Firearms, children, and health care professionals.

Firearms claim the lives of .30 000 Americans annually; frequently among these are children. This problem is not new; it has existed for decades. One of the most publicly visible physicians of our time, C. Everett Koop, a pediatric surgeon and former Surgeon General of the United States, recognized that violence was a public health problem, and in 1985 convened a workshop to address this problem. In a follow-up editorial regarding violence, he admonished, “We can wait no longer to act” to address firearm violence. Nearly 3 decades later, little has changed. In that time, there have been .900 000 firearms deaths, including 100 000 children in the United States. Koop recognized that, “In science, you can’t hide from data.” Regarding pediatric firearms mortality, the data are indisputable. The recent mass shooting event at Sandy Hook Elementary School, which claimed the lives of 20 children, was compelling. The American Pediatric Surgical Association (APSA) is a professional organization composed of.1200 surgeons dedicated to the care of ill and injured children. We belong to the broader health care community whose job it frequently is to care for children injured by firearms. We have a perspective on the problem that is unique and persuasive. We have a perspective that differs from that of policy makers who are in a position to enact change in the capitals of our states and the nation. We see the lives of the victims and families altered forever by gun violence. We as a health care community should share our perspective and provide a voice to the violence that we witness. In response to the tragedy at Sandy Hook, APSA updated its position statement on firearm injuries and children. The association also took the unprecedented step of obtaining, through a vote of affirmation by the membership, an endorsement of these position statements regarding firearm injuries and children. This process included a period of public (association-wide) review followed by an open discussion at the business session of the annual meeting. The measures passed with overwhelming support of the membership (Table 1). Adding the affirmation of an entire association strengthens the message, and we encourage other professional organizations to consider a similar process. In addition to commonsense measures that have broad popular support (eg, universal background checks, improved mental health services), the policy statement highlighted several issues particularly relevant to health care providers caring for victims of firearms violence: the freedom to pursue research, the wounding capacity of civilian weaponry, and the sanctity of the physician-patient relationship. AUTHORS: Michael L. Nance, MD,a Keith T. Oldham, MD,b and Thomas M. Krummel, MDc University of Pennsylvania School of Medicine, and The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; Pediatric Surgery, Medical College of Wisconsin, and Children’s Hospital of Wisconsin, Milwaukee, Wisconsin; and Stanford University School of Medicine, and Lucile Packard Children’s Hospital, Stanford, California