Florida politicians will not change pediatrician resolve to advocate for and protect children. There’s no question that a gag order cannot halt a passionate child advocate. I’d call the recent Florida ruling a dull tool taken to a very sharp crowd. Consider this post an open letter to Florida politicians…
I live as far away from Florida as any continental American (you do the math) yet Florida politics this past week affect pediatricians and families everywhere. In my opinion, every parent should tune in and follow this case. Florida just restricted physician free speech and hindered a physician’s ability to help your neighbors, your relatives, and your family create a safe environment for children.
Guns In Your Home? Do you ask about guns at playdate drop-off? Have you seen the Moms Demand Action For Gun Sense In America online presence (and progress) or follow their feed on Facebook?
Florida may have gotten this wrong thinking that restricting a pediatrician’s words and inquiry about safely storing firearms meant that pediatricians were trying to take away guns. Not so fast.
The Florida Physician Gag-Order Law:
Last Friday The 11th Circuit Court of Appeals in Florida upheld the “physician gag law” in Florida, a law that violates the First Amendment rights of pediatricians and family doctors and threatens their ability to counsel parents about how to protect children from unintentional injury and death. This started way back in 2011. Then the law was appealed. Now the appeal is overturned. This ping-ponging is just politics but the waste here is distraction from protecting children. In 2011 I explained the gag-order for pediatricians — basically it’s this: Florida says it’s illegal for pediatricians to ask about how families and guardians store firearms in their home even though we know about 4,000 American children die every year from firearm injuries.
Relevant Firearm Statistics
- Guns are in about 1/3 to 1/2 of American households (data I reviewed varied). For the parents that don’t have guns, research finds that over 1/2 have never talked to their children about gun safety. Since more than a 1/3 of all accidental shootings of children take place in the homes friends, neighbors, or relatives gun in your home or not, guns are a safety issue for all children. Another reason the Florida legislation matters to us all.
- One in every twenty-five admissions to pediatric trauma centers in the United States is due to gunshot wounds. See information about handguns in the home and ways to protect children.
- Storing guns separately from ammunition and in a locked container reduce likelihood of accidental injuries.
The American Academy of Pediatrics condemned the Florida ruling this morning in a statement that strongly goes against the ruling and delicately lays out the facts for why:
Research has shown that physician counseling about gun locks and safe storage, tailored to a child’s specific age and development, increases the likelihood a family will take the steps to store their firearms safely. Pediatricians routinely counsel families about firearm safety just as they offer guidance on seat belt use, helmets and parental tobacco use to reduce the risk of injury to children where they live and play
Limiting a physician’s right to inquire about a child’s home, including safe storage of firearms, remains an impediment and outrageous threat to safety. It’s not just our own homes, but the homes our children visit that must be safe. This is why Florida legislation matters for most of us.
Dr James Perrin sums it up beautifully, “Parents who own firearms must keep them locked, with the ammunition locked away separately. In this case, a simple conversation can prevent a tragedy. The evidence is overwhelming – young children simply cannot be taught to overcome their curiosity about guns, and to suggest otherwise is, frankly, the height of irresponsibility.”
This law (if it is upheld again) won’t save lives. These antics waste state and federal money, distract politicians from governing and re-direct research dollars. Good thing is I know who we’re dealing with; I met pediatricians formally as teachers and mentors back in August of 1998 when I started medical school. In fact the very first lecture I heard at med school was given by Dr Ken Ginsburg an adolescent expert. He gave a talk on firearms, adolescents, risk and responsibility. And although I don’t remember the numbers shared in that talk nearly 16 years ago, I remember the intent he inspired in me.
The efforts and goals to protect children are pre-conditions when living on earth for parents and pediatricians. Antics like gagging pediatricians will not deter advocacy and there is no question what my 16 years in the community of medicine has taught me: this will not change pediatrician resolve to protect children’s lives. Inquiring and learning about a child’s environment while providing tips for safety for those who protect children will always be a part of that, gun-safety included. Florida politicians or not. The AAP notes that since 2011, 10 other states have attempted (and failed) to enact similar legislation. Click on the map to view which ones:
Physician Counseling Bill States-Map
See here what other pediatricians and advocates have said about this ruling on twitter:
@SeattleMamaDoc the gag is unprecedented and forces the doc to be negligent. Why does this risk factor deserve special dispensation?
— Matthew Loxton (@mloxton) July 28, 2014
@SeattleMamaDoc It’s about privacy apparently. So I can ask about sex, drugs, abuse, etc. But not a projectile hurling death machine?
