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Is Gun Trafficking A Pediatric Health Issue?

gunsThe discussion of physicians and guns often turns to a privacy issue or things more dangerous to children than firearms.  The best-selling book Freakonomics famously introduced the idea that backyard swimming pools were a greater danger to children than guns.  But that theory is misleading.

“Swimming pools kill more children than do guns only in the preschool-aged group,” said Nancy A. Dodson, MD, and David Hemenway, PhD, in the current issue of JAMA Pediatrics.

In fact, “homicides account for close to two-thirds of all gun deaths of young people 19 years and younger,” said Dodson and Hemenway. “Gunshots (from both suicide and homicide) are the second biggest killer of teens and the top killer of black teens.”

On the second anniversary of the tragedy at Sandy Hook Elementary School in Connecticut, pediatricians are calling on Washington, D.C. to keep all children safe from gun violence.

“Pediatricians have been working all across the country in state capitols, local communities and in Washington, DC to advocate for public policies that prevent gun violence and ameliorate its effects on children, but progress has been too slow,” said Thomas K. McInerny, M.D., past president of the American Academy of Pediatrics (AAP).

“Children deserve to be safe and to feel safe in their homes and communities,” said James M. Perrin, M.D., president of the AAP. “Common-sense policies like safe storage of weapons, physician counseling about firearms, background checks, and limits on access to assault weapons can make a difference. The AAP will continue to advocate for these simple but powerful policies as long as children continue to be harmed by guns.”

For the record, death by drowning is no better or worse than death by a bullet.  They’re both awful.  If one can be avoided or lessened through intervention by a physician, isn’t that a better course of action than citing other unrelated causes of death?

Dodson and Hemenway say that pediatricians “should be at the forefront of efforts to reduce gun trafficking.”

Pediatricians are trained to ask patients and parents about dangerous environmental hazards such as lead paint and fast food.  No one seems to claim privacy when those topics are discussed.  So why not talk about guns?

“Because of permissive gun laws, our patients often live in neighborhoods saturated with dangerous, available guns,” said the authors. “Adolescence is characterized by impulsivity, risk taking, and strong emotions. These factors combine to create an epidemic of teen gun death that is unique among developed countries.”

Many doctors agree that guns are a health issue and should be discussed with patients.  However, what should that discussion include?  And how should the physician follow up?  A standard must be set and followed by the medical community to properly treat firearms as a health issue.

WBUR in Boston interviewed Melissa Moore, a mother of three, who said her children’s pediatrician always asks about guns in the home.

Moore’s husband is a retired police officer. Moore says she and her husband keep the guns and ammunition locked in separate places. But when Moore sees her own primary care physician, she asks, “Do you have guns in the home?” Moore says ‘yes,’ and leaves it at that, which seems odd to Moore. “Those follow-up questions are really important if you want to treat guns as a public health issue,” she said.

Dr. Megan Ranney, an E.R. doc at Rhode Island Hospital in Providence, helped organize the the nation’s first Continuing Medical Education-accredited program held on gun violence, which was held last week in Boston.  Dr. Ranney said “it’s time to clarify the questions doctors should ask patients at risk for domestic violence, homicide, suicide or accidental gun violence, and establish the steps doctors should take to reduce the threat,” according to WBUR.

-Alan Lyndon

2 comments

  1. It takes a lot of guts to use Nancy A. Dodson, MD, and David Hemenway, PhD, as sources. They have been proven to be hard core gun control people and are fond of making up facts as necessary for their political agenda.

    The goal should never for people to “feel” safe but to be safe. To be safe they must be trained and have the tools necessary to defend themselves. The duty and responsibility for protect is your job not that of government or police. And certainly totally not something the political medical activist groups should be involved with.

  2. Why isn’t the AAP recommending consulting the NRA or the patient’s local firearm trainer? That would make sense because the NRA has a program called Eddie Eagle designed to promote child safety and trainers want firearm owners to understand the responsibility of firearm ownership and use. I am currently in child and adolescent psychiatry fellowship training and in talking with fellow psychiatrists and pedatricians I have come to realize that they understand very little about firearms including safety. Firearm safety isn’t a part of training for child psychiatry or pediatrics so why would this be the role of a pediatrician or really any physician? The truth is that liberal doctors and liberal physician organizations that are afraid of firearms or the idea of owning them simply want less firearm freedoms. The goal (firearm safety) that is stated is not honest and unfortunately many well meaning residents in training are learning from influential physicians in institutions and professional organizations and will pass it on.

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