Guns and why doctors should partner with the National Rifle Association

Is there anything that we physicians can and should be doing to help with the huge problem of gun violence in America?

We all know it is nuts to sell guns and ammo to nuts, yet as a country we do it every day.

We all know that, in contrast to rifles and shotguns, the only moving targets for hand guns are people; that the Congress and president in this century legislated that any size of ammo magazine and speed of gun firing was OK; that the National Rifle Association (NRA) is the most effective lobby since Cleopatra; and that the current version of the Supremes by John Roberts has determined that individual Americans have a constitutional right to bear arms.

Some of you may remember that on June 10, 1992, the JAMA and all the AMA specialty journals focused on violence in America, and Chick Koop and I called it a “public health emergency.”

The AMA published a compendium of 422 pages of its journals’ articles on violence. We wrote that the right to own or operate a firearm should be similar to the right to own or operate an automobile.

We proposed that the firearm owner or operator must meet these specific criteria:

  1. Be of a certain age and physical/mental condition.
  2. Be required to demonstrate knowledge and skill in proper use of that firearm.
  3. Be monitored in the firearm’s use and
  4. Forfeit the right to own or operate the firearm if these conditions are abrogated.

Back then the CDC was doing big time research on violence as a public health issue.

Then the politics changed, and the far right put a halt to almost all of those efforts.

Guns don’t kill people; people kill people.

Yet, if a person wishes to inflict violence upon many others in a short time, bare hands, baseball bats, most poisons, stilettos, garrotes, even machetes, are far less efficient tools of killing than are guns, especially automatics and semi-automatics.

So what could American physicians do now?

Psychiatrists, what motivates so many Americans, in contrast to the people of most other developed countries, to own and use guns?

Gun rights are such a deeply held belief of so many in the American culture, and the gun lobby “owns” most of the politicians in both parties.

Taking a different approach, could it now be time for organized medicine, on behalf of the health of the public, to partner with the National Rifle Association to try to remove much of the hazard from the American gun scene?

Think about it. The AMA and the NRA working together to do good.

If you have a better idea, especially you gun-totin’ docs, let us hear it.

George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association.

Originally published in MedPage Today. Visit MedPageToday.com for more health policy news.

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  • http://www.medicallessons.net Elaine Schattner, M.D.

    Why invoke Cleopatra in this?

  • http://drpullen.com medical blog

    Do you really think that the NRA has any interest in partnering with anyone who has an interest in any type of handgun or assault weapon limitations at all? I think the chance of the NRA working with the AMA is zero, even for relatively minor changes.

    • jsmith

      Bingo.

      • ninguem

        +1

        What medical blog said

        Why should the NRA lower itself to partner with the AMA? I’m a physician and I won’t partner with the AMA.

  • http://www.BocaConciergeDoc.com Steven Reznick MD

    In the State of Florida it is easier to get a weapon than to get a renewal of your drivers license. Any efforts by the AMA and NRA to make sure that guns can be obtained by sane , rational law abiding citizens who can demonstrate knowledge of use,maintenance and safety of the weapon is a plus

    • http://emtmedicalstudent.wordpress.com/ Joe Paczkowski

      While I agree with the premise that a person who legally owns a fire arm should be mentally fit, have a [relatively] clean record (A bank robber, an insider trader, and someone with non-violent misdemeanors shouldn’t be treated the same, especially over time), and can safely operate and store a fire arm.

      The last point is easy to test, even if ineffective. After all, how many people knowingly violate traffic laws?

      Criminal records can be done through a records search and restoration of rights for ex-convicts can be handled through the legal system.

      However, how are we going to engage both in initial monitoring and long term monitoring to ensure that gun owners are mentally fit? Should everyone who owns or wants to own a firearm be forced to visit the local psychiatrist every 2 years? What about other objects that can cause death? A car is very similar to a fire arm in the sense that it can be used for enjoyment (something often overlooked by both sides. My shotgun is my toy. A dangerous toy that is dismantled and locked up when not at the local trap range, but a toy never the less), work, or as a weapon. Should drivers also be forced to undergo initial and continuous psychological screening as a condition of licensure?

  • Muddy Waters

    Those who think gun control laws are the answer are incredibly foolish. The majority of gun-related violence is perpetuated by CRIMINALS. Last I checked, they don’t tend to follow the laws of society. And, even if a “mentally unstable” citizen were denied a gun through legal means, I GUARANTEE you they could procure one on the black market relatively easily. Thus, the only ones who are hurt by gun control laws are law-abiding citizens. Would you have us defenseless? Afteralll, when seconds count, the police are minutes away.

    • Doc Park

      Mr/Ms Waters,

      As a physician who has seen the results of gun violence as well as someone w/ numerous physician friends in other countries I would humbly beg to differ with you views on gun violence/ crime NOT being linked:

      http://www.neahin.org/programs/schoolsafety/gunsafety/statistics.htm

      also food for thought from justfacts.com on why your assertion doesn’t pass muster from a statistics perspective:
      ” Right-to-carry” states allow individuals to carry firearms for protection against crime. In these states, the violent crime rate is 24% lower than the rest of the U.S., the murder rate is 28% lower, and the robbery rate is 50% lower.[8]

      * Reason for elimination: This data does not account for other factors that impact crime rates, such as cultural differences, arrest rates, illegitimacy rates, poverty, etc.
      Note that many gun control studies attempt to control for such factors, but opposing sides inevitably point to other factors that are uncontrolled,[9] and due to data limitations, it is practically impossible to control for all relevant factors.[10] Conversely, some researchers fault studies that do not show significant results until the effects of controls are considered.[11]
      In accordance with our mission to provide verifiable facts, Just Facts uses time-series data and lets this data speak for itself instead of subjecting it to statistical analyses. For example, we provide homicide rates in the state of Florida in the years leading up to and after passage of the Florida “right-to-carry” law. Such data does not prove cause and effect, but it does allow us to observe trends and limits the impact of numerous variables because the data is drawn from a large population set with limited demographic changes from year to year. To provide additional context, Just Facts sometimes provides comparative data (such as homicide rates for the nation as a whole over the same time period), but we provide this data in unadulterated form; we do not control for it in our calculations.”

