The Potentially Lifesaving Difference in How a Gun Is Stored

Put aside your personal beliefs regarding gun ownership and the Second Amendment for a moment:

In the last decade, guns killed more than 14,000 American children. A startling number of those deaths — more than a third — were classified as suicides and around 6 percent as accidents. Many more children were injured.

I live in Texas. I automatically assume everyone I meet owns a firearm. They are so prevalent here that I regularly ask my patients if their guns are locked and unloaded or safely locked away from children, just as a reminder that little hands are curious and teens are at higher risk of accidental and intentional deaths and suicide when there are guns available in the home.

Dr. Michael Monuteaux, an assistant professor of pediatrics at Harvard Medical School and an author of the study, said, “We need to communicate to parents that storing guns in a way that makes them inaccessible to children can reduce the number of children who die year after year, especially from suicide.”

In 2010, researchers examined who owned the firearms used in youth suicides. In cases where this could be determined, three-quarters of the time, the owner was a parent, and for a further 7 percent, it was some other relative.

With suicide accounting for two-thirds of firearm deaths in the US, this is one instance where small changes can make a significant impact on morbidity and mortality without infringing on an individual’s right to legal gun ownership.

Policy can make a difference, too. In 2004, a study examined how laws that focused on the sale of guns affected the suicide rates of children, compared with laws mandating safe storage of firearms. They found that between 1976 and 2001, minimum-age purchase laws and possession-age laws had no effect on adolescent suicide rates. Laws preventing children’s access to guns, on the other hand, were associated with significant reductions of suicides by guns, even when reductions were not seen in suicides by other methods.

The availability of biometric gun safes has alleviated any concerns about quick access to a firearm in the case of an emergency.  Therefore, making firearms inaccessible, or even less accessible, to children and teens could save thousands of lives and reduce the likelihood of a terrible, avoidable accident or an impulsive moment from becoming a reoccurring nightmare for thousands of parents, family members, and friends. This appears to be one of the most effective and inexpensive strategies to reduce the number of times physicians feel compelled to scream “THIS IS OUR LANE!”

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Cynthia R Stuart DO

Dr. Stuart is Board Certified in Family Medicine. Originally from Georgia, she spent most of her youth in Miami, Florida and has been a Texas resident since the early 1990s. She attended UNTHSC-Fort Worth and completed her residency at UTSW/Methodist Hospital System where she was Chief Resident in her senior year. She is an Associate Professor at UTSW and UNTHSC, participating as a preceptor for medical students and residents. She completed a two-year course at SMU Cox School of Business in Advanced Leadership that enables her to advocate for quality health care providers and local public health programs in her community. She is the head of the Credentials Committee, sits on the Medical Executive Committee and the Ethics Committee at Baylor Scott and White Hospital of Carrollton. She has appeared on numerous news and radio programs to educate the public about various health topics. Dr. Stuart has managed her private practice in Carrollton since 2005 and is now a Direct Primary Care Physician. 

  13 comments for “The Potentially Lifesaving Difference in How a Gun Is Stored

  1. Steve O'
    May 24, 2019 at 8:46 am

    I worry that we physicians, in this discussion, are struggling because are innately obeying rules and assumptions that we have not carefully considered, but rather have had impressed upon our awareness as physicians that our response seems unreasoned and automatic.

    What should, or should not, be mandated in policy? That question alone lies on a bed of assumptions and superstitions endemic to 21st Century America.

