A Pediatrician's Role in the Gun Debate
Laws in the works may prevent pediatricians from asking parents whether they have a gun in their home -- and, in effect, to discuss gun safety. Doctors and parents weigh in on this thorny issue.
Would you object to your pediatrician discussing gun safety with you, including asking whether you have guns in your home?
- Yes. It's not my doctor's business.
- No. The doctor is just trying to help prevent unintentional injuries.
That's the poll question we recently posed to our Facebook community. The overwhelming majority (70 percent) of respondents said they would not object.
This very topic has been the subject of debate for quite some time -- long before the events in Newtown, Connecticut shook us to our core. Back in 2011, Florida's legislature passed a bill, which was then signed by its governor, making it illegal for pediatricians to ask families whether they have a gun. (An early draft called for doctors to face five years in jail and a $5 million fine.) The lawmakers who created and supported the bill believed these conversations interfered with patients' Second Amendment right to bear arms. A federal judge overturned the bill, citing it interferes with a physician's First Amendment right to free speech. But the Florida government is appealing the ruling, and six other states have pursued similar laws.
This worries many doctors, including pediatrician Anne Edwards, M.D. "It concerns us that there are policies that may prohibit us from discussing risk factors when it comes to safety," says Dr. Edwards, who practices near Minneapolis-St. Paul, Minnesota. "Pediatricians value their relationships with families and want to have an open dialogue to keep children safe and healthy."
Oklahoma's proposed legislation has called for informed consent before discussing gun safety, which means that your doctor would have to get your approval before broaching the topic (something like "May I discuss firearms and how it might affect your child's safety?"). But "that changes the dialogue," says Dr. Edwards. "It raises a concern with parents; it gives them pause and creates another barrier between the pediatrician and the family. They may wonder, 'What's behind this question?' You can only be effective when you have an open dialogue that's not judgmental."
And therein lies the heart of the issue of discussing guns: judgment. As one Facebook commenter explained, "I would object to being called upon to prove to any doctor how safe my home is or isn't." But pediatricians maintain that their only mission is to protect kids. "We are not anti-gun, we are pro-child," says M. Denise Dowd, M.D., M.P.H., pediatrician in Kansas City, Missouri, and an author of the American Academy of Pediatrics' most recent policy statement on firearm-related injuries.
"I don't want people to have guns in their home, but that's not my agenda when I talk to parents," says Wendy Sue Swanson, M.D., Parents advisor and pediatrician at The Everett Clinic in Everett, Washington. "I want to make sure that the gun isn't loaded, that it's in a locked cabinet, and that the ammunition is locked stored separately from the gun."
In Dr. Edwards' practice, which she says is "in a community where people have guns in their home," the gun safety discussion is not only welcomed, it makes a difference. She'll explain that children are different from adults in terms of curiosity, the way they approach the world, and how they may interact with things like guns. "Almost on a daily basis, a parent will pause and say, 'Sure, that makes sense -- I never thought about that," says Dr. Edwards.
Many parents who commented on our Facebook poll understand her intentions. Said one mom: "Doctors ask whether or not we keep our cleaning supplies up high or in a locked cabinet -- why not guns? They're all dangers to kids who don't know how to treat them with caution." "Our pediatrician and family physician has asked us this," said another. "I do not take offense to it. She knows my daughters' dad is a police officer and he does keep his weapons in the house. She also asks about pets, smoking, family dynamics, school, and other personal aspects of our lives. It's important to have the full picture to really understand a child's health and well being."
"This is a really hard thing to talk about," admits Dr. Swanson, author of Seattle Children's Hospital Seattle Mama Doc blog. "Asking parents whether they have a gun in their home comes off like it's loaded with judgment. It's uncomfortable, but it doesn't impede me from asking. And that's because I have cared for children who've sustained injuries from guns, which is nothing any human being wants to do. No one will dispute that."
Copyright © 2013 Meredith Corporation.