Are Guns Pathogens? Yes. They Cause A Disease Called Gun Violence.

            You may recall that last year eight national medical organizations plus the American Bar Association issued a manifesto calling for medical professionals to become more involved in the debate about gun violence. Actually there wouldn’t be any reason for physicians to justify or explain their professional responsibility to counsel patients on gun violence if it weren’t for red-meat politicians at the state and federal level who gin up political support from Tea Party elements by pretending that guns aren’t a risk to health.

 docs versus glocks           Of course we all know that guns don’t kill people, right? Know how many gun homicides and suicides were recorded by the CDC in 2014?  32,743.  Know how many homicide-suicide deaths occurred with every other type of device?  26,354. Nah, guns aren’t lethal, people are lethal. And if you really agree with Wayne-o and all the other gun promoters on that one, please don’t waste your time sending me a snarky tweet or a nasty blog.  Go lay brick.

            When the Florida gun-crazies passed the physician gag law I was actually somewhat pleased in a perverse kind of way.  Because the truth is that prior to Docs v. Glocks, medicine had allowed itself to get sidelined on the gun issue through a combination of inadvertence, lack of specific counseling guidelines and the refusal of the federal government to fund gun-violence research through the CDC.  And even though medical academies like the AAP had issued pronouncements about gun violence over the years, stating a concern about a medical problem is one thing, doing something about it is something else.

            But last year’s manifesto by the 8 medical organizations marked a turning of the tide, and a recent editorial in the Boston Globe demonstrates that the medical community is moving back into the center of the gun debate where it happens to belong.  The editorial, “Doctors should talk to patients about guns,” is a no-holds barred declaration by the newspaper’s editors that doctors need to go beyond voluntary screening for gun risk and incorporate such questions into their everyday contact with patients.  The editorial recommends the development of clinical guidelines that would not only give guidance for what kinds of questions should be asked, but would “lay the groundwork for breakthrough research on the effect of gun ownership and the roots of gun violence.” In this regard, doctors in Massachusetts have a willing and forceful ally in State Attorney General Maura Healey, who has offered the resources of her office to help develop and implement treatment guidelines as well.

            The Globe editorial was acknowledged several days later in a Letter to the Editor from two prominent Massachusetts pediatricians, Judith and Sean Palfrey, the former a past-President of the AAP, the latter a leader in the campaign to rid lead from environments in which children live and play. What makes this letter so important is the following statement: “Guns, and the bullets they shoot, are deadly pathogens….” 

            Like it or not, that statement happens to be the truth.  The evidence to bolster that statement has been published again, and again, and again.  And I believe that as physicians get more involved in counseling their patients about guns, their approach should be governed by this one fact above all: guns are pathogens.  And a pathogen is something which causes a disease.  And 120,000 violent deaths and injuries each year is a disease.  Period.  Let’s cut the nonsense, okay?

            By the way, calling a gun a pathogen has nothing to do with 2nd-Amendment ‘rights.’  I happen to be carrying around 30 pounds of excess weight.  And when I see my beloved internist he would be remiss if he didn’t tell me to cut out some of those carbs that I love to eat.  But it’s my choice if I want to keep eating more than I should.  And it’s his responsibility to remind me of how what I choose to eat might affect my health.  Think it’s different with guns?  Think again.

Advertisements

Guns and Violence: Believe What You Want to Believe

It’s about time that someone (namely: me) began debunking some of the myths that have been propagated by various NRA cronies who spring into action every time the gun control issue rears its ugly head.  The NRA has done a remarkable job (I’m being serious here) of pro-actively pushing its anti-gun control agenda whether the gun control crowd shows up or not.  Their strategy is very consistent: publicize research that “proves” guns protect people from crime, and make it easier for everyone to carry a concealed weapon.  An armed citizenry is a safe citizenry.  And an armed citizenry is exactly what the gun industry wants because it’s a guaranteed path to higher sales.

But in order to use “research” to bolster this campaign, the NRA also has to discredit the large body of evidence about the relationship of guns to violence that tells a very different story, namely, that guns not only don’t protect us from crime, but may actually result in less safety both for armed and unarmed citizens. This has been the consensus of public health professionals whose views were cited by the Clinton Administration to justify passage of the Brady Act which created the background check system in 1993.  Ever since then, public health professionals and researchers have been a particularly favorite target of the NRA, witness the recent attacks on Dr. Judith Palfrey and the American Academy of Pediatrics.

The basic public health position on gun control was stated most comprehensively in an issue of the Journal of the American Medical Association published in 1994 (April, Vol. 271, No. 16.) This editorial, endorsed by the President of every major New York City hospital and the New York Academy of Medicine called for:  expanding background checks, limiting assault rifles, taxing ammunition, restricting multi-purchases and stricter controls over dealers.  And here’s the sentence that sums it all up: “Ideally, handguns…should be banned completely, but we recognize that this strategy is not currently politically feasible.”

