Senin, 26 Maret 2018

Clinicians Join Throngs in March for Our Lives

Clinicians Join Throngs in March for Our Lives


WASHINGTON — Physicians, residents, medical students, nurses, and other healthcare providers joined the hundreds of thousands of people participating at the March for Our Lives here on Saturday and at the more than 800 “sibling” marches across the United States, calling for stricter gun laws and more research into gun violence.

The March for Our Lives, held on March 24, was organized by students from Florida’s Parkland High School, where 17 students were killed in a mass shooting on February 14.

Marchers were young and old and of all races and ethnicities. Among the crowd in Washington, many were spotted wearing white lab coats.

Now that the march is over, the students are converting their movement into the Fight for Our Lives. They are seeking to register adolescents to vote and to garner support to ban assault weapons, prohibit the sale of high-capacity magazines for weapons, and to tighten background checks for those purchasing guns.

At the march in Washington, thousands packed a nine-block stretch of Pennsylvania Avenue to listen to 3 hours of performances and speeches by student leaders from Parkland and other schools around the nation, each talking about how gun violence had personally affected them. Samantha Fuentes, who was shot in the leg at Marjory Stoneman Douglas High School in Parkland, jauntily addressed the crowd, then momentarily stopped to vomit, overcome by nerves. She laughed it off and continued.

Nine-year-old Yolanda Renee King, a granddaughter of Martin Luther King Jr, rallied the crowd with an “I have a dream” speech for a new generation.

At the conclusion, Marjory Stoneman Douglas High School student Emma Gonzalez brought those who were raucously chanting “vote them out” and other chants to a complete silence by standing on the stage without speaking for several minutes — approximating the time it took for the gunman to complete the shooting and exit the school undetected.

President Donald J. Trump, having gone to his estate in Florida, was not in the White House during the march. A White House press secretary stated, “We applaud the many courageous young Americans exercising their First Amendment rights today,” and noted that the Department of Justice had just issued a rule to ban bump stocks.



 

Physicians join the protest. From left to right, pediatrician Barbara Boardroom, MD; resident Margarita Ramos, MD; unidentified; resident Manju Korattiyil, MD, resident Lexie Crawford, MD. Courtesy of Alicia Ault

 

“As pediatricians, we are public health advocates, so it is so important for us to stand for the lives of the children that we try to protect every day,” Lexie Crawford, MD, a second-year resident at Children’s Hospital National Medical Center in Washington, DC, told Medscape Medical News.

Crawford said that she had been actively involved in “counseling our families on how to deal with the anxiety and the trauma that our kids are facing in school.”

Margarita Ramos, MD, another second-year resident at Children’s Hospital, said many teenage patients were “telling me they are very anxious and scared to go to school. They’re looking for resources, people to talk to, and mental health counselors because they don’t know how to deal with what they’re seeing.”

It is time to allow more epidemiologic research into gun violence, said Barbara Boardman, MD, a pediatrician at Virginia Hospital Center, in Arlington. She said efforts to prevent such research — and to block pediatricians from asking about guns in the home — were “outrageous.”

Boardman said, “It has to stop,” adding that the actions the children at the March were seeking needed to be taken.

Another second-year resident at Children’s, Manju Korattiyil, MD, said the march gave her cause for optimism. “I’m hoping with all this that there’s more changes to come,” said Korattiyil.

“I have renewed hope and faith in our younger generation,” agreed Ankoor Shah, MD, president-elect of the Washington, DC, chapter of the American Academy of Pediatrics. “They are determined, they’re right, and just by hearing them, I felt inspired,” he said. He added that he felt that because it was youth — not adults — leading the charge, change was more likely.

Shah attended the march with 20 to 30 other pediatricians from the Washington, DC, area, but he said that hundreds more were there — it was impossible for them to stay together because of the overwhelming size of the crowd.

He said it was important for physicians to care about gun violence. “Your job is to heal people, to improve health and wellness,” he told Medscape Medical News. “When you see a public health epidemic like gun violence, if you’re not standing up, then you’re allowing it to happen,” he said.

Medical Societies Voice Concern

Many other physician-led organizations actively participated or issued statements of support for the march and its mission.

The group Doctors for America sent out a statement that was cosigned by multiple other medical societies stating that gun violence is a public health threat and that “pediatricians and other health professionals are on the front lines.”

“Doctors are expressing their disappointment that, despite the recent and tragic loss of children’s lives in Parkland, Congress has not restored the federal government’s ability to research gun violence and find evidence-based solutions to this uniquely American epidemic,” the group said.

The American Public Health Association (APHA) has been seeking to focus the nation’s attention on gun violence as an epidemic. In early March, the organization granted public access to research in its journals on gun violence, and it has pushed for a reopening of federal funding for such research.

The massive 2018 government spending bill signed recently by Trump opened the door somewhat, allowing the US Centers for Disease Control and Prevention (CDC) to conduct research on gun violence, but it did not provide funding, nor did it remove the so-called Dickey amendment, which prohibits the use of federal funds to advocate for gun control.

“I took it as a step forward,” said APHA Executive Director Georges C. Benjamin, MD. “From our perspective, we’re going to take it on face value and declare victory,” he told Medscape Medical News.

Benjamin also participated in the March, as did public health contingents all over the country, he said. Clinical colleagues have an obligation to participate in reducing gun violence, said Benjamin. “They took an oath as a physician to heal people and improve their health,” he said, adding that they “have an ethical and moral obligation to do anything to help their patients.

“I think they can do that even if they support firearms,” said Benjamin.

He views guns as dangerous tools that need to be safely used — just like automobiles or chainsaws. Seventy percent of people do not properly secure their weapons, said Benjamin, calling that “a big deal.”

Benjamin said he believes the kids leading the march may be successful. “This is a generation that’s going to take over,” he said. “They are unhappy. They are well informed. They’re very progressive in their views around violence, and they believe the can do something about it.”

The American Psychiatric Association (APA) issued a statement of support before the march. “We agree with the students that separating gun violence from mental illness reduces stigma and encourages people with mental health and/or substance use disorders to seek treatment,” said the APA, adding that it encouraged “all young people to be politically active in seeking improved access to mental health care and eliminating the unnecessary and harmful stigma surrounding these illnesses.”

The American Academy of Family Physicians (AAFP) did not organize its members for the march or issue any march-related statement, but it has called on the federal government to declare gun violence a national public health epidemic.

The AAFP also supports the marchers’ mission of enacting stricter background checks for gun purchasers and restricting large-capacity magazines and “firearms with features designed to increase their rapid and extended killing capacity.”

The AAFP has also sought funding for gun violence research at the CDC.

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