Unintended Consequences of Zero Tolerance for Guns in the Home

 

The recent tragic story of a 4 year old boy who accidentally shot and killed his father with a gun "found in the living room" teaches many valuable lessons. As a pediatrician, I am willing to support responsible gun ownership if it includes legislative proposals that require background checks for all gun-buyers, safety and proficiency testing for gun owners, safety devices on weapons kept at home, a ban on the sale of assault weapons to the public, and an increase in penalties for carrying or selling illegal guns. Many pediatricians endorse policies that would help to keep children out of harm's way, but our zero-tolerance for accidental and purposeful behaviors that might harm children can sometimes make us less critical of pertinent data. Emotional responses to stories like this one are understandable but they also make it harder to set priorities when deciding where we should direct  limited time and money in order to accomplish our goal.

Our most common error is not matching numerators with denominators. If one-third of households with young children have guns in the home and a tragic story like this one is reported in the national rather than the local news, a thoughtful reader should wonder whether the incidence of serious accidental gun-related home injuries by young children or to them might actually be VERY low. We are quick to criticize pro-gun enthusiasts when they publicize the rare case of a gun owner who successfully protects his family without also shooting himself or an innocent bystander. And we criticize the media when they ignore numerators and denominators as a way to sensationalize the evening news ("Health officials warn that during this past week there were 20 cases of disease X reported in the greater New York area" - without also mentioning that they occurred in a population of 22 million people.)

Zero tolerance for anything - but especially child injury - is a laudable but emotional goal that is not usually pragmatic and is rarely achievable. (Using the same resources, preventing 80 percent of serious injuries from three sources might save more lives than trying unsuccessfully to prevent 100 percent of the injuries from one high-profile cause.)  Personal and professional emotional responses should not be confused one with the other. We must take care to exercise the same numerator/denominator awareness that we accuse opposing special interest groups of ignoring if we are to maintain credibility and find practical solutions for these difficult problems.