Doctors urged to join gun debate

POSTED: Tuesday, January 1, 2013 - 4:30pm
UPDATED: Tuesday, January 1, 2013 - 4:41pm

he shooting at Sandy Hook Elementary School in Newtown, Connecticut, on December 14 has compelled the editors of the medical journal Annals of Internal Medicine to call on other physicians to become active participants in the discussion about gun violence and gun policy in this country.

More than 30,000 people die from gun injuries each year, according to the Centers for Disease Control and Prevention. Gun injuries account for nearly 1 in 5 injury deaths in the United States. More than 96% of those deaths are due to suicide and homicide.

In an editorial published in Annals, a publication of the American College of Physicians (ACP), on Monday, Dr. Christine Laine, editor-in-chief of the journal and a general internist, calls on physicians to use their voices in this gun control debate, just as doctors have done regarding other issues that threaten public health, such as smoking, air pollution, drunk driving and vaccinations.

Laine points out that the American College of Physicians, which is the largest medical-specialty organization and second-largest physician group in the United States, identified gun violence as a public health issue back in 1998, but says the subsequent response from fellow physicians - whose mission it is to prevent, detect and treat illness in adults - is "lackluster" when it comes to their involvement in preventing gun injuries.

The editorial points out that only one professional medical organization, the American Academy of Pediatrics, has established a policy to reduce gun access and injuries in children, by recommending that pediatricians counsel parents of children as young as 6 months old. Last year, a federal judge overturned a Florida lawthat would have prevented pediatricians from doing just that.

"We're going to have to tackle policies that prohibit discussions with patients about guns," says Laine. She also says more research is needed to help doctors shape policies on this contentious topic.

"It is almost impossible today to get federal funding for firearm injury prevention research," says Dr. Arthur Kellermann in a December 19 article in the Atlanta Journal-Constitution. Kellermann, now with the Rand Corporation, treated (among others) gunshot victims during his 25-year career practicing and teaching emergency medicine, most recently in Atlanta. He's referring to how federal funding for gun studies dried up because "the (National Rifle Association) strategy of shutting down the pipeline of science was effective."

The NRA did not respond to a CNN request for comment on the federal funding issue Monday.

The U.S. Centers for Disease Control funds a lot of grass-roots research, but in the 1990s the agency's budget for studying gun violence was cut. In 2003, the director of the CDC's Injury Center at the time, Dr. Sue Binder, told reporters: "We are prohibited from using any of our funds to advocate or promote gun control." At the time she was discussing a new study that looked at 51 existing studies about the efficacy of existing gun laws and couldn't draw any conclusions, as researchers said the data was unreliable and the analyses were inappropriate and inconsistent.

Laine says the lack of funding has created a vacuum when it comes to preventing gun violence.

Which is why the editors of Annals are also calling for more studies on how to identify people at risk for violence, which mental health conditions play a role and under which circumstances. This could then help shape future policies on reducing gun violence (something that can't be done in time for the proposals sought by President Barack Obama from his task force due at the end of January).

"We're in place where nobody wants people with uncontrolled seizures operating cars or school buses," Laine writes. "Why have someone with uncontrolled psychosis own a firearm?"

Physicians, she says, should resolve "to raise our voices on the matter of guns" in 2013.

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