Most Americans have strong feelings about gun control, whether in favor of more or less. Legislation has even been passed restricting physicians from discussing guns with patients. What is your opinion about healthcare professionals discussing safekeeping of guns in the home?
Gun ownership and regulation is a very emotional issue in the U.S. and there has been strong reaction to whether physicians and other healthcare providers should be involved in doing more to curb gun related injuries and deaths. I would like to hear some of your opinions regarding physician involvement, but first let's look at some of the gun statistics in the U.S.
More than 108,000 people are shot per year in murders, assaults, suicides, suicide attempts, unintentional shootings or by police intervention.
* More than 32,000 of them die.
* The U.S. has the most gun homicides of any developed nation. 29.7 per 100,000.
* Everyday 297 people are shot.
* 89 people die.
* 31 of them are murdered.
* 55 are suicides.
* 2 are killed unintentionally.
* 1 is killed by police.
* 1 is unknown intent.
* One in five deaths are people ages 15-29.
Over 17,000 American children and teens are injured or killed each year due to gun violence.
* 2,677 of those children die.
* Nearly 48 youth are shot per day including 7 fatalities.
* 5 are murdered and 2 are suicides.
1 in 3 homes with children have guns.
* 42% of parents with guns keep at least one unlocked.
* 25% of parents with guns keep at least loaded.
* 3 in 4 children know where firearms are kept in the home.
(Statistics; bradycampaign.org).
It has been suggested that clinicians could play a major role in reducing children's access to guns by asking if there is a gun in the home, and if so, counseling on firearm storage practices. One study showed that patients who received counseling on firearm storage were more likely to make a change in storage practice than patients who did not receive counseling. (64% vs 33%). (J Am Board Fam.Pract).
Pediatrician's offices and hospitals routinely give out infant and car seats, would it also be appropriate to distribute trigger locks and lockboxes? Firearm related injuries are a public health issue, so should there be public health initiatives regarding firearms such as there have been for reducing tobacco, toy and motor vehicle related deaths?
Specializes in NICU, PICU, Transport, L&D, Hospice.
Would someone please explain to me how asking about the security of firearms kept in the home equals saying you have no right to own them?
Conflating the two makes no sense at all.
It is representative of the fear, paranoia, and agitation that currently accompanies any discussion of firearms in this country at this time.
Notice how the discussion of the fact that hundreds of children die from gunshot wounds and thousands are injured by them, the discussion is turned to the definition of "childhood" by age group rather than the notion that we have an obligation to protect our young.
Meh
I am sick of the gun worshiping cowards of the USA. They are so afraid of losing their own guns that they will sacrifice children for their agenda.
Where again is the "well regulated" part of our armed "militia"?
The issue with asking is that many would deem the issue to be so minor compared to other childhood issues such as fire safety that asking about it is silly. Others would ask if a registered nurse would even know what safe handling and storage would even be or what interventions would take place if the patient answered in the negative.
The main issue with asking is for the same reason why there are states regulating the asking of the question, pediatricians and other practitioners are using it as a way to screen their patient's for political acceptability and denying care to those who they politically disagree with.
The asking of the question has become a barrier to care.
Why does no one get upset with the fact that asking about HIV is about 1,000x more regulated and taboo?
The vicious and negative reaction to gun ownership justifies why some people are wary of those who inquire about ownership, rightfully in my opinion. I keep reading stupid, paranoid, etc, etc
I guess my concern is this. You ask if I have guns in the home, and I say yes. You educate me on gun safety. OK, I get that. (As if I didn't already know, BUT because other folks are ignorant or just plain don't care, I have to sit through the lecture). What I don't like is you checking off a box saying "educated on gun safety". It's now on my insurance records because they have access, right? And we all know how private information can never be breached, right? It's just more information out there about me that's not their business. Yes, obviously the government knows because I have a permit, but does every Tom, Dick and Harry need to know that as well? Or maybe the local newspaper, because, after all, it's their duty to publish that information, right?
