Doctors could soon be checking to see which of their dementia patients hold gun licences.
According to a paper released by the Medical Journal of Australia this week, there are no guidelines for health professionals regarding mandatory firearm screening.
Lead author Dr Anne Ward says she was shocked to discover that there were no protocols available.
“There is of course the Firearm Act in states and territories, which says, of course, if a health professional is concerned a patient they have has a firearm, and might be at risk to themselves, the community or other people, then they must report that to the police,” she said.
“But there’s no stipulation for any kind of regular monitoring for people who have a firearm.”
Dr Ward says it’s shocking that there is more scrutiny applied to driving licences.
“Obviously there are many checks and balances required and some of that is on the basis of age and medical conditions,” she explained. “But there’s no equivalent for firearm use ,which was quite staggering.”
Dr Ward says there is no data that identifies whether there’s an increase in gun-related violence or suicide by people with dementia.
“We don’t know, and because firearm misadventure and suicide is fairly rare in Australia, ABS data isn’t broken down for people with dementia and for those without.”
Dr Ward also says dementia often goes undetected in Australia.
“What we do know,” she said, “is that dementia is often unrecognised in the community and, even when it is picked up, family members and doctors find it hard to appreciate what the risks might be.
“We need to make appropriate arrangements for things like firearms, for example.”
Despite the concern, Dr Ward warns that not everyone with dementia should be excluded from owning a firearm.
“There are different stages of dementia,” she said.
“It’s quite possible people in the early stages of dementia, particularly those who are long-term gun owners, have crystallised intelligence which may allow them to safely use a gun for longer than someone who might be a casual shooter.”
The authors from University of New South Wales have designed a risk-and-capacity assessment model to be used on a patient-by-patient basis.
“The capacity-based approach is the new angle,” said Dr Ward. “The risk assessment is already part of the Firearms Act, for example.
“However, the capacity-based approach looks at a number of factors which may impair a person’s ability to safely use a firearm, so it’s combining both those models that we’re advocating.”
Dr Ward says it’s important to consider the ethical and moral issues as well.
“I think rural health professionals find it very confronting to have that dual role; being the doctor but also being someone who may know the patient socially, their living situation, employment and also how important a gun might be to the person’s identity.
“That’s why in the paper we continue to say this assessment should be individualised.
“This shouldn’t be a blanket ban or any kind of ageist or cognitive discrimination.”