Rand Paul has placed a hold on Dr. Vivek Murthy, Obama’s nominee for Surgeon General, because of calling guns a significant public health threat. Paul stated, “As a physician, I am deeply concerned that he has advocated that doctors use their position of trust to ask patients, including minors, details about gun ownership in the home.”
As I have discussed before, this position is based upon recommendations of medical organizations which are justifiably concerned about the health risks of gun violence in this country. Following the Newton shootings fifty-two medical organizations including the American Medical Association, American Psychiatric Association, American College of Physicians, American College of Surgeons, American Academy of Family Physicians and American Academy of Pediatrics sent a letter to President Obama requesting such intervention.
The text of the letter (pdf here) follows (emphasis mine):
The undersigned medical organizations, together representing the vast majority of practicing physicians and medical students in the United States, share the nation’s grief and sadness over the recent tragic school shootings in Connecticut. As physicians, we see first-hand the devastating consequences of gun violence to victims and their families. We offer our experience and expertise in finding workable, common sense solutions to reduce the epidemic of gun violence—indeed the overall culture of violence—in America. We also urge the nation to strengthen its commitment and resources to comprehensive access to mental health services, including screening, prevention, and treatment.
The investigation into the Connecticut shootings is still continuing, and the issues surrounding such violence are often complex and can vary significantly from case to case. Strategies for preventing gun-related tragedies must also be complex and carefully considered. The relatively easy access to the increased firepower of assault weapons, semi-automatic firearms, high-capacity magazines, and high-velocity ammunition heightens the risk of multiple gunshot wounds and severe penetrating trauma, resulting in more critical injuries and deaths. Even for those who manage to survive gun violence involving these weapons, the severity and lasting impact of their wounds, disabilities and treatment leads to devastating consequences for families affected and society, and contributes to high medical costs for treatment and recovery. Renewing and strengthening the assault weapons ban, including banning high-capacity magazines, would be a step in the right direction.
Many of the deaths and injuries resulting from firearms are preventable. More resources are needed for safety education programs that promote more responsible use and storage of firearms. Physicians need to be able to have frank discussions with their patients and parents of patients about firearm safety issues and risks to help them safeguard their families from accidents. While the overwhelming majority of patients with mental illness are not violent, physicians and other health professionals must be trained to respond to those who have a mental illness that might make them more prone to commit violence. Funding needs to be available for increased research on violence prevention in general, and on the epidemiology of gun-related injuries and deaths in particular, as well as to implement available evidence-based interventions. Of equal importance is providing sufficient access to mental health services. While we strongly supported the passage of the Mental Health Parity Act of 2008, unfortunately, the promise of better access top psychiatric treatment will not be a reality absent requisite federal and state funding. This effort should be combined with an education campaign that reduces the stigma of seeking mental health services.
Newtown, Connecticut has now been added to the sad litany of recent mass shootings, including Columbine, Virginia Tech, Fort Hood, Arizona, and Aurora. As we come together as a nation to mourn the most recent victims of senseless gun violence, we must make a real and lasting commitment to work together on meaningful solutions to prevent future tragedies. We stand ready to work with Congress and the Administration to make progress in protecting our communities, especially our children, from this epidemic of violence.
We would expect that a nominee for Surgeon General would support the recommendations of these medical organizations. Discussing the presence of guns in the home does not mean these medical organizations are advocating banning guns. Medical organizations recommend that physicians ask about a wide variety of potential risks. When we ask patients about use of seat belts we are not seeking to ban automobiles. When we ask elderly patients about electrical cords which could present a risk for falls we are not seeking to ban electric lights. When we discuss keeping medications safe and out of the hands of children we are not seeking to ban medications.
Think Progress has more on how Rand Paul’s view is out of step with that of the medical profession:
The idea that gun violence is a danger to public health is utterly uncontroversial among doctors’ groups, academic institutions that focus on public health, and children’s safety advocates. Although Paul criticizes Murthy’s position that physicians and pediatricians should ask patients about the presence of guns in their households, the American Medical Association (AMA) adopted a resolution in 2011 officially opposing any law that bars doctors from having open conversations about gun safety and the risks of having firearms in a household with their patients.
In fact, just yesterday, the American Academy of Pediatrics (AAP) issued new guidelines recommending that households with children who are diagnosed with depression should remove guns and ammunition from their homes entirely.
Not only would Obama’s nominee for Surgeon General be making recommendations in the mainstream of medicine today, Murthy’s views are consistent with those of Reagan-appointee for Surgeon General C. Everett Koop who has written about the dangers of gun violence.
Cross posted at The Moderate Voice