Pediatric Annals

Editorial Free

Pitting the Second Amendment against the First

Stanford T. Shulman, MD

Do you as a primary care provider value your First Amendment right to free speech? You may be unaware that legislation passed by the Florida legislature in 2011 (The Firearm Owners’ Privacy Act) specifically bars physicians (mostly pediatricians) from discussing with parents firearms safety issues such as keeping guns that are in the home locked away, unloaded, and apart from stored ammunition.1 Six other states — Alabama, Minnesota, North Carolina, Oklahoma, Tennessee, and West Virginia — also have tried to pass the National Rifle Association-backed Firearms Owners’ Privacy Act.

This bill was signed by Florida Governor Rick Scott, but fortunately has not yet gone into effect because of a lawsuit filed against Scott and other Florida officials by three physicians and the Florida chapters of the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians, 4 days after Scott signed the law.2 Implementation of the law was blocked by US District Judge Marcia Cooke of Miami, who issued a permanent injunction shortly after it was passed, and she then in July 2012 ruled that the law violates doctors’ freedom of speech. Undeterred, the state of Florida has appealed this ruling to the 11th Circuit Court of Appeals in Atlanta, seeking to overturn Judge Cooke’s ruling.

NRA’S Impact on Pediatrics

Invoking the Second Amendment right to bear arms, the National Rifle Association (NRA) conceived and lobbied for the passage of this legislation. The NRA also succeeded in adding a provision to the Affordable Care Act penalizing doctors for having discussions about gun safety.1 It also prevents doctors from collecting data on guns in the home; however, President Obama recently issued an executive order to indicate that the new health care law, in fact, does not preclude doctors from discussing gun safety with patients and parents. Also due primarily to NRA lobbying efforts, for the past 17 years, Congress has restricted the Centers for Disease Control and Prevention (CDC) from collecting data on gun injuries and deaths.

The US is home to less than 5% of the world’s population but with approximately 300 million weapons in circulation, has 40% of the world’s guns in civilian hands.3 Many of these weapons are military-style assault weapons for which there is absolutely no legitimate use in a civilian population. The same is true for high-capacity ammunition magazines. These have been the weapons of choice in the series of tragic mass killings, including in Newtown, CT late last year. Meanwhile, handguns are the most common weapon used in what seems the daily urban shootings that in the aggregate take more lives of young people than do mass shootings.

We have become a land ruled by the NRA, which is against any change in gun legislation, and certainly against Americans having any evidence-based data with which to formulate opinions. For example, according to the New York Times, in 1996, after CDC research began to contradict NRA dogma that guns in the home made families safer, the NRA kicked into gear and managed to persuade Congress to prohibit the CDC from research that might have an impact on firearms legislation.4 This means we do not have data to formulate policies based upon actual facts such as how effective our current laws are at curbing criminals from committing crimes with guns to how many homes have a firearm in them.5

Public health researchers working with Vice President Biden’s gun violence commission created in the wake of the Newtown killings highlighted that mortality rates from almost every important cause of death have dropped impressively over the past 50 years, and that motor vehicle deaths per mile driven have fallen by more than 80%. In contrast, the US homicide rate, mostly gun-related, is virtually unchanged from the rate in 1950. In 2011, an average of 88 Americans died each day from firearm violence; another 202 were seriously injured.3

French stamp issued June 18, 2012, in honor of the 30th anniversary of the first heart-lung transplant in Europe.

French stamp issued June 18, 2012, in honor of the 30th anniversary of the first heart-lung transplant in Europe.

First Amendment Rights

I pray that the Newtown massacre, in a way that previous mass killings of innocents by fully armed gunmen have not, will be able to galvanize a fundamental change in the attitudes of the American public and its legislatures toward the dangers of guns in the wrong hands, a deadly phenomenon that has been made possible through greedy, effective lobbying, not through science, data collection, and certainly not common sense.

And we must protect our First Amendment right to free speech to do what we can to educate parents about gun safety.

This Month’s Stamps

The French stamp with the cartoon of the heart and lungs was issued June 18, 2012, in honor of the 30th anniversary of the first heart-lung transplant in Europe, which was performed March 1, 1982, by Christian Cabrol, MD, and colleagues at the Hôpital La Pitié in Paris. The world’s first such transplant was performed at Stanford Medical Center in 1981 by Bruce Reitzin, MD, assisted by the pioneering transplant surgeons Norman Shumway, MD, and John Wallwork, MD. Apparently, Wallwork performed Europe’s first successful heart-lung transplant at Papworth Hospital (near Cambridge, UK) in 1984, and he then set up a pediatric transplant service at London’s famous mecca of pediatrics, Great Ormond Street Hospital, known as GOSH.

