Fit to have a gun: who is?

Recent tragic events in Cumbria have brought the problems with gun licensing into sharp relief. The police take most of the responsibility for who should be allowed a shotgun license: but it is doctors, usually GPs, who are asked to sign to say that there are no health concerns with gun ownership.

GPs are used to dealing with risk. Uncertainty is the name of the medical game: I’m not uncomfortable with dealing with unknowns. But one has to acknowledge that uncertainties exist, and make sure that decisions which one makes takes congnisence of them. This is the problem: I don’t know any test which helps to tell me who is going to be safe  in owning a gun. Even if I have no note of ‘mental instability’ (and even if I know what that is) in the notes – and even if this was a good predictor of a problem – there is no guarantee that has never existed. Because of the lack of evidence in directing me towards good decision making, I’ve had a personal policy of not signing these certificates for anyone.

This paper gives a good overview : and this editorial has wise words:  “it is impossible to predict with certainty who might be unsafe with a gun.” Medical certification gives a seemingly professional approval where, really, none can exist.

3 Responses to “Fit to have a gun: who is?”

  1. Dr Zorro June 3, 2010 at 10:09 pm #

    You have misunderstood the regulations here. There are two aspects.
    1. The police will contact the GP directly to ask whether the GP has any record of psychiatric illness or disability which would make someone unfit to own a firearm. This is totally confidential and the applicant will not see it. To answer is a statutory requirement, and it is the GP’s responsibility to inform the licensing authority of any change in circumstances which will affect a licence holders fitness.
    2. Countersignatories. Both applicants and doctors often view this in the same light as a passport application but it is not. Simply being a patient’s GP is NOT sufficient to be a countersignatory and you are right not to sign in these circumstances. Countersignatories must not only be of standing but should have known the applicant personally for a number of years. Countersignatories will be contacted by the licensing authority by telephone to further confirm their close personal knowledge of the applicant.
    Your action in refusing is right but for the wrong reason.

  2. Margaret McCartney
    margaretmccartney June 3, 2010 at 11:03 pm #

    well…..I’m not talking about countersignatories, but the medical certification itself. A copy of that certificate would usually be placed in the patients notes. Patients have a right to see their notes in almost all circumstances. I’m not sure about it being a statutory requirement either; it would be akin to a conscientious objection to me not to be able to do the form: I can’t, in conscience, provide any professional recommendation based in evidence that ownership is safe.
    As for the idea that GPs have to monitor for change in circumstance making gun ownership – see page 3 – http://bma.eu/images/firearmsaug2009_tcm27-146721.pdf- ‘tagging’ of notes doesn’t seem to exist, and taking responsibility for upcoming problems doesn’t seem to be on the BMA’s agenda for doctors either.
    But I agree completely about countersignatories: I’m even aware of some GP practices charging to do this – seems very wrong.

  3. Margaret McCartney
    margaretmccartney June 6, 2010 at 10:27 pm #

    as a PS, this is Alan Johnson in the House: (http://www.theyworkforyou.com/debates/?id=2010-06-03a.592.0&s=NHS#g593.0)
    “In particular, we may need to focus on the question of follow-up checks. Does the Home Secretary think that they are adequate, and does she agree that there may be a need for a greater role for GPs and the NHS? She will know that while there is a role for the applicant’s family doctor before a firearms certificate is issued, there seems to be little involvement thereafter to ensure that the certificate holder’s mental health, in particular, is not deteriorating.”
    And the test for that would be….?

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