Do Attitudes Of Gun Owners And Non-Gun Owners Differ That Much? I’m Not So Sure.

You may recall that several months after the Sandy Hook massacre, the New England Journal of Medicine published a survey on attitudes towards gun regulations that was developed by the gun violence research group at The Johns Hopkins University’s Bloomberg School of Public Health.  Which means, of course, that the survey was designed to promote the gun-grabbing agenda of Mayor Mike.

hopkins            I’m being a bit sarcastic in what I just wrote because there is simply no way I can hold a conversation or direct anything I write towards a dialog with Gun-nut Nation, because thanks to Street Thug Trump, Gun-Nut Nation is rapidly becoming a haven for the lunatic fringe.  And if you want proof of that last statement, I direct you to a missive from a gentleman named Dr. Michael Brown, described on the Doctors for Responsible Gun Ownership website as a “pragmatic Libertarian environmentalist,” who writes in detail about what he calls “The Ten Favorite Lies of the Gun Control Lobby,” And Lie #6 just happens to be the findings of the Johns Hopkins survey which found that a majority of gun owners want “more gun control.”

When the Hopkins survey was released back in 2013, attention was riveted on an attempt to get the scope of FBI-NICS background checks expanded to cover secondary (i.e., private) transactions and sales. The bill ultimately went nowhere fast, but the findings from the Hopkins survey were used by Manchin-Toomey supporters to help build their case. In light of the claim by Michael Brown that these findings were nothing more than a lie, I decided to take another look at what the details of that survey really show.

The survey was actually two surveys, one covering gun policies, the other devoted to guns and mental health.  I’m going to focus only on the former because this is the part of the survey which has been characterized as a “lie.”  The survey was completed by 1,865 respondents, of whom one-third reported that there was a gun in the home.  Here are some of the findings:

  • Banning purchase of assault weapons: Non-gun owners yes – 75%.  Gun owners yes – 46%.
  • Confiscation of currently-owned assault weapons: Non-gun owners yes – 63%, Gun owners yes – 37%.

The survey also asked whether a physician whose patient expressed a desire to hurt himself or others should be allowed to contact the NICS system to prevent such individuals from having a gun for a period of six months.  Actually, the survey question is slightly confused because NICS covers purchases, not ownership of guns. But the bottom line is that 75% of non-gun owners believed that physicians should be able to intervene in instances where a patient’s access to guns demonstrated a risk. Ready? 72% of gun owners felt the same way. Wow.

The results of this survey are astonishing in terms of what it says about how attitudes of gun owners and often differ from the usual narrative that we get about guns. If nearly four out of ten gun owners agree that assault weapons should be confiscated, if nearly half current gun owners believe that the purchase of assault weapons should be banned, if seven out of ten gun owners think that physicians should have the authority to help prevent at-risk patients from access to guns, then I think it’s time for Gun Violence Prevention advocate to stop worrying about being demonized for wanting to ban certain guns, and it’s time for physicians to drop their concerns about raising valid medical issues that  might make them appear to be anti-gun.

It will probably be difficult for the remainder of this campaign cycle to distinguish between the rantings of Gun-nut Nation and what might be in the minds of average folks who happen to own guns.  But if things turn out the way they should on November 8th, a serious and substantive gun debate might actually take place.  The Hopkins survey clearly indicates that there are reasonable voices on both sides.

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The Doctors For Responsible Gun Ownership Crawl Out From Under Their Rock Again.

               It figures that just when an effort is being made to push money for gun research back into the budget of the CDC, that the Doctors for Responsible Gun Ownership would crawl out from underneath their rock and once again simply lie to the American public about the medical risks of guns. These guys have been around for the last twenty years and even though they claim to represent a large group of physicians, I have never found a single doctor who would admit to being involved with these charlatans because what they say about guns and medicine is simply an attempt to promote gun ownership without the slightest shred of evidence that supports anything they claim to be true.

               Their latest attempt to use the fact that they claim to be real physicians in order to pretend that what they say is scientifically-based is a little meme on their Facebook page which purports to give the true ‘data’ about gun violence, in particular the number of lives lost each year because of guns. Their post begins with the statement that 32,000 ‘firearm-related’ deaths a year are, in fact, a number in decline.  Actually, the 2014 number is 33,599, which is up from the 2011 total of 32,351.  In fact, the number has been rising steadily since 2000 when it hit a low-point of 28,663.  Where do I get my numbers which show a 17% increase since Y2K?  The same place those schmucks claim to have gotten their numbers: the CDC. Moving right along.