Oh, and let's take this to the extreme, because we all know what a slippery slope is, right? OK, so now let's ask everyone if they have knives at home. You, do? Let me educate you on the dangers of using a knife. What about beer or wine at home? Oh, OK, let's educate you about responsible drinking. Oh, you drive a car, too? Let's educate you on how to drive it. Oh wait, a lawn mover? Well let's talk about that, too. etc etc ad nauseaum.
Obviously I'm exaggerating to make a point. I'm tired of being told how to live my life, frankly. The government is getting more and more involved, and I don't like it one bit.
Specializes in Nurse Leader specializing in Labor & Delivery.
I ask every patient I see about HIV history or exposure, as well as abortion hx. It's part of my duty as a women's healthcare provider.
If I worked in pediatrics, I would ask about corificeats, bike helmets, and gun accessibility. If I worked in pediatrics in, say, Phoenix or LA, I would ask about pool safety/accessibility. It would be part of my duty as a pediatric healthcare advisor.
And I've been asked in the context of my own children, and I was not in the least offended. I responded, yes, we have firearms, and yes, they're locked up in a biometric safe, with ammunition locked up in a separate location. As Farawyn has said, asked and answered. Not such a BFD.
We are also specifically talking about this discussion in the context of a PEDIATRIC setting (or BH/MH).
The random adult medicine patient, don't give a flying fig if you own a gun. In the context of children in the home, it IS relevant and IS a health/safety question.
People in this thread are being ridiculously reactionary and hyperbolic.
I agree that the whole gun thing has become almost hopelessly polarized.
People who want effective community control over a lethal technology often refuse to consider that there are many valid points being raised by gun advocates. On some issues, they're being the canary in the coal mine and it behooves us to pay attention. (I'm still wrestling with the whole concept of government-mandated lists because I know they exist and they skeeve me out, too.)
From where I sit, the dominant voice I hear from the gun-owning community seems to be saying that the worries and reservations of those who choose to live un-armed are irrelevant and should not even be allowed a hearing, lest they take over and and turn everyone into a sissy or a slave.
And so we constantly get sidetracked into a grand duel of dogmas, winner take all.
I say "almost" hopelessly polarized because it wasn't always that way and doesn't need to be now.
I agree with TMB, when untrained children - regardless of how you define a child - have access to a gun and ammunition, totally preventable badness is highly likely to ensue. The same goes for some people with major psych problems. I'm a nurse - prevention of badness is my job. As far as I'm concerned, the worst that can happen when asking about the security of guns in the home is that an owner will have the idea in his head, if only long enough to tell me all about myself.
Watch out -- when I made the same statement, I got told off!
You're all about the facts, though, right? My intent wasn't to "tell you off." I provided you with peer-reviewed research demonstrating that the idea that a person who is suicidal will necessarily choose any method at hand is factually inaccurate. Suicide is a very personal decision, and many people do have a preferred method that fits with their idea of what's acceptable (avoiding disfigurement, clean, quick, etc). Thus, some people will substitute and others won't, and the decision will be made on these personal factors of what is and isn't acceptable to them. Long-term trends will also show that cultural factors influence choice, such that reducing access to firearms may create a rise in social acceptability of hanging, but that's related to long-term group choices rather than short-term individual choices. Was I unnecessarily harsh when I corrected you previously? If so, I apologize.
I was going to provide Meriwhen with the same information, but now I feel like I'm overstating it if I make the same point in two posts in a row... maybe I'll make this a twofer. brillohead, you can ignore this part of the post as review... though I'll include more data this time, if you're interested.
Study One: "The relationship between the availability of lethal methods of injury and suicide rates is an important, but unresolved question. We investigated this relationship by prospectively classifying lethal methods according to their accessibility in the five counties of New York City ... Virtually all of the differences in overall suicide risk among counties were explained by differences in rates involving methods that were differentially available in the counties, principally fall from height, overdose of prescription medications, and carbon monoxide poisoning. We conclude that differences in suicide rates between communities are, in large part, due to differences in accessibility to lethal methods of injury."
Study Two: "To assess the impact of the 1978 Canadian gun control law on suicide rates in Ontario, the authors compared firearm and nonfirearm suicide rates for 1965-1977 for those with 1979-1989. There was a decrease in level and trend over time of firearm and total suicide rates and no indication of substitution of other methods. These decreases may be only partly due to the legislation."