— Clay Jones (@skepticpedi) July 28, 2014
I share concern of @AmerAcadPeds: AAP condemns ruling against physicians’ right to counsel on firearm safety https://t.co/VhneCTxEk3 — Laura Jana (@kiddocjana) July 28, 2014
The text of the FL decision blocking doctors from asking about guns is pretty amazing. https://t.co/Zi8LiNNxJi So gun safety is irrelevant? — Dr. Claire McCarthy (@drClaire) July 28, 2014
Karen Kilian says
Simply: Unbelievable
Ken Tegtmeyer says
Well said on an obscene law. One minor correction in your opening. Alaska, technically, is on the continent so friends in Pediatrics there, and as the AAP mapping project shows there are a few, are further away. Alaska is not one of the contiguous United States, of which you clearly are about as far as you could get.
Wendy Sue Swanson, MD, MBE says
Fair enough. A blunder. With your correction I see what I meant to say was “I live as far away from Florida as any living in the lower contiguous 48” — will work to make sure I avoid this mistake going forward.
John says
Does the gag prevent a doctor from TELLING parents? or just ASKING?
Because from the rest of your article, what difference does it make if the household would have said yes, or no to the question in the first place? why not presume 100% of the parents do, and make them all know about gun safety?
You summarized above, even for the parents without guns, most haven’t talked to their children about gun safety.
And yet, we talk to our children about stranger danger, mr yuck, etc, without questions first, like “do you regularly see strangers?” “do you have cleaning materials at your house”?
If the law doesn’t prevent ped’s from flat out telling parents to lock up their guns, then that’s what they should do. Someone should come up with a standard paragraph, no questions necessary, something like:
“I am not allowed by law to ask you if you have firearms in your home. I do not care if you do. But if you do, you should [store them properly, teach your children about gun safety, etc]. If you do not, you should [teach your children about gun safety, etc].”
Viviana Goldenberg, MD says
I am a Family Doctor in GA and member of “Moms Demand Action for Gun Sense in America”. Our State lawmakers passed the most horrifying pro gun legislation in the country HB60. It is matter of months for them to imposse the same law with providers here. Great article! It is important to be relevant in this issue, most of pro gun activist insist there is not reason for doctor to talk about that. I explain that it is part of wellness visit to address safety the same way that we screen for lead, domestic violence, we ask about smoking or pets in the household. Gun injuries are projected to become the first cause of death in the population 10 to 24 years old by 2015. It is a morbi-mortality issue and as such it has to be addresed by Medical providers and by Public Health experts and not by the NRA and their local gun lobbyist.
Kristin says
It’s Florida. Enough said, and unfortunately not surprising.
Lynda M Otvos says
Kristin, you are so right. I lived in South FL for twenty-eight years and was horrified decade after decade by the incredibly bad legislation around kids and their health. I left for the SF Bay in 2000 and have never been happier. Real rules that mostly make sense, penalties that coincide with the problems, solutions and Regional Centers and Independent Living Associations–it’s all so very civilized. A huge change from the wilds of Florida.
Jessica Brest says
I think pediatricians should just have a “safe firearm” conversation with all their patients. They don’t really need to know whether there is a gun in that persons home to have the conversation.
Mr. C says
Hi all. I live in Florida with a 3 year old and was also very upset over this at first. I wanted to share some things I have learned though from researching which helps me sleep a little better at night.
Last year, in Florida alone, 262 kids drowned in pools. I have never even worried about this since I do not own a pool but the great majority of those are non-pool owner’s kids dying in neighbor’s pools (which applies to me). 3 children died from unsecured guns in FL which this law relates to while 7 died in total from shootings (including the 3 accidentals).To put that into context, on average, 6 kids die DAILY in the US from car accidents. Further 55 people died in lightning strikes, and there were 791 deaths from toasters nation wide. Actually more children died from being left in vehicles this year so far (17).
There are well over one million gun permits in Florida alone (highest in any state). In Florida you aren’t required to have a permit unless you conceal carry in public so the gun ownership rate in homes is much higher than the one million who carry on a daily basis. Most of the gun owners I know for instance, who have children and keep guns at home, don’t carry in public or have permits. I’m not great at math but that’s way, way less than 1% on the accident side… which is a pretty impressive record for anything, especially with such high numbers. I know one accident is too many but our time would be much better spent focusing on deaths related to pools, lightning or toasters… mentally I can’t really bring myself to do that bc I supervise my child and do not leave him unattended at other people’s houses. I also do not hesitate to hop in the car and drive him around so why shoud I be so much more worried about this.
