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US doctors demand right to advise on gun ownership

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Doctors in America are up in arms over the suggestion that they have no business advising their patients on gun ownership and safety. The incensed medics insist that it's their duty to tell Americans not to keep guns in the home, or if they do, to keep them unloaded and locked away.

The debate on this issue was kicked off in June when a law went into effect in Florida which placed limits on doctors' ability to ask their patients what guns they owned and how they kept them stored, and prevented them entering any such information into people's medical records. Similar measures have been proposed to prevent medics interfering in the relationship between US citizens and their often-treasured firearms in other states, though no other such laws have yet made it onto the books.

The passage of the Florida law made Dr Eric Fleegler of the Children's Hospital Boston pretty mad. He and some colleagues have written a paper, published today in the American Journal of Preventive Medicine, which contends that guns kept at home are a major danger to Americans - particularly to American children.

"The role of the physician is to treat, and help prevent, injuries and disease that can occur from behaviors or environment," says Fleegler, in tinned quotes issued by the Children's Hospital Boston press office. "We ask about gun ownership for the same reasons we ask about infant sleeping positions, car seats, pools, drugs, alcohol and tobacco. It is our responsibility to understand possible health risks and provide appropriate information to help patients make decisions to keep themselves and their families safe."

A different press release issued by the Journal of Preventive Medicine editorial office also adds:

The American Academy of Pediatrics ... notes that a gun in the home is 43 times more likely to be used to kill a friend or family member than a burglar or other criminal. AAP and American Medical Association guidelines cited by Fleegler and colleagues "encourage physicians to inquire about the presence of household firearms and support the storage of unloaded firearms with trigger locks and in locked cabinets."

"Morbidity and mortality from firearm injury represent a ubiquitous and costly epidemic," write Fleegler and his co-authors.

Preliminary data (PDF) on causes of death for 2009 issued by the Centers for Disease Control and Prevention note the following figures for that year in the USA.

  • Accidental discharge of firearms: 588 deaths
  • Accidental drowning and submersion: 3,539 deaths
  • Accidental falls: 24,834 deaths
  • Accidental poisoning and exposure to noxious substances: 30,504 deaths
  • Motor vehicle accidents: 36,284 deaths
  • Complications of medical and surgical care [medical accidents]: 2,550 deaths

It would seem that there are many more important health and safety issues out there than firearms accidents. In most cases where an American gets killed by a gunshot, it is suicide (18,689 cases in 2009). It seems reasonable to suppose that many of these suicides would happen anyway without access to firearms, as 17,859 Americans managed to kill themselves by other means that year.

Gunshot homicide, a lot of which does involve criminals being killed rather than the shooter's family members or friends (though the doctors are correct to say that this is only rarely a matter of a householder shooting an intruder - it is more commonly criminals shooting each other) is a small health issue overall compared to accidental poisonings or falls. It resulted in 11,406 deaths in 2009 according to the CDC. If one chose to subtract the criminal-on-criminal violence it would be smaller still.

A US doctor, unless he or she happens to be an expert on firearms safety, might very well find time with a patient better spent discussing what household cleaning products that person owns and how they are stored, or what shoes they wear, or what ladders they own, or what car they drive and how they drive it, rather than talking about their guns.

Or frankly, given that most doctors aren't experts on hazardous materials or ladders or stair carpets or motoring either, it might be more cost-effective for them to focus on traditional doctor stuff like heart disease and cancer (hundreds of thousands of deaths in 2009). ®

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