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Abstract
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As a pediatric trauma surgeon who has been in practice for more than 36 years, I have seen my share of morbidity and mortality in adolescents and teenagers. But if you had told me at the outset of my career that deaths due to firearms would eventually become the leading cause of death among children in the United States, I would have been extremely skeptical and not believe that such a horrific phenomenon could be taking place.
The data are clear and undeniable, however, about firearm related fatalities among American adults and youth. More than 49,000 Americans died because of a firearm injury last year with 1,629 of these deaths occurring in children and adolescents <18 years old. This number represents a staggering number of deaths, and particularly of suicides, which represent more than one-half of all firearm homicides. Suicide is the low hanging fruit of gun violence prevention because all evidence shows that the presence of a gun in the home dramatically increases the successful completion of a suicide attempt. Since most suicide attempts are impulsive acts, it is the gun that we should target as the vector of death in this subgroup of firearm related deaths.
My approach to gun violence prevention has evolved over the years and I have been a strong believer in the need for individual households to be able to rid themselves of guns ever since reading the seminal paper that showed a markedly increased risk of a firearm fatality in association with the possession of a firearm in the home1.
My approach to this continuing epidemic in the United States has always involved voluntary gun buybacks which I helped to establish both in Allegheny County, PA and in New England's second largest city, Worcester, MA. These programs involve a unique collaboration between the local district attorney granting amnesty to persons who turn in their firearms, local police departments who help collect and destroy the guns, and the local healthcare system, frequently in concert with city and local public health officials, to provide the public with information about the responsibility that goes with our 2nd Amendment rights to own firearms. We have also relied on local merchants to provide gift cards to reimburse individuals who turn in their weapons.
While these buyback programs have not, however, been widely embraced by gun violence prevention researchers because they have not been shown to reduce crime, they do in fact raise public awareness about the dangers of having a gun in one's home and help to promote partnerships between law enforcement and the medical community.
What has made our gun buyback program particularly effective is its coupling with education on gun violence prevention through use of medical students from the University of Massachusetts Chan Medical School. We are teaching and encouraging these future healthcare providers during the earliest years of their training to ask patients about gun ownership and issues related to the risk and responsibilities associated with firearms. If the patient or an accompanying family member reveals that they are gun owners, then the student helps the patient build an individual risk assessment for their household. While these may sometimes be awkward conversations initially, practice with standardized patients and with on-line tools that have been developed with the Massachusetts Attorney General and the Massachusetts Medical Society can reduce the trepidation of young providers “going there” with their patients ...
Language: en |