               They then claim that 80% of all gun homicides are the result of crimes and participation in gang activity.  Now to begin with, they give the number as 10,560 when in fact the real number of gun-related homicides is 10,945.  You might think this is a trifle to be upset about, but remember we are talking about doctors who are supposed to use evidence-based data to support their point of view.  So either the number is correct or its wrong.

               More important, their statement about 80% of gun homicides being the work of criminals or gang members is simply not true.  According to the FBI, less than 20% of all gun homicides take place during the commission of violent crimes.  And somewhere around another 5% of all gun homicides are listed as involving criminal activities between gangs.  Most gun homicides are crimes after the fact because they take place as a result of a domestic or other dispute and until someone decides to end the argument by pulling out a gun, no crime has usually occurred.  Moving right along.

               Having decided that only 5% of all gun homicides take place outside of criminal events, these medical frauds then concoct the usual statistic designed to show that there’s really no gun violence in America by simply taking the number of murders left over after eliminating just about everyone killed with a gun, dividing that number by the total American population and declaring that “America does not have a gun problem.” 

               I’ll tell you what America has right now.  It has two or three men claiming to be physicians who simply invent whatever numbers they want to invent in order to serve as shameless shills for the NRA.  That’s all these guys are: shills and stupid ones at that.  You would think that if they wanted to convince any physician that their numbers mean anything at ball, that at least they would copy the numbers correctly from the CDC.

               But the truth is that these phonies aren’t looking to convince other physicians of the rightness of their cause. They are simply trying to make sure that any time the issue of gun violence and medicine comes up, they’ll get a call to appear on Fox News, the NRA video channel or some other media channel that will help them spread their exaggerations, untruths and outright lies.  God bless America, even quacks like this bunch can find a warm rock under which to build a nest.

              

This Doctor Better Not Read Medical Charts The Way He Reads Reports On Hospital Crime.

This was a pretty quiet week in the world of guns.  The Republican debate came and went without any born-again pledges of absolute fealty to the 2nd Amendment, only 67 people were shot dead since the middle of the week, which is below the normal rate, and the headline article on the NRA-ILA website was just a kvetch about Hillary’ taking away all the guns. So I figured I’d have to dig pretty deep to come up with something to say in the column I write every Monday for the Huffington Post, until low and behold the looniest pro-gun group, a.k.a., my friends at Doctors for Responsible Gun Ownership, let fly with yet another attempt to challenge the assumption that physicians align what they say with at least some regard for reality, if not for facts.

docs versus glocks              Because the truth is that we really wouldn’t feel pleased about visiting the doctor if we felt that what he told us about our health was something made up out of thin air. So when we hop on the scale or let the nurse wrap our arm in a blood-pressure cuff, the whole point of these tests and others is to give our physicians an opportunity to evaluate our medical condition based on what he sees and what he knows.

But when it comes to their views on guns and gun violence, the physicians who contribute commentaries to the DRGO website are about as far removed from any reality as the veritable man in the moon.  The latest flight into fancy is a column written by a family physician in Iowa, Sean Brodale, who is of the opinion that hospitals are not only becoming very dangerous places, but that the remedy is – you guessed it! – allowing the medical staff to be armed.  In fact, this physician believes that since healthcare professionals are entrusted with caring for patients every day, why shouldn’t doctors be trusted to “defend our patients’ lives with a firearm if a violent situation requires it?”

In all of the explanations and justifications for CCW put forth by Gun Nation, this statement comparing medical caregiving with armed self-defense has to rank as maybe the single dumbest thing I have ever heard.  In order to administer medical care to his patients, the author of this riveting commentary first graduated college with a specialty in pre-med, he then did four years of medical school, followed by at least three years of internship and residency and perhaps then a fellowship year or two.  In other words, before he ever sat down to discuss anything with a patient, he had been training for upwards of a dozen years.  And to maintain his medical license, he needs to spend a substantial amount of time in accredited, continuing education classes, as well as being re-tested on his medical boards.  Know what the training requirements are for CCW in the Hawkeye State?  Taking a couple of hours to complete the usual NRA course.

