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Are Violent Video Games a First-Amendment Issue?

On June 27, in a 7-2 decision, the U.S. Supreme Court struck down a California law banning the sale of violent video games to children. The majority argument for the ruling was that banning the sale of these games to children is a violation of First Amendment rights protecting free speech. The California law would have imposed a $1,000 fine on stores selling violent video games to minors.

Predictably, representatives of the video-gaming industry expressed strong support of the Supreme Court decision. California legislators, however, most of whom voted to pass the video-game restriction, felt that this ruling exemplified the high court majority's support and protection of corporate America under the mantle of First Amendment rights. In my opinion, this is not a First Amendment issue. The issue here, tragically overlooked by the Supreme Court, is the health and protection of America's children.

As studies emerge on the impact of video games on children's growth and development, it is becoming increasingly clear that playing violent video games is correlated with increases in aggressive behaviors and aggressive cognitions in children. And the violence depicted in video games is becoming more realistic as computer graphics become ever more sophisticated. Some of the most popular games, and in particular first-person shooter games, depict the killing of people and animals in graphic detail. Drug and alcohol use, criminal behavior, disrespect toward authority and law, sexual exploitation and violence toward women, racial and gender stereotyping, and obscene language—the list of images these video games present to children is lengthy and distressing. A child cannot view an R-rated movie without parental consent or purchase pornographic magazines, so it is unfathomable that the Supreme Court has made other images that are clearly unsuitable for children readily available, via video games, for purchase by youngsters of any age.

The majority of children in the United States play video games. The exact number of hours per week spent on video gaming remains unclear, although it is likely far more than the maximum two hours per day recommended by the American Academy of Pediatrics. What is clear, however, is that children are spending increasing amounts of time playing video games and that many of these games have extremely violent content.

Moreover, beyond the impact of the violence, time spent playing video games has additional deleterious effects on children's health. Children who spend large amounts of time playing video games get less exercise and spend less time with family, engaged in positive social activities, and doing homework. This can result in poor social skills, poor academics, and poor physical health—consequences that will not quickly be ameliorated.

Proponents of the Supreme Court decision will point to parents as the ones responsible for determining appropriate video-game content for their children. Often, however, parents lack an understanding of the current rating system, which can be confusing and misleading. Patents tend to buy games based on what their children say their friends have or on what they are told by clerks in the stores that sell the games. Do we really want store clerks recommending which games are appropriate for children?

I strongly believe that not only should there be limitations on selling violent games to youngsters, but that the deleterious effects of the games on children should be clearly spelled out on the label. This is no different from a Food and Drug Administration "black box" warning prominently displayed on a variety of products from cigarettes to antidepressants. This type of warning would make parents aware of the potential for harm to children associated with involvement in these games.

In reality, many products that are appropriate for adults are simply inappropriate for children, and we must protect children from the harmful impact of these products on their health and development. It is imperative for experts in child and adolescent mental health and physical health to explain this to the courts and to refocus the debate away from the First Amendment issue to the issue of what is in the best interests of our children.

Louis Kraus, M.D., is chief of child and adolescent psychiatry at Rush University Medical Center in Chicago.