Pediatricians and NRA: Physician gag rules and the CDC, ACA, and states.

Pediatricians vs. the NRA: The Fight Isn’t Over Yet

Pediatricians vs. the NRA: The Fight Isn’t Over Yet

Health and medicine explained.
Feb. 1 2013 2:53 PM

The Pediatricians vs. the NRA

How the gun lobby is trying to gag doctors from talking about kids and guns.

Parents of Sandy Hook Elementary massacre victims at a press conference
Parents of Sandy Hook Elementary massacre victims hold hands during a press conference on the one-month anniversary of the elementary school massacre.

Photo by John Moore/Getty Images

What does the body of a 6-year-old girl look like after a Bushmaster AR-15 assault rifle’s high-velocity bullets rip through her? The average 6-year-old girl weighs about 44 pounds and stands around 3 feet 9 inches tall. The size of her organs and the diameters of her arteries and veins, bowel, and bones are much smaller than an adult’s. But a 6-year-old girl is not a miniature adult; her organs are more vulnerable and less protected by bones. So when a high-velocity projectile like a .223-caliber bullet, traveling at approximately 2,000 miles per hour, from an assault weapon like a Bushmaster AR-15, enters her body, all hell breaks loose. If that bullet pierces her chest wall into her heart, it will cause her heart to explode, and if it passes within 3 inches of her aorta, the shockwaves will tear it open. If it slices into her arm, it will shatter her humerus into so many fragments that it will no longer be recognizable as a bone. If it spirals into her brain, the cavity and damage the bullet causes will be so extensive that her head will break apart.

Guns kill kids. In 2010, according to the Centers for Disease Control and Prevention, 2,694 children and teens in the United States died because of a firearm. Another 15,578 children and teens were injured. Every 30 minutes, a child is killed or injured by a gun. The American Academy of Pediatrics (AAP), the largest organization of pediatricians, recommends that conversations about guns and gun safety start during a prenatal visit and be repeated every year as part of anticipatory guidance. Those conversations start with a question: “Do you own a gun?”


One Tuesday in the summer of 2010, at Children’s Health of Ocala, Fla., a pediatrician named Chris Okonkwo asked the mother of a 7-year-old patient, “Do you have guns in the home?”

Her response was unexpected: “None of your business!”

Okonkwo tried to explain why he was asking the question. He told the mother he routinely asked questions about safety regarding firearms, swimming pools, and bike helmets, to name just a few. He told her that if there was a gun in her home, it should be locked and any ammunition also locked and kept separately.

Instead she continued to yell at him, “Didn’t you hear what I said? None of your damn business!”

Okonkwo finished the rest of the physical exam, administered immunizations, and then informed the mother she had 30 days to find another doctor. He felt they were unable to establish a “relationship of trust,” given her refusal to answer questions about basic safety.

What happened in that pediatric office led an NRA lobbyist to sponsor legislation in the Florida State House. “Privacy of Firearm Owners” was signed by Gov. Rick Scott and passed into law on June 2, 2011. This law prohibits doctors from “making written inquiry or asking questions concerning the ownership of a firearm or ammunition by the patient or by a family member of the patient.” It also prohibits doctors from “unnecessarily harassing a patient about firearm ownership during an examination.” But this law does not define what “unnecessarily harassing” means. The question Okonkwo asked could be construed as “unnecessarily harassing” if that mother filed a complaint with the Florida Board of Medicine. And Okonkwo could be censured and his license to practice medicine revoked, as well as fined up to $10,000. But this was a watered-down version of the law. The original bill called for more Draconian measures: a third-degree felony punishable by a fine of up to $5 million and a maximum of five years in prison. All for simply asking the question, “Do you have guns in the home?”

Days after the law passed, three physicians, Bernd Wollschlaeger, Judy Schaechter, and Tommy Schechtman, along with the Florida chapter of the AAP and other medical societies, filed a suit to block enforcement of the law. They sued Rick Scott, in his official capacity as governor of Florida, on grounds that the law violated the First Amendment right to freedom of speech for physicians and also violated the First Amendment right of patients to hear that speech.

Wollschlaeger is a family practitioner who makes house calls. Before he became a naturalized citizen of the United States, he served in the Israeli army and is intimately familiar with firearms. He owns guns and is a concealed-weapons permit holder. He used his personal knowledge of guns to relate to his patients who are gun owners to counsel them on gun safety. But the Florida Physician Gag Law, as the plaintiffs refer to it in their suit, changed his practice. He stopped talking about guns. Wollschlaeger used to be a member of the NRA. Now he feels the NRA has “metastasized into a lobby for the gun industry.” And the law, which was “all NRA proposed, all NRA sponsored, all NRA supported,” was a form of intimidation. Wollschlaeger doesn’t like to be intimidated. He volunteered to be a named plaintiff in the suit because “our voices and our words matter. We have to stand up for what is right.”