Bioethics Forum Essay
Calling on Doctors to Take the Lead in Fighting for Gun Control
The National Rifle Association recently condemned doctors who are against gun violence, telling us to stay in our lane. Reducing preventable deaths is the main lane for doctors.
And despite thinking that doctors would not be targeted because we are here to help, we are not immune. The tragic shooting at Mercy Hospital in Chicago on November 19 that left an emergency physician among the victims brought home to physicians how vulnerable we are to acts of violence.
The Centers for Disease Control and Prevention recently released a report on firearm homicides and suicides. In an understated way, it said that “firearm homicides and suicides represent a continuing public health concern in the United States.” In 2015 and 2016, the U.S. experienced 27,394 homicides, including 3,224 among youths ages 10 to 19, from guns. In the same period there were 44,955 firearm suicides, including 2,118 among 10-to-19-year-olds.
We are so much worse than any other Western democracy that comparisons are almost meaningless. As I point out in my new book, Prescription for Bankruptcy, people can attempt suicide by many means, but none is nearly as “successful” as suicide by gun. Most people who attempt to kill themselves by cutting their wrists or taking an overdose survive, and repeat attempts are rare. The lethality rate when the means used is a firearm is close to 100%.
Last May, CNN reviewed data on school shootings around the world. While this study was less than truly scientific because it relied on media reports and, thus, might have missed shootings in which no one died, what it found was sad enough. From January 1, 2009 through May 21, 2018, there were 288 shootings with fatalities at U.S. schools, including grade schools and colleges and universities. This was 57 times as many as in the rest of the G7 nations combined. There were two school shootings each in France and Canada, one in Germany and none in Japan, Italy, or the United Kingdom.
A study in Health Affairs last January looked at the death rates among children and teenagers in 19 countries in the Organization for Economic Cooperation and Development. Teens in the U.S. were 82 times more likely to die at the hand of a gunman than were their peers in the other 15 countries.
We are well aware of what happens after each mass slaughter of innocent children. Politicians mouth platitudes and offer their prayers and comfort to the victims and their families. They then hop back in the pockets of the NRA and do nothing to prevent the next shooting.
We can lower firearm fatalities without infringing on the legitimate use of firearms by hunters. Massachusetts has one of the toughest gun laws in the nation and the lowest death rate from firearms. If every state in the country had a similar law and death rate from guns, tens of thousands of American lives could be saved.
To own a gun in Massachusetts, you must obtain a permit from your local police department. This requires paperwork, an interview and a background check. In addition, the local police chief may use discretion if he or she knows something about you that does not show up in your criminal record. Only after you get this permit can you go to a gun store and purchase a firearm. All firearms are registered, and if you get yours from a relative or private seller, that person must verify that you have a permit. Certain weapons, such as automatic weapons and sawed-off shotguns, are illegal. Firearms must be stored in a safe or with a trigger guard. While 97% of permit requests are granted, it is assumed that many people do not bother requesting one knowing the process.
A clear majority of Americans want better gun control. Allowing hunters and others with a legitimate need to own rifles or shotguns after background checks would respect their rights while protecting our right to live. We must stand up to the NRA and tell our elected officials they will not be re-elected if they do not grow spines.
Physicians, dedicated to preserving lives, must take a lead, acting both as individuals and working through their organizations in fighting for common sense gun laws and making it clear that this is as high a priority as fighting the opioid epidemic to avoid senseless preventable deaths.
Edward Hoffer, MD, is a recently retired Massachusetts internist and cardiologist who works part time at the Massachusetts General Hospital on diagnostic decision support.
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