COMMENTARY

'Docs Should Promote Gun Safety With Patients': Caplan

Arthur L. Caplan, PhD

Disclosures

March 27, 2014

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Is Gun Violence a Public Health Problem?

Hi. I am Art Caplan at the Division of Medical Ethics at the New York University (NYU) Langone Medical Center. Is gun violence a public health problem? If you ask the National Rifle Association (NRA), they say no. They are up in arms because the candidate that President Obama put forward for the office of Surgeon General, a physician at Harvard named Vivek Murthy, has spoken out a number of times about gun violence and about the need for medicine in public health to do more about this huge problem in the United States. The NRA says that he's just playing politics -- it isn't really a science issue; it isn't a health issue. I think the NRA is flat-out wrong.

There is a huge problem with guns in the United States, and there are many things that public health can do, and many things that doctors should do to try to minimize the threats that guns pose to children, families, and all of us. One of the leading problems with guns is that we don't educate children to know what to do when they find a gun or see a gun. So, if a 5- or 6-year-old sees a gun, we need a program that teaches that child that if you see a gun, walk away, get out of the area, and then tell an adult. That is a public health program. It's something that school nurses could do. It's something that pediatricians should talk about with their child patients. It's something that families should hear about. We need a campaign. Vivek Murthy, the Surgeon General candidate, thinks that it is an appropriate thing to do. Apparently, the NRA doesn't.

Let's switch over to another problem with guns: suicide. One thing you have to ask patients is whether they own guns and whether they know how to keep them safely. Do you keep ammunition stored separately from the guns? Just as we might say, "Lock your medicine chest so that kids don't get in there and steal medicines," locking up your ammunition and your guns is a way to promote safety around gun ownership. That, to me, is public health that is established by science as sound policy, and one that we can use to diminish gun violence and gun accidents. Probably the biggest area in which guns are absolutely a public health challenge is suicide. Suicide is now killing more people in the United States than car accidents. It's a major cause of death for young people. What do we do about it as doctors? What do we do about it in terms of public health approaches?

Involving Gun Shop Owners in Safe Gun Ownership

An interesting program that has been tried in New Hampshire is to teach gun shop owners and people who own shooting ranges not to sell guns to people who are suicidal or emotionally despondent. You might think, "Don't they know that?" No. No one has actually discussed it with them. No one has told them how to pick up some of the signs that someone might be distraught. No one tells them what hotline number to give to a person they are worried about or how to contact a counselor or religious leader. They are not prepared to respond if they are concerned about a person who says, "I want to buy a gun."

Nearly every suicide in which somebody buys a gun takes place within 3 days after the purchase of the weapon. That is a public health problem in which people who favor gun use and favor owning guns can participate. The people in New Hampshire -- more than half of the gun shop dealers and those who own gun ranges who are involved with the program -- are proud of it. The NRA may not like it, but those who are at the front lines of using guns safely and promoting safe gun ownership understand that it is a public health program, and they think they have done a lot of good by trying to handle this suicide threat and manage it in a more intelligent way.

Politics are being played with the gun issue, but I don't think it is medicine. I think it's the NRA, and on this one, it's worth standing up and saying that guns are a public health problem. We could use a Surgeon General who will speak about guns, and we need a lot more doctors and nurses who will start to promote gun safety as part of their practice. I'm Art Caplan from the NYU Langone Medical Center. Thanks for watching.

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