Last year the American College of Surgeons was one of eight national medical organizations that endorsed a ‘Call to Action,’ an important step forward for bringing the medical community back into the gun violence debate. Physicians felt less than welcome when CDC-funded gun research was cut off in 1997; they felt even more marginalized after Florida passed a law in effectively gagging doctors who wanted to counsel patients about guns. So the 2015 manifesto by eight medical organizations (plus the American Bar Association) was a welcome signal that the nation’s healthcare providers were once again prepared to lend their energies to finding solutions to deaths and injuries caused by guns.
Now one of those eight organizations, the American College of Surgeons – Committee on Trauma, has taken this issue to the next level and issued their own strategy for firearm injury prevention, or what they refer to as a “consensus” approach to preventing gun deaths. When it comes to gun injuries, trauma surgeons represent medicine’s “front line” because their skills and techniques are usually what maintains someone’s life after they have been shot. The evidence is difficult to analyze on this point, but I suspect that one of the major reasons that gun mortality continues to drop while overall gun injuries continue to rise is due to what goes on in a trauma center after the shooting victim is wheeled in.
The violence reduction strategy being advanced by trauma surgeons marks a new approach in one major respect because it calls for trauma centers to become not just places where shooting victims are treated for their injuries, but locations that “focus on developing and implementing evidence based violence prevention programs.” Such a pro-active approach recognizes that gun violence victims are often serial victims of violence in general, they tend to come back to trauma units frequently over time. The trauma surgeon is often the last physician who consults with a shooting victim before the patient is discharged and thus should be counseling the patient on the risks of continuing a life-style which encourages further violence and will no doubt result in a reappearance in the trauma unit again.
Evidently there is a division of opinion among trauma surgeons as regards the whole issue of gun violence, because this new, pro-active approach being suggested by the Committee on Trauma reflects what the Committee finds to be a “significant controversy” among surgeons regarding “two dominant contrasting narratives” about the role and value of guns. One narrative, according to the Committee, views guns as an ‘emblem’ of personal liberty; the other views guns as an ‘emblem’ of violence. The Committee believes that the gap between these two narratives can be combined by creating a new narrative which they call ‘freedom with responsibility.’ In other words, guns make us ‘free’ as long as we use them in a ‘responsible’ way.
I have been following the bandying about of various calls for freedom by Gun Nation for the last twenty or thirty years and with all due respect to the serious and thoughtful effort by the Committee on Trauma to find a new path that will achieve some degree of consensus on both sides, I’m not sure that their concerns for acknowledging the need for gun-owning freedom are all that well placed. I am no constitutional scholar by any means, but freedom to me has nothing to do with how I feel about it or what kind of emblems I tote around to express my desire to be ‘free.’
As far as I am concerned, freedom means one thing and one thing only, and that is the rule of law. It’s law that keeps us free and it’s law which defines our public behavior in every respect, including how we own and use guns. Have you noticed lately that Gun Nation and its noisy political acolytes like Donald Trump never tire of reminding us that gun violence won’t be solved with more laws?
Freedom and responsibility? How about just responsibility?