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St. Louis Docs’ Open Letter: Guns Are a Pediatric Issue

Robert Farago - comments No comments

 Dr. David Jaffe (courtesy news.wstl.edu)

We are writing today as pediatric emergency and trauma physicians to share our concern about the epidemic of gun violence that threatens the safety, health, and well-being of our children in St. Louis and in the United States . . .

Since 2002, St. Louis Children’s Hospital has cared for 771 children injured or killed by gunfire; 35 percent were younger than 15. These include the recent 12-year-old boy accidentally killed by his friend when playing with his grandfather’s pistol kept under his pillow, the 2-year-old boy paralyzed when his father accidentally discharged his gun during loading, the 5-year-old girl caught in a cross-fire as she sat on her front porch, the 10-year-old boy killed by his mother overwhelmed with mental illness, and the 4-year-old boy who found a handgun in a closet at home, placed the barrel into his mouth and pulled the trigger as he had often done to get a drink from his water-pistol. Many of these children died despite the heroic efforts of our highly trained pre-hospital, emergency, surgical and critical care staff.

In 2010, seven American children age 19 and younger were killed every day. This is twice the number of children who die from cancer, five times the number from heart disease, and 15 times the number from infections. This is also the equivalent of 128 Newtown shootings.

It has been estimated at least 38 percent of American households have a gun. In homes with children younger than 18, 22 percent store the gun loaded, 32 percent unlocked, and 8 percent unlocked and loaded. The children in these homes know the gun is present, and many handle the gun in the absence of their parents.

Children who have received gun safety training are just as likely to play with and fire a real gun as children not trained. In one study, 8-to-12-year-old boys were observed via one-way mirror as they played for 15 minutes in a waiting room with a disabled .38 caliber handgun concealed in a desk drawer. Seventy two percent discovered the gun, and 48 percent pulled the trigger; 90 percent of those who handled the gun and/or pulled the trigger had prior gun safety instruction.

Rather than confer protection, careful studies find guns stored in the home are more likely to be involved in an accidental death, homicide by a family member, or suicide than against an intruder. In 2009, suicide was the third leading cause of death for American youth, with firearms the most common method used. The American Academy of Pediatrics has concluded, “The most effective measure to prevent suicide, homicide, and unintentional firearm-related injuries to children and adolescents is the absence of guns from homes and communities.”

We concur with recent recommendations from more than a dozen national pediatric professional organizations, including the American Academy of Pediatrics, Academic Pediatric Association, and the American College of Surgeons in response to the Newtown school shooting. We called for action in three areas: reinstating and revising the ban on assault weapons and large ammunition magazines; improving quality and availability of mental health services; and reducing the exposure our children have to media violence. In addition, we called for increasing research on the relationship of these factors on the epidemic of death and injury to children caused by firearm violence and for ending restrictions to this research imposed by Congress.

We are gratified the plan President Obama recently announced addresses all of these issues. The president called for public support of these initiatives, and we strongly agree. As physicians who care for children and families devastated by gun violence, we know first-hand the importance of taking action that will begin to make the environment in St. Louis safer for our children. It has been done in many other economically advanced countries, and we can do it in the United States.

As Gabrielle Giffords said to Congress: “Too many children are dying. Too many children. We must do something. It will be hard, but the time is now. You must act. Be bold, be courageous. Americans are counting on you.” Our children are counting on us!

Dr. Robert M. Kennedy is an emergency pediatrician at St. Louis Children’s Hospital. Dr. David M. Jaffe [above] is chief of the division of pediatric emergency medicine at St. Louis Children’s Hospital. He is the current president of the Academic Pediatric Association. Dr. Martin S. Keller is director of trauma services at St. Louis Children’s Hospital.

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Robert Farago

Robert Farago is the former publisher of The Truth About Guns (TTAG). He started the site to explore the ethics, morality, business, politics, culture, technology, practice, strategy, dangers and fun of guns.

0 thoughts on “St. Louis Docs’ Open Letter: Guns Are a Pediatric Issue”

  1. Failure of logic. The cited study refers to handguns which can readily be aimed at oneself and fired. These are not being addressed by any proposed laws b/c the courts have already ruled on that. Instead they target scary black rifles of which I haven’t seen any documentation of use for suicide, or child injury.

