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Guns at Home – The Paediatric Opposition

A well regulated militia, being necessary to the security of a free state, the right of the people to keep and bear arms, shall not be infringed.

These words sparked the cult of the gun in the USA.

A third of all Americans with a child under the age of 18 have a gun. Nearly 40% of all those households have an “unsafe” gun.

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See? A gun as a deterrent must by definition be unsafe. Loaded and easily accessible. Not locked away in a safe. And an unsafe gun is an accident waiting to happen.

We judge the quality of safety by the safety of children. See, safety isn’t stopping children from playing sport or rough housing. It isn’t the broken bones of “rough play” while growing up. It’s things that kill large numbers of children that are avoidable risks. While play does injure children, the health and social benefits from encouraging kids to be adventurous and independent outweighs the occasional broken bone.

The US Firearms Fatality Rate of children under the age of 15 is nearly 12 times higher than a sample of 25 other westernised industrialised “first world” nations. Combined.

It appears that the USA is deaf to a major epidemic of gun violence aimed at children. 3000 children a year die to gun related deaths a year. Every  30 minutes a child is a casualty to gun violence and is either wounded or killed by a gun in the USA.

The New England Journal of Medicine quotes the total deaths of people aged 1 – 24 as 6759 in the previous year. A little perspective?

That’s twice as many deaths to cancer, five times as many as heart disease and fifteen times the US fatalities caused by infections.

And this is without the injuries. A further 20,000 children are injured by guns every year in the USA. In the majority of medical studies of gun injuries, the problem goes unresolved. Parents often fail to appreciate the damage a gun can cause. Nearly 40% of parents with guns often leave guns unattended or in unsafe places.

But here is something weird? The majority of firearm injuries to the under 24s occur to adolescents. The minor safety precautions such as shoving the gun in a hiding place seem sufficient to thwart most children. It is adolescents who suffer the most. And parents with adolescents according to the CDC are more likely  to store a firearm unlocked. Because parents never think that their good, well behaved son is going to pick up that deadly weapon and fool around with it. Or shoot someone. Or shoot themselves.

Suicide is the third biggest cause of death in the USA in those aged 10 to 24. The most common method is firearms. Let’s understand a vital difference between suicide methods. See? A gun is designed to kill people as efficiently as possible. Sure you could kill yourself with a car exhaust or drugs or hang yourself. But those are difficult. Many a person who has attempted to commit suicide has stopped solely because of the time taken to kill by these methods. In many cases that hesitation and a change of mind has lead to people getting the help they need.

The deadliness of firearms makes the majority of suicide attempts successful. In India? The majority of suicide attempts are poisonings. Organophosphates and Drugs being the methods of choice. Nearly 40% of Organophosphate attempts end in death. Only 5% of drug attempts lead to death. Firearm attempts are nearly 100% fatal.

Yes, I read the Salon on this topic. And I write in support of the doctors who should be leading the fight for common sense. Paediatricians are there to campaign for the rights and safety of children. We are entrusted by training, education and career to care for the health of others. And that means opposing the notion that a deadly weapon is integral to “being American”.

According to the AAP (American Association of Paediatricians)

Pediatricians play a key role in injury prevention by providing anticipatory guidance to parents. In controlled studies, individuals who received physician counseling were more likely to report the adoption of 1 or more safe gun-storage practices.

Nearly 70% of physicians in the USA who have family practices or paediatric practices enquire about gun ownership. About half of all doctors recommend the removal of guns from the home. And it is a large majority that recommend increased safety such as unloaded and locked guns.

The October 18th issue of Paediatrics by the AAP (Their in house publishing) recommended that paediatricians in the USA incorporate a direct approach to gun safety within the medical history and urge parents to store guns safely or remove them. The official stance (and mine is) that the safest home for a child or adolescent is gun free.

As a foreigner I am sure “true patriots” of the USA would ignore my words but here is the thing? The NRA is simply the most puzzling entity in the USA to me. It’s a body dedicated to irresponsible gun ownership.

The words of Marion Hammer (Former President of the NRA) amuses me greatly.

’We take our children to the doctor because they’re sick or need health care, We don’t take them there for political dialogue or for pediatricians to ask us not to exercise a constitutional right.”

Indeed.

It is your right to smoke. However Paediatricians get incredibly frowny if you do. Not because we are complete kill joys but because we know it is harmful to children and to say so isn’t a political dialogue. Just one of common sense. Are we really willing to sacrifice children solely to prove our dedication to being “patriotic”. Or is the NRA purposefully obfuscating the dialogue. I am willing to bet that most gun owners aspire to responsible use but are struck by the blackout run by the NRA with regards to quality control, medical research and a crippling of doctors with regards to speaking out against the lax legislation of gun safety.

In effect the NRA is powerful enough to make it illegal for doctors, healthcare programs and insurers to collect information relating to the presence of storage of a lawfully possessed firearm or ammunition on the property or residence of an individual. Seriously? It’s illegal for doctors to ask about the presence of a deadly weapon that nearly 40% of gun owners often leave unguarded and that wounds nearly 20,000 children a year. Sounds like the NRA simply fears that science will harm their cult of the gun. That doctors will break their stranglehold on the dialogue on guns.

But research is being done.

In 13 states of the USA there is legislation explicitly barring doctors from making written inquiry or questions with regards to the ownership of firearms or ammunition. This is often called a Firearm Owners Protection Act. Which is amusing, I thought you didn’t need protecting when you had a gun.

In June 2011, Florida became the first state to bar doctors from asking about a major risk around the house. It’s as if chefs demanded we stop insisting care around knives. A physician could have lost a license or be fined up to $10,000. In response the AAP challenged the law as a violation of the First Amendment. After all? It is a government restriction of the free speech of physicians and a physician isn’t really reducing the capacity to own guns. Merely telling people that the research shows that gun accidents often harm children and a gun free house is inherently safer. We baby proof our house and put child friendly locks on bleach but are quite happy to not legislate even that level of safety on guns.

Despite that the law still stands. In Florida at least, the First Amendment is sacrificed for a travesty of the second.

Last year 60,000 doctors across the USA voted overwhelmingly to support stronger gun control due to an evidence based stance that guns are harmful (Who Knew!). In response to firearms research freezes and bans Paediatricians marched on Capitol Hill. Only a 100 did it but remember, a hundred paediatricians is a LOT.

The AAP requests are quite simple. Assault Weapon restrictions, Mandatory Background Checks, Licenses, Handgun Regulation, Restriction on High Capacity Magazines, Safe Firearm Storage and even an interest in Fingerprint Locks. Basically make it harder for children to get hurt by guns accidentally and increase responsible gun ownership and prevent guns from being used by and on adolescents and children.

This is a bizarre world. Where negative data doesn’t change public policy. Hence I prefer to call the US’s fetish for guns a cult. No evidence seems sufficient to stop the fetish for gun ownership.

 


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