No article promoting the value of armed self-defense would be complete without some attempt to prove that the world is a very dangerous place.  And in this instance, the author gets his evidence from a report on hospital security which shows a whopping 40% increase in hospital violent crime between 2012 and 2014.  But if the DRGO author had bothered to read beyond Page 3, he would have discovered that this growth consisted entirely of increases in vandalism and cars being stolen out of hospital parking lots; every category of person-to-person violent crime – assault, disorderly conduct, burglary, theft – went down.

I just hope that when Dr. Brodale puts together a patient’s wellness program, he reads the relevant test documentation with a bit more care than he used in making the argument for letting hospital staff walk around with guns. He might also ask whether the NRA’s stance against any mandated CCW training meets the most minimal definition for reducing medical risk. Don’t worry, it doesn’t.

Want To Learn Nothing About Public health And Guns? Listen To The DRGO.

There are a couple of loud-mouth fools out there masquerading as physicians who run something called Doctors for Responsible Gun Ownership (DRGO).  Actually, what they run is a website that is sponsored by the 2nd Amendment Foundation, and these characters have been pandering to the NRA and the gun-nut audience since medical research on guns became verboten thanks to defunding of the CDC.

Their latest screed is an all-out attack on the decision by the major medical societies, along with the American Bar Association, to take a more aggressive stance on gun violence, something which has been defined as a public health issue since 1981.  And by the way, in case you’ve forgotten, the President that year happened to be a fairly-conservative guy named Reagan, not some gun-grabbing liberal like Clinton or you-know-who.

Gun violence was and is considered a public health issue for one simple reason, namely, that shootings result in the deaths and injuries of more than 100,000 human beings each year.  And it doesn’t matter whether these human beings are mostly old, White men living in small towns who impulsively stick a gun in their mouths and pull the trigger, or young, minority males who just as impulsively settle arguments with guns rather than their fists, the bottom line is that much of this damage wouldn’t occur if it wasn’t so easy to get one’s hands on a gun.

emt                I wouldn’t have any argument with the DRGO gang except for the fact that what they claim to be the mission and method of public health is so far removed from the truth.  In fact, not only do they misrepresent public health, they don’t even remotely or accurately convey what the public health community thinks about guns.  Instead, they pretend there’s no difference between the strategies promoted by advocacy groups like Brady or VPC, as opposed to peer-reviewed research conducted by experts in public health.

The fact is that gun-safety advocacy relies on public health research for many of the arguments that they promote in the public domain, but advocacy still drives public opinion, evidence-based or not.  The late Senator Daniel Patrick Moynihan once said, “We are all entitled to our own opinions, but we’re not entitled to our own facts.”  Public health research on any issue is an exercise in fact-building, how those facts are then used or not used by advocacy doesn’t invalidate the research itself. On the other hand, the pro-gun community not only eschews reliance on evidence-based research in forming and promoting their point of view, they often distort or wholly lie about the little bit of research which they claim proves what they say to be true.

And the most flagrant example of such lying is found in the attack on public health by DRGO.  Here’s the DRGO verdict on public health and guns: “Today the phrase ‘public health perspective’ as applied to gun violence only takes into account the harmful results of gunfire. It ignores the variety of reasons guns are valued. Most significantly, it ignores people using guns defensively at least 760,000 times per year (90% of the time not even needing to fire them) and the disincentive for criminality that promotes.”

Even if it were true that guns prevent 760,000 crimes each year, the idea that this transforms the 100,000 gun deaths and injuries each year into something other than a public health issue is absurd, and no physician who takes medicine seriously would advance such a stupid state of affairs.  But worse, the 760,000 figure wasn’t derived from any research at all; it was “estimated” by Gary Kleck in a Politico piece attacking critics of his research not because of what they said, but because their criticism was ‘proof’ they are part of the gun-grabbing cabal.

I’m going to send a note to DRGO that I’m willing to debate them any time, any place, on the issue of public health and guns.  They won’t agree to such a debate because they’re all about denying gun risk, not about truth.  Whatever happened to the Hippocratic Oath?

 

 

 

A Medical Voice From The Past Explains Gun Violence In The Present.

