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A gag order cannot halt a passionate child advocate

Wendy Sue Swanson, MD
Physician
August 4, 2014
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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 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

Recently, 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.

See here what other pediatricians and advocates have said about this ruling on Twitter:

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@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 http://t.co/VhneCTxEk3

— Laura Jana (@kiddocjana) July 28, 2014

The text of the FL decision blocking doctors from asking about guns is pretty amazing. http://t.co/Zi8LiNNxJi So gun safety is irrelevant? — Dr. Claire McCarthy (@drClaire) July 28, 2014

Wendy Sue Swanson is a pediatrician who blogs at Seattle Mama Doc. She is the author of Mama Doc Medicine: Finding Calm and Confidence in Parenting, Child Health, and Work-Life Balance.

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