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  2. Yes, if we remove all firearms your probability of being killed by your own gun will go down. From incredibly slim to none. Just like how if you removed all motor vehicles your likelihood of dying in a MVC will do down.

    But how can we measure the loss of life caused by the absence of a gun?

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    • The probablility of being killed by your own gun goes down. What they refuse to understand is that the probability of being killed by someone else’s gun (or knife, ball bat, hammer, brass knuckles, lead pipe, etc) goes up.

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  3. glad none of these dumbasses are my kids’ pediatrician. Again, if they want to claim 19 yr old are “children” then call the friggin’ UN. The USA is using child soldiers in war. The horror. . . . . . .

    Can’t have it both ways – if they can go to war and die for their country, they are not children.

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  4. And here we thought the disarmament crowd don’t like numbers.

    What percentage of docs want to live free, with all of the attendant rewards and consequences?

    Freedom-lovers are from Mars, safety-lovers are from Venus. Maybe we really can’t all live together.

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    • Depends on the bullet weight, your barrel quality & length, etc.

      People in the accuracy game play with the leade on their loads – a lot. Some benchrest shooters eliminate the issue entirely and seat their pills into the lands, appropriately reducing their powder charges to account for the higher pressures that result.

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  5. None of the examples above would have happened if the guns had been secured. Seems like the really smart doctors “overlooked” that little fact in their conclusion.

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    • Killed in crossfire, sitting on her porch.
      Paralyzed when negligent father was attemping to load weapon.
      Shot my mentally deranged mother.

      Sure none of those would have happened if the gun was secured, but they weren’t safe storage issues, they were usage issues. A gun locked up 100% of the time might as well not exist.

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    • and none of the problems cited would be solved by banning “assault weapons” either. This is so much like building a careful argument why apples are bad for you (putting aside the deceptive numbers used), then suggesting that you therefore shouldn’t eat oranges

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  6. “In 2010, seven American children age 19 and younger were killed every day.”

    Need a cite doc and does that state just mean deaths by guns or what? How many kids die each day in/by cars?

    Yet another case of a idiot with a MD/PhD with a God complex, thinking they know it all.

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  7. And in other news the best way to never fall off a bicycle is to never ride a bicycle.

    I also call BS on those tests with 8-12 years olds in a clinical observation room with a desk full of toys and a revolver in the drawer, the sterile envirnment is no where close to reality.

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  8. In one study, 8-to-12-year-old boys were observed via one-way mirror as they played for 15 minutes in a waiting room with a disabled .38 caliber handgun concealed in a desk drawer. Seventy two percent discovered the gun, and 48 percent pulled the trigger; 90 percent of those who handled the gun and/or pulled the trigger had prior gun safety instruction.

    There’s a cite and a study I want to track down. 8-12? Who instructed this 90% on gun safety, FPSRussia? The NYPD? Charles Manson?

    Were these kids told there was a toy gun in the room and to find it? Why were these kids playing in the desk? Were they told too? This stuff just defies every bit of experience anyone I have ever known has had. Maybe an 8 year old who doesn’t see firearms everyday is a bit sketchy. Maybe. But a 10 year old, let alone a 12 year old? Especially after actual training? Utter nonsense. Were that that study valid, every kid in a home with firearms would kill someone.

    When I was a kid that age, we all owned guns – especially by 12. None of us shot anyone. Accidentally or on purpose. At 8 or 9 even the YMCA summer camp had a rifle range and relentlessly practiced range safety and gun safety.

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    • I’ll bet their “prior gun safety instruction” consisted of showing them a picture of a gun and telling them if they ever see a gun, don’t touch it and get an adult, and maybe lasted 10 minutes. And I’ll also bet that’s ALL the “gun safety instruction” any of them had ever had. Anyone who has ever tried to teach an 8 – 12 year old boy knows it takes a lot more than that to get anything to sink in. Had they been raised to respect guns and taught gun safety all their lives, they wouldn’t have behaved like they did.

      It was like telling a bunch of 8-12 year old boys they shouldn’t look at pictures of naked ladies then leaving them in a room with a copy of Playboy buried in a stack of magazines. What else would you expect them to do when they find it?

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    • See my post below with citation info.