The NRA crowd jumped on this statement in 1994 and have been riding it ever since.  They used it to justify the de-funding of gun research by the CDC in 1997 and they continue to raise the battle cry about ‘anti-gun’ physicians, including a recent Florida law which makes it a felony for a physician to ask a patient whether there are guns in the home.  The most blatant attempt to justify the ‘armed citizen’ approach to gun ownership is a recent article by pro-gun activist and attorney Don Kates, who stated unequivocally that the National Academy of Sciences could find no evidence in a 2004 report that gun controls of any sort reduced gun violence.

Except that’s not what the NAS report actually says.  What it says is that research had not yet found any direct links between crime rates and right-to-carry gun laws.  But the report also said that there was a link between keeping guns in the home and an increased incidence of suicide,  even though pro-gun activists like Kates continue to push the idea that physicians should be prohibited from inquiring about the ownership of guns.

The conflict between pro-gun activists and public health specialists boils down to the following: both groups are advocates with very different goals.  The pro-gun activists want Americans to own more guns; the public health specialists want less violence.  And since the data on the relationship between guns and violence is somewhat ambiguous, both sides can pull what they want from the research and come up with arguments that support their point of view.

NRA (or should I say DRGO) versus AAP: Round 2

On May 14  I published a blog criticizing the NRA ally Doctors for Responsible Gun Ownership for attacking Dr. Judith Palfrey and the American Academy of Pediatrics.  The head of DRGO, Tim Wheeler, responded with several letters  which you can read (along with my responses) in the sidebar to that blog.   In one letter, he told me that all of his articles were “painstakingly researched,” but if I found any errors he would be glad to correct them.  So here goes~~

  1. On May 14 Wheeler published a link to an interview he gave on the NRA Video channel in which he referred to the gun safety advice given by Dr. Judith Palfrey on CNN.COM as “dangerously wrong.”   In fact, her specific advice for keeping guns and kids safe in the same home (lock the guns up, loan and unload carefully, etc.) reads like it was lifted right out of the NRA’s Gun Safety in the Home manual, a course that many NRA instructors, myself included, have been teaching for years.
  2. On May 7, Wheeler’s blog contained several references to America’s “100 million gun owners” whose political clout would be felt at the polls.  The latest surveys indicate that 40% of all U.S. households may contain guns.  Is Wheeler saying that each of these households has 2 1/2 gun owners living under the roof?  I guess he’s assuming that for every guy in a house with a gun there must also be a gal and of course she’s just as much into guns as he is.  Fine.  That still leaves us how to figure out the identity of the half owner.
  3. The May 1 blog was about the lobbying of AAP on Capitol Hill.  His blog referenced a story from The Hill, and asserted that the AAP wanted to ban all semi-automatic weapons and refused to recognize criminology research “showing responsible gun ownership to be a net social good.”  None of these assertions can be found in the referenced story, so I guess they’re from Wheeler’s memory bank. There’s only a small problem. The AAP has only wanted to ban semi-automatic weapons that hold hi-capacity mags (which puts them well within the mainstream) and there has yet to be a single piece of academic scholarship that has definitively linked  gun ownership to crime rates, either negatively or positively.
  4. The April 29th blog was a snide description of the CDC meeting held the previous week to begin discussing research priorities if and when Congress appropriates funding to once again allow the CDC to support research into gun violence.  Perhaps Dr. Wheeler took painstaking notes about the meeting but there’s no evidence that he did any research for this blog.  He was at pains, however, to note the absence of another right-wing, pro-gun researcher named John Lott who, according to Wheeler, is the nation’s “foremost researcher of the effects of gun ownership on crime.”  So here we have one painstaking gun researcher vouching for the credentials of another one.  Except there’s one little problem, namely, that Wheeler is talking about the same John Lott whose painstaking research was discredited when it turned out that he not only faked data used for his thesis but later faked his own identity to strike back at his critics.
  5. The April 19th blog is simply an unvarnished editorial about the defeat of the Manchin-Toomey Amendment in the Senate along with the usual anti-Obama claptrap that sometimes makes me believe that people like Wheeler still think that the 2012 election didn’t take place.  Painstaking research?  There’s no research.
  6. The April 16th blog is a rehash of the May 14 blog which attacked Dr. Judith Palfrey and the American Academy of Pediatrics over their position on guns, and since Wheeler found it necessary to repeat his criticisms about the AAP, I’ll repeat my comments about him.  Either he didn’t bother to read the AAP Policy Statement on Preventing Firearm-Related Injuries, in which case he’s simply wrong.  Or he did bother to read it in which case he’s not only wrong but a liar.  And just to make it clear, when I use the word ‘liar’ I am simply asserting that someone knows something to be true and states otherwise.  If Dr. Wheeler read the AAP Policy Statement he could not have described it the way he did unless he consciously chose to misrepresent what was said.  In which case, he’s a liar. Either way, this blog does not contain any painstaking research, or any research of any kind, for that matter.
  7. The April 2nd blog is an attack on Marian Wright Edelman who, as President of the Children’s Defense Fund spoke out about gun violence after the massacre at Sandy Hook.  There’s no research here, there’s just another editorial swipe at a long-time advocate for children who doesn’t think that guns and kids are a good mix.  But I did notice one tiny bit of data that struck me as rather odd, given that it was presented by a man who describes his own research as “painstaking.”  In his attack on Dr. Edelman, our painstaking scholar Wheeler mentions that 80 million Americans own guns.  Yet his May 7th blog contains several references to the 100 million Americans who own guns.  Is he saying that 20 million more Americans became gun owners between April 2nd and May 7th?  I raise this point because Dr. Wheeler assured me in his response to my previous blog that his work was based on “painstaking” research.  So I took him at his word and began looking for examples of his painstaking efforts.  I read every word of his last seven blogs and the only, single fact that I could find that came from him rather than from someone else was the number of Americans who own guns.  Except that the number changed – in just 5 weeks it jumped by 20 million.