    To show the riddle in the form of one of my favorite resident-pimping questions:
    “What is the normal daily potassium output of the adult human kidney?”
    The correct answer is:
    The normal daily potassium output by the adult human kidney is that amount of potassium ingested, increased or decreased by the amount of potassium which is needed to augment or diminish the body’s stores under normal physiological conditions.
    The point is that the healthy kidney in the healthy patient handles potassium so as to keep the total amount correct for that particular patient.
    The sicker a kidney is, the more likely it is to hold to a constant amount, independent of the body’s needs. For patients on dialysis, the number is likely to remain exactly constant and invariant, day-to-day. That is one of the reasons why they are on dialysis.
    To redirect the question, what is the proper thing for Dr. Cynthia R. Stuart to say to her Texas patients about firearms? I suggest that the question is as absurd as asking what Dr. Cynthia R. Stuart’s renal output of potassium was yesterday. I do not know; and I am afraid I do not care in the least.
    If she is speaking to a patient for whom she has been providing care, it is none of my business. I assume by deference she says what that patient needs to hear, but not in the ass-kissing sense in which the phrase is often used. If she is a “gun-nut” or “gun-grabber,” it is none of my business, but belongs in the privacy of the dialogue between patient and doctor; a privacy that has been nearly destroyed under the rubric of “confidentiality.”
    The patient may listen, ignore, or quit her DPC practice. Again, I could care the least. I have no measure to determine whether she is doing good, or bad, primary care in this instance.
    What is dangerous is the assumption that there needs to be Standard Policy, that one guideline fits all, that Janie Doe needs to cheer herself up by going back to the gun store, or Jimmie Doe needs to get rid of all his evil firearms, pronto. Who the hell am I to offer such an opinion?
    The root of the disease is deeper than Dr. Stuart’s possible influence on her individual patients.
    As we were warned over a century ago, we pretend to be individuals with free choice, but have coalesced into mobs of subhuman gangs. Even though we vote on propositions and policies, and imagine that we have each an independent voice, “(t)his rare and brief exercise of their free choice, however important it may be, will not prevent them from gradually losing the faculties of thinking, feeling and acting for themselves, and thus gradually falling below the level of humanity. de Tocqueville, below, cited in Butler Shaffer’s article on the collapse of western civilization.

    We have been suckered into the myth of “one-size-fits-all” algorithmic and policy-driven medical practice, which has caused it to decline. The faster it declines, the more we enforce rules and dicta on what needs to be done in all cases, no matter what the patient needs. People are seduced by these rules into thinking that they are “providers,” no matter what letters they put after their names, because they can enforce certain rules and maxims on all humans, regardless of their individual needs and illnesses. Anyone with an app can be the new “provider.” That, not the scope of practice argument, is killing American medicine.

    To end with a quote I’ve posted on another essay here in Authentic Medicine, here is the problem in a nutshell, written about 170 years ago by a French writer visiting the United States. He speculates on how this promising government might decay. He warns that it may come about in America that…
    Above (each citizen) stands an immense and tutelary power, which takes upon itself alone to secure their gratifications, and to watch over their fate. That power is absolute, minute, regular, provident, and mild. It would be like the authority of a parent, if, like that authority, its object was to prepare men for manhood; but it seeks on the contrary to keep them in perpetual childhood: it is well content that the people should rejoice, provided they think of nothing but rejoicing. It covers the surface of society with a network of small complicated rules, minute and uniform, through which the most original minds and the most energetic characters cannot penetrate, to rise above the crowd. The will of man is not shattered, but softened, bent, and guided: men are seldom forced by it to act, but they are constantly restrained from acting: such a power does not destroy, but it prevents existence; it does not tyrannize, but it compresses, enervates, extinguishes, and stupefies a people, till each nation is reduced to be nothing better than a flock of timid and industrious animals, of which the government is the shepherd. [de Tocqueville, Democracy in America, Bk. 4 Ch.6]

    The book is not all that hard to read, but makes for slow reading; because one must stop and think to appreciate its profoundness. Too hard for summer beach reading, sorry. Even this reply is too long for the modern attention span: TLDR.

  2. JRDO
    May 23, 2019 at 2:28 pm

    Mandating safe gun storage sounds sensible, but is it possible to enforce it?
    Drunk driving is illegal yet it is still done frequently.

    • Cynthia Stuart
      May 23, 2019 at 2:52 pm

      I agree with you that mandating would be difficult to enforce, then you have to consider the consequences of non-compliance. Do you charge a grieving parent for an accidental gun death or injury involving a toddler or child or when a teen commits suicide? That’s a hard pill to swallow. Education and awareness with reminders and quick access solutions (i.e., fingerprint safes and trigger guards) for those who are using them for home protection are what I think is most effective with the least disruption to individual rights. Those who use guns for hunting or sport can easily lock them with a trigger guard or safe.

      Is a PSA campaign too much to ask?

      • May 30, 2019 at 10:40 pm

        Advise, yes; mandate, no!