Study Three: "Accessibility to and the lethality of particular methods of suicide may have profound effects on overall suicide rates. Such effects appear to depend upon the popularity of the method and the extent to which alternative methods that are acceptable to the individual are available."
Study Four: "The effectiveness for restricting means of committing suicide has been demonstrated, at least as regards toxic domestic gas, firearms, drugs, and bridges. At the individual level, studies tend to indicate that many persons have a preference for a given means, which would limit the possibility of substitution or displacement towards another method."
Study Five: "Restriction of access to means for suicidal behavior, especially dangerous methods, is a key element in most national suicide prevention strategies. In this paper the rationale for this is discussed, including the fact that suicidal impulses are often brief, that availability of a method may influence both the occurrence and outcome of a suicidal act, and that if a favored means becomes less available it does not always result in substitution by another method."
The issue with asking is that many would deem the issue to be so minor compared to other childhood issues such as fire safety that asking about it is silly. Others would ask if a registered nurse would even know what safe handling and storage would even be or what interventions would take place if the patient answered in the negative.
The main issue with asking is for the same reason why there are states regulating the asking of the question, pediatricians and other practitioners are using it as a way to screen their patient's for political acceptability and denying care to those who they politically disagree with.
The asking of the question has become a barrier to care.
Why does no one get upset with the fact that asking about HIV is about 1,000x more regulated and taboo?
The vicious and negative reaction to gun ownership justifies why some people are wary of those who inquire about ownership, rightfully in my opinion. I keep reading stupid, paranoid, etc, etc
Gun safety is not a "minor" issue for children. Where are you getting that a doctor can't discuss HIV with their patient?
Can you cite an example of where a Pediatrician dropped a patient because their parents were gun owners? If the parents simply refuse to answer any questions about the child's health risks as some are suggesting they should, I can certainly see having no other than dropping them as a patient if they just refuse to to take part in office visits.
I get that some (certainly not all) gun owners are paranoid to the point of delusional beliefs but I don't think a Pediatrician, ARNP, nurse etc should be protecting or deferring to that paranoia more than their patient.
Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
So glad that those numbers are acceptable to you.
The teens 15-17 must just be expendable, yes?
Once again, where on earth did I say any of that? Please, either show me where I said that, or stop making stuff up. (You'll notice that the last time I asked someone -- begged, even -- to show me where I said what they said I did, all I got was a bunch of crickets chirping.) Seriously, stop making stuff up. It's silly.
The fact is, those numbers don't exist for ages from 15-17, or at least they are not easily accessible to the public. The CDC lumps them into the "young adult" category along with 18yo, 19yo, 20yo, 21yo, 22yo, 23yo, and 24yo adults. To state that we should be counting seven different ages of adults as children simply because it suits your agenda is pretty silly.
I'd also say that it's pretty silly to assume that 15yo, 16yo, and 17yo kids who are dying due to gunshots are *mostly* dying because they found an unlocked gun and managed to kill themselves / get killed with it. Does it happen -- yes, I'm not denying that. So please don't make up yet another false attribution to me. I said "mostly" and I even starred it to draw attention to that word. I'm not claiming it has never happened.
But much more likely is that the people in the "young adult" column were the victims of a homicide (which is why I say that gangbangers should not be considered in these types of situations -- that is totally different than a child finding a gun and having an accidental discharge) -- there are more firearms homicides in that young adult age range than firearms suicides and firearms accidents combined.
Note that I'm not saying that ANY deaths are okay. I know you won't have actually comprehended that sentence, so let me repeat it: NOTE THAT I'M NOT SAYING THAT ANY DEATHS ARE OKAY.
But there are WAY more accidental drownings than there are accidental firearms deaths in the pediatric ages, even if you include your beloved young adults ages 18-24 as "kids" -- are we asking about bathtubs and buckets and toilets and sinks at every well-child visit, as well as bike helmets and seatbelts/corificeats and firearms?
