[Congressional Record Volume 141, Number 137 (Wednesday, September 6, 1995)]
[Senate]
[Pages S12749-S12750]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


  JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION'S ISSUE ON VIOLENCE IN 
                                AMERICA

 Mr. SIMON. Mr. President, today, I would like to call my 
colleagues' attention to an important issue of the Journal of the 
American Medical Association, which examines violence as a public 
health issue.
  As too many Americans know, violence has become an epidemic in our 
country. Despite some admirable efforts, the problem has unfortunately 
not been successfully addressed by congressional action. Given the 
scope of the problem, it is important for all Americans to focus on 
this issue and contribute to the solution. I would like to take this 
opportunity to commend the American Medical Association for taking a 
leadership role in drawing public attention to this issue.
  The June issue of the Journal of the American Medical Association 
(JAMA) is a prime example of the AMA's commitment. This issue focuses 
on the recent emphasis in the medical community on addressing violence 
as a public health issue. Putting violence in this context raises the 
profile of the issue and, I believe, greatly contributes to creating 
better solutions.
  For example, an editorial entitled ``The Unrelenting Epidemic of 
Violence in America'' lists grim statistics about the prevalence of 
violence in our society, and estimates the tremendous social and 
medical costs to society caused by this violence. The editorial then 
calls upon physicians to take an active role in working to reduce the 
magnitude of this problem, and offers advice on ways to proceed:

       Patient centered interventions may include education that 
     emphasizes primary prevention, such as discussing the hazards 
     of firearms and encouraging safe firearm storage practices, 
     appropriately screening for child abuse, domestic violence, 
     and elder abuse, and identifying and initiating proper 
     counseling for harbingers of violence such as alcohol and 
     other substance abuse, behavioral problems, emotional 
     disorders, and inadequate social support.

  JAMA also encourages physicians to become antiviolence advocates by 
participating in community, State, or national public health policy 
debates on violence, influencing public attitudes in favor of violence 
prevention initiatives, and supporting legislative and regulatory 
measures intended to reduce violence, such as those that limit the 
availability of handguns.
  Because the causes of violence are so complex, we sometimes feel 
overwhelmed before we even begin the work to find solutions. To 
encourage its members, JAMA relates the story:

       . . . of a stranger walking along a beach at noon on a 
     brilliant sunny day. As the tide has receded, a large number 
     of starfish have been stranded on the hot sands, baked by the 
     noonday sun. They surely will not survive until the next tide 
     returns. An older woman skitters about the beach, gently 
     picking up the starfish and tossing them back into the ocean. 
     As the stranger approaches and notices the tens of thousands 
     of starfish on the miles of sandy beach, he stops to ask the 
     woman, ``How can you possibly make a difference, with the 
     vast number of starfish that are stranded?'' The woman 
     replies, gently picking up a starfish next to her and showing 
     it to the stranger, ``For this starfish, it makes all the 
     difference in the world.''

  To further encourage its readers, JAMA then relates the work of John 
May, a physician with Cermak Health Services in Chicago, who is making 
an important difference in his community. According to JAMA, Dr. May 
has received local and national attention for his work to develop 
patient screening and counseling techniques, study risk factors 
associated with firearm violence, and promote violence prevention 
awareness. May has developed a simple mnemonic device involving the 
word ``guns'' to assess whether someone is at risk for a firearm 
injury: Is there a gun in your home? Are you around users of alcohol or 
other drugs? Do you feel a need to protect yourself? Do any of these 
situations apply to you: Seen or been involved in acts of violence? 
Sadness? School-aged children at home? Furthermore, May believes that 
physicians must work to deglamorize the gun, as they have done with 
cigarettes: Unfortunately, guns and violence are promoted as powerful, 
sexy, and effective. It's no wonder that young people are drawn to them 
and, tragically, killed by them.
  The June issue of JAMA is not, however, the first example of the 
AMA's commitment to exploring the issue of violence. In 1994, the AMA 
joined with the American Bar Association and nearly 100 other groups in 
presenting the National Conference on Family Violence: Health and 
Justice. This important conference focused on the disturbingly 
widespread problem of family violence, and made specific 
recommendations, such as primary prevention through education, early 
intervention in at-risk families, and the development of community-
coordinated efforts to address this problem.
  My colleagues, the Nation's physicians, and all Americans, can learn 
from the articles in the June issue of JAMA. But more importantly, we 
can all learn from the AMA's example of 

[[Page S 12750]]
civic responsibility. I applaud their efforts and encourage my 
colleagues to review the June issue and share it with medical 
professionals in their communities.


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