      However, lest anyone automatically stamp me as anti-gun activist, I fully support the right for Americans to bear arms ( i used to be a gun owner myself) but I kinda agree that physicians should speak up on this public safety issues and i FULLY support restrictions on gun ownership. Just my 2 cents

  • http://www.ambulancedriverfiles.com Ambulance Driver

    A good first step might be educating yourself on forearms and gun control legislation, because you appear to be rather ignorant on the subject.

    “We all know it is nuts to sell guns and ammo to nuts, yet as a country we do it every day.”

    False. It is a felony to sell a gun to anyone who has ever been adjudicated mentally incompetent. Do you propose we deprive people of a Constitutionally protected right based on an opinion?

    Because that is what it will boil down to, someone’s opinion, unless the person has been ruled so through due process of law.

    Want to prevent shootings like Gabrielle Giffords? Instead of devoting your time to railing against inanimate objects, why not devote AMA’s time and efforts to repairing a dysfunctional mental health system that allowed a disturbed young man to still be walking the streets with little or no psychiatric care or followup? Jared Laughner was well known to local law enforcement and the medical community long before his shooting rampage.

    “… that the Congress and president in this century legislated that any size of ammo magazine and speed of gun firing was OK.”

    Also false. The 1994 Assault Weapons Ban did not ban assault weapons. Assault weapons, those capable of fully automatic fire, have already been unavailable to anyone but law enforcement and a very few highly scrutinized private citizens, since well before 1968.

    And the few truly automatic weapons owned by private citizens are used in crime in infinitesimally small numbers.

    It is also a fallacy that converting semi-automatic weapons to fully automatic fire is easily done, and it is already a federal felony to do so.

    What the 1994 Assault Weapons Ban did do was ban aesthetically displeasing weapons, whose operating mechanism is no different than my Daddy’s bird hunting shotgun that you seem to have no objection to.

    That ban was allowed to expire because even the DOJ admitted that it did absolutely nothing to curb gun crime.

    Likewise, your magazine capacity argument is flawed. Let’s say you define an acceptable magazine capacity, X.

    By your reasoning (or lack thereof), an unacceptable number of casualties must equal X+1. It therefore follows that any other number of casualties less than X is acceptable to you.

    “Yet, if a person wishes to inflict violence upon many others in a short time, bare hands, baseball bats, most poisons, stilettos, garrotes, even machetes, are far less efficient tools of killing than are guns, especially automatics and semi-automatics.”

    I agree. And bare hands, baseball bats, most poisons, stilletos, garrotes and even machetes are far less efficient tools at defending yourself against a gun-wielding assailant, too.

    And as before, the inclusion of automatic weapons in your example is a straw man. I challenge you to find more than a couple of credible instances when a fully-automatic weapon was used in a crime in the past thirty years.

    Take your time, I’ll wait.

    It seems rather incongruous to me that we, a profession that has embraced evidence-based medicine to the degree that measurably improved outcomes are the gold standard by which we judge a medical treatment, yet so much of the medical community still clings to beliefs on guns based purely on emotion, fear and ignorance.

    Where is your evidence, doctor? Show me some studies, any studies that gun control legislation has ever reduced crime.

    Were we all to apply your reasoning to other facets of medicine, we’d still be administering lidocaine prophylactically to MI patients, using rotating tourniquets for CHF, and aggressively lowering blood pressure in acute stroke patients, because it seems logical until you look at the outcomes.

  • http://jeffthebaptist.blogspot.com Jeff the Baptist

    Is firearms ownership a civil right? If so then you cannot simply abridge it without due process of law. If you applied numbers (2) through (4) to a different civil right, like voting, then we’re back in the Jim Crow South. It isn’t surprising that many firearms owners who do see firearms ownership as an important civil right aren’t willing to happily submit to this sort of regulatory regime.

  • Vox Rusticus

    “And as before, the inclusion of automatic weapons in your example is a straw man. I challenge you to find more than a couple of credible instances when a fully-automatic weapon was used in a crime in the past thirty years.”

    You are treading on thin ice, there. While you talk the NRA talk, it is exactly the cases of assault weapons crime that have both changed police armament policies and divided the NRA/gun lobby from the rest of the country, including most of law enforcement: to wit: the North Hollywood, California shootout in 1997 and the 1986 FBI Miami shootout.

    Not a straw man. And I write that as a gun owner.

    • http://www.ambulancedriverfiles.com Ambulance Driver

      Nope. Straw man.

      The North Hollywood shooters used semi-auto versions of the AK47 that had been illegally modified to fire full auto – which is both a federal felony, and a task suited for only a highly-skilled gunsmith. It is beyond the capability of even most criminals.

      Note that I said criminals. In other words, people who ignore laws.

      The FBI Miami shootout did not involve assault rifles. Michael Lee Platt used a Ruger Mini 14, which is a semiauto rifle. It is akin to the M14 assault rifle only in aesthetic features. The parts are not interchangeable, nor are the operating mechanisms similar.

      And you’ve managed to name only the two most famous shootouts, only one of which actually involved the weapons he described. I’m waiting for another.

  • Jason

    Partner with the NRA? Mmmmmmkay…..

    Me thinks you’d have a better chance at partnering with the ABA to help reduce malpractice lawsuits…

    I don’t understand why some people still hang onto the belief that violent crimes are only commited with legally-obtained firearms and that gun control is the answer for reducing these same violent crimes…

    And while baseball bats, knives, machetes, etc. are less efficient, they are only minimally less lethal….

    As far as your specific criteria, who do you propose shall enforce and monitor the enforcing of those criteria and where shall the funding necessary to provide for such come from?

  • http://fertilityfile.com IVF-MD

    If X is the number of guns in the hands of criminals used for violence against others and Y is the number of guys in the hands of you and me to be used to protect our families, any legislation should be viewed and analyzed in terms of which direction it will shift the X:Y ratio.