If this topic really is about preventing accidents and unnecessary deaths, it makes a lot more sense to bring up situations that are horses rather than situations that are zebras.
Notice how the discussion of the fact that hundreds of children die from gunshot wounds and thousands are injured by them, the discussion is turned to the definition of "childhood" by age group rather than the notion that we have an obligation to protect our young.
Meh
Nice try, but the definition of "childhood" by age group was because the "gun haters" were trying to state things that were blatantly false, and they got called on it.
I absolutely have an obligation to protect my young -- in addition to making him wear a bike helmet (he's 15yo and "none of the other kids do" ... but he does!), making him wear a seatbelt (and he wasn't allowed to sit in the front seat until he was big enough to make the airbag sensor turn off, and he went to kindergarten still in a 5-point corificeat), teaching him about the dangers of tobacco, drugs, and alcohol (and giving him information about his increased genetic risk based on both sides of his family), and researching and buying top-end hockey gear (how many 6yos do you know who had a $600 hockey mask? there's a reason some popular brands are referred to as "widowmaker" among those in the know!), I also own a Sig Sauer P238, and my son knows where it is and how to safely handle it and fire it, if needed.
Just because YOU are afraid of guns and just because YOU don't know diddly-squat about gun safety and just because SOME people are unsafe with their guns, that does not mean that guns are evil and nobody knows what they're doing with them. And it certainly doesn't mean that you have the right to look down your nose at people like me and call us names. Talk about a schoolyard bully!
You don't want a gun? Then don't have one. I don't care -- you are not my responsibility, and what you legally do in your home with your own family is not my problem and none of my business. Which makes me wonder, why are you wanting to be soooooooo involved in MY home and MY business?
If you are actually a nurse, I feel sorry for your patients and your colleagues -- you must be all kinds of fun to be around if you resort to name-calling whenever something doesn't go the way you deem it should be.
And I'll say it again, for the umpteenth time in this thread -- AFTER ALL, THIS IS THE ACTUAL POINT OF THE THREAD -- I don't have any problem with asking if guns in the home are secured from very young children, as long as it's asked in conjunction with car safety, bathroom safety, poison safety, etc. Ditto for asking in the mental health realm. But asking details or getting judgmental and lecturing is completely inappropriate. Ask the question, hand out a pamphlet on gun safety if needed, and continue on with the rest of the encounter.
Reporting from Tombstone, Ariz. — A billboard just outside this Old West town promises "Gunfights Daily!" and tourists line up each afternoon to watch costumed cowboys and lawmen reenact the bloody gunfight at the OK Corral with blazing six-shooters.
But as with much of the Wild West, myth has replaced history. The 1881 shootout took place in a narrow alley, not at the corral. Wyatt Earp and Doc Holliday weren't seen as heroic until later; they were initially charged with murder.
And one fact is usually ignored: Back then, Tombstone had far stricter gun control than it does today. In fact, the American West's most infamous gun battle erupted when the marshal tried to enforce a local ordinance that barred carrying firearms in public. A judge had fined one of the victims $25 earlier that day for packing a pistol.
"You could wear your gun into town, but you had to check it at the sheriff's office or the Grand Hotel, and you couldn't pick it up again until you were leaving town," said Bob Boze Bell, executive editor of True West Magazine, which celebrates the Old West. "It was an effort to control the violence."
A national debate over gun control has flared since a gunman killed six people and wounded 13 others, including U.S. Rep. Gabrielle Giffords, two weeks ago in Tucson. The suspect, Jared Lee Loughner, is accused of firing 31 shots from a Glock semiautomatic pistol with a high-capacity ammunition magazine.
Hours after the rampage, Pima County Sheriff Clarence W. Dupnik appeared to partly blame Arizona's lax gun laws for the violence, saying he opposed "letting everybody in the state carry weapons under any circumstances that they want, and that's almost where we are."
"I think we're the Tombstone of the United States of America," he declared.
Dupnik's dig didn't go down well here.
Deep in the desert southeast of Tucson, Tombstone is tucked in a sere landscape of gullies and gulches, sagebrush and sorrel. About 1,500 people call it home, though the population swells each day as tourists clomp down wooden sidewalks, munch buffalo burgers and shop for cowboy kitsch.