      Safety instruction constituted child reported receiving instruction varying from Police, teachers to family members.

      While I see no fault in the paper for its intentions, trying to determine boyhood behavior. I see plenty of fault of pediatricians trying to cite this and construe it as firearm safety training is a failure with boys aged 8-12 and thus shouldn’t be considered. Instead they argue to ban guns that aren’t even cited in the paper.

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  9. 771 in ten years sucks, sure, but it’s not an epidemic. Not even if the statistic were comprised solely of deaths, not a mixture of death and injury. Sorry your hospital is in a shitty part of town, docs, but pulls your heads out and enjoy some fresh air.

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  10. At which hospitals do these altruist saints work?

    I bet it’s in those serving the most well-to-do areas of St. Louis….

    Of course, even if they do not, Level 1 Trauma centers are usually not located at community hospitals serving the most affluent. They tend to be at academic hospitals sometimes located near the worst parts of town. But even if they are in the ritziest parts of town, patients will still be transferred there from other hospitals if need be.

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    • The hospital attributed to these geniuses is St Louis Children’s. It is just inside the city limits and is a Level 1 trauma next door to two other hospitals where all of the gunshot victims are brought. It is on the edge of Forest Park. There are some nice homes nearby, but like any major city area, there are elements that detract from said nice homes.

      I am very confident that their experience with “guns” relates to the sweet Utes that come in after jacking someone and getting a surprise instead.

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      • “…there are elements that detract from said nice homes.”

        How UNFORTUNATE we have to live amongst those less fortunate. Aren’t there RESERVATIONS or something we can send them to?

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  11. Hel if you want to put the hurt on someone just do like we used to do. Open chambe of weapon, insert blank firing round, close chamber. Next insert 1 section of appropriately sized cleaning rod into the muzzle end of the barrel, take aim and fire!!!
    You would be surprised how deep in a tree you can bury a cleaning rod!! LOL!!
    Especially out of an M60 MG!

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  12. In 2011, the U.S. Department of Health and Human Services (“HHS”) reported 2,512,873 deaths in the United States from all causes (U.S. Department of Health and Human Services, National Vital Statistics Reports, October 10, 2012, Volume 61, No. 6, Table 2 at pp. 39-42.) HHS reported the leading cause of death in the United States was major cardiovascular diseases, recording 778,503 deaths. Malignant neoplasms (cancer) accounted for 575,313 deaths, and was the second leading cause of death according to HHS.

    According to HHS’ statistics, in 2011 there were 122,777 accidental deaths in the United States. Of the total 122,777 accidental deaths, HHS attributed 34,677 deaths to motor vehicle accidents, 33,554 deaths due to poisoning and exposure to noxious substances, and 26,631 deaths due to falls. In contrast, HHS reported only 851 deaths due to the accidental discharge of firearms.

    HHS reported that in 2011 that there were 40,239 drug-induced deaths and 26,256 alcohol induced deaths.

    According to HHS, in 2011 there were 38,285 deaths attributed to intentional self-harm (suicide), of which 19,766 were caused by the discharge of firearms. For the same time frame, HHS reported 15,953 homicides, and attributed 11,101 of these homicides to “discharge of firearms”. HHS attributed 258 firearms related deaths to “legal intervention”.

    HHS statistics suggest the following:

    (1) a person is 3 times more likely to be killed in a traffic accident, 3 times more likely to be accidentally poisoned, and 2 times more likely to die from a fall, than to be the victim of a firearm related homicide;

    (2) drug and alcohol induced deaths account for more than 6 times the number of firearms related homicides; (66,765 vs. 11,101);

    (3) slightly more than half of all suicides (51.6%) reported by HHS are accomplished with a firearm, while the remaining 18,519 suicides were attributed to other lethal means, showing the willingness or purpose to take one’s own life would always overcome any lack of access to a firearm;

    (4) accidental deaths attributed to firearms is less that 1% of all accidental deaths; and

    (5) the number of all firearms related deaths is statistically insignificant to the number of deaths attributed to heart disease and cancer.

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  13. “The outright banning of guns is a concept that should never be uttered in any free society.”

    Fixed that for ya, tyrant. I don’t care that he pulled these bills (purely out of self-interest), the fact that he says that means he’s a traitorous threat, same as any other.

