By Richard Lenti
The school shootings that left 26 children and adults dead in Newtown, Connecticut have reignited a national debate over gun control. But according to some in the medical community, legislation that restricts research into gun violence may be just as much to blame for a string of mass shootings as easy access to firearms.
According to the Centers for Disease Control and Prevention (CDC), more than 31,000 Americans die from firearms annually. While there’s decades of research on what leads people to commit violence against themselves or others, there’s significantly less information on how access to firearms contributes to the likelihood and consequences of these acts.
That dearth of research, say Arthur Kellermann, MD, vice president of the RAND Corporation and Frederick Rivara, MD, Seattle Children’s Hospital, is the direct result of pro-gun members of Congress mounting an effort in 1996 to eliminate funding for the National Center for Injury Prevention and Control at the CDC. Although the effort failed, language was added preventing the CDC from using federal funds “to advocate or promote gun control.”
“The nation might be in a better position to act if medical and public health researchers had continued to study these issues as diligently as some of us did between 1985 and 1997,” they wrote in an editorial published online in the Journal of the American Medical Association. The effect of that legislation, they say, was the silencing of the science on gun research.
“Precisely what was or was not permitted under the clause was unclear. But no federal employee was willing to risk his or her career or the agency’s funding to find out. Even today, 17 years after this legislative action, the CDC’s website lacks specific links to information about preventing firearm-related violence.”
But according to Kellermann and Rivara, it’s not just at the national level where discussion of gun violence is being stifled. They point out that in 2011, Florida’s legislature passed HB 155, which subjects health care practitioners to possible sanctions, including loss of license, if they discuss or record information about firearm safety that a medical board later determines was not “relevant” or was “unnecessarily harassing.”
Although a federal judge has issued a preliminary injunction blocking implementation of the law, the matter is still in litigation and 7 other states have proposed similar legislation.
It’s those efforts to place legal restrictions on what physicians and other health care professionals can and cannot say, that has prompted doctors, scholars and lawyers in Florida to join forces in an effort to defeat the bill. They charge that the law violates the First Amendment by having a chilling effect on confidential discussions with patients.
“This case is about the core principle of the First Amendment that the government cannot tell individual citizens what they can and cannot say,” said lawyer Doug Hallward-Driemeier, partner at Ropes & Gray. “Patients have a right to trust that doctors are providing their honest and best advice about matters of health and safety. The Florida legislature cannot require that doctors first put that advice through a government-approved filter.”
According to Kellemann and Rivara, not only does the legislation undermine the sanctity of the doctor-patient relationship, but it also suppresses research that can have a real and lasting effect. They point out that deaths from motor vehicle accidents, fires and drowning have declined not from banning automobiles, swimming pools, or matches — but from translating research findings into effective intervention.
“The United States has long relied on public health science to improve the safety, health, and lives of its citizens. Perhaps the same straightforward, problem-solving approach that worked well in other circumstances can help the nation meet the challenge of firearm violence,” they wrote.
“Otherwise, the heartache that the nation, and perhaps the world, is feeling over the senseless gun violence in Newtown will likely be repeated, again and again.”