Dr. David Summers wrote an article entitled “The NRA Tells Doctors: ‘Stay In Your Lane’” which I read with great interest. His objection to the NRA comment about doctors is quite reasonable. Even as an NRA member, I think the comment was over the top.
Dr. Summers pointed out that physicians and other medical professionals have a vested interest in reducing the incidence of firearm-related injuries and deaths.
But I have to wonder if doctors are doing all they can to lower that toll. Especially considering that they can have a direct influence on at least one facet of the problem.
Childhood deaths and injuries from accidental gunshots are relatively rare, which is possibly why they create such a stir when they happen. In 2016, the Centers for Disease Control and Prevention reported 2,562 deaths and injuries requiring at least emergency room treatment among kids from infant to eighteen. The number of fatalities was 117 for the entire nation. This figure includes 608 deaths and injuries with victims ranging in age from newborn to twelve. There were 61 deaths in that age group.
In reality, firearm-related accidental fatalities among all ages totaled 495 in 2016. This includes hunting accidents as well as the “I didn’t know it was loaded” carelessness.
Incidentally, you will note the highlighted area from 2008 to 2012. That period covers one of the largest gun-buying frenzies in modern U.S. history. It kicked off when Barack Obama won the Democratic presidential nomination and ended when the 2012 midterm elections gave the Republicans control of Congress. Firearm manufacturers were running flat-out; gun shop shelves were stripped and popular calibers of ammunition were being rationed.
Many gun control advocates and politicians dismissed this as existing gun owners stocking up and hoarding, and that is true to an extent. But the number of new concealed carry permits being issued also rose, indicating there was an expansion in the ranks of gun owners. As of the end of 2017, there were nearly 16.4 million active permits, an all-time record. Based on that figure, it’s quite likely that there may be 81 million to 98 million American gun owners.
Compared to the population of the United States, the numbers of injuries and deaths may be small but virtually every one of these injuries and deaths could have been prevented.
Doctors are one of the best resources available to get the safety message out to gun owners. While patient trust has become an issue in recent years, the majority of Americans still trust their doctor. The doctor has a unique one-on-one opportunity to shape the discourse with a patient who is accustomed to receiving health advice from a professional.
But carrying water for gun control advocates can create a rift between physician and patients. Gun control is a deeply divisive issue in America and positioning medical professionals and medical associations as adversaries to gun ownership can be counterproductive.
Let me be very blunt: As doctors and health advisors, the goal should be a reduction in casualties, not passing judgement on guns or gun owners. The number of guns or gun owners isn’t the issue; encouraging safe and responsible ownership can have more of a positive impact than standing on a soapbox. Especially when gun owners become defensive and point out that children ages infant to 18 are more than eight time as likely to drown, most often in a private swimming pool, as to die from an accidental gunshot.
So what should a doctor do? Easy, be a doctor and focus on prevention rather than legislation.
Talk to your patients and parents of younger patients about Project ChildSafe. This is a program of the National Shooting Sports Foundation, which is the gun industry’s trade association. Since 1999, Project ChildSafe has distributed more than 37 million free gun safety kits, including a gun lock, through law enforcement agencies nationwide.
Since the introduction of the program in 1999, the rate of deaths and injuries from accidental gunshots with victims from newborn to age 18 has dropped more than 41%, according to the CDC. Even the U.S. Department of Justice has a positive view of the program. It awarded Project ChildSafe a $2.4 million grant to expand its efforts.
But I have not yet seen a single medical professional association come out in support of Project ChildSafe. Perhaps I am not aware of its inclusion in doctor-patient discussions but I am not aware of any evidence the medical community even acknowledges the program’s existence.
If not, why not? It’s a far more common-sense approach than ignoring guns and it does come from experts.
Have you recommended the NRA’s Eddie Eagle program to parents and public schools in your area? Yes, it’s been criticized but the criticism has centered around the fact that the lessons must be refreshed regularly by parents, something the NRA itself says is an important part of the program.
Maybe I am off base here, but I have yet to see any medical associations lining up to ask the NRA to produce a better program and offer input from medical professionals including childhood development experts. In fact, I have yet to see anyone deploy a program even as good as Eddie Eagle.
Why haven’t they done this?
Doctors can remind parents that the only safe place for any loaded firearm in a home with young children is physically on the person of an adult. Not in a purse; not on a shelf; not in a nightstand — on the person of an adult. That satisfies the requirements of self-defense while minimizing access by others. Inconvenient, perhaps, but if a parent doesn’t believe their child’s life is worth a little inconvenience, there may be a larger problem involved.
All other firearms should be unloaded and secured and ammunition should be stored securely and separately. For those for whom a traditional gun safe might be a financial challenge, cable-type gun locks and trigger locks are inexpensive and sometimes are even free from gun shops. All new firearms come with such a lock. Handguns often come with a lockable plastic storage box.
Most states do not have a legislative requirement for firearm safety training. Instead of an adversarial relationship, medical associations, physicians, surgeons and other medical practitioners and first responders could work with the NRA and the NSSF to develop programs and initiatives to not only promote firearm safety training but to explore ways to deliver that training in a no-cost or low-cost manner.
In fact, as a first step, these groups could work together to provide information about local resources to medical professionals. A doctor could simply enter a ZIP Code and get information about certified instructors and ranges offering instruction in their area. Project ChildSafe already offers a web page that lists participating law enforcement agencies that distribute the free safety kits. The doctor can select a state and look for agencies in their area.
Instead of an adversarial relationship with the NRA why don’t you and your fellow practitioners try a cooperative relationship? Beyond parental counseling, why not approach the National Shooting Sports Foundation with an offer to help investigate ways to reduce suicide? The American Foundation for Suicide Prevention did and the two groups are developing an educational program for firearm retailers to help them spot buyers that might be contemplating suicide.
Yes, I know all about red flag laws. But has anyone given serious thought to the possibility that people might avoid confiding in family and friends in order to avoid police showing up at their door to seize their guns? People considering suicide are already dealing with feelings of low self-worth: how eager are they going to be to endure public humiliation? Is it possible that it could provide the trigger for them to end their lives by another method? Nobody has yet suggested confiscatory laws for belts, ropes, extension cords or prescription drugs.
How should we be handling this?
I urge doctors to continue talking about guns. But I strongly suggest that you consider some of the tools available to make the conversation meaningful and productive. A person’s decision to have a firearm is their right. But you can be a important partner in ensuring that gun owners are aware of the need to be responsible with their firearms.
Instead of making an impossible gun ban the goal, let’s all make zero accidents a goal. That is not only more doable, it doesn’t require legislators to do anything at all.