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  14. Apart from the obvious bent, and misinformation one stands out as particularly ignorant. He wrote, “We are gratified the plan President Obama recently announced addresses all of these issues.” Umm, how exactly is that the case. President Obama’s plan says nothing of handguns. I would ask this “genius” how many childhood accidents or suicides involved “Assault Weapons” or more than ten bullets? I am going to bet the number is awfully close to zero. I sure hope I never have this guy as my doctor, he doesn’t seem very intelligent.

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  15. Too bad they didn’t cite references to lend some credence to all those statistics they’re tossing about. Instead they used weasel word phrasing like “it has been estimated” and “careful studies find.” Either they were too lazy to document their assertions (maybe because they couldn’t stand up to close scrutiny or were taken totally out of context), or they just pulled them out of their nearest bodily orifice. I’m kind of leaning toward the latter.

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  16. Wonder how they figure in all the thousands or even millions of households where there is one or more firearm and no one has ever been shot by accident?

    And if what they are saying is true, shouldn’t we be hearing about a lot more negligent shootings, as in multiple shootings every single day?

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  17. I understand the position completely. But, what happens the next time? Character is doing something of you own volition. If some one has to be grabbed by the throat and threaten into doing the “right” thing, it kind of lessens the kudos earned for doing so.
    Sorry .

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  18. A truly sad litany about needless child deaths.
    Not unlike an earlier article that discussed injuries to children unrestrained in car crashes. He thought the solution for that was manditory whooping cough vaccinations.

    Not being able to own a 30 rnd mag will make the irresponsable adults in these childrens lives become responsible. Now I get it! Aren’t we all stupid!

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  19. 1) here is the paper referred to about 8-12 year old boys…
    Pediatrics. 2001 Jun;107(6):1247-50.
    Seeing is believing: what do boys do when they find a real gun?
    Jackman GA, Farah MM, Kellermann AL, Simon HK.

    2) Here is an excerpt from the above cited paper describing the gun safety education. “Twenty-eight of the 30 boys (93%) who handled the gun and 15 of 16 (94%) who pulled the trigger reported that they had previously received some sort of gun safety instruction. The nature of the safety instruction taught to the boys varied from police officers to teachers to informal instruction by family members”

    3) And here is the experimental design from paper cited in #1
    “At the time they were led into the room, the children were told that they could play with the toys that were placed on the counter. They also were told that they could exit the room at any time if they had any questions or problems. They were not told to explore the room or to open any cabinets.
    Within the examination room, 2 brightly colored plastic water pistols were concealed in 1 drawer. An actual metal .380 caliber semiautomatic handgun was placed in another drawer.”

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  20. As soon as the gun haters can frame this as a public health issue we are f’d. You’ll give up every gun you own if threatened by the state with taking your children. Despicable as any of these other tactics but a clever one to be sure.

    The america of personal responsibility ended about the same time as radiator fan boxes came with a warning about not sticking you hand in the running fan…..

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  21. I like what he said, but it would also be easy to read this and come away thinking that he made a good argument for why civilians should not be allowed to own this “force multiplier” (i.e., its so effective for cops, that it would be too dangerous for civilians). Calling it a patrol rifle just supports this interpretation.

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  22. The AR above is waaay overbuilt, it’s got mo gadgets than Mr Gadget.
    Any time an AR approaches the weight and bulk of a 762×51 it has completely defeated it’s POU

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  23. Interesting idea. However, I wonder if we’re all committing a logical fallacy in the fact that we (most of us, anyway), are logical actors who behave in fairly predictable ways from a psychological and sociological standpoint. Put more bluntly, a regular guy with no history of mental illness wouldn’t commit such a crime because he understands that such action is not right, for a variety of reasons.

    The problem is when we try to understand actions committed by people who perceive and understand the world in a fundamentally different way. It may never be possible to establish a motive simply because the rest of us don’t relate to the world in the same way as Lanza did. In no way am I letting the kid off the hook – what he did was beyond reprehensible. I’m just saying that most of our mass shootings are committed by crazy people, and the non-crazy people will always wonder why they did it but will probably never know because they themselves aren’t crazy and don’t understand the world in the same way.