    Don’t forget to factor in the deterrence factor. If you are a criminal planning a home invasion of a helpless woman, would you be more prone to launch an actual attack in a city where you can confidently know that the homeowner has no gun with which to defend herself or in a city where all the good guys are on a level playing field with the bad guys with regards to firearms?

    Yes, I realize this is just a correlation, but take a look at the murder rates in areas with super strict gun restrictions and compare them to areas where normal people have free access to firearms.

  • Oakenheart

    Vox, perhaps you should read this.

    http://www.guncite.com/gun_control_gcassaul.html

    If you are, as you say, a gun owner, then I submit you are a very uninformed one, and perhaps should study a bit more about the subject. “Assault Weapons” are the equivalent of putting a body kit on a vw beetle, it may look like a ferrari enzo, but at the end if the day it’s still a beetle in a pretty wrapper. The so-called Assault weapons ban did nothing but ban cosmetics. My dad’s 1864 Winchester 30-30 deer rifle is more powerful than an AR-15. Here’s a quote for you –

    Washington Post editorial (September 15, 1994)

    “No one should have any illusions about what was accomplished (by the ban). Assault weapons play a part in only a small percentage of crime. The provision is mainly symbolic; its virtue will be if it turns out to be, as hoped, a stepping stone to broader gun control.”

    Josh Sugarmann ((Executive Director, Violence Policy Center) – “…the semiautomatic weapons’ menacing looks, coupled with the public’s confusion ..[that] anything that looks like a machine gun is assumed to be a machine gun – can only increase the chance of public support for restrictions on these weapons (1988 memo)

    So why should we not take these people at their word. They have stated, repeatedly, that the calls for restrictions on guns are incremental steps to banning all guns. Why should any sane person cooperate with someone who will lie and misdirect the public for their agenda?

    I have only one thing to say to further restrictions on guns: NO. None of the current restrictions have effected criminals in any way.

  • jim m.d.

    Three epidemics in America: Alcohol, Tobacco and Firearms. All regulated by the Treasury Department. Need I say more?

  • Vox Rusticus

    “What the 1994 Assault Weapons Ban did do was ban aesthetically displeasing weapons, whose operating mechanism is no different than my Daddy’s bird hunting shotgun that you seem to have no objection to”

    Really? I suppose if Daddy used a Benelli SA, no plugs, then OK, but please don’t confuse things here. The mechanisms of most sporting guns are different from “assault” weapons, and you know it. There is a huge difference between a bolt-action deer rifle and a Mini 14 or an AR15, in that the latter two are modifiable to selective fire where the former is not. If you want to make the case that semiautomatic weapons are no more significant in crime statistics than are other weapons, say so, but if you are trying to say that they are no different from what most people associate with sporting arms, then you impeach yourself.

    • Tristan Phillips

      Vox: The mechanisms of most sporting guns are different from “assault” weapons

      Outright lie. Sporting guns and assault weapons use the exact same mechanics. Assault RIFLES (Those weapons that can fire more than one bullet with a single pull of the trigger) operate on a slightly different mechanic, and from a manufacturing perspective EASIER to make.

      Vox: There is a huge difference between a bolt-action deer rifle and a Mini 14 or an AR15, in that the latter two are modifiable to selective fire where the former is not.

      Another outright lie. NONE of those guns can be easily converted. The parts are not available to civilians, and gun smiths will require a lot of time and skill to MANUFACTURE the necessary parts.

      BTW, if you want to sound more coherent keep in mind that unless the gun can fire more than one bullet per trigger pull (AKA FULLY AUTOMATIC) that makes them SEMI-AUTOMATIC. Almost all guns in the hands of civilians AND law enforcement are SEMI-AUTOMATIC.

      You’re not a gun owner. Stop lying.

  • PhillipC

    The thing that always bothers me about people calling for tighter restrictions on firearms ownership is that it intentionally discriminates against the lawful, law-abiding gun owners.

    I’ve no doubt that you would have said I shouldn’t have a gun when I went through the process of renewing my concealed carry license and purchasing a new carry handgun in 2007. I was recovering from a fall off a 40 foot cliff which left me broken in body and vulnerable to attacks. At the same time, there were a rash of parking lot muggings in my area, and I became very aware of how much I looked like a victim. I take the medication Trazadone for an off-label use as a sleep assistant, as well as a standard sleeping pill most nights, and especially at the time as the discomfort made my normal chronic insomnia even worse. I was also taking painkillers to deal with the pain of a shattered hip.

    Every time I read something about “tightening up gun laws” that comes out of the mouth of a doctor, it seems that they’re focusing on people who have to take mood levelers, painkillers, or something else, as though that automatically makes them unsuitable to own a handgun. Guess what? If I know that my judgment is impaired, I put my gun up and don’t leave the house. I’m accustomed enough to my medication to know what effect it will have on me, and I’m not going to be careless with a firearm just because I had an anti-depressant as a sleep aid ten hours ago.

    If you want to stop criminals using guns, focus on the criminal, not on the gun. I’ve known criminals in my life, and I’ve seen them turn a piece of pipe and a sharp stick into a makeshift distance weapon. Criminals are criminals, they’re going to find weapons one way or another, and you’re just trying to make it harder for decent people to defend themselves against them.

    And before you start bleating about my taking drugs and carrying a firearm, my Primary Care Physician knows that I carry, and has expressed no concern about it, and he knows exactly what medication I take.

  • http://www.ambulancedriverfiles.com Ambulance Driver

    Semiauto weapons are used more often in crime because they are more common, period.

    And a gas-operated weapon that fires a single round with each pull of the trigger is functionally no different than a Benelli shotgun with the plug IN, or a Remington 1100, 11-87, or what have you.

    If you believe otherwise, I can only assume that you are frightened of black plastic furniture and scary-looking doodads.

    Your objection to (or support of) firearms seems to be based on aesthetics and arbitrary things like magazine capacity. If a ban on standard capacity magazines succeeds, and next week some disturbed individual cuts loose with a handgun stoked with a 10 round magazine, what’s your next step, six-rounders?

