When we don’t ask, children are shot. Nearly
As lethal as bullets are, many of these kids die. Twice as many
live, but they are never the same. They are traumatized emotionally and
physically. They are missing an eye, missing an ear, missing parts of
their brain. They can’t walk. They can’t talk. Their lungs
are scarred. They need trachs to breathe and get recurrent
pneumonias. They need catheters or ostomy bags. They don’t go back
to school. They get started on opioids, and become addicted.
They lose their dreams. They lose their
friends. They lose hope.
When we don’t
ask, children — toddlers and teenagers — shoot themselves. They also shoot
their siblings, their cousins, and their friends. They don’t mean
to. What do they then do with that guilt? Who is responsible for
It would be
easy to believe that gun injury isn’t a pediatric problem, but that’s not
true. There are more gun deaths than death from cancer, HIV or blood
infections. It would be nice to believe that homes are safer with guns,
but that’s not even remotely true, as has been evidenced time and again, since
the landmark “Protection or Peril”
study in 1986. In 2015 alone, Centers for Disease Control and Prevention data show there were more than 3,400 unintentional gun injuries among US youth age 20 and younger — 111 of them fatal.
That is why
the American Academy of Pediatrics (AAP) recommends
that pediatricians routinely discuss firearm safety with patients and families
to prevent injury.
In the mid-1980’s, the vaccine for HIB was released and thirty years later we no longer see this disease. Because of the effectiveness of this vaccine my younger partners only know of HIB meningitis through textbooks (and some of my anecdotes).
This is the recurring story of vaccine preventable diseases.
- See more at: https://www.aap.org/en-us/aap-voices/Pages/We-Can%27t-Let-Our-Guard-Down-Against-Vaccine-Preventable-Diseases.aspx#sthash.196pj2e8.dpuf
"The study supports prior research indicating that gun owners with children tend to underestimate the dangerous combination of firearms in the home and a child’s natural curiosity."
The need for
such conversations became clear yet again with a new
study in Hospital Pediatrics showing nearly 40 percent of gun-owning
parents wrongly believed their children did not know where their household gun
was stored. In addition, 22 percent of parents incorrectly thought their
children had not handled that gun. The study supports prior research
indicating that gun owners with children tend to underestimate the dangerous
combination of firearms in the home and a child’s natural curiosity.
For the past
six years, pediatricians had to fight for the right to keep kids safe – to talk
with patients and families about firearm safety – after Florida passed what was
known as the “physician
gag law.” In this legislation – which was never actually enforced due
to an immediate injunction by the courts -- the State of Florida attempted to
limit physicians from screening for firearm access which might put children and
others at risk for injury. This violated physicians’ First Amendment
right to freedom of speech, and patients’ rights to hear speech. With the help
of the Florida Chapter of the AAP, several physician litigants, and pro-bono
attorneys including Ropes and Gray, the Brady Group, Edward Mullins, and Amicus
groups, the law was overturned in a ruling in the U.S. Court of Appeals for the
11th Circuit, which deemed it unenforceable.
"Pediatricians are at the front line to advocate for firearm injury prevention."
We will never
know how many families might have been spared the tragedy of gun injuries
during this period. Despite the law’s injunction, misperceptions about legal
challenges may have had a chilling effect on conversations in the
pediatrician’s office that can help prevent these injuries.
In the final
ruling of Wollschlaeger v. Governor of the State of Florida, physicians
can ask or record information about firearms. There is no penalty for
that and no legal action for what was described as unnecessary harassment. This
ruling is an important victory, as freedom of speech in an exam room is
essential as a right – critical to our practice, and necessary to provide safe
care for children.
are at the front line to advocate for firearm injury prevention. As
research continues to show, we can’t assume parents don’t need help
understanding what children know and don’t know as young brains develop, or how
to better protect them.
We need to
The views expressed in this article are those of the authors, and not necessarily those of the American Academy of Pediatrics.
Judy Schaechter, MD, MBA, FAAP, who served as a
litigant in Wollschlaeger v. Governor of the State of Florida, is an
elected member of AAP’s Council on Injury, Violence and Poison Prevention and
an appointed member of the council’s subcommittee on
violence prevention. She is a professor and chair of the Department of
Pediatrics at the University of Miami Miller School of Medicine, chief of
service at Holtz Children’s Hospital at Jackson Memorial Medical Center, and
past president of the national Injury Free Coalition for Kids.