Doctors punished for protecting children

A 9-year-old girl in Arizona accidentally fatally shot her shooting range instructor last month after he set her Uzi to automatic and allowed her to hold the weapon on her own. The incident garnered national attention and became part of the debate over gun-control laws, specifically children’s access to firearms.

Source: davitydave (Flickr/CC)

Over 7,000 children and adolescents are hospitalized every year for firearm-related injuries. For children ages 0 to 4, the mortality rate is 17 times higher in high gun ownership states than low gun ownership states. Firearm prevalence and unsafe storage practices are associated with higher rates of unintentional firearm deaths.

Child access prevention legislation (CAP) makes gun owners criminally liable if they allow children unsupervised access to firearms.

Researchers have found that families with preschool-aged children at home who are living in states with specific child access prevention legislation were more likely to practice safe firearm storage behaviors. CAP laws seem to have greater effect when instituted in states with higher levels of pediatric firearm incidents and tougher penalties associated with firearm usage. However, this study did not examine whether such legislation reduced pediatric morbidity or mortality, and previous research has shown mixed results. Additionally, limited research has been done to determine if there is a direct effect of these regulations on actual firearm storage behaviors.

Though the study does not demonstrate causation between the legislation and firearm storage behavior, brief counseling by physicians has been shown to make a significant impact in improving these behaviors.

Despite this evidence, legislators in Florida have passed a law that has been upheld by the 11th Circuit Court that would strip physicians of their medical license or fine them $10,000 for asking about guns in the home.

Politically motivated legislation that interferes with the physician-patient relationship harms patients’ health. This trend should disturb anyone who cares about the integrity of evidence-based medical practice as well as anyone who cares about the health and safety of American children.

Abstract

OBJECTIVES: We investigated how state-level firearms legislation is associated with firearm ownership and storage among families with preschool-aged children. METHODS: Using 2005 nationally representative data from the Early Childhood Longitudinal Study-Birth Cohort (n = 8100), we conducted multinomial regression models to examine the associations between state-level firearms legislation generally, child access prevention (CAP) firearms legislation specifically, and parental firearm ownership and storage safety practices. RESULTS: Overall, 8% of families with children aged 4 years living in states with stronger firearm laws and CAP laws owned firearms compared with 24% of families in states with weaker firearm laws and no CAP laws. Storage behaviors of firearm owners differed minimally across legislative contexts. When we controlled for family- and state-level characteristics, we found that firearm legislation and CAP laws interacted to predict ownership and storage behaviors, with unsafe storage least likely among families in states with both CAP laws and stronger firearm legislation. CONCLUSIONS: Broader firearm legislation is linked with the efficacy of child-specific legislation in promoting responsible firearm ownership. PMID: 24825210.

Prickett, KC et al. AJPH. 2014; 104 (6): 1080-6.

by

May Nguyen, MD, MPH