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Posted by Habibi (Guest) - Friday, September 10 2004, 22:16:53 (CEST)
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PEDIATRICS Vol. 108 No. 6 December 2001, pp. 1391-1392


The AAP and Gun Control
To the Editor—
I am certainly not an advocate for frequent changes in laws and constitutions. But laws and institutions must go hand in hand with the progress of the human mind. As that becomes more developed, more enlightened, as new discoveries are made, new truths discovered and manners and opinions change, with the change of circumstances, institutions must advance also to keep pace with the times. We might as well require a man to wear still the coat which fitted him when a boy as civilized society to remain ever under the regimen of their barbarous ancestors.

Thomas Jefferson

Letter to George Washington

January 4, 1786: "This plan..."

The expression "children killing children" is becoming all too common. The recent killings at Santana High School in Santee, California, and Columbine High School in Littleton, Colorado, illustrate the terrible impact easy access to firearms has on our society’s children. Unfortunately, these horrific events are not isolated incidents. We in the United States have watched school shootings occur in Springfield, Oregon; Fayetteville, Tennessee; Pomona, California; Edinboro, Pennsylvania; Jonesboro, Arkansas; Paducah, Kentucky; and Bethel, Alaska. And the school shootings, as spectacular as they are in the media, are only the tip of the iceberg. While approximately 40 children die per year in schools in the United States, almost 4200 others die from homicide on the streets of our cities and in their homes.1,2,4 Most of these children are killed with guns.1,2,4 They do not get the media attention of the large-scale school shootings because we have been dulled by their constancy, and we tend to pay less attention, as a society, to the deaths occurring in the socioeconomically disadvantaged.

There are approximately one quarter of a billion guns in the United States. The very presence of these weapons increases the risk of death when adolescents and adults are involved in confrontations. The National Rifle Association (NRA) is fond of saying: "Guns don’t kill people; people kill people." But research has clearly shown that, in the United States, people kill people—with guns. In fact, the death rate from gun violence in our country is higher than in any other industrialized country. It dwarfs the violence-related death rates in Canada, Western Europe, England, and Japan.2 Some of the guns involved in committing these acts are semi-automatic or automatic weapons that have no conceivable purpose other than killing human beings. They are not even used by hunters, and they certainly should not be in our homes. We should not forget, however, that handguns are the major cause of death by gun violence in this country.

Many tragedies can be prevented by gun control legislation that stops children’s access to guns.3 The ease with which children are able to obtain firearms makes one wonder why there are not stronger gun control laws in the United States. Indeed, we cannot help but wonder why semi-automatic weapons and handguns have not been banned here. Why have the American Academy of Pediatrics (AAP) and other medical societies not taken a stronger stand against the NRA? Clearly, the NRA is winning the battle against gun control legislation despite the fact that there is an overwhelming amount of epidemiologic and sociologic scientific data documenting the harm firearms contribute to society. Evidence is abundant that even firearms placed in homes for protection are more frequently used in domestic violence than for defensive situations.2,5,6 The AAP did support the Child Firearms Access Prevention Act, S.1917, that was authored by Senator Durbin. This proposal, if enacted, would have held any adult owning a firearm liable if a loaded gun or a gun stored with ammunition was accessed by a child and used to injure or kill another individual or brandished in a public space. Unfortunately, if a child does injure or kill another individual with a firearm, it is too late. Prosecuting the responsible adult does not bring those injured or murdered any reconciliation. Although the NRA continues to advocate that the right to bear arms and our personal freedom are synonymous, our children’s safety is a far more important concern.

We propose that the AAP endorse a national grassroots letter- writing campaign that will take place in the offices and clinics of our members. This letter (e-mail) will advocate stricter gun control in which weapons other than those that are used for hunting are banned. Additionally, hunting weapons will be limited to those that are truly legitimate hunting weapons. The purpose is not to deprive hunters the use of guns for sport but to rid our society of weapons that have no other purpose than to maim and kill. Additionally, every gun owner should receive mandatory training on gun safety and storage. Child access prevention (CAP) laws should be enacted, and child safety locks should be required. We propose that the AAP provide the mechanisms to mobilize this campaign, encourage all of our parents and children to sign the documentation, and forward the petitions to our representatives and senators in Washington, DC, as well as to President Bush. The time for action is now. A national grassroots campaign can achieve success. The public awareness on the harm of firearms is at a very high level right now. We must act to ensure our children are safe from violence.

REFERENCES


Coyne-Beasley T, Schoenbach VJ, Herman-Giddens ME. The epidemiology of adolescent homicide in North Carolina from 1990 to 1995. Arch Pediatr Adolesc Med.1999; 153:349–355
American Academy of Pediatrics, Committee on Injury and Poison Prevention. Firearm-related injuries affecting the pediatric population. Pediatrics.2000; 105:888–895
Ludwig J, Cook PJ. Homicide and suicide rates associated with implementation of the Brady Handgun Violence Prevention Act. JAMA.2000; 284:585–591
Murphy SL. Deaths: final data for 1998. Natl Vital Stat Rep.2000; 48:1–105
Kellerman AL, Reay DT. Protection or peril? An analysis of firearm-related deaths in the home. N Engl J Med.1986; 314:1557–1560
Kellerman AL, Rivara FP, Rushforth NB, et al. Gun ownership as a risk factor for homicide in the home. N Engl J Med.1993; 329:1084–1091

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In Reply—
We are pleased to read and respond to the letter written by Drs Graff and Robinson relevant to the American Academy of Pediatrics and gun control. These authors have thoughtfully considered the magnitude of the firearm epidemic and potential solutions in the context of our current culture. The statistics they quote in their first paragraph (4200 others die from homicide) should be that 4223 children under age 20 died in 1997 from firearm injuries on the streets of our cities and in their homes and that of these deaths, 2562 (61%) were homicides. Eighty-five percent of homicides in the age group of 15- to 19-year-olds are firearm-related.

Drs Graff and Robinson propose a letter-writing campaign instigated by physicians that would be a superb example of advocacy for our constituency, the children of our practices and the country. These letters should not only be to Congress but also to the leaders of our municipalities and state legislators.

The Committee on Injury and Poison Prevention in conjunction with the Committee on State and Government Affairs will soon have a Firearms and Children State Legislative Packet available on the AAP Members Only Web site. As was stated in the recent commentary,1 the AAP policy statement on firearm injury sets a course for pediatricians along many avenues. We each, in the context of our regions and communities, can establish initiatives to reduce the incidence of firearm injuries and deaths of children and their family members. Drs Graff and Robinson are to be congratulated for their insight and enthusiasm.



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