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  24. I don’t understand the question. Adam Lanza, lest we forget, was an AUTISTIC, post-adolescent boy, and we have absolutely NO evidence he had ever handled a firearm before, much less fired one. Where does this leave us? With a ton of unanswered questions, that’s where. A little wisp of a boy, autistic… how can we accept he pulled this off, all by his lonesome, especially with persistent reports of two other shooters?

    We HAVE to confront the possibility, however remote it may seem, that this event was VERY different from what we’ve been led to believe….

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  25. If you live around Denver, you know that you always have to roll up your car windows and set the A/C to ‘recirculate’ whenever you drive through Senator Ulabarri’s district of Commerce City. (We used to call it ‘Commerce Sh!tty.’)The stench is enough to make your eyes water on a warm day, and now we know where it comes from.

    Here’s his contact information:
    Colorado Senator Jesse Ulabarri
    200 E Colfax Room 339, Denver, CO 80203
    (303) 866-4857
    [email protected]

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  26. Today I watched Barry on cnbc, instead of politicizing the deaths of children as he SO quickly did with sandyhook, he had emergency workers stand behind him. And he politicized the urgency that the emt’s ,firefighters, border patrol, fbi, tsa, oh yeah and plenty of teachers are going to be out of a job, and it’s all the republican’s fault. And as he spewed his hateful lies, i noticed the eyes of some of these workers standing behind him. They had the look of what did I get myself into? the look of realizing as they stood there they are endorsing what this idiot is spewing. Then I saw the wavering voice of Barry as he started questioning what he was saying, maybe it was the response of his audience, as he realized to himself. “hey these sheeple aren’t buying my line, hook line and sinker?” But the truth comes out in his apprehension. He said it seems like “the repubs” keep coming up with manufactured crisis every few months. Then as I am thinking, yeah manufactured crisis? like Fast & furious, benghazi, and sandyhook? then you see barry squirm for a minute like he just caught himself. We know you want to raise taxes, we know you want to dismantle the Constitution, we know you want more big government. Lay off your TSA, they haven’t caught one terrorist yet, unless it was in the pants of a 4 year old. we see right thru you barry, you need better material your same old lines aren’t working anymore.

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  27. Did the doctors ever notice how many ppl die annually from medical malpractice? Sheesh, these shlubs should stick to what they know!

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  28. What have you DONE?! Shield your eyes man! Those cosmetic features will cause that a salt rifle to viciously attack people with reckless abandon!

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  29. The teachers at Sandy probably had pens./// At the first sign of trouble that asshat will go crying to the police for protection, Randy

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  30. Props, another vendor on my permanently approved list. Well done. Gun rights advocates must stand together, its us against the democrats. Ideology be damned. A vote for a democrat is a vote for tyranny, Colorado just the latest example.

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  31. Steven King naturally joins Hollywood, the writers, actors, and producers, all working together to maximize their revenue playing upon the ordinary bored person’s desire to be excited. By a book. A movie. Sex and violence are their stock in trade. They habitually, for lucre, turns guns into a fetish, because only a supernatural gun or insane gun user holds an audience’s attention. King and others want to continue their “good story telling,” their measured introduction of sex, madness, and guns or other means of brutality…without feeling responsible for the mentally ill who inflict real life mayhem. Nope. It’s not a firearm in a safe or a holster that’s kinky. It’s the stories they tell. So write love stories or political thrillers. Just give up grotesque stories of gratuitous mad violence. It isn’t your stories or guns that cause violence. It is madness and gangs. You have little to do with it.

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  32. Just because someone owns/makes/sells/fixes/shoots/collects/photographs/writes about/sings songs of/hunts/reloads guns, doesn’t make him automatically my friend. You prove your friendship by your actions. I’ve said it before. These gun companies and their management need to be watched very carefully. Sadly this particular guy sounds like his priorities are not mine.

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  33. Why, for the love of Flying Spaghetti Monster, are you giving these attention whores publicity?…

    They’ll do and say anything to be in the spotlight.
    Their booger hooks only confirm what their vapid stares and stupid blather betray…

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  34. The clause of ” Prohibit handgun ammunition capable of penetrating body armor” would ban most handgun rounds in existence are at least CAPABLE of puncturing armor (especially type I).

    Also, ammunition designed to penetrate body armor is already banned, so this must be a round about way of banning handguns.

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