A group of physicians representing the front lines of medicine in the battle against gun violence has issued a report which identifies nearly 60 areas of research that still need to be done in order to more effectively respond to a public health problem resulting in more than 125,000 deaths and injuries every year. The authors of this report are both researchers and emergency medicine clinicians, all of whom have seen more than their fair share of patients killed or injured with guns.
This report marks yet another instance of doctors getting more engaged in the gun-violence issue since the 11th Circuit threw out the Florida gag law (‘Docs v. Glocks’), thus giving the medical community the same immunity from legal assaults when doctors discuss guns with their patients that they enjoy when talking to their patients about any other health risk. There are still a few crazies hanging around the edge of the medical community who believe that physicians shouldn’t talk to patients about guns. But there are also some well-intentioned nuts out there who are convinced that the Martians keep arriving at Area 51, okay?
With all due respect to the group of dedicated medical professionals who authored this report (and in the interests of full disclosure I should mention that I have warm and ongoing relationships with many of them), I simply do not understand why they are advocating an approach to this particular type of public health problem which is not found when doctors respond to other medical conditions that have similarly been identified as serious risks to health. You don’t need to be a rocket scientist to understand that a particular condition, in this case the condition happens to be access to a gun, represents a serious health risk when it kills or injures more than 125,000 human beings each and every year.
How do physicians respond when a patient presents other types of symptoms or behavior that carries a similar level of health risk? They advise the patient to try and eliminate whatever is causing the risk and, if necessary, will give the patient a plan to make the elimination of the problem easier and more doable in each case. There isn’t a single physician in the United States who would tell a smoker that he or she should try to”’cut back.” There isn’t a single medical clinician who would advise a patient that they only need to lose a few pounds to reduce the risk of being 50 pounds overweight. So how is it that the physicians who wrote this report feel comfortable avoiding the issue of extreme lethality and health risk represented by guns?
The report states: “The first step in the prevention of firearm injuries is identifying patients at increased risk.” The report then goes on to list certain obvious risk categories; i.e., suicidal ideation, intimate partner violence, peer violence, the usual bit. Are the authors saying that if a patient doesn’t fit into one of these categories the existence of a gun isn’t a medical risk? Oh, I forgot. For the ‘normal’ gun-owning patient we can always advise a safe storage plan. The fact that after endless research on safe storage there has yet to be identified any safe storage strategy which totally mitigates gun risk, oh well, oh well, oh well.
I’m not a physician and I’m not a researcher on public health. But I do know something about guns and I find it interesting that the esteemed group who authored this piece didn’t include a single individual with any degree of gun-owning experience at all. Because if the authors of this article took into account what people like me know about guns, they could never have published a research agenda on gun violence which seeks to find some happy, middle ground between gun ownership and the risks of same.
There is only one thing that doctors should tell their patients about guns, which is that access to any gun represents a risk which cannot be mitigated or ignored. And this statement does not need to be validated by any further research; it says what doctors should be saying to their gun-owning patients right now.