    Will you be decrying the use of destructive high capacity assault revolvers next?

    Here’s the litmus test: Imagine your own idea of a “fair” gun law, all the restrictions on ownership you think are reasonable, limitations on magazine capacity, whatever you want.

    Now, have it enforced by your worst enemy.

    It is the nature of laws to become more restrictive and difficult to enforce, not less. Do you think anyone imagined the morass Medicare reimbursement has become when it was first enacted?

    • ninguem

      Ambulance Driver – “………Do you think anyone imagined the morass Medicare reimbursement has become when it was first enacted?…….”

      There were, indeed, people who imagined the morass, back in the early 1960′s when Medicare was created.

      They were sneered at by the bien pensant.

  • http://www.skincancercenter.com Brooks

    i have never considered this partnership, but your points and arguments are very compelling. This makes perfect sense… unfortunately many accidents and crimes are committed by people who don’t use the normal channels of acquiring a firearm. This would be a good step.

  • ninguem

    I’ve learned over the years. When a writer takes on the subject of gun control…….

    Look for the gerund “-ing” in a description of the gun owner.

    When the author abbreviates the gerund
    ” -ing ”
    to
    ” -in’ ”
    to describe the owner of a firearm, you know you are not dealing with an honest broker. The writer has no intention of contemplating reasonable restrictions on firearms consistent with maintaining Second Amendment rights.

    There are variations on that rule. Description of gun owners with criminal references normally associated with film noir, B-movie crime flicks, or hillbillies.

    “Heat” As in “packin’ heat”. Covers two of the grammar rules.

    “Gat”. “Piece”. “Shootin’ iron”. Surely there are more.

    I’ve found that quite helpful to avoid wasting time with biased writers.

    Application of this rule:
    “…..If you have a better idea, especially you gun-totin’ docs, let us hear it……”
    See, that sentence alone demonstrates the writer’s frame of reference; that the writer has absolutely no interest in hearing any idea that differs from his own preconceptions. This allows the reader to move on without wasting time on such writers.

  • Jeff Taylor

    I guess it’s too much to expect any sensible discussion of the public health effects of so many lethal weapons flooding our society. The argument that criminals, er, commit crime is facile – where did they get the weapons from? And how many US made guns are use in Mexico and other countries to kills many thousands for people?

    And as for the comment above:

    ‘Show me some studies, any studies that gun control legislation has ever reduced crime.’

    That’s the wrong question. We’re taking about harm reduction, and most other developed countries show categorically that strict firearm control means firearm deaths and injuries many times lower than ours. In London UK, a very large city with much overall crime, gun homicides are about 25 a year I believe, and if anyone is caught with a handgun they get jail time.

    So – this is a medical forum, Address the health issues.

    • http://www.ambulancedriverfiles.com Ambulance Driver

      “I guess it’s too much to expect any sensible discussion of the public health effects of so many lethal weapons flooding our society. The argument that criminals, er, commit crime is facile – where did they get the weapons from? And how many US made guns are use in Mexico and other countries to kills many thousands for people?”

      That is a Pandora’s box that you cannot close. You will no more limit the access to guns in this country by public health initiative or legislative fiat than you can wish away disease.

      And to answer your assertion of how many U.S. guns are being used in the Mexican drug war, the answer is 17% of the traceable guns.

      Of course, that’s a very small percentage of the total guns used, because U.S. gun dealers are the only ones whose records can be minded for that data.

      But you’re right, this is turning into a political debate in Kevin’s medical forum.

      Which begs the question, when are medical organizations like the AMA going to stop delving into political issues under the guise of public health concerns?

    • http://jeffthebaptist.blogspot.com Jeff the Baptist

      If we’re actually looking at harm reduction, then you need to look at total deaths and injury from violent crime in general, not just firearms deaths. It does little good to pass lots of laws and regulation only to move corpses from “gun death” to “blunt trauma death.”

    • Gunowner

      Now please check the stats for other violent crimes comitted in the UK while your so fond of quoting stats. I believe your find that while crimes with firearms are down. Violent crimes by other means are way up, so much so, that now they are looking at laws banning knives with sharp points, (like it’s better to be stabbed with a blunt object), to banning glass mugs in pubs because some are using the glassware as weapons…. Do you not see the folly in you arguement on banning the tool, rather than dealing with the behavior that causes the injury? More simply put it isn’t the tool that’s causing the problem, it’s the human’s interaction with the tool that is at issue here. Simply banning the tool does nothing to resolve the behavior, another tool will be found and used. So using your methodoligy where do we stop? Once we’ve banned or controled everything, where do we stop. At what point will you finally realize that it isn’t the tool it’s the human that is the problem..

  • Jason

    I knew the UK example would come…

    Yes, gun-related violence is down…

    However, the gun laws there have had no impact on overall violent crime and, if anything, violent crime has increased…They’re just finding different ways of killing or attempting to kill each other…

    Can someone give one example of a civilized nation where gun control laws have actually reduced overall violent crime?

    Amazing how much in common current proposed gun control laws in the U.S. have in common with the Nazi gun control laws enacted in 1928

  • http://www.lundberginstitute.org george lundberg

    I am pleased by this robust discussion. But I have not recognized a Psychiatrist response. I asked Psychiatrists specific questions. For the record, in the US, there are approximately 33 000 motor vehicle fatalities and 31 000 firearm fatalities per year. For a multiyear span in the 20th Century after public health research was done and some public health measures placed into effect, substantial progress was made at lowering these high death rates for both. Obviously, motor vehicles are essential for everyday life for most Americans. Just as obviously, firearms are essential for the military and for law enforcement and …….maybe Olympic Game events? I personally like to compare my USA favorably with other developed countries whenever possible. Unfortunately, my USA compares unfavorably even with many developing countries on this cause of death parameter.

