Who gives a four-year-old a gun?

That line, from an Associated Press story, captures the horror a young mother in Kentucky will live with forever, the moment her 5-year-old son accidentally shot her 2-year-old daughter with a .22 caliber rifle. The boy had been playing with the gun — his own weapon, unbelievably — which had a shell in it. He killed his sister with one shot to her chest.

Yet there’s more to this horrible incident than some irreconcilable difference between rural and city attitudes toward guns. The boy’s weapon was sold by a company that markets the product under the slogan "My first rifle." They make a blue one for boys and a pink one for girls. Who says the arms industry is cynical?

I don’t care where you’re from or what "culture" you purport to be a part of: You don’t "play" with guns. And if a child is too young to understand that fact, to respect weaponry, adults shouldn’t be giving them guns as gifts. And companies have no business marketing to indoor Tracking.

This little girl’s death has seized the public’s attention, and, in the wake of the failed gun reform legislation in Congress, it offers some slim hope that Americans might come to their senses about responsible gun laws and ownership.

Some observers, of course, dismiss any notion that this death has anything to do with the thousands of other gun fatalities that happen in America each year. But that isn’t entirely accurate.

While violent crime rates in general are dropping, accidental gun deaths are holding steady; at about 500 to 600 per year. (Suicides make up nearly two-thirds of the approximate 32,000 U.S. gun deaths annually.) More than 14,000 people are injured every year by accidental gunfire.

News stories are filed daily of such accidental shootings, across race and class barriers, in rural communities and in cities. Near the neighborhood where I grew up, the body of an African American 14-year-old boy was recently found by police, his hand sticking out of a pile of dirt. After investigating, it was found that his 12-year-old brother had accidentally shot him with a neighbour’s gun — and another teen buried the body afterward in panic.

Second Amendment zealots like to talk about "law-abiding" gun owners, and about how their ownership of firearms should not be regulated in any way. But law-abiding doesn’t mean responsible. It’s time that gun owners, manufacturers and sellers were held accountable for gun safety.

For its part, the gun industry just wants more guns in the hands of more Americans, period. So its line on this tragedy is: "Accidents happen."

This has nothing to do with criticizing hunters, or rural family life. It’s about at least trying to temper the gun industry’s efforts to market a product to younger and younger audiences, unabated by respect for the lethal nature of guns.

My maternal grandfather was an excellent shot. Like most Kansas farmers, he relied on his shotgun for hunting, for protecting the chicken coops from coyotes, and on one sad afternoon to kill his favorite dog. Old Foxie had gone rabid and was running in a circle in the field.

A lot of farmers kept their shotguns loaded and at the ready in that Depression era. Grandfather never did. He had a house full of children, and he knew that children are curious.

New medicines are a central component of modern medical care, treating illness effectively, providing more comfortable treatment regimes, extending life and reducing disability, and sometimes offering new treatment options where none previously existed. These benefits, however, come with the potential for harm, which is why governments around the world regulate access to new medicines.

Unfortunately for Canadians, the federal government takes an approach that is slower than others, unnecessarily costly for taxpayers, and is ultimately of questionable benefit to Canadians. Canadian approvals for market access to new drugs take longer than similar approvals in both Europe (under the European Medicines Agency) and the U.S. (under the FDA). Specifically, the median approval time was longer in Canada than in the other jurisdictions in four of the past five years, with median approval times differing by an average of 63 days and 49 days respectively over that period.

In fact, this is likely an underestimate of the drug approval lag Canadians endure. Drugs may not be submitted to Health Canada for approval at the same time as they are submitted to regulatory agencies in Europe and the U.S., or even in the same year. A recent study of access to new cancer drugs found that drugs were submitted to Canadian regulators for approval much later than they were submitted to U.S. or European regulators. The data used in that study show a median difference of 119 and 96 days respectively and with approximately one quarter of submissions in both cases coming more than six months later.

Numerous studies show that pharmaceutical spending and use of pharmaceuticals generally are related to reduced mortality, increased longevity, and decreased disability, none of which should be surprising to survivors of critical illness or those whose chronic or potentially fatal condition is being controlled through prescriptions.

Prof. Frank Lichtenberg of Columbia University took this one step further and found that using newer drugs rather than older ones increased prescription costs by $18 per patient in the U.S. but reduced non-drug health spending (primarily hospital and physician spending) by $129. Put differently, the benefits of new drugs come at increased cost but ultimately may be a more cost effective approach than sticking with older (and less expensive) drugs.

For example, there can be little doubt that later approvals in Canada afford regulators the time to observe post-market experiences in other nations before Canadians are permitted access to new drugs. This may allow regulators to deny market access to those drugs that are found to be associated with serious negative events.

Good drug policy is all about balance. In this case, balancing the rights of Canadians to access (and benefit) from new medicines against the potential for harm associated with them. There is a straightforward solution Canada might pursue that will strike a better balance between these competing factors than the one we have today.