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Guns and Public Health

For most of us, the Fourth of July weekend meant plenty to celebrate: the anniversary of our nation’s birth coinciding with the arrival of glorious (and long overdue) summer weather. But we had a lot to mourn: the spate of shootings here in Chicago. The latest tally is 82 people shot and 14 killed over the holiday weekend, with victims ranging in age from 7 to 66 years, many of them bystanders. Television news is reminiscent of movies, with chases and shootouts, helicopters flying overhead and vans unloading SWAT teams onto the streets. But real people are maimed and murdered in our midst, and the toll rises every day.

Though the underlying causes are complex, the one common denominator is guns. Legal and illegal guns are in the hands of criminals. And this likely will not change in the near future. Even talking about guns is problematic, because the issue has become so highly politicized in our culture with vehement and emotional arguments. But I would say this problem should be viewed as a public health issue and as physicians, we have an obligation to confront it.

Twice recently, patients have told me they were offended by a question on our health history form. It’s like many standard safety questions we learn to ask in medical school, such as, “Do you wear a seatbelt? Do you wear a helmet when you ride a bike?” You can guess which question upsets people: “Do you have a gun in the home?” While meant to spur discussion about how to safely keep guns in the home, instead it provokes defensiveness and anger. The distortion in our public discourse is so great that people believe that talking with their doctor about firearm safety violates their 2nd Amendment rights. And some state legislatures have sought to criminalize these discussions.

But now, in the State of Illinois, with the new concealed carry law, physicians are mandated to report any gun owners whom they suspect may be a danger to themselves or to others. But how can we have this conversation when patients are reluctant to even admit to their physicians that they own guns? This epic catch-22 has physicians caught in the middle.

Not only is our discussion stymied, but so is our effort to conduct research on gun safety. Current federal law reads: “None of the funds made available for injury prevention and control at CDC may be used to advocate or promote gun control.” Similar language was added to the National Institutes of Health budget. This restriction represents a lost opportunity to acquire information that directly affects public health and safety. Would more research allow physicians to better identify gun owners who pose a threat? Both the Chicago Medical Society and Illinois State Medical Society have policy in place encouraging research into gun violence by public health agencies.

Regardless of our individual views, we should be able to have rational, open discussions with patients about safe gun ownership and to research the magnitude and causes of gun violence. We can make important contributions in this area. Knowledge is power. As we’ve seen, the cost of ignorance is prohibitively high.

That’s why I urge you to support a new bill (HR 2612) in Congress by Rep. Carolyn Maloney (D-NY). The bill authorizes the appropriation of funds to CDC for conducting or supporting research on firearms safety or gun violence prevention. Please encourage your representatives to support HR 2612.

Kathy M. Tynus, MD
President, Chicago Medical Society

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