President Obama just signed 23 executive actions to curb gun violence, and gun advocates are already in a fit over one directive regarding healthcare professionals. Except that the order actually just preserves a legal expectation for doctors to report on their patients that has existed for 37 years. The sixteenth and seventeenth points on Obama's outline today read:
Clarify that the Affordable Care Act does not prohibit doctors asking their patients about guns in their homes.
Release a letter to health care providers clarifying that no federal law prohibits them from reporting threats of violence to law enforcement authorities.
Almost immediately, headlines on the conservative Internet heralded the arrival of an Orwellian healthcare system full of doctors prying guns out of patients hands. Newsmax's homepage showed a pediatrician asking a cute little girl, "So Tell Me Annie, How Many Guns Does Daddy Have?" The Weekly Standard went with, "Obama Asks Doctors to Help Deal With Guns." Elsewhere, The Drudge Report screamed OBAMA DEPUTIZES DOCTORS." Slate's Dave Weigel said this would happen:
Obama order most likely to scare Drudge: "Clarify that PPACA does not prohibit doctors asking their patients about guns in their homes."— daveweigel (@daveweigel) January 16, 2013
But those freaking out about Obama's executive order should know that it doesn't give doctors any new rights to report credible threats of violence—nor does it create new requirements for them to monitor patients prone to gun violence. Doctors have been expected to report potentially violent patients to law enforcement going back to 1976, when the Supreme Court of California decided in Tarasoff v. Board of Regents of the University of California that physicians have a legal obligation to break confidentiality when patients outline specific threats against specific parties. "If you have a patient who says, 'I'm planning to kill my parents,' that's the far end of the spectrum and would trigger a warning to the parents," says University of Wisconsin medical ethicist Alta Charo on the issue. Gun advocates can take issue with these laws all the want—just so long as they know President Obama didn't create them by fiat today.