    • Tim Dougherty

      Interestingly, motor vehicles are not given their own entry in the Constitution, but the right to bear arms is given its own entry. Just like firearms technology has progressed through the years, so has transportation technology. However, motor vehicles are not a right, one can also walk. It just takes longer and can be unpleasant in inclement weather.

      Going by your specified figures, we should be more concerned with motor vehicle deaths. I notice while checking the report from the CDC (dated May 20, 2010) that your figure for motor vehicle deaths is off by about 10,000. When we look, we see that there are 254.4 million passenger cars privately owned in America, and there are estimated to be 250 million privately held guns in America. When looking at the statistics from the CDC, motor vehicles are responsible for far more deaths. As has been pointed out by several people already, your bias shows very clearly against private firearms ownership. I doubt very highly that you will sway organizations to follow your suggestions when you cannot accurately quote the statistics that you base your arguments on. Additionally, while you feel that there are only a few areas that firearms are essential, I personally see far more. While I respect your right to have your opinion, I do not agree with it nor would I support it, just like you would likely not agree with my position on 2nd amendment rights. I ask only that you respect my right to own a handgun and exercise my 2nd amendment rights as I respect your 1st amendment right to free speech.

    • Gunowner

      The soluition to the question of gun safety much like the issue with automobiles is not to ban, but to educate… When a drunk driver collides with another motorist and kills them do we talk of banning the automobile? Or do we punish the offender? Why all the education of don’t drink and drive? Why not apply the same rule used for gun control and ban the automobile?
      Education and Knowledge will do more to lower the incidence of firearm death than all of the gun laws and bans combined. Try a little logic for once, leave your fear, ignorance and knee jerk reactions out of the soluition.

  • http://fertilityfile.com IVF-MD

    Before we can discuss this further, Jeff Taylor, can we assume you would NOT consider it a good thing if firearms deaths decreased by 100 while deaths from stabbings and beatings increased by 1000? Bear in mind that the physically smaller people, such as women and the elderly would be especially vulnerable. Without firearms, how would these people have any chance in the world at deterring an attack from someone much bigger and stronger?

    • gzuckier

      Unfortunately, in real life, aggression goes along with size and strength in the male of the species, and availability of firearms, rather than leveling the playing field, results in more lethal attacks on women; even in households where there is a history of man on woman domestic violence, the addition of a firearm is vastly more likely to involve the shooting death of the woman than any self defense by her.

  • B. Knapp

    >>>I guess it’s too much to expect any sensible discussion of the public health effects of so many lethal weapons flooding our society.<<>>The argument that criminals, er, commit crime is facile – where did they get the weapons from?<<>>And how many US made guns are use in Mexico and other countries to kills many thousands for people?<<>>We’re taking about harm reduction, and most other developed countries show categorically that strict firearm control means firearm deaths and injuries many times lower than ours.<<<

    That's very true, and can be shown by data here in the US. For example, I can't find a single record of a US citizen in the United States being blown up by a rocket propelled grenade or land mine in the last 5 years. Because we don't have them here. Res ipsa loquitur, and essentially useless to the debate you so desire here.

    However, you demand that we "Address the health issues." And I acquiesce.

    The United Kingdom has very, very stringent controls on firearms, and therefore has a low firearm violence rate However, their total violent crime index, as measured in incidents per 100,000 people, is one of the highest in the developed world at 2,034. By comparison, the United States has 466 violent crimes per 100,000.

    So, using your logic, is a decrease in firearms ownership (and along with it, a decrease in firearms violence) worth a 436% increase in violent crime?

    Not to mention, we have a pair of fantastically porous borders, through which we are singularly unable to stop the smuggling of illegal drugs and illegal persons, so I really don't see how adding illegal firearms to the cargo manifold will be that much of a stretch.

    Those are my thoughts on the health issues. What are yours?

  • Jeff Taylor

    A few points:

    The comparison of violent crimes rates is not valid because countries count and categorize such crime in different ways (I’ve checked and in England rates doubled a while ago because they counted things we don’t in violent crime stats).

    Having been to England I do know they have a problem with late night drinking and fights in city centers. If they had guns there would be carnage. Alcohol is the public health issue here.

    We do know the homicide rate is much less. In England and Wales, there were only 619 homicides in 2009/10 and only 40 or so were with guns.

    I’m afraid there is no hiding the fact we have massive public health problem with gun injuries and homicides, not to mention accidents.

    And taking steps to minimize this harm is inevitably a political issue as well as a medical one.

    Does anyone here not want to minimize the harm?

    • http://fertilityfile.com IVF-MD

      Yes, Jeff, we want to minimize harm.

      But having armed criminal gangs and leaving the general little people stripped of all means of defending themselves is NOT anybody’s idea of minimizing harm.

      The technology to make guns has already been unleashed in the world, so either we have a world where good responsible people have equal access or else we have a world where only the criminals and police state have guns. Which do you think will result in the potential for less harm?

      • Jeff Taylor

        Clearly, the societies with strict gun control have far fewer homicides. They also have far fewer gunshot injuries and gun accidents. So the answer is not in dispute.

        • http://fertilityfile.com IVF-MD

          Clearly, the societies with strict gun control have far fewer homicides.

          Jeff, I’ll acknowledge that your statement MAY be true if you acknowledge that it MAY be false. So being open-minded as we are, how would we go about testing it and finding the truth?

          When people point out that strict gun control locales such as Chicago and Washington DC have terrible homicide rates compared to Utah or Montana, those who share your opinion pooh pooh that as comparing culturally different people or comparing different tabulation methods. So then I would challenge you. What would be a way to either prove or disprove your statement?

          If something is non-disprovable, it is meaningless.

          • Jeff Taylor

            The rate of gun deaths and injuries in Western European countries is much lower. There’s no argument about that – these stats are solid.

            Chicago and Washington, the last time I Iooked, are part of the USA, which has about 200 million guns, many of them handguns (not sure of exact number). There are no border controls at the city boundaries.

          • http://www.ambulancedriverfiles.com Ambulance_Driver

            “There are no border controls at the city boundaries.”

