"We did everything we could." The refrain echoes in our minds weeks, months, even years after we perform the horrifying task of telling a mother that her child has died.
As physicians in pediatric emergency medicine and critical care medicine, we have trained for years to master the intricate dance of a trauma resuscitation, so that when faced with the potential loss of a young life, we are prepared to intervene. We also humbly accept that there will be times when even our best efforts fail and we must deliver news that will change a family's life forever. At such times, we sit next to parents and tell them that we did everything possible to save their child's life.
But what can we say to a mother whose child has been killed by a bullet?
In the wake of the tragedies we see, physician-scientists work passionately to do everything in our power to ensure that each and every child in our community has the chance to live a full and productive life. We investigate car-restraint devices, bicycle helmets, and smoke detectors. We teach about button batteries and prescription drug misuse. We study the most effective means to protect children from vaccine-preventable diseases and seasonal illness outbreaks. We know that our research-based interventions save lives, and we rejoice in data demonstrating decreases in pediatric mortality.
We cannot, however, say the same about efforts to stem the tide of young lives ended by guns.
Between 2015 and 2017, more than 400 of Philadelphia's children were shot. They came from all walks of life, and were often shot by accident — with guns that were just as likely to be owned legally as not. We were unable to save them all, and many who survived now face lifelong disability. While many of these shootings go unrecorded in the news media, their numbers tell the story of an epidemic.
When faced with epidemics, scientists launch research efforts to combat the threat. Not so for the gun-violence epidemic, for which research efforts have been stymied by a lack of both funding and political will. Imagine if the Centers for Disease Control and Prevention were unable to study the causes of influenza. Currently, we are unable to measure basic gun-injury risk factors, such the rate of gun ownership in the United States. Until we are able to answer these simple questions, we cannot look a mother in the eye and tell her that we did everything possible to prevent her child's gun-related death.
We were heartened that the latest omnibus spending bill clarifies that the CDC will be allowed to conduct research into gun-related injury. However, the 1996 Dickey Amendment — inspiring Congress to slash federal funds for gun-related injury — remains. At this time, no additional funding has been allocated to the CDC for gun-injury research. We therefore urge our colleagues in medicine both to take up the mantle of gun-injury research, and to continue to ask local and federal legislative bodies to expand funding directed toward the study of gun-injury prevention.
We know that rigorous scientific studies often take years to complete; therefore, it is also critical that we develop common-sense policies that can save lives immediately. These include:
Clear directives allowing physicians to discuss firearms safety as routine injury-prevention guidance.
Laws requiring that firearms in homes with children be stored and secured properly, using locks and other storage devices that are proven to work.
Improvement in both the availability and quality of mental health services for children and young adults.
Universal background checks for all firearm transactions, including private and gun-show sales.
Bans on military-style, semi-automatic magazine-fed rifles and carbines, as well as devices that allow semi-automatic weapons to be fully-automatized.
Increased enforcement of existing laws, including those designed to eliminate "straw purchasing."
While each of us, like most other Americans, holds personal beliefs on the interpretation of the Second Amendment, we believe that we must get past the politics of gun control. We do not advocate confiscation of legally acquired firearms. Rather, we are moved as advocates for the welfare of children to put personal politics aside and to address the problem of gun-related injury as the national epidemic that it is.
Perhaps one day we will have fulfilled our promise to that crying mother, and be able to say that we have done everything possible to prevent these tragedies from ever happening again.
Anna K. Weiss, Justin L. Lockman, and Joel A. Fein are doctors at Children's Hospital of Philadelphia.