On July 30, state Sen. Kris Jordan, R-Dist. 19, introduced Sen. Bill 165, which would prohibit physicians from asking patients questions about whether there are guns in their home. What do guns have to do with a person’s health, and why should physicians care whether their patients have guns?
Pediatricians ask these questions because guns are a leading killer of children. The Children’s Defense Fund reported that in 2008 and 2009, 5740 children and teens, including 299 children under age 10, were killed by guns, and 8162 children and teens, including 847 children under age 10, were injured by guns. In 2008 and 2009, gun homicide was the leading cause of death for black teens, ages 15 to 19; for white teens, ages 15 to 19, it was vehicular accidents followed by gun homicide in 2008 and gun suicide in 2009.
“For a child, curiosity can be lethal, and guns spark curiosity,” states Robert Murray, MD, a pediatrician and professor at The Ohio State University. “Pediatricians are trained to evaluate environmental risks for children and seek ways to minimize them. We help parents understand that some of the things they take for granted are real sources of danger for their children. Guns are a public health issue for children, no different than chemicals or electrical outlets.”
Angela Sauaia, MD, who completed a study of children treated for gun injuries at two trauma centers, stated, “We didn’t expect to see this many childhood injuries due to everyday gun violence … far too many of these were self-inflicted.”
Florida passed a law similar to SB 165, but it was declared unconstitutional by a federal district court. The case is on appeal. The statute prohibits pediatricians, under penalty of loss of license, from asking questions or making any written record about firearms in the house. The Miami Herald reported that the bill was written by the NRA. According to court records, the statute was a response to a mother complaining her doctor told her she would need to find another doctor after she refused to answer questions about guns in her home.
The Florida statute permits questions about guns only when a physician believes “in good faith,” that the information is relevant to a patient’s safety. There is no similar provision in SB 165. As Florida physician Bernd Wollschlaeger, MD, points out, “You can only determine the relevance of the question once you have the answer.”
Wollschlaeger, along with practically every medical association in Florida challenged the statute, which was struck down for violating the First Amendment right to free speech. The court held, “This law chills practitioners’ speech in a way that impairs the provision of medical care and may ultimately harm the patient.”
So, why would politicians ever think it good policy to suppress meaningful information about gun violence? The answer comes from former U.S. Rep. Jay Dickey. R-Ark, and Arthur Kellermann, MD: “Most politicians fear talking about guns almost as much as they would being confronted by one.” Formerly an ardent gun advocate, Dickey has admitted that he once “served as the NRA’s point person in Congress.” Kellerman, formerly with the Center for Disease Control, published a study in the New England Journal of Medicine about guns in the home increasing the risk of homicide by a family member or acquaintance.
Murray agrees with the federal court’s decision and sees real harm from SB 165. “As pediatricians, we don’t care about guns themselves, but we do care about the danger they present to children. Too many kids get killed by guns. All we want to do is minimize that risk.”
Murray thinks that clinical research is needed so that pediatricians can better understand gun-related injuries and develop sensible measures to insulate children from the harm of mishandled firearms. President Barack Obama has proposed $10 million in his 2014 budget to study gun violence prevention and convened a panel group to develop areas for study. The panel consists of members of the Institute of Medicine, National Research Council, American Association for the Advancement of Science, the CDC and several universities.
The panel’s goal is “to provide a tool for the country to address this very difficult issue more productively than it has been able to do in the past.” Its report states that “basic information about gun possession, distribution, ownership, acquisition and storage is lacking.” The absence of good data makes it “virtually impossible to answer fundamental questions” about gun violence or programs that may reduce that violence.
We study highway collisions, airplane crashes, smoking, and HIV/AIDS, all for the purpose of saving lives. Why shouldn’t we study gun violence, and why do we want to get in the way of how physicians treat their patients?
To subscribe to this blog, use the subscribe box at http://www.considerthisbyjd.com.