Pediatricians renew call for counseling on gun safety, following Sandy Hook shooting

Two Boston pediatricians, in a New England Journal perspective piece published Friday, call on their colleagues to focus on gun safety, following the tragedy two weeks ago at Sandy Hook Elementary School in Connecticut, where a gunman killed 20 children and six adults.

“It is time to act for these families and for those who continue to lose children to gun violence,” write Drs. Judith and Sean Palfrey , who are pediatricians at Boston Children’s Hospital and Boston Medical Center.

Gun injuries are a leading cause of death in U.S. children and young people, the Palfreys write. They caused twice as many deaths in 2010 as cancer did among people ages 1 to 24.

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The American Academy of Pediatrics recommends that physicians talk with parents about gun safety, including storing ammunition separately and using a gun safe or a trigger lock.

Such conversations have become a subject of controversy in some parts of the country. Florida Governor Rick Scott has appealed a court decision to block a law he signed last year limiting a doctor’s ability to ask patients about whether they own a gun. Several other states have considered similar laws.

The Palfreys argue that gun-safety counseling from doctors is effective and necessary.

“As a nation, we have it in our power to protect our children from gun injuries, as other countries have done,” they write. “Doctors, teachers, city and state officials, gun owners, families, and young people must come together with a creative and meaningful commitment to improving our society.”

A common goal of reducing the number of guns in homes and communities and increasing research on gun injury prevention is warranted, they write.

Drs. Arthur Kellermann and Frederick Rivara of the RAND Corp. and Seattle Children’s Hospital, in the Journal of the American Medical Association last week, said such research has been stifled by pro-gun groups. They write:

The nation might be in a better position to act if medical and public health researchers had continued to study these issues as diligently as some of us did between 1985 and 1997. But in 1996, pro-gun members of Congress mounted an all-out effort to eliminate the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC). Although they failed to defund the center, the House of Representatives removed $2.6 million from the CDC’s budget—precisely the amount the agency had spent on firearm injury research the previous year. Funding was restored in joint conference committee, but the money was earmarked for traumatic brain injury. The effect was sharply reduced support for firearm injury research.

To ensure that the CDC and its grantees got the message, the following language was added to the final appropriation: “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.”

Precisely what was or was not permitted under the clause was unclear. But no federal employee was willing to risk his or her career or the agency’s funding to find out. Extramural support for firearm injury prevention research quickly dried up. Even today, 17 years after this legislative action, the CDC’s website lacks specific links to information about preventing firearm-related violence.

The authors outline how public health efforts in the past two decades have reduced the number of fatal car accidents and deaths from fire and drowning. “Given the chance, could researchers achieve similar progress with firearm violence?” they write.

What do you think: What is the appropriate role of researchers and clinicians in gun safety and injury prevention?