            Which is precisely why any measure to limit access to guns will eventually fail miserably, and only exacerbate the problem.

            It’s a bell that cannot be un-rung, Jeff. There were over 14 million guns sold in the U.S. just last year.

            They will not be eradicated, nor will we even succeed in limiting criminal access to the guns already extant. It is simply an impossible task.

            And if we cannot eradicate the disease, then the question becomes, how do we limit its spread?

            Step One on that path would be admitting what you have thus far failed to grasp:

            Violence is the disease, and guns are but one symptom

            And curing the disease by limiting access to guns is about as likely to work as it would be to cure the common cold by making it illegal to cough.

          • Jeff Taylor

            ‘Violence is the disease, and guns are but one symptom’

            OK – how would you reduce violence?

            But I don’t agree with your defeatist attitude that we are somehow unique in not being able to regulate guns.

        • Gunowner

          And in those socities where there is strict gun control the people are subjects not citizens.
          An armed man is a citizen. An unarmed man is a subject. — Machiavelli
          To disarm the people is the best and most effectual way to enslave them.” George Mason, Father of the Bill of Rights
          Gun bans don’t disarm criminals, gun bans attract them.” Walter Mondale, VP
          Laws that forbid the carrying of arms…disarm only those who are neither inclined nor determined to commit crimes…Such laws make things worse for the assaulted and better for the assailants; they serve rather to encourage than to prevent homicides, for an unarmed man may be attacked with greater confidence than an armed man.” -Thomas Jefferson, quoting Cesare Beccaria.
          Gun control? It’s the best thing you can do for crooks and gangsters. I want you to have nothing.” Sammy “The Bull” Gravano
          Gun Control / Stupidity is defined as doing the same thing over and over again and expecting different results. Albert Einstein

    • LibraryGryffon

      I recall reading a few years ago that part of the reason the British homicide stats were lower than ours had to do with how they categorized a death.

      In this country if I’m in a parking lot and a man comes at me with a knife screaming “I’m going to kill you”, and I shoot him, even though it is self-defense, and I won’t be charged with anything, it is classified as a homicide. In Britain, it wouldn’t be, since as I understand it, to be considered a “homicide” it must be murder, manslaughter, or infanticide. Since self-defense isn’t one of those, even though a man died, it wouldn’t be considered in their statistics. So we’ve got to find a way to compare our apples and oranges with their apples before we can use their crime stats to show how bad we are.

  • gzuckier

    However, given the wording of the second amendment, it’s clear that it espouses the right to own and bear arms specifically in order to resist a government’s overstepping its bounds; which means, ironically, “military style” weapons, “assault rifles” and the like, not hunting weapons or defense-against-crime guns; the exact opposite of what “rational gun policy” would espouse.

    Thorny knot.

  • Markus Unread

    Since mental health funding was cut in the 1980′s and never replaced, the mentally ill have dumped on the public and police to deal with. There is very little in place to detect, diagnose and treat the mentally ill as they spiral down to disaster. That and the drug/gang/prohibition cycle are the major causes of violence. It costs “too much” to help the mentally ill, and there’s too much money being made off of the war on drugs for that to change.
    Treat the root cause. Masking the symptoms doesn’t cure anyone.

  • B. Knapp

    OK, I’ll take that bait.

    The comparison of violent crimes rates is not valid because countries count and categorize such crime in different ways (I’ve checked and in England rates doubled a while ago because they counted things we don’t in violent crime stats).

    Actually, the spike in England’s violent crime rate occurred when the British Government brought their reporting in line with EU standards, which are modeled on the standards established by the FBI for their Uniform Crime Report. The argument that there cannot be a 1:1 comparison is false.

    Additionally, critics fault the British home office for “cooking the books” with regard to their crime statistics because they do not include violent crimes committed on or by those under the age of 16. When those results are tabulated with the existing violent crime index, the UK moves from 2,034 per 100,000 (436% of the US rate) to almost 3,000 per 100,000 (644$ of the US rate). A valid argument can be made that US violent crimes are underreported in the UCR, but the fact remains that violent crime reporting rates are almost identical across the western, industrialized world, with the Ukraine and Russia excepted.

    Having been to England I do know they have a problem with late night drinking and fights in city centers. If they had guns there would be carnage.

    Upon what factual basis, exactly, are you basing your assumption that the introduction (really, reintroduction) of firearms into England, specifically the city centers, would result in carnage? I might point out that previous to the Dunblane, firearms were in fact common in England, so one would assume that there was blood running down Victoria St. to the Thames nightly. That just wasn’t the case, sir. You are, respectfully, making things up.

    Alcohol is the public health issue here.

    I could not agree more. I would argue that alcohol is the single biggest public health issue that faces the industrialized world as a whole.

    We do know the homicide rate is much less. In England and Wales, there were only 619 homicides in 2009/10 and only 40 or so were with guns.

    This is very true. However, Europe in general, and England in specific, has ALWAYS had a lower homicide rate than the United States. Moreover, when the UK banned handguns, there was not a statistically significant drop in their overall homicide rate, when looked at over a 10 year span.

    I’m afraid there is no hiding the fact we have massive public health problem with gun injuries and homicides, not to mention accidents.

    I would argue that the public health problem you wish to address is one of violence in general. You are using firearms as a catch-all, if you will, to distract others from looking at the overarching picture. I personally am not willing to trade a drop in firearm homicides for a spike in violent crime. Moreover, I have taken personal steps to protect myself in a way that would be impossible in England.

    And taking steps to minimize this harm is inevitably a political issue as well as a medical one.

    And here we get to the real crux of the issue: the right to own firearms, indeed handguns, is a Constitutionally protected one. As with all rights, it is subject to reasonable regulation, but I personally believe that ALL constitutionally protected rights should be, and indeed are, subject to strict scrutiny when faced with abrogation.

    Does anyone here not want to minimize the harm?

    I don’t think that there is any reasonable person that would not seek to minimize the harm that violence begets our society. I, however, don’t see how additional regulations on legally owned firearms would make any impact whatsoever.