Dupnik has "bank robberies and murders every week up there," fired back Ben Traywick, 83, a Tombstone historian who keeps a pistol on his desk and a shotgun nearby. "And he's bad-mouthing us? If you wanted to commit a crime, would you go to a town where everyone carries a gun? We have no crime."
But that's another Tombstone myth.
Local crime is low by big-city standards. But given the size of its population, with two rapes and 10 assaults in 2009, the last year for which figures are available, the town's violent-crime rate was higher than the state's average on a statistical basis. Similarly, with 88 crimes total, the town's crime index per 100,000 was higher than the national average, 475.5 compared with 319.2.
Arizona's gun laws are among the most lenient in the nation. Under legislation passed last year, guns are permitted almost everywhere in the state except doctors' offices and some businesses. It is one of three states, along with Alaska and Vermont, that allow people 21 or older to carry concealed weapons without a permit. Concealed guns may be carried into bars as long as the gun owner isn't drinking, and guns are permitted on school grounds as long as the weapon is unloaded and the owner remains in a vehicle.
Any law-abiding citizen 18 or older may buy or possess a rifle or shotgun. To buy a handgun, federal law requires a minimum age of 21. Firearms may be sold 14 hours a day, seven days a week, except Christmas.
Arizona's love of guns is rooted in its rugged rural history and enshrined in the state's constitution, drafted in 1910. "The right of the individual citizen to bear arms in defense of himself or the state shall not be impaired," it reads. The state celebrates its independent spirit and a culture of individual rights and distrust of government.
Given its lurid past, Tombstone may not be a typical community. But it provides vivid evidence of what state law allows in practice.
"In this town, pretty much everyone carries a gun," said John Wiest, 65, a storekeeper who patted a Ruger semiautomatic pistol on his side.
"I carry it into the bank when I go in to make a deposit each morning," said Dave Ericson, 60, a California native who moved here last year and wears a working reproduction of an 1873 Colt Peacemaker in a hand-tooled holster on his hip. "No one even looks up."
A few shops and restaurants in the historic district, including Big Nose Kate's Saloon, remain true to the Old West gun ordinances that were common on the frontier and have posted "No Weapons Allowed" on their doors. A block away, the OK Corral gunfight site similarly bars anyone from bringing a real gun to the fake gunfight.
Still, many here view the idea of gun control — even restricting sales of the extended-ammunition magazine used in the Tucson shootings — as little better than cattle-rustling.
Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
How about some perspective, from the CDC's 2013 data. Let's look at what REALLY endangers children in the USA.
Annual accidental* deaths for ages 0-14:
Accidental discharge of firearm -- 69
Accidental Drowning -- 625
Accidental Smoke/Fire -- 280
Vehicle Accidents -- 1345
Other Accidents (unspecified, non-transport related) -- 1469
*does not include homicide or suicide, as those are not "accidental"
Kids are almost TEN TIMES more likely to drown than be accidentally shot. If you're getting all hot and bothered over guns in the home, ask yourself if you're ALSO getting ten times as hot and bothered over pools and bathtubs?
ANY accidental death is a tragedy. But if you really want to protect as many kids as possible, lectures about bathtubs and toilets and buckets and pools are going to save way more kids than lectures about guns in the home. Same for fire, corificeats/belts, bikes, etc.
If you're getting all worked up about this gun issue, maybe some soul-searching is called for. Guns are not the problem. Guns have been in people's homes for centuries. If you have a personal issue with that, that's on you -- nobody else.
toomuchbaloney
16,039 Posts
It is representative of the fear, paranoia, and agitation that currently accompanies any discussion of firearms in this country at this time.
Notice how the discussion of the fact that hundreds of children die from gunshot wounds and thousands are injured by them, the discussion is turned to the definition of "childhood" by age group rather than the notion that we have an obligation to protect our young.
Meh
I am sick of the gun worshiping cowards of the USA. They are so afraid of losing their own guns that they will sacrifice children for their agenda.
Where again is the "well regulated" part of our armed "militia"?