My point is I’ve learned that your child is way more likely to die in a car wreck than an accidental shooting yet you probably do not think much about hopping in the car and doing a long vacation drive or dropping them off at school in the am. That’s far more lethal than irresponsible gun owners who need doctor intervention. Numbers do not lie and that is a lot of responsible gun owners …which indicates that while I’d like docs quizzing parents about guns… docs really would be better served putting their time and effort into other topics that they can approach. So this might actually save more lives. They now can’t be focused on the “less likely to occur but more dramatic death scenarios from guns” but can use that time to be more focused on the “more likely but less dramatic (in terms of national headlines) and more taken for granted life threatening scenarios” that almost ALL our children face each day (like cars/lightning and toasters).
I have also learned that there are very strict Florida gun laws regarding securing your firearms. It’s illegal to own a gun and not properly secure it. Home or car… doesn’t matter. You are responsible for it 24/7 and you face jail time for not doing so. If you get in trouble for it… even after jail you are never able to legally own one again. From the less than 1% accident rate it’s obvious that virtually all parents are responsible and are keeping them unloaded and locked up according to the law. We all know there are a lot of irresponsible parents out there.. that’s why I was shocked to see how low the number here was. You can’t let the way less than 1% of bad apples ruin it for more than 99% of the people who are securely protecting themselves with firearms.
With the government’s new involvement in our healthcare system and the current litany of scandals (IRS abuse of power/conservative targeting that even a good deal of liberals are shocked by… for instance) there is grave concern for privacy now a days. The issue becomes where do you draw the line? Should doctors instruct on toaster and car safety? It’s far more lethal.
I’ve taken several years of martial arts and one of the main principles you learn is that the human is the weapon. Not the weapon itself. I know that some of these scenarios aren’t as easy to have an accident with but some of these are and probably kill more children a year than guns. Anything can be lethal. Kitchen knives. A fork. A phone cord. A shoe lace from your shoes in your closet. A hammer. A chair. A book. A hand. Your knee. There are even deadly techniques just using your fingers or thumb alone. A tree limb in your back yard. A hand full of leaves or sand strategically placed in someone’s throat/nose. A glass of water. A coke can or bottle ripped into a jagged edge. A rock. The metal flag ripped off your mail box. A set of car keys used between your fingers with a strategically placed jab at someone. A pillow or piece of loose clothing/the bottom of your jacket. At some point though we have to draw the line and when you start seeing that the media makes these cases seem more commonplace than they really are, since the idea of them is so tragic and dramatic, and you start finding out that kitchen knives cause more injuries and death than guns you have to kind see that it’s one of the smaller issues to worry with. Texting and driving and driving while using cell phones is causing more deaths but no one is out panicking about that. I had to let it go after coming to this realization.
More than letting it go. Hearing first hand what is happening on our border right now in terms of the cartels/gangs/terrorist being able to easily bypass any sort of security now that the border agents are assisting families and standing down and hearing/seeing how bad some of the related crime/kidnappings/beheadings are from family who live in a border state near the border… I’m actually for the first time ever considering purchasing a gun and taking a class. I’m sure there are good/honest people crossing too and they probably out number the cartels etc. But Clearly the criminals coming over the border have the ability to cause more deaths than unsecured firearms… yet not many people seem concerned that the government isn’t enforcing our laws to protect us.
I also learned that Gun violence in Florida has decreased to all time lows since we went from a “might issue” to select people to a “shall issue” to just about anyone state. If you investigate state records you see that the firearm-involved violent crime rate dropped 33 percent between 2007 and 2011, when the number of issued concealed weapons permits and the number of residents carrying guns rose nearly 90 percent during that time. Homicides etc fell but the bad news is a higher percentage of those homicides were carried out with guns instead of knives/pillows/strangulation etc. Perhaps not terrible news though since there were less homicides and the ones that happened were by gun, which in my mind is much faster/humane for a victim than a knife or strangulation attack. At any rate… I could go on but some of these facts really helped me rest easier about what is going on in my state. Hope it helps some of you that share my previous concerns.
Timothy Wheeler, MD says
Dr. Swanson’s raging against Florida’s Firearm Owners’ Privacy Act might carry some moral force if not for her professional society’s all-out culture war on gun owners. That’s why the people of Florida passed this law. Regulation of physician conduct, including speech, is well-established in state law throughout America. It is designed to curb unprofessional conduct. Florida’s law prohibits the practice, vigorously promoted by the American Academy of Pediatrics, of doctors pushing a political agenda of gun control in the exam room. The people of Florida understand this, as does the Circuit Court of Appeals and gun owners across America. For a thorough discussion of the politics of pediatricians’ involvement in this issue, go to our website.
Timothy Wheeler, MD
Director
Doctors for Responsible Gun Ownership
A Project of the Second Amendment Foundation