    • Jeff Taylor

      No – the stats you cite about the US and UK are wrong because we include only aggravated assault in violent crime (plus murder and nonnegligent manslaughter, forcible rape, robbery) while England records non-injury and harassment in its stats. In any case, it is simply beyond belief to think that UK ‘violent crime’ is four times the US.

      As for guns in the UK, I doubt you’d get many people there voting to distribute handguns to drunken youths in city centers.

      Your point that I’m arguing for cutting violence overall and not guns is not right because we can quantify the increased harm and costs of the many thousands of gun deaths and injuries as an excess in our society, such as that guy who shot four police in Detroit the other day.

      Nothing you’ve said address this major public health issue. All you are saying is the usual mantra that what we have is an acceptable situation. For many of us, it’s not.

  • joel

    Let’s be realistic. Rarely can an inanimate object kill on its own. It takes, for the most part, a human with an intent or maybe an accident. There was murder before guns and if by some magic we could destroy all the guns in the world people would still find ways to kill each other. Why not make the penalty for using a gun in the commission of a crime SO painful that no one would consider using a gun? Not spending 5-10 with 3 meals and a cot, but 20-life of hard labor?

  • Canuck ER MD

    I’ve always found America’s do or die ranting about gun possession fascinating…

    As for the statistics quoted above as “evidence” – hogwash says I : lies, damn lies and more lies ;-)

    Folks, all I know is that north of the border in my ER, I’ve seen 4 gunshots in the last 10 years : all accidental hunting rifle accidents.

    And no, I don’t see hordes of assaults / stabbings etc etc as a result of the lack of handguns…

    I originally hail from a country where I would see an average of 10 gunshots per day.

    If the average Canadian citizen can do without a handgun, why the hell do Americans think they cannot ?

    It truly bemuses me…

  • http://ohioccwforums.org/ evan price

    Sir: You mention that you and the AMA beleive that firearms ownership should be put to the same set of laws that driving a car should be put to.

    As a CCW holder and lifelong shooter, I would say that I [i]Conditionally[/i] agree with you.

    At age 16 (or 14, if your state allows it), I should be able to pass a simple written test in which the answers are given in a government published pamphlet. I should be able to have a certain amount of range time to demonstrate my ability to correctly identify which end of a gun the bullet comes out of and be able to pass a childishly simple series of handling excercises. Following that I would receive a license to own and carry guns.

    This license would be valid in any of the fifty states- just like a driver’s license. If I wanted to carry a gun in Washington DC, I could do so despite DC’s much stricter gun laws than say, my home state of Ohio, because my Ohio driver’s license is recognized as valid anywhere in the US. I would be allowed to carry those guns openly or concealed or any way in which I desire. It would allow me to carry my gun anywhere I so desired and in any way I wanted- just like I could drive my car anywhere. I could take it to amusement parks, bars, police stations, schools, or any private property that allowed me to enter.

    I would be able to own as many guns as I wanted, of whatever type or size that I wanted, as small or large as I could imagine. They could be fully automatic machine guns, concealable miniature pistols, short barreled shotguns, pistols with an extra grip under the barrel, guns shaped like Oscar Mayer weiners, quad-barreled 20mm cannon, and anything in between. I could trick my guns out with any size barrel or handles I wanted, including combinations that today would be considered illegal according to ATF because they have no “sporting” purpose.

    In fact, the whole idea of “sporting” use would vanish, since automobiles can be built in any style or shape or color the owner desires. If I wanted to add an extended capacity fuel tank, collapsible trunk spoiler, headlight shrouds, tactical push bar, trailer hitch that protrudes conspicuously below the chassis, detachable rear seats, or a shoulder thing that goes up to a car- well, only my wallet size is be an issue- so why would it not also apply to my guns equally?

    I would be able to buy or sell those guns with nothing more than a cash exchange and a handshake to anyone in the United States anywhere with no background checks, no worrying about “Parking Lot Loopholes” or large-capacity fuel tank restrictions. I could advertise them in any venue I wanted. I could open a dealership in firearms anywhere in any state without anything more than the most basic zoning for commercial businesses.

    I would not be answerable to a federal bureau (ATF) for my existance and continued ability to stay in business. I wouldn’t need to call in transactions to an instant background check. I wouldn’t have to worry about government inspectors checking my paperwork and possibly revoking my business license for the dastardly deed of allowing a customer to use the abbreviation “ST.” instead of spelling out “STREET” when they wrote their address on the purchase order.

    Furthermore- as has been clearly and repeatedly demonstrated in the cases of geriatric Americans plowing through buildings, flea markets, street faires, etc- the ‘privelage’ of having such a license would be something that is fought for tooth and nail and renewals would be nearly automatic- meaning that my right to keep and bear arms would be virtually impossible to legislate away.

    Most importantly- if we continue the “treat guns like cars” meme- if I desired to never operate my gun in public, I would never need to have a license, pay registration fees, carry insurance, or use taxed “ammunition” (fuel)- just like vehicles which never use public highways; farm vehicles, for example.

    So yes, treating gun ownership like car ownership would actually be a great advantage!

  • joel

    After all the comments and suggestions I have read I have yet to read ONE thing that will keep guns out of the hands of CRIMINALS! My father the gun control nut once told me that the man who beat my cousin to death with a 2×4 and threatened to come shoot my family would never be able to do that because for him to have a gun would be illegal. I see. Murder is an OK crime but obtaining a firearm after a felony conviction? That is THE crime!

    STOP IT! Drunk driving is illegal yet how many accident victims from drunk driving do we treat? Just possessing drugs is illegal yet how many drug addicts do we treat? Stabbing your wife is illegal yet last night who do you think I was treating?

    Someone come up with a solution for CRIMINALS! Then the question of what weapon they use is mute!

  • PAULMD

    Soylent Green.

  • Markus Unread

    Mexico has very strict gun laws. They also adopted our war on drugs mentality. That’s working out really well.

