi-automatic long arms.

“We need a review, revision and tightening of existing laws and more effective restrictions and controls on possession, import and sales of handguns and other firearms, especially via the internet and by illicit imports.”

The authors also refuted gun lobby and media claims that “mental illness underpins gun violence and should be a key site for intervention”.

“[Studies] confirm that most violent individuals do not have mental illness, and that the vast majority of individuals with mental illness are not violent,” Dudley and colleagues wrote. “They are more likely to be victims not perpetrators of violence.

Media portrayal of violence by people with mental illness reinforces public perception of their dangerousness, further stigmatising and endangering them.”

Dr Wand, who co-authored a 2014 MJA ethics and law article called Firearms, mental illness, dementia and the clinician, told MJA InSight that there was nothing in current firearms legislation to prevent gun owners with diminished capacity, for whatever reason, from continuing to hold their licence.

“The onus is on the owner of the firearm to self-report any impairment they might have,” she said.

“We make people of a certain age do a driving test regularly, and have guidelines about not driving for defined periods with certain medical illnesses, there is no such resource for clinicians with guns.”

“It’s incredible that we rely on self-reporting even when the person may not have the capacity to do so. The biggest issue with the National Firearms Agreement legislation is that there is no stipulation to independently review whether the licence holder still meets the requirements to store and use a firearm, or process for assessment of potential risks.”

“It’s crazy.”

For driver’s licences, age is the trigger forcing people to retest. In NSW, for example, once a driver reaches 75 years, an annual medical review is required. After age 85 years, drivers need an annual medical review and have the choice of either accepting a modified licence restricting either time of day or distance driven, or taking a practical driving test every 2 years to maintain an unrestricted licence.

Health professionals can access an online resource for assessing the fitness to drive of their patients.

Medical conditions which can result in restriction of licence include blackouts; cardiovascular conditions; diabetes mellitus; hearing loss; musculoskeletal conditions; neurological conditions, such as dementia, epilepsy, vestibular disorders, Parkinson disease, multiple sclerosis and stroke; and psychiatric conditions, such as schizophrenia, bipolar affective condition, depression, anxiety and post-traumatic stress disorder, and aggressive and impulsive personality conditions.

No such resource exists for physicians assessing the fitness of their patient to own a firearm. Dr Wand said something similar for general practitioners would be useful, but she did not believe age was an appropriate trigger for reassessment of gun owners.

“There are physical conditions – such as stroke or seizures – and mental conditions, such as dementia, which reduce capacity, that [are a better trigger],” she said. “GPs have a good set of skills for assessing their patients.

“I believe Dudley’s point is that we should not just be screening people with a mental health illness for firearm ownership. Mental health is only one part of this.

“This is about doctors in general thinking about the capacity of any of their patients [to make safe decisions about firearms].”

Dudley and colleagues concluded their article by urging doctors to participate in “firearm risk management” while resisting the targeting of those with mental illness.

“The campaign to deflect social concern over firearms availability into a debate about whether people with mental illness histories should access such weapons should be exposed as a calculated appeal to prejudice.”


Poll

Should doctors screen their patients for gun ownership?
  • No (58%, 69 Votes)
  • Yes, it makes good sense (33%, 40 Votes)
  • Maybe, if there's time (9%, 11 Votes)

Total Voters: 120

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7 thoughts on “Treat gun owners like drivers

  1. Ian Hargreaves says:

    While I agree with the author’s overall intent to restrict firearms licences and firearms, the analogy to drivers’ licences is incorrect.

    All urban gun licence holders in NSW must be a registered gun club member, and compete in at least four range shoots per year. Any unsafe action would be evident, and I have witnessed an incident where a pistol club member was suicidal and acting suspiciously, and the club called police and ambulance while restraining the person. Many licensed shooters store guns in their club safe, decreasing risk.

     

    I had to relinquish my licence because the club is required to audit and annually report on all members, and I failed to attend often enough (I was principally there as driver of my teenage son, who was a superb marksman, while I was mediocre).