So much for the painstaking research of Dr. Wheeler, the NRA medicine-man who can’t tell the difference between research and editorials and probably doesn’t care.  Yes, we will be publishing some more blogs on Wheeler and the other so-called scholars who toady up for the NRA.

NRA Takes on the AAP: Have They Lost Their Minds?

aap

 

When the NRA or one of its minions goes after pediatricians, the way they are now going after Doctor Judith Palfrey and the American Academy of Pediatrics, they have fallen off the cliff.  This isn’t just more proof that the leadership has come under some extremist, radical spell.  To me it means they have entered goofy-land.  And it scares me because I’m a member of the NRA.  I don’t like to think that this organization, which I joined in 1955, could now be led by people who have completely lost their minds. The NRA didn’t attack Dr. Palfrey and the AAP directly.  It was done for them by an interesting sub-group called Doctors for Responsible Gun Ownership.  The head of this group, which claims “1,400 doctors, health care professionals, scientists and others nationwide,” is a physician named Timothy Wheeler.  This organization doesn’t even make a pretense of being rooted in science or fact and coming from other physicians,  its attack on Judith Palfrey and the AAP,  is a professional disgrace. According to Dr. Wheeler, Dr. Palfrey “was recently the president of the notoriously anti-gun rights American Academy of Pediatrics (AAP), which urges doctors to pressure their patients to get rid of their guns.” That statement is simply a lie.  This past January, the AAP produced a Policy Statement: “Preventing Firearm-Related Injuries in the Pediatric Population.”  It is the official AAP statement on gun ownership as it relates to the health and welfare of children and it was published after the Sandy Hook massacre.  I am assuming that Dr. Wheeler read this statement which is why I am calling him a liar.  If he didn’t read it, he’s a fake.  Either way, here’s the AAP’s official position on guns:

Counsel parents who possess guns that safe storage (locked

and unloaded) and preventing access to guns reduces injury

(by as much as 70%), and that the presence of a gun

in the home increases the risk for suicide among adolescents.

Physician counseling, when linked with the distribution

of cable locks, increases safer home storage of firearms.

                See anything here about getting rid of guns?  See anything here about not owning guns?  See anything here about being notoriously anti-gun?  Well, I guess that if you believe that leaving guns unlocked around the house makes you anti-gun, then that makes most gun owners, including me, anti-gun.  In the interests of full disclosure, I happen to be married to a pediatrician.  She has no problem with the fact that I own a gun shop because she knows that I understand what gun safety really means.  She knows that I counsel my customers about gun safety the same way she counsels her patients.  I guess this makes us both anti-gun, right Dr. Wheeler? Judith Palfrey is among the most respected, eminent pediatricians in the United States.  She has passionately and pragmatically argued for child health priorities over a long and distinguished career.  She deserves a seat at any table when the issue of gun safety is discussed.  What she doesn’t deserve is to have her views distorted by a toady for the NRA.  The NRA leadership can reclaim their credibility by renouncing Timothy Wheeler’s reckless and false statements.  They don’t need to look for enemies under every bed.  They need to come out from the extremist rock under which they have crawled, join with groups like Evolve and contribute to finding sensible solutions to gun violence.