Gun Policy and Safety: Doctors Know Best?

Years ago, the California Academy of Pediatrics asked me to help develop policy and educational materials regarding having guns in the home, so that doctors could best advise parents on the safest practices on this topic.
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Dan Cartwright, co-owner of TDS Guns, places a semi-automatic pistol on display at his store in Rocklin, Calif., Friday, July 27, 2012. The California Department of Justice expects 725,000 weapons will be legally purchased in 2012, 100,000 more than last year and nearly twice the 371,000 guns legally purchased five years ago.(AP Photo/Rich Pedroncelli)
Dan Cartwright, co-owner of TDS Guns, places a semi-automatic pistol on display at his store in Rocklin, Calif., Friday, July 27, 2012. The California Department of Justice expects 725,000 weapons will be legally purchased in 2012, 100,000 more than last year and nearly twice the 371,000 guns legally purchased five years ago.(AP Photo/Rich Pedroncelli)

Headline: - A lone gunman opened fire today in (San Francisco, Aurora, Columbine, Virginia Tech, Tucson, Oak Creek...) and shot _____ innocent people, killing _____ people and wounding ____ more. " Politicians offered sympathy, but no solutions. Survivors were left to grieve without hope of change that might prevent more such tragedies.

That's the sad frustrating story, each time a mass shooting occurs. But beyond the headlines lies an ongoing national epidemic: Thirty people are murdered via guns on the average day, adding up to almost 12,000 gun homicides each year. In addition, accidental shootings claim many more, many of those kids. Inevitable, or preventable?

The answer depends on who you ask. Some people think we should ask physicians. Years ago, the California Academy of Pediatrics asked me (perhaps because I was once a certified "junior marksman"?) to help develop policy and educational materials regarding having guns in the home, so that doctors could best advise parents on the safest practices on this topic. About one-third of American homes have guns, and half of those are not locked away, even with kids present. Thus, two-thirds of unintentional shooting deaths occur in the home.

Working with pediatricians, we developed some evidence-based advice and published it. We didn't say "ban guns" but offered seemingly obvious advice such as "Keep your guns locked away, unloaded, warn your kids about them," and so on.

The guidelines were widely praised as sensible, even obvious. But soon I began hearing from gun owners who thought we were anti-American, and worse. One physician (?) told me he needed to draw his gun every time he came to San Francisco (!). This seems a dominant paranoid mentality in the National Rifle Association, judging from their public comments and positions -- even though violent crime has been declining in most American communities for a long time, and most gun crimes -- and accidents -- occur among people who know one another. But the NRA ignores this, favoring cooked-up "evidence" about guns being used to deter crime.

Thus, perhaps the craziest recent development in this realm is that politicians in Florida actually passed a law that would have made doctors who followed the guidelines into criminals -- it would be illegal to talk about guns with patients. Even the AMA found this law to be ridiculous, and it was overturned, but indicates both the power and extremism of the "gun lobby" (as well as something about Florida, perhaps).

In San Francisco, the NRA recently challenged local ordinances requiring that guns be "safely stored" in homes and requiring trigger locks, and banning possession of "particularly dangerous ammunition" such as fragmenting bullets and expanding bullets with "no sporting purpose." A judge tossed out the challenge, but the NRA has vowed to keep fighting, and their members and followers have, true to form, labeled such minor, commonsense rules as some sort of "war on gun ownership." They also call a proposed new ban on assault weapons "California's worst gun confiscation threat in 20 years!"

In a more perfect world, perhaps we could usefully ban guns. The United Kingdom does, and its homicide rate is about one quarter that of the United States. But that's politically impossible here, and nobody reasonably proposes it. Still, that's the specter raised by the National Rifle Association, which calls any virtually change in the status quo "gun grabbing." The NRA's motto is "no compromise." Their solution to most any gun-related problem? More guns -- they say this will deter crime. But the Harvard Injury Control Research Center's evidence is that the more guns, the higher the homicide rate. The NRA doesn't care for such facts, though, and any form of gun control is to them a step towards a total ban.

For an illuminating, balanced examination of the protracted gun debate, see the 2011 book Gunfight: The Battle Over the Right to Bear Arms in America by Adam Winkler, professor of constitutional law at UCLA . Winkler retells key legal battles and examines scandals regarding gun policy research on both sides. Historically, gun control was first proposed to disarm freed slaves and a century later, ironically, flaunted by the Black Panthers, who held that "the gun is the only thing that will free us." He also shows how the NRA evolved from a sporting organization to a powerhouse lobby whose CEO calls federal authorities "a jack-booted group of fascists." Thus in elections, gun issues are rendered another form of "don't ask, don't tell" -- even politicos known to favor more gun control are afraid to advocate their beliefs.

Yet Winkler notes that "strong majorities of gun owners favor compromise when it comes to gun control," and he would welcome mandated gun safety courses, background checks and waiting periods for gun purchases, and bans at places such as campuses. He reaches for optimism that we can have both a right to weapons and better controls. But he has to admit that's not coming soon, as the NRA is the Tea Party, the Right-To-Lifers, the fanatic, paranoid, no-compromise wing of gun policy that dominates the debate.

Thus, until more sanity prevails, here is what the American Academy of Pediatrics offers as practical advice :

Gun Safety: Keeping Children Safe

Research shows guns in homes are a serious risk to families:

  • A gun kept in the home is 43 times more likely to kill someone known to the family than to kill someone in self-defense.
  • A gun kept in the home triples the risk of homicide.
  • The risk of suicide is 5 times more likely if a gun is kept in the home.

Advice to parents:

The best way to keep your children safe from injury or death from guns is to NEVER have a gun in the home.

  • Do not purchase a gun, especially a handgun.
  • Remove all guns present in the home.
  • Talk to your children about the dangers of guns, and tell them to stay away from guns.
  • Find out if there are guns in the homes where your children play. If so, talk to the adults in the house about the dangers of guns to their families.

For those who know of the dangers of guns but still keep a gun in the home.

  • Always keep the gun unloaded and locked up.
  • Lock and store the bullets in a separate place.
  • Make sure to hide the keys to the locked boxes.

So, there's what doctors advise. It's interesting how this advice is similar to the San Francisco laws the NRA so detests. But does any of this sound like "gun-grabbing" or a threat to the American "right to bear arms" to you? And if it does, have you considered that you might not have the good judgment, or perhaps even be mentally fit enough, to own a gun?

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