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Gunplay - A Physician's Point-of-View About Gun Control

"Grandma Swift's" guest post about the need for gun control elicited many comments and much conversation. So today, Peter Acker, a practicing pediatrician and author of the medical thriller Blood Brain Barrier weighs in on the issue from a physician's perspective.

A few years ago I wrote an essay with the provocative headline “It’s the Environment Stupid”. It was inspired by a talk from Dr. Y. Cathy Kim, associate director of the Pediatric Environmental Health Center at the Maria Fareri Children’s Hospital. I wrote about the environmental factors that influence the health of children and argued that it was well within our purview as pediatricians to get involved in community issues such as the type of food readily available in our schools. Of course, every doctor should want to know about environmental influences, but I think it is of particular moment in pediatric care because we pediatricians are charged with advocacy for a group that does not have the clout of adults.

I thought of this piece while digesting all the articles I have been reading about the current gun control debate. Unfortunately, it is loaded (excuse the use of this verb!) with hyperbole, myopia and absurdity. For example, does anyone really believe that we need to have assault rifles in our homes to protect ourselves from the government? Does it make sense to cite that statistically mass murders are a very small number and shouldn’t govern a policy debate, yet after 9/11 we invaded countries, instituted drone attacks, condoned torture and generally turned our country upside down for a loss of life dwarfed by the ten times larger number of fatalities each year on our nation’s highways? I get it – I know that there is a much greater emotional and dramatic impact about a terrorist attack, but shouldn’t reason prevail so we can focus on the quotidian and more common risks to our lives?

The American Academy of Pediatrics has been accused by the far right of having a leftist agenda, on many issues, but especially on gun control. This is where the myopia comes in. Looking at guns purely from a public health perspective, the statistics are simply overwhelming. Here’s one: a person between the ages of 15-24 is 35.7 times more likely to commit suicide if he or she lives in a house that contains guns. Adolescents, we know, are subject to impulsive acts. What would usually be a suicidal gesture involving a bottle of pills (2% mortality), with a gun available would almost always result in death (90% mortality). Furthermore, those suicidal gestures involving nonlethal means usually results in treatment and the great majority of those do not go on to have a successful suicide. Would anyone buy a house if they were told, oh, by the way, this house is 35.7 times more likely to burn down than your neighbors? Yet in article in the New York Times a couple of months ago, chronicling the heartbreaking story of a Wyoming family in which the teenage son committed suicide, the father clung to his strong pro gun stance.

Now to the absurdity part. In June of 2011, Governor Scott of Florida signed in to law a bill prohibiting physicians from asking about the presence of guns in the household. It is perfectly OK to inquire about any other household risk such as swimming pools, containers with toxic liquids, seat belt use, but not about the one item which is most likely to harm a child or an adult. This echoes the contretemps that arose recently when the Journal News published the locations of household guns in which gun owners complained that it was an intrusion, an invasion of privacy. I can’t help but think a paranoiac element is clouding our thinking. As a parent, I think knowing whether a household has a gun would be important to know before sending one’s child for a play date.

To my mind, physicians need to cognizant of the public health disaster that has been perpetrated upon us by largely the National Rifle Association which, let’s be clear, are lobbyists for a hugely profitable business – the makers of guns. Our country has by far the highest rates firearm related deaths of any of the developed world and that, in my view, is a disgrace.

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