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Missouri's Physician Gag Law: What Doctors Can't Say

A legal overview for medical professionals

Doctors traditionally enjoy a confidential doctor-patient relationship. But in Missouri, like all states, physicians are required to obey specific laws and regulations to maintain their right to practice. In some cases, state law may restrict how doctors discuss certain subjects with their patients or when and how doctors can report issues — even if the doctor believes there is a medically valid reason to do so.

Missouri is, in fact, one of a handful of states where legislators have passed a “physician gag law” designed to limit when doctors may ask patients about their gun ownership, usage of firearms, or gun violence.  Florida lawmakers passed the first such gag law. A federal appeals court ultimately held that the Florida law violated doctors’ First Amendment right to free speech. However, this decision does not affect Missouri’s gag law since Missouri is in a different federal circuit. So, for now, physicians need to be aware of how to handle situations involving their patients and firearms.

Doctors Need to Think Before Asking Questions About Guns

The Missouri physician gag rule was part of a larger package of firearms-related measures adopted by the Missouri lawmakers in 2014. The specific gag rule states that “[n]o health care professional licensed in this state,” or any person under the supervision of such a professional, shall be “required by law” to do any of the following:

  • ask a patient if they “[own] or [have] access to a firearm”;
  • document in a patient’s medical record whether the patient owns or has access to a firearm; or
  • disclose the identity of a patient to “any governmental entity” based solely on their ownership of, or access to, a firearm.

The law does not necessarily ban doctors, pediatricians, or primary care physicians from asking their patients about gun ownership or gun safety. In fact, a separate section of the law states that physicians can inquire and document whether a patient owns or has access to a firearm if this is “necessitated or medically indicated” by the health care professional’s judgment.

In other words, as long as asking patients about firearms does not violate “other state or federal law,” physicians can do so. The law simply says that physicians shall not be required by law to ask such questions.

However, the law does state that physicians may only disclose information regarding firearms if they have an appropriate court order and:

  • there is a “threat to the health and safety” of the patient or another person;
  • the patient has been referred to a mental health professional; or
  • the patient consents to the disclosure by signing a separate authorization form “dealing solely with firearm ownership.”

Furthermore, a health care provider may inquire and document a patient’s firearms access only if such information:

  • “is necessitated or medically indicated” by the provider’s professional judgment—and the inquiry itself does not violate some other federal or Missouri law.

Finally, the law provides that health care professionals may not use electronic medical record programs that require saying whether a patient owns or has access to a firearm in order to save the medical record.

When Should You Contact a Missouri Health Care Lawyer?

What is the takeaway from Missouri’s gag law? Physicians may ask patients about their ownership or access to firearms if that information is necessary in the physician’s judgment. But there are restrictions on what physicians can actually do with the information. Unless physicians have a court order in a specific set of situations, they cannot disclose any information they may have, regardless of its seriousness.

If you have additional questions or concerns about whether your medical office is complying with the law in this area, you should contact a qualified Missouri health care attorney right away.

For more information on this area of law, see our overview of health care law.

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