It seemed just a little bit odd to me, a first-year medical student, to be hearing a lecture about firearms. Wasn’t I supposed to be learning the Krebs Cycle and the five birds that cross the diaphragm?* What did this have to do with medicine?
The lecturer was Dr. Zita Surprenant, from the Preventive Medicine department. She was tall, brash, and utterly captivating. By the end of an hour with her, I didn’t need any more convincing: I knew that firearm safety was important to my patients’ health and asking about it was part of any good medical visit, especially for my pediatric patients.
It isn’t a secret that doctors who care for kids have often supported stricter gun control laws. The American Academy of Family Physicians has a policy against private ownership of assault weapons and is in favor of any legislation that would restrict firearm access for those under 18. In 2008, the American Academy of Pediatrics filed an amicus brief in support of the handgun ban in Washington, D.C. Doctors and the NRA have rarely been on the same side of legislative actions.
However, the NRA is now taking this battle right into the doctors’ home turf – the exam room. A bill that has passed the Florida legislature and is expected to be signed into law by Gov. Rick Scott will prevent doctors asking their patients about gun ownership. Any doctor who does so will be subject to sanctions by the Florida Board of Medicine. Similar bills are underway in Alabama and North Carolina. The American Medical Association reported that the original language of the bill would have come with a $5M (yes, that’s five million dollar) fine and up to five years in prison for the doctor who dares inquire whether Timmy’s mom has a loaded handgun in her nightstand. The bill was written by NRA lobbyists and has, believe it or not, the tacit approval of the Florida Medical Association whose spokesman is “satisfied” with the language and “pleased” that the fine and jail time were taken out of the equation.
If laws can be passed to punish me for asking a question about firearm safety, is the second amendment twice as important as the first?
This chart from the Centers for Disease Control & Prevention (CDC) lists the top ten causes of injury death by age demographic in 2007, the most recent year available. Firearms are the 8th leading cause of injury death in tiny children, ages 1-4. They are the 4th and 9th leading causes (homicide and unintentional, respectively) in elementary school children ages 5-9. And they are the 2nd, 9th, and 10th leading causes of injury death in 10-14-year-olds (homicide, suicide, and unintentional). On average in 2007, an American child under 14 was killed by a firearm every day – and that’s not even counting non-fatal gun injuries, nor the high school years, when violent deaths climb dramatically.
But wait, you say, it’s all about personal responsibility, right? This isn’t for the government to legislate. Consider a 2001 study that examined 30,000 accidental gun deaths between 1979-1997. Children 0-4 living in the four states with highest gun ownership were 1700% more likely to die in a gun accident than their peers in the 4 states with lowest ownership. Most of the guns came from the victims’ homes or the homes of their friends. Greater gun availability, which depends in large part on the stringency of gun laws, correlates directly with accidental gun deaths.
When a doctor asks a patient or parent about gun ownership in the home, it isn’t harassment any more than it is when the doctor asks about the amount of candy Junior eats or the amount of TV he watches. And to suggest that a doctor who inquires about Susie’s access to firearms is infringing on her dad’s second amendment rights is patently ridiculous. Doctors can’t come take guns out of your home, but they can and absolutely should advise you that the best way to keep your kids safe is to lock the guns up, unloaded, and store the ammunition separately; as well as educate the children never, ever to handle them.
Governor Scott hasn’t yet signed this bill, but I can tell you it has already had an effect on my practice. Maybe I had been a little bit lax up to now and maybe I didn’t always ask the gun question – after all, there are so many things to cover in a well-child visit. But since this story hit the news, I have asked it every time.
*The five birds are the Esopha-goose, the Va-goose, the Azy-goose, the Hemiazy-goose, and the Thoracic Duck. You’re welcome.
 Miller, M, Azrael, D and Hemenway, D. Firearm availability and unintentional firearm deaths.Accident Analysis & Prevention 2001; 33:477-484.