  • Jim in Houston

    “Unfortunately, in real life, aggression goes along with size and strength in the male of the species, and availability of firearms, rather than leveling the playing field, results in more lethal attacks on women; ”

    You of course have evidence for this.

    Right?

  • Jim in Houston

    “Jeff Taylor January 25, 2011 at 1:06 pm

    Clearly, the societies with strict gun control have far fewer homicides. They also have far fewer gunshot injuries and gun accidents. So the answer is not in dispute.”

    You have evidence for this?

    • Jeff Taylor

      Yes – the rate of gun violence in the UK, France, Germany etc is much much lower. But you know that I’m sure.

  • Gunowner

    If you are opposed to gun ownership then it is your right not to do so, & I respect and support your decision. However it is also my constitutionally guaranteed right to keep and bear arms. (A pre-existing right which predates the law of man, as were recognized in the Bill of Rights and the Declaration of Independence). So all who wish may choose not to keep & bear arms. Again that is your right & I respect that choice no matter how ill advised I believe it to be, that is your right. However you should also respect my right to do as I choose which is to keep & bear arms, as is my right. The problems/crime which resides within our society cannot be legislated or regulated away by law or regulation. Murder is already illegal across the country; yet murders still occur every day. Does banning the tool used make the crime committed any less heinous? Your remedy seeks to regulate the tool instead of the behavior. Evil will always find a way. Only the law abiding will follow the law. Criminals never will. Why should the law abiding be left defenseless? This logic escapes me…
    These are the principles and tenants on which our great nation was founded. I will not impose my views on you and please do not attempt to impose your views/beliefs on me and we’ll all be just fine. I am a sheepdog, I will protect my flock (loved ones) when the wolves come to prowl.

    A world where weapons did not exist may indeed be a better place; however that is not the world in which we live. Man has been killing man since Cain slew his brother Abel. Using the same logic as that applied to the gun issue should we not also forbid the procession of stones? Again the problem is not the tool; the problem is the behavior of man. You figure out how to solve that problem you let me know. Until them I will keep my firearms and trust in myself to protect my own.
    When speaking of a means of self protection the saying goes “It’s better to have it and not need it, than to need it and not have it. The Police have no duty or obligation under the law to protect you.. So sez the US Sup court. Besides when SECONDS count and you or your loved ones life is on the line the Police are just MINUTES away…… Something to think about…. So you must ask yourself am I a sheeple……. Or am I a sheepdog….. I might also add a firearm that’s locked up and put away will be useless to you when you actually need it… Do you really think that you will be able to open a safe combination or otherwise when you’re in a life and death situation, and all of your fingers have been replaced with thumbs.. Under stressful situations the first thing you lose is your fine motor skills, such as those required to open a safe… Take a firearm safety class, teach your children, be safe, practice with your firearm and above all else survive when the time comes. Survival is a mindset and a way of life. The Gun is only the tool; the human employs the skill set and will to use it.

  • Hexanchus

    On the subject of health issues, depending on which statistics you use, the number of completely unnecessary deaths in the U.S. each year caused by a combination of hospital acquired nosocomial infections and medical errors is 3 to 5 times that of firearms deaths. The results of the medical industry’s efforts to reduce this have been, for the most part, ineffectual.

    I submit that before they go looking for other causes, they need to clean their own house first.

    • Jeff Taylor

      The fact that there are other causes of harm does not preclude discussion of any other major source of harm. Here we are discussing the public health harm from guns.

      • http://www.lundberginstitute.org george lundberg

        A little more data to share…..some years ago I practiced Forensic Pathology in New York City, Sweden and England. In one month in NYC, we studied 101 new gunshot wound fatalities, mostly homicides; in 3 months in London, I saw zero gunshot wound fatalities in our Coroner district; in 3 months covering the southern 20% of Sweden I saw 3 gunshot wound fatalities, all suicides.

  • Dave, RN

    My office is in a building that, on the first floor, is the office of a Disabled Crime Victims organization. It’s full of tragic stories of people who got stabbed and shot by criminals and made quadriplegics and paraplegics while minding their own business. And many times they are the survivors, as members of their family died in the robberies or home invasions. None of course were carrying a concealed weapon so they could defend themselves. As the wheelchairs go in and out of that office every day, I’m reminded that I need to protect myself, or I could be one of them.
    A few years ago, some very good friends of ours were the victims of a home invasion. The punks bashed their front door down at midnight. My friends were lucky to escape with their lives. They could not go back to their beautiful home because of the bad memories and had to move, and get counseling as well.
    And just 2 weeks ago, in my nice neighborhood of 2,000 to 5,500 square foot houses, a 15 year old had a gun pulled on him at our playground. And just one block away, there was a home invasion on Saturday at 1:00 in the afternoon.
    So, I keep a loaded shotgun under my side of the bed. I keep security lights on the perimeter of my home at night. I’ve taught my 17 year old daughter how to shoot the shotgun and pistol (she’s confident with them and a damn good shot too). The wife is next. My son has decided to be a cop.
    And NONE of these personal experiences happened in a “bad” area.
    And so I carry. It sounds trite, but it’s true. Take guns away from us, and the only ones that will have them will be the scum that don’t think twice about taking your hard earned money and kidnapping, raping, torturing and killing you and family.
    So tell those disabled crime victims about how guns are a threat to public health, because I’ll bet there’s not one of them who didn’t wish they had exercised their 2nd amendment right to carry concealed and have the opportunity to NOT be a victim.

  • Anonymous

    Tristan, your insulting reply defeats your arguments. You have absolutely no way of knowing who here is a gun owner and who is not. None. So writing that someone who disagrees with you is a “liar” (or saying what is nothing more than a matter of opinion is an “outright lie” when your own contrary statement is no different) really is nothing more than saying you have no rational response to offer. Was that what you really intended? And from the post above, it seems the poster really does not need your emphatic and labored effort to instruct on the differences between semi-automatic and automatic weapons. Read again for comprehension.

    Make a cogent argument if you can, but ad hominem attacks and smearing other posters is a sign of ignorance and a weak mind.