By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 01/06/2013
Last month, the country was shocked to learn that a gunman shot and killed 20 schoolchildren in Newtown, Conn. The tragedy sparked yet another so-called "national conversation" about gun control, igniting predictable passions on both sides of the heated debate. While National Rifle Association leadership recommended armed security guards in schools to enhance children's safety, gun-control advocates demanded stricter legislation to limit assault weapons and high-capacity magazines.
Locked in stark disagreement, still, both sides claimed to be aiming at the same objective: to keep children safe. How could that be?
"Keeping children safe" is always a great idea. But as an idea or abstraction, it can be easily shaped into a platitude, a moral imperative, or a political sound bite used to lure people toward wildly differing points of view. Want to keep children safe and healthy? Well, then -- do/do not have them vaccinated. Do/do not provide them with sex education. Do/do not allow contact sports. Do/do not pass legislation allowing confidential abortion counseling for teens. Do/do not tinker with school lunch menus.
A major problem with "keeping children safe" is, well ... that it is such a great "idea." It brilliantly shines as a shared concept, but is dimly seen as a collective reality. Why should that be?
Perhaps we are all too aware that the actual world is, in fact, an uncertain and sometimes dangerous place, so "keeping children safe" can only exist as an abstraction. We invoke it as a praiseworthy objective to rationalize our decisions and the situations we impose upon children -- even when they are not rooted in actual evidence.
And maybe it's just too excruciating, too heartbreaking, too shaming to imagine that we -- as individuals and a society -- would ever do anything to endanger children or leave them in harm's way. It's simply unthinkable. Accordingly, we don't question our responsibility for the world our children are inheriting.
Meanwhile, however, children often suffer our delusions about their health and safety. Even if you possess the means to fortify your child with healthy foods, great health care, a secure and comfortable home in the 'burbs -- still, you can't protect her from the spinning world. From the contaminated strawberries that escaped detection due to inadequate funding for food safety inspections. From the schoolmate with whooping cough whose parents rejected vaccinations. From the mentally ill man whose only available shelter was a mother's gun-stocked home.
When it comes to guns -- whether in Newport, or Chicago, or Oakland -- we have failed as protectorates by not having strategized how to keep children safer, well in advance of our strong social embrace of gun ownership. Whether for or against gun regulation, we should have better anticipated how to protect children from gun-related homicide, suicide, accidental death and injury, crime, gang violence and social intimidation.
All those risks were foreseeable -- so many children in the midst of so many guns. Indeed, according to a 2011 Gallup Poll, 47 percent of American adults reported having a gun in their home or elsewhere on their property.
Our current shortage of cancer drugs provides yet another telling example of our failure on a national scale to prevent foreseeable child endangerment. While caught up in self-congratulatory rhetoric about our victories in the "war against childhood cancer" we also somehow allowed critical chemotherapy drugs for children to disappear from pharmacy shelves.
Mechlorethamine -- an old, generic workhorse drug that for years had predictably helped thousands of children and adolescents with Hodgkin's lymphoma -- became suddenly scarce or unavailable in recent past. There existed no alternate drug with a comparable track record. So, how did we allow this to happen to vulnerable children and families in the middle of treatment, and to newly-diagnosed children who hoped to access optimal therapy?
Suffice it to say, mechlorethamine -- like most of the 230-plus drugs on our national drug shortage list -- is a generic injectable medication, and not a single megabuck blockbuster drug appears on that list. And despite the predictable need for mechlorethamine, we had somehow allowed its supply to depend upon a single manufacturer -- in Denmark -- that temporarily closed its doors in 2010.
Now, two years later, the current New England Journal of Medicine reports on the lamentable impact of treatment disruption: a child's 88-percent chance of being cancer-free for at least two years following treatment with mechlorethamine dropping to 75 percent with attempted drug substitutions. Children who relapsed also required more aggressive interventions, like stem cell transplants, which increased their risks of developing side effects, infections, infertility, and other cancers.
The point is, we had this idea that we were winning a war on childhood cancer, but all the while we failed to protect actual children on the ground. The drug industry didn't bother to hold the line, health policy failed to ensure needed drug recruitments, and the unthinkable happened -- we left vulnerable children in harm's predictable way.
Much self-serving rhetoric about us keeping our children safe and healthy could benefit from a hefty dose of reality, stripped free of political and financial agendas.
But that will require a lot of courage and humility, because it will force us to address many hard questions we've kicked down the road, into the uncertain path of our children's future. It will require us to think about children's safety as both a personal and communal responsibility.
Kate Scannell is a Bay Area physician and syndicated columnist. She is the author most recently of "Flood Stage."
Copy right 2013, Kate Scannell
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A physician's memoir about the early AIDS epidemic (1985-1990) in the US. Originally published in by Cleis Press, 1999. Brought back into print in 2012, and reissued with photographs in 2018. Click here for its paperback purchase.
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