I don’t usually applaud anything that the quack physician, Timothy Wheeler,  posts on his Doctors for Reponsible Gun Ownership website, but he’s done us all a favor today by digging up a remarkable article that was originally published in 1980 by Lester Adelson, who served for many years as the Deputy Coroner of Cuyahoga County.  In case you don’t know it, Cuyahoga is a.k.a. Cleveland, which means that Dr. Adelson knew a lot about gun violence.  I’ll ignore the usual stupidities of Wheeler and get right to what Adelson said, because thirty-five years after the fact much of what Adelson observed then remains relevant today.

Adelson confronts us first not with the issues of mortality and morbidity from guns, but with a much more profound problem, namely, the quality of life experienced by those who survive a gunshot wound.  He notes that an increasing number of gun-violence victims survive the assault, which is even more true today than it was thirty years ago.  But he then raises the post-trauma quality of life issue of which we know very little.  Adelson mentions in passing that survivors of gun violence have shortened lives, but he offers no data and I can’t recall a single study which sheds information on this fact.  He also talks about post-incident psychological trauma, again an acknowledged result of being at the wrong end of the barrel when a gun goes off, but we lack specific data to better understand this issue as well.

conference program pic                Think about this: there may be more than 1.5 million of us alive today who at some point endured the pain, suffering and physical/psychological damage caused by a bullet puncturing and exiting our bodies or remaining inside.  What kind of lives do these folks lead after they are discharged from the hospital and told that everything’s “o.k.?”  Can they go back to work?  Will they live out a normal life-span or expire at an earlier age?  We keep very good records on cancer patients in order to determine whether the treatment they received kept their cancers in remission or resulted in reappearance of the “emperor of all maladies.”   But the survivors of gunshot wounds, unless they come back to the hospital with another gunshot wound, are largely on their own.

Two other points from Adelson’s article deserve mention.  First, he confronts the degree to which we are immune to the issue of gun violence, noting that if Cuyahoga County experienced as many deaths each year from typhoid fever as they did from guns, there would be “mass hysteria.”  And Adelson wrote this article in 1980, well before shooting deaths in Cleveland and other major cities peaked in the 1990’s.  But this comment struck a chord because I recall that we started rushing medical supplies to Central Africa to ward off Ebola which, if it killed the same number of people in a year who are killed by gunshots in America (roughly 30,000), would have been considered an epidemic by the WHO.

The second, and perhaps more important point raised by Dr. Adelson is the recognition that gun homicides and crimes aren’t the same thing.  The idea that gun violence and crime are synonymous has been a convenient way for the pro-gun folks to distinguish between ‘law-abiding’ gun owners who shouldn’t have their guns regulated, as opposed to criminals who do the bad things with guns and just need to be locked away.  Adelson cuts right through this nonsense when he says, “The accessibility of a firearm permits the instantaneous metamorphosis of a law-abiding (hot-headed?) person into a murderer,” citing data which shows that most homicides are not associated with other felonies and often erupt in the context of a domestic dispute.

Adelson’s brilliant and prescient article underscores one thing that is true beyond a shadow of a doubt: guns are very, very lethal and no matter what an idiot like Tim Wheeler says, putting one into someone’s hands creates medical risk.  That’s not just a problem for gun owners per se, it’s an issue that physicians always need to address.

 

Not All Physicians Think Guns Are Bad – A Few Think They Are Very Good.

Last month a 3-year old in New Mexico grabbed his mother’s gun and shot both Mommy and Daddy, although luckily both parents survived.  The previous month in Idaho, Mommy wasn’t so lucky when her 2-year old pulled a gun out of her purse and shot her to death.  Both of these senseless, ridiculous events provoked the usual storm of media coverage leading to the predictable condemnation of guns on the one hand and defense of guns on the other.

