This article was written by O. Marion Burton, MD, FAAP , President of the American Academy of Pediatrics. It is cross posted from the AAP President’s Blog, Speaking of Kids where it originally appeared on June 10, 2011.
Not far from where I live in South Carolina, a three-year-old child crossed her parents’ bedroom, saw the family’s loaded handgun sitting on the windowsill and picked it up. The gun went off, killing her.
A few simple questions and guidance for a parent from a physician, perhaps at the child’s most recent check-up, may have prevented the tragedy: Is there a gun in your home? Is it locked away – unloaded? Does it have a trigger lock and is the ammunition locked away separately?
In Florida, physicians have effectively been gagged from asking these questions and providing follow-up safety advice as appropriate. A bill signed into law June 2 by Florida Governor Rick Scott restricts physicians’ ability to counsel patients in that state about gun safety in the home. The Florida chapter of the American Academy of Pediatrics, along with those of the American Academy of Family Physicians and the American College of Physicians, as well as 3 individual Florida physicians (2 of them pediatricians), have joined the Brady Center to Prevent Gun Violence to challenge the law in court. But other state legislatures have considered similar bills, and it is expected they will again in their next legislative sessions.
The main objection to the Florida law – referred to in the legal complaint as the “Physician Gag Law” – is that it blocks a physician’s ability to provide comprehensive advice to promote health and safety for parents and patients. As part of any well-child exam, pediatricians ask parents about a variety of safety issues, including poison prevention, car safety seat usage, drowning prevention and bicycle helmet use. This guidance is geared to the age and developmental stage of the child. The ability to discuss the risks posed by firearms and offer advice on gun safety is simply a part of the equation: keeping children safe. Doctors are just doing their job when they ask safety-related questions.
Today, more than 1.5 million U.S. children live in a home with at least one loaded, unlocked firearm. Firearm injuries remain the second leading cause of death of children and youth aged 1 to 21 years, with over 4,500 killed annually.
Moreover, evidence supports the recommendation to provide guidance on firearms injury prevention. In controlled studies, individuals who were counseled by a physician were more likely to report adopting one or more safe gun-storage practices.
In my practice, I have been amazed at the positive response of parents when we discussed gun safety. Nothing comes close to the trusted relationship and conversation between a physician and parents, patients and families.
The situation in Florida revolves around the core principle of the First Amendment that the government may not tell individual citizens what they can and cannot say. In a medical home there is a family-centered partnership where trusted doctors and families discuss matters of health and safety – without intrusion by the government – including guidance regarding firearms in the home. Also, Florida’s families should not be denied the right to receive such information from their physician; this law hurts patients wanting information about gun safety by inhibiting their health care practitioners from initiating a conversation about the topic.
The tragic scenario that played out recently in South Carolina is not a one-time event. Tragedies involving guns occur all too often around the nation. Why would anyone try to stop a conversation that could prevent even one of these events? This issue continues to evolve and the AAP and other medical organizations continue to fight for physicians’ and families’ rights in this matter. Visit the AAP Web site often over the coming weeks for updates on this important child health matter.
I welcome your thoughts on this subject.
O. Marion Burton, MD, FAAP
American Academy of Pediatrics