In a recently released article (10.1542/peds.2018-3058) in Pediatrics, Dr. John Petty and colleagues, and the American Pediatric Surgical Association (APSA) Board of Governors, lift their voices as one in a Position Statement on Firearm Injuries and Children. This is an unequivocal, resounding, evidence-based statement from physicians on the front lines of firearm violence and injury. While not provided in direct response to the National Rifle Association (NRA)’s tweet last November, which advised “self-important anti-gun doctors to stay in their lane,”1 this Position Statement is a bold and comprehensive repudiation of that tweet. As the APSA Statement notes, >90% of surveyed APSA members provide pediatric trauma care, and >80% believe that APSA should give high priority to reducing gun/firearm- related injuries. Firearm violence prevention and reduction are indeed in their lane.
This Position Statement is powerful and well written, and referenced throughout. The emphasis is on approaching firearm violence prevention as a public health issue, “…rather than an issue of law, politics or personal freedom.” The analogy to reducing motor vehicle fatalities is a theme of the paper, and serves well to emphasize that when resources and commitment are behind a multi-pronged public and legislative approach, injury and fatality reduction is feasible. The authors proceed methodically through topics related to gun violence, and systematically endorse the most comprehensive approaches. These include: improved access to mental health services, universal background checks for all firearm transactions, removal of policy barriers that prevent funding of firearms-related research, restrictions on ownership of assault-style weapons, legislation limiting child access to in-home guns, strong Child Access Prevention (CAP) laws, and further research and treatment for survivor (“second victim”) care. The statement endorses unequivocal opposition to interference with physicians’ ability to discuss gun safety with patients, and to the arming of teachers in schools. Specific other recommendations include support for “stop the bleed” training for lay persons and pediatric trauma care as the optimal resource for injured youth.
Pediatricians, too, have the ability and tools to act as advocates to prevent firearm violence, and to work on behalf of each of these initiatives. AAP Voices is the AAP blog site, where you can reach out to colleagues and share your own views and thoughts. The AAP’s top priorities on gun violence prevention are found both at the AAP’s advocacy site and at the Department of Federal Affairs site. This first page has links to “How Pediatricians can Advocate for Children’s Safety in their Community” (AAP online resource page) and to the AAP Policy on Firearm Safety. The Section on Pediatric Trainees (SOPT) has a resource and action list for trainees (not restricted to firearm violence prevention actions) on its own website. Let’s step up and partner with colleagues from all areas: no one of us has the time to do it all, but each one of us has the time to make a difference.
Reference
1. Ranney ML, Betz ME, Dark C. #ThisIsOurLane — Firearm Safety as Health Care’s Highway. N Engl J Med 2019; 380:405-407 DOI: 10.1056/NEJMp1815462