Don’t get me wrong.  We are all human and we all do stupid, senseless things, from driving when we’ve had too much to drink, to sitting in a full bathtub while trying to plug a hair dryer with a loose wire into the wall.  But what’s different in the case of these gun accidents is that we’re not talking about something as important as an automobile or even as necessary as looking the best we can before we leave home for work.  We are talking about the decision to walk around with a gun, based on the idea that guns protect us from crime.

docs versus glocks                I have no issue with people who decide to carry a gun and I have never written a single word calling for limits on CCW or gun ownership, believe it or not.  But I think that if people decide to buy or carry a gun for self-defense, they should understand the risk involved, and not let the gun industry’s marketing serve as the final word.  Unfortunately, some of the most uninformed and blatantly misleading information about guns is provided by a small group of physicians who should know better, if only because physicians are the one profession in which decisions about risk can only be driven by evidence-based knowledge and not by their own personal views of what’s good for a patient’s health.  It’s a group of medical crackpots called Doctors for Responsible Gun Ownership, which began life in the mid-1990’s as a sycophantic, pro-NRA effort to defund gun research coming out of the CDC.  They claim to have a network of more than 1,400 health professionals but their website, associated with the 2nd Amendment Foundation,  is just a blog on which several physicians post commentaries whose distortions and downright falsehoods have been the subject of more than one of my own posts.

Just to be clear, I don’t have any issue with anyone who wants to opine on any subject at all. But when a professional dispenses professional advice that runs counter to the accepted practices and policies of his profession, then we’re not just dealing with idle talk.  In the case of medicine, we are dealing with advice which, if followed by patients, could result in serious medical harm.  To cite one example, in a recent DRGO post, the physician-author claims that “research shows how more guns in the right hands can minimize violence.”  There is no such research, at least none that meets even a minimal, evidence-based standard.  Is this physician counseling someone concerned about violence to go out and buy a gun even though he can’t point to a single, evidence-based study  that validates his point of view?

To show you how loony and unprofessional the DRGO group really is, their website carries a commentary by Jane Orient, a physician who told a conspiracy-minded web-hosted talk show that more than 100,000 West Africans who might be infected with Ebola were sitting in Central America getting ready to cross into the United States.  If Jane Orient is now the standard by which DRGO defines statements about medical risks from guns, Ebola or anything else, it becomes impossible to imagine that physicians belonging to this organization should be counseling on health risks at all.  But the point is that these medical charlatans don’t believe that guns are a risk.  And they are happy and even proud to promote this nonsense because they don’t support the Hippocratic Oath.  They support the marketing strategy of the NRA.  In the interests of full disclosure, I’d love to know how much and to what degree the 2nd Amendment Foundation is supporting them.

 

When It Comes To Guns, Physicians Should Forget The Hippocratic Oath.

Now that America finally has a Surgeon General, you would think that the debate over his appointment would give way to an honest and serious effort to evaluate Vivek Murthy’s performance as he leads the nation’s public health effort for at least the next two years. But there’s one guy out there who simply can’t leave the issue behind, and as he continues to fulminate over Obama’s choice for Surgeon General, the hot air and the lies continue to expand.  I am referring to Tim Wheeler, the sometime head of an alleged organization which claims to represent thousands of physicians who support ‘responsible’ ownership of guns.  The NRA has been pushing this quack into the public arena ever since the gun lobby decided that the listing of gun violence as a public health problem meant that physicians had become, to gun owners, Public Enemy Number 1.

      Vivek Murthy, M.D.

Vivek Murthy, M.D.

I didn’t notice the automobile industry attacking physicians when car accidents made the list as a public health problem.  In fact, Detroit collaborated with public health researchers when it came to designing and producing safer cars.  The same could also be said of the household recreation industry which helped craft legislation passed by state after state which mandated that fences be installed around all in-ground, backyard pools.  But somehow the gun industry decided that its products not only did more good than harm, but decided that they did so much more good than harm that the issues of lethality and safety risks didn’t need to be discussed at all.  Enter Timothy Wheeler, who has doggedly led the fight to disconnect physicians from any public discussion or publicly-funded research about guns.  And if you doubt the validity of anything he says, remember, this is a guy who claims to be an M.D.

Now I’m not an M.D. but I can do simple math.  And if guns are the method of choice in 100,000 fatal and non-fatal but serious injuries each year, then we’re not talking about chopped liver in medical terms.  We’re talking about a medical condition which costs countless lives, billions of dollars and untold family trauma each year, the human results of which inevitably end up in a critical-care treatment bay with the terrified family and friends waiting to be told whether they’ll ever be able to speak to the shooting victim again.

 

Wheeler’s latest effort to spread misinformation and stupidity about the role of physicians in gun violence is an op-ed on the National Review website which features his bizarre frothings from time to time. In this particular effort, he not only takes aim at Murthy and the potential danger that he represents for gun owners over the next several years, but he also repeats the fiction that physicians have no right to invade patients’ privacy by advocating “gun control” in the examining room.

