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Viewpoint: Doctors Punished for Protecting Children

Nguyen, Bich-May MD, MPH

doi: 10.1097/01.EEM.0000461707.64393.86
Viewpoint

Dr. Nguyenpractices in a community health center in Houston, TX and is a current National Physicians Alliance Copello Health Advocacy Fellow. This article originally appeared on Policy Prescriptions, a website that advocates for evidence-based health policy created by Cedric Dark, MD, MPH, the site's executive editor. Visitwww.policyrx.org, and follow on Twitter @PolicyRx and on Facebook athttp://bit.ly/PolicyPrescriptions.

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A 9-year-old girl in Arizona accidentally shot her shooting range instructor to death in August 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.

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

Child access prevention (CAP) legislation 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 CAP legislation were more likely to practice safe firearm storage behavior. CAP laws seem to have a greater effect when instituted in states with higher levels of pediatric firearm incidents and tougher penalties associated with firearm usage. This study, however, did not examine whether such legislation reduced pediatric morbidity or mortality, and previous research has shown mixed results. Limited research has been done to determine if the regulations directly affect actual firearm storage behavior.

The study does not demonstrate causation between the legislation and firearm storage behavior, but brief counseling by physicians has been shown to make a significant impact on improving these behaviors. Despite this evidence, Florida legislators passed a law 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.

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