Australian stamps issued in 2012 to honor the its Nobel laurates. Sir Howard Walter Florey, PhD (1898–1968) (left); Sir John Carew Eccles, AC, FRS (1903–1997) (middle); and Sir Frank Macfarlane Burnet, MD, PhD (1899–1985) (right).Images courtesy of Stanford T. Shulman, MD.

Australian stamps issued in 2012 to honor the its Nobel laurates. Sir Howard Walter Florey, PhD (1898–1968) (left); Sir John Carew Eccles, AC, FRS (1903–1997) (middle); and Sir Frank Macfarlane Burnet, MD, PhD (1899–1985) (right).Images courtesy of Stanford T. Shulman, MD.

The other three stamps are from a set of five also issued in 2012 by Australia to honor its Nobel laureates. Sir Howard W. Florey, PhD, (1898–1968) shared the 1945 Nobel Prize for Physiology or Medicine with Ernst Chain, PhD, and Alexander Fleming, MB, BS, for the discovery and development of penicillin. Florey, a pharmacologist and pathologist, received a Rhodes scholarship to Oxford, then moved to Cambridge (Gonville & Caius College) where he received his PhD in 1927. Beginning in 1938, he worked with Chain initially on lysozyme and then on penicillin, which was first discovered by Fleming in the late 1920s but not purified. In 1939, Florey and Chain (financed by the Rockefeller Foundation) succeeded in purifying a limited amount of penicillin, showed its effect upon bacterial infection in animal models, and treated the first patient in 1941, a man with a highly invasive facial infection. The patient’s condition improved until the supply of penicillin was exhausted, after which he died. The investigators then focused on childhood infections (which required smaller amounts of drug), and by 1945, they had achieved large-scale production. Their efforts ultimately saved many millions of lives.

Sir John Eccles, AC, FRS, (1903–1997) also received a Rhodes scholarship to Oxford, where he worked with the eminent Sir Charles Sherrington, OM, GBE, PRS, who received the Nobel Prize in 1932 and coined the words “neuron” and “synapse.” Eccles shared the 1963 Nobel Prize in Physiology or Medicine with Alan Hodgkin, OM, KBE, PRS, and Andrew Huxley, OM, PRS, for his landmark studies on synaptic transmission of neurons in the central nervous system. Although he initially did not believe in the chemical theory of synaptic transmission, he ultimately proved the central role of acetylcholine in transmission. Eccles’ professional career took him to academic research positions in Australia, New Zealand, Chicago, and Buffalo.

Sir Frank Macfarlane Burnet, MD, PhD, (1899–1985) shared the 1960 Nobel Prize in Physiology or Medicine with Sir Peter Medawar. A renowned virologist and immunologist, Burnet studied influenza and herpes simplex viruses and discovered the nonviral causes of Q fever (Coxiella burnetii) and psittacosis (Chlamydophila psittaci) early in his career. Educated at the University of Melbourne (MD) and University of London (PhD), he spent his entire scientific career in Australia, receiving the Nobel for his breakthrough, basic immunologic studies that clarified the mechanism of acquired immune tolerance and served as the basis of his theory of clonal selection.


  1. Kroll A. After Newtown, will NRA still demand a ban on docs asking kids about guns? Available at: Accessed Feb. 14, 2013.
  2. Gibson W. Docs challenge gun lobby to raise safety concerns. South Florida Sun Sentinel. Feb.4, 2013.
  3. Wintemute GJ. Tragedy’s legacy. N Engl J Med. 2013;368(5):397–399 doi:10.1056/NEJMp1215491 [CrossRef] .
  4. Editorial. What we don’t know is killing us. NY Times. Jan.26, 2013.
  5. Palfrey JS, Palfrey S. Preventing gun deaths in children. N Engl J Med. 2013;368(5):401–403 doi:10.1056/NEJMp1215606 [CrossRef] .


Pediatric Annals Editor-in-Chief Stanford T. Shulman, MD, is the Virginia H. Rogers Professor of Pediatric Infectious Diseases at Northwestern University Feinberg School of Medicine; and Chief of the Division of Infectious Disease at the Ann and Robert H. Lurie Children’s Hospital, Chicago, IL. Dr. Shulman is the recipient of the AAP 2011 Award for Lifetime Contribution to Infectious Disease Education.

An avid stamp collector, Dr. Shulman chooses relevant stamps from his personal collection to accompany his column each month.

Reach Dr. Shulman via email:


Sign up to receive

Journal E-contents