Doctor says proposed 'red flag' gun laws will help physicians save lives

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An emergency department doctor says the Canadian government's plan to introduce "red flag" gun laws will help him save lives — but some of his colleagues say it will breach patient-doctor confidentiality.

Public Safety Minister Bill Blair told the Globe and Mail on Monday that his government's gun control legislation will include a provision to allow doctors, lawyers, educators, police officers and loved ones to petition the courts to have a person's guns seized, if they are deemed a danger to themselves or others. 

The government confirmed the plan in an email to As It Happens, but did not provide a timeline or any details about how it will work. 

Gun rights advocates have condemned the move. The group Doctors for Firearm Safety & Responsibility said on Twitter that it creates the "potential for a serious confidentiality breach," noting that doctors can already flag their concerns to the Chief Firearms Office, which can revoke a person's gun license.

But Dr. Alan Drummond, an emergency doctor in Perth, Ont., says going through the CFO takes too long. He's a member of the Canadian Association of Emergency Physicians, which has long advocated for red flag laws to curb firearms suicides. 

Here is part of his conversation with As It Happens host Carol Off. 

When someone comes into your emergency room expressing suicidal thoughts, what are your obligations?

It's pretty clear cut when somebody comes in ... with a suicidal plan. Then it's pretty straightforward. Our number 1 obligation is to protect them from themselves and their impulses.

We usually put them on a mandatory psychiatric evaluation order. They are sent to a psychiatric facility where they are evaluated and treated.

The bigger problem is that we see a significant number of people coming into the emergency department who have depression or psychoses, let's say, and they may have a thought process that suggests that suicide is a potential, but is not a direct threat.

OK. So those are the people who are going to go home. And so the question becomes do you have an obligation, or are you able to assess whether or not they have firearms at home?

I don't know if I'm sending them home to a loaded shotgun, or I don't know if I'm sending them home to an arsenal in their basement.

And that's a bit of a problem. You know, there are ways of reporting people at risk, but it's bureaucratic and slow and doesn't really answer the imminent clinical need that I may have in the wee hours of the morning.

The Canadian Association of Emergency Physicians, they say that 80 per cent of all firearm deaths in Canada are suicides. So that's shocking, because we don't often hear that.

We don't, and that's kind of what, you know, has been the problem.

I think I understand what the rationale is for a discussion of criminality. It makes a lot of Canadians feel very uncomfortable in their own communities when bullets are flying around and seven-year-olds in Hamilton are being shot through the door by a wayward bullet. So I understand it entirely.

But I think if there was more emphasis placed on suicide, and particularly rural suicides, then there would be a much broader discussion.

It seems to be that you have to go to a justice of the peace, you have to petition the courts to have the guns removed. Yet, as you point out, you might have hours in order to act. And so do you think that there'd be a fair bit of pushback from those who'd say, well, that's a violation of people's privacy?

Yes, there will be blowback and, yes, there will be pushback.

But I think we can all agree that, you know, people who are suffering from untreated psychosis with delusions, paranoid delusions, somebody who is contemplating suicide, somebody who is involved in intimate partner violence, that these people shouldn't have guns until the situation has been stabilized.

People will say, "Well, you know, maybe you'll prevent people from seeking help."

Well, that may be true. But I think in the long run, we'll probably save more lives than we'll lose.

And I think it's also important to re-emphasize the fact that Canadian physicians looking at the greater societal good have already had mandated reporting laws for people who are maybe unsafe to drive because of a medical reason, pilots who are unfit to fly, certain infectious diseases, child abuse, elder abuse.

The idea of protecting society or putting the greater rights of society beyond that of the individual is already well-established in Canadian medicine.

And again, being in a small town as you are, you're more familiar with rural communities in Canada. And there's a different attitude toward gun ownership, isn't there?

Oh, there is. I mean, I own weapons. All my neighbours own firearms. Hunting is a major pastime in rural Canada. Every two weeks November you can't get your car fixed or your toilet fixed because everybody's off hunting with the boys. And so gun ownership is prevalent.

But if you look at the Canadian data, it's pretty clear that those communities, which tend to be more rural, tend to have higher firearm suicide rates. And those community and those provinces that tend to have more predominant hunting also tend to have far higher firearm suicide rates.

So access to the firearm — and this is well-established in the world literature; there's no debate about this whatsoever —access to a firearm in the home places individuals in that home at greater risk of both homicide [and] suicide.

How likely is it do you think that minister Bill Blair will be able to get this red flag proposal into law?

This is something that surely those of us on both sides of the gun control discussion can see that there should be some, you know, benefit.

Suicide is tough. It's most certainly tough on the families who end up with shattered lives. And even if we could save one Canadian life, like, wouldn't that be worth the effort of at least trying it?

Where to get help:

Canada Suicide Prevention Service: 1-833-456-4566 

In Quebec (French): Association québécoise de prévention du suicide: 1-866-APPELLE (1-866-277-3553)

If you're worried someone you know may be at risk of suicide, you should talk to them, says the Canadian Association for Suicide Prevention. 

Written by Sheena Goodyear. Interview produced by Kate Swoger. Q&A edited for length and clarity.