Personal Health: Keeping Firearms Away From Children

I doubt that our forebears who ratified the Second Amendment in 1791 ever imagined how carelessly and callously firearms would be used centuries later. Witness the senseless slaughter of 20 innocent children and 6 adults last month in Newtown, Conn. As a mother of two and grandmother of four, I can’t imagine a more painful loss.

If you are as concerned as I am about the safety of your children and grandchildren, consider that it may be time for a grass-roots movement, comparable to Mothers Against Drunk Driving, to help break the stranglehold the National Rifle Association seems to have on our elected officials. Do you really want, as the association proposed, an armed guard in every school?

The Connecticut massacre occurred just two months after the American Academy of Pediatrics issued a new policy statement on firearm-related injuries to children. Murder and accidental shootings were not the academy’s only concerns. “Suicides among the young are typically impulsive,” the statement noted, “and easy access to lethal weapons largely determines outcome.”

In an article published online last month in The New England Journal of Medicine, Dr. Judith S. Palfrey, a pediatrician at Boston Children’s Hospital, and her husband, Dr. Sean Palfrey, also a pediatrician in Boston, highlighted the shocking statistics.



Every day in the United States, 18 children and young adults between the ages of 1 and 24 die from gun-related injuries. That makes guns the second leading cause of death in young people — twice the number of deaths from cancer, five times the deaths from heart disease and 15 times the deaths from infections.

Dr. Judith S. Palfrey has seen this heartbreak up close. “My niece, who was sad about something, might be alive today if she hadn’t had such easy access to a handgun at age 18,” she told me.

The United States has the dubious distinction of leading high-income countries in firearm homicides, suicides and unintentional deaths among young people. Among American children ages 5 to 14, an international study showed that firearm suicide rates were six times higher, and death rates from unintentional firearm injuries 10 times higher, than in other high-income countries.

Innocent Victims

The Palfreys said they were haunted by the death of one of their patients, a 12-year-old boy who went on an errand for his mother and was caught in the cross-fire of a gun battle. The boy had shortly before written a letter to his mother expressing his desire to become a doctor.

And Dr. Sean Palfrey recalls “with horror” picking up a loaded .22-caliber rifle, at age 11 or 12, and threatening his baby sitter with it. “This scared the hell out of me and remains seared in my memory. I could have killed this person.”

In explaining why he had a gun, he said, “I’m a great-grandson of Theodore Roosevelt, who was a hunter as well as a naturalist, and when I grew up guns were an acceptable part of youth. I took target practice and was an N.R.A. member myself as a child. We had guns for hunting, not automatic weapons that can shoot hundreds of rounds within seconds.”

Now, he said, “I do all my shooting with a camera. This is not the same world it was when the Second Amendment was written. Guns have to be removed so that they can’t be accessed by those who are immature, impulsive or mentally ill.”

In their article, the Palfreys pointed out that “little children explore their worlds without understanding danger, and in one unsupervised moment, an encounter with a gun can end in fatality.” School-age children who see guns used on television, in movies or video games “don’t necessarily understand that people who are really shot may really die,” they said.

Among teenagers, who may fight over girlfriends or sneakers, or have their judgment impaired by drugs or alcohol, “a fistfight may cause transient injuries, but a gunfight can kill rivals, friends, or innocent bystanders,” the pediatricians wrote. Among depressed adolescents, they said, “less than 5 percent of suicide attempts involving drugs are lethal, but 90 percent of those involving guns are.”

Preventing Access

In a 2006 study of gun-owning Americans with children under age 18, 21.7 percent stored a gun loaded, 31.5 percent stored one unlocked, and 8.3 percent stored at least one gun unlocked and loaded. And in households with adolescents ages 13 to 17, firearms were left unlocked 41.7 percent of the time.

These are accidents, or worse, waiting to happen, and the pediatrics academy reiterated its earlier recommendations that pediatricians talk to parents about guns in the home and their safe storage, and follow up by distributing cable locks.

To limit unauthorized access to guns, the academy recommended the use of trigger locks, lockboxes, personalized safety mechanisms, and trigger pressures that are too high for young children.

Still, the academy emphasized, “the safest home for a child or adolescent is one without firearms.”

The Palfreys said that when one of their colleagues asked a mother about guns in her home, she responded, “Why, yes, I have a loaded gun in the drawer of my bedside table.” It was only then the woman realized that this could be a danger to her child, Dr. Judith Palfrey said.

The academy also called for restoring the federal ban, in effect from 1994 to 2004, on the sale of assault weapons to the general public. None of the many attempts to renew it have succeeded in Congress.

The Supreme Court ruled in 2010, in the case of McDonald v. the City of Chicago, that the due process clause of the Fourteenth Amendment applied to provisions of the Second Amendment, and prevented states and localities from restricting citizens’ right to bear arms. The academy stated that the ruling “set the stage for Second Amendment legal challenges to local and state gun laws, including laws requiring the safe storage of firearms and trigger locks, as well as laws aimed at protecting children from firearms.”

In 2011, Florida passed legislation that raised First Amendment questions by forbidding doctors to ask families about guns in the home. Although a permanent injunction against the law was issued, Gov. Rick Scott has appealed the ruling. At the federal level, wording introduced into the Affordable Care Act restricts collection of data on guns in the home.


This post has been revised to reflect the following correction:

Correction: January 11, 2013

The Personal Health column on Tuesday, about firearms and children, using information from The New England Journal of Medicine, misstated the number of children and young adults between the ages of 1 and 24 who die each day in the United States from gun-related injuries. Eighteen people between the ages of 1 and 24 die every day — not seven people between those ages. (Seven deaths a day is the number for children and young adults between the ages of 1 and 19.) And the article misstated part of a Supreme Court ruling. In the case of McDonald v. the City of Chicago in 2010, the court ruled that the due process clause of the Fourteenth Amendment — not the equal protection clause — applied to provisions of the Second Amendment, which guarantees the right to keep and bear arms.

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