        Situations are different. Responsible parents of an inquisitive small child or two will want to protect their kids. Their methodology should depend on their circumstances, not on mandates.

        Regarding teens and suicide, I would hope that parents who have firearms would take the time and effort to offer appropriate training so that their teens would be useful in an emergency, rather than “protected”. On the other hand, I recognize that some parents, particularly if they have teens who are subject to depression, paranoia or schitzophrenia (i.e. smoke pot), may need “protection”. Once again, the actions should be dictated by the circumstances, not by mandates.

        YMMV

  3. Douglas Farrago MD
    May 23, 2019 at 1:08 pm

    I will ask everyone to keep this argument civil. We are on the same team. I let almost everything go and take no sides in this matter but I won’t allow pissing matches. Be respectful, kind and cordial. Save the vitriol for the idiots who are not doctors trying to bring us down.

  4. Cynthia Stuart
    May 23, 2019 at 11:38 am

    Mr. Guastavin, to clear up any confusion, I have never been a member of the NRA and neither have millions of American gun owners. I subscribe to evidence-based data and a common sense approach to problems. If the NRA recommends safe storage as a principle of responsible gun ownership, I support that. There are other things I take issue with, such as the supposition doctors don’t belong in the debate surrounding gun safety. This IS our lane.

    • Pat
      May 23, 2019 at 1:30 pm

      Dr. Stuart, to the degree that many doctors have enjoyed “Our Lane” publicity, I respectfully disagree, and have no interest in white coat-parading with them. I do not take that to be your tone in a good column, yet I will always fear physicians being used as tools in greater societal conflicts. I cannot put aside my personal beliefs, but I did appreciate your even-handed tone.

      • Cynthia Stuart
        May 23, 2019 at 3:07 pm

        I’m not asking to be a pawn in Washington’s game or to help make legislation. I’m trying to make a difference in my patient population through open discussion and reminders about safety. I have never met a gun owner who disagreed with the principles of responsible gun ownership. However, I have heard the rhetoric around people saying doctors shouldn’t even ask their patients if they own a gun and the recommendation they should answer in the negative if they are asked. I don’t agree with that position. I feel that a simple reminder about gun safety, especially as the children under my care get older or as new babies arrive, this is a small part I can play in keeping some children safe. That is my job and it is in my lane. Will you see me marching in Washington? No. As you can see from the emotional responses of a carefully measured commentary on keeping children safe, there are too many arguments on all sides. Can’t we just agree to make an effort to protect the children under our care?

        • Sir Lance-a-lot
          May 23, 2019 at 4:25 pm

          I give my patients advice regarding guns when it is relevant and appropriate. I also give advice (or at least the benefit of my own experiences) regarding construction, use of hand tools, operating heavy machinery, tree felling, cooking, and auto mechanics when it makes sense to do so, and I won’t come off as a jerk for doing it. Patients seem to appreciate their doctor understanding what’s going on in their lives and wanting to help.

          What I object to is being told by some governmental agency, board, or employer that I must ask questions (and document answers) about guns, or seatbelts, or drug use, or anything else not relevant to the visit or to my care of the patient.

          So, yeah, sure, I make common-sense suggestions when appropriate, but I do not bring up gun storage when treating a sprained ankle or a head cold (I also think it’s silly that the medical assistant asks everyone if they feel “safe,” whatever that means).

          • Cynthia Stuart
            May 23, 2019 at 5:46 pm

            Who doesn’t? Who doesn’t? And who wouldn’t? So we all agree. Great! 🤜🤛

          • Sir Lance-a-lot
            May 23, 2019 at 6:38 pm

            I agree that we agree.

  5. Thomas David Guastavino
    May 23, 2019 at 7:15 am

    I wonder of the author is a member of the NRA because she just articulated their exact position when it comes to gun safety and storage. No need for physicians to “get in the lane”.

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    • Sir Lance-a-lot
      May 23, 2019 at 8:37 am

      Yes, Thomas, as a LIfe Member of the NRA (for political reasons, not because I think Wayne LaPierre and Ollie North are great guys), I find it amusing when people “discover” “common-sense” solutions that have been NRA policies for decades.

      Like any other potentially dangerous tool, guns need to be kept safely away from those who might misuse them.

      Thank you for noting this.

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