    The problem of rural gun deaths is difficult, as many farmers can’t afford to hire a professional to shoot foxes or feral pigs etc on their property.

     

    Perhaps the road toll would be less if drivers were required to join a car club and race/rally their car four times a year, under supervision by expert drivers. We should treat drivers as rigorously as gun owners.

  2. michaelkennedy says:

    We are not the USA where there is clearly a gun problem. We are becoming quite a nanny state with increasing controls and regulations that are far from evidence based.

    As someone who was brought up with guns I had an air rifle at age about 10(like almost everyone else) and we knew all about  firearm safety.

    Shooting is an olympic sport , it is not easy to obtain a firearm licence but it is very easy for someone to obtain one illegally.

    Maybe we would be better off teaching fire arm safety in schools (some have firing ranges) and avoid going down the nanny state any more.

     

     

     

  3. Sandra Skinner says:

    There is no point in stopping more law abiding citizens from owning guns.  Australia has far bigger problems. 

  4. Sue Ieraci says:

    It seems that the majority of our citizens are very happy with gun control and don’t see it as a ‘nanny state’ issue. The reason our society is not like the US is that we DO have gun control. People can pursue their shooting sports if they comply with the controls. In a civil society, though, the right to pursue a sport does not override the safety of the population. I would be happy to see gun-owners required to get a medical clearance – perhaps annually or every second year – it might get people to the GP who might not otherwise get their health checked. Once in a year or two is not too onerous.

  5. Geoffrey Robert Nisbet Smith says:

    As a gun writer and firearms instructor of 40 plus years I have provided advice to the SA Government & the Coroner on many occasions. Your writer seems unaware that, at least in SA, medical professionals including GPs MUST advise the police if in their opinion, a patient is unfit and poses a risk with guns. The big issue of self harm remains real and present as adjustment disorder (loss of job, loved one etc) is more a factor than mental illness and GPs may not see this in their regular work. Affected people often dislike admitting failure. Meanwhile our current laws are adequate as they are. The shooting sports are an important part of many peoples’ lives. Here in SA we already had the  major parts of the NFA in place several years before Pt Arthur (namely permits to acquire, mandatory secure storage, mandatory training including practicals). And while gun suicides may have declined, overall suicide figures follow economic patterns rather than rates of gun ownership. As for guns in crime, no amount of legislation will alter the fact that criminals ignore legislation. For me one of the biggest factors is keeping ammunition and guns secure against little boys whose fascination for things that go bang will be very familiar to most of your members! The gun accident rate in SA virtually stopped when our tighter laws came into effect in 1993. The few that have occurred since often have involved alcohol abuse, unregistered firearms and unlicenced persons. Once again legislation didn’t have any effect on these folk 

  6. Marcus O'Dean says:

    Please protect me from medical incompetence and negligence, rather than from licensed firearm owners. I personally know of so many cases of patients being prescribed multiple and varied drugs, some just to counteract the serious side-effects of others and my own father was on 11 separate prescribed drugs in his final years. Seriously, we need to look at our society’s health a bit more holistically than just relying on the medical profession and place the responsibility for a person’s health more squarely on the individual, tax the crap out of unhealthy processed foods, alcohol and cigarettes. For the person who suggested medical checks to retain firearms licences, who pays for the medical? It just drives demand to enrich doctors.

    This just adds one more expense to all the other compliance costs to the legitimate firearms owner. Firearms licences should be granted for life and only cancelled at the request of the licensee or in the case of the licensee committing a serious criminal offence. Get rid of 90% of the functions of firearms registries (and expense to the licensed shooters) and spend the money on measures that actually contribute something meaningful to public and individual safety.

     

     

  7. Sue Ieraci says:

    Marcus O’Dean says “Firearms licences should be granted for life and only cancelled at the request of the licensee .” That is nonsensical – conditions that preclude safe use develop over time. And displacing the argument to medical error as a reason for not regulating firearms better is pure logical error.

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