If Wheeler is so lacking in the most rudimentary understanding of how medical professionals attempt to asses patient risk he can be excused if only because he may not know how much disinformation he’s handing out.  But if he’s aware of how physicians are trained to assess medical risk then he’s just pandering to an audience who can be excused for not knowing what Wheeler’s supposed to be talking about.

Physicians usually begin an examination by asking the patient how he or she feels.  The answer to that question prompts the next question,  the answer to the next question prompts a third, a fourth and as many questions and answers as the physician needs to ask in  order to assess the health risk of the patient sitting in the examination room.  To place any limits on the doctor-patient exchange of information is to ask a physician to violate the Hippocratic oath.  But Wheeler’s not interested in the method that physicians use to reduce harm.  He’s interested in helping the NRA marketing team, which means he’ll say whatever the gun industry needs to have said in order to sell guns.  He’s a good salesman from that point of view; as a physician he says things that simply aren’t true.

Why Should Doctors Talk To Patients About Guns? Let The NRA Do It.

When the 11th Circuit re-instated the Florida gag law on physicians talking to patients about guns I knew that sooner or later we would hear from Timothy Wheeler and his gun-promoting group which believes that 19,000 gun suicides, 11,000 gun homicides and 50,000 (or more) intentional gun injuries each year shouldn’t concern physicians at all.  Wheeler is the doctor who began promoting the idea that doctors who inquire about gun ownership are their patients’ worst enemies, and his organization is rolled out by the pro-gun lobby whenever they need additional ammunition to keep America from adopting a common-sense approach to the issue of gun violence.

Wheeler’s organization, for which his claim of having thousands of members has never been verified in any way whatsoever, has just launched a small campaign to support the Florida gag law, at the same time that a coalition of medical associations and advocacy groups are going back to the 11th Circuit to ask the entire court, en banc, to overturn the recent ruling.  Which is exactly why Wheeler and his buddies in the gun-blogging community are trying to tilt public opinion the other way.

docs versus glocks                In the interests of full disclosure, I should state that I am married to an attending pediatrician, and am also a member and certified gun trainer for the NRA.  I have no issue with private ownership of guns but I take personally these indecorous attacks on physicians who are required to speak with patients about any matter which they feel might pose a medical risk, particularly involving something as potentially lethal as a gun.  The shabby attempt by physicians like Wheeler to pretend that guns do not constitute a health risk reminds me of the pathetic charades conducted back in the 1950’s by a few physicians and scientists who publicly disavowed any link between smoking and cancer.

Of course Wheeler and his cronies, in this case a psychiatrist named Robert Young, don’t want their audience to believe that they are against safe use and storage of guns.  After all, everyone’s in favor of safe gun use these days,  just ask the NRA and they’ll tout their gun safety program, aka Eddie Eagle which has “reached more than 26 million children in all 50 states.”  The same website that contains this information about Eddie Eagle also states that the NRA is “not affiliated with any firearm or ammunition manufacturers,” which is, simply put, a lie.  But Dr. Young seems oblivious to the requirement in his own medical profession to base clinical decisions and strategies on evidence-based information, since he advises his medical colleagues to use the Eddie Eagle handouts in contacts with patients who might or might not own guns.

I saved the best part for last.  Although Dr. Young believes in educating children in safe behavior around guns, he also wants to make sure that the safety of children is balanced out by the requirements for self defense.  And I quote:  “Even the sound practice of storing guns and ammunition in separate, locked places isn’t always right if they are intended to be used for emergency protection.”

This guy’s a physician?  This guy took the Hippocratic Oath which requires him to counsel patients about risks to their health?  There is not one single piece of credible research which shows that keeping a loaded, unlocked gun around the house creates protection from crime that outweighs the risks of injury or death from the existence of that gun.

People like Robert Young and Timothy Wheeler find media outlets for their destructive ideas because we really are committed to the idea of hearing “both sides” in the public policy debate.  But I don’t think that there are two sides when it comes to discussing a health issue which claims 80,000 or more victims each year.  Unless, of course, you’d rather believe that mortality and morbidity at those levels has nothing to do with health at all.