Posted on 12/27/2012 3:28:49 PM PST by neverdem
On December 14, a 20-year-old Connecticut man shot and killed his mother in the home they shared. Then, armed with 3 of his mother's guns, he shot his way into a nearby school, where he killed 6 additional adults and 20 first-grade children. Most of those who died were shot repeatedly at close range. Soon thereafter, the killer shot himself. This ended the carnage but greatly diminished the prospects that anyone will ever know why he chose to commit such horrible acts.
In body count, this incident in Newtown ranks second among US mass shootings. It follows recent mass shootings in a shopping mall in Oregon, a movie theater in Colorado, a Sikh temple in Wisconsin, and a business in Minnesota. These join a growing list of mass killings in such varied places as a high school, a college campus, a congressional constituent meeting, a day trader's offices, and a military base. But because this time the killer's target was an elementary school, and many of his victims were young children, this incident shook a nation some thought was inured to gun violence.
As shock and grief give way to anger, the urge to act is powerful. But beyond helping the survivors deal with their grief and consequences of this horror, what can the medical and public health community do? What actions can the nation take to prevent more such acts from happening, or at least limit their severity? More broadly, what can be done to reduce the number of US residents who die each year from firearms, currently more than 31 000 annually?1
The answers are undoubtedly complex and at this point, only partly known. For gun violence, particularly mass killings such as that in Newtown, to occur, intent and means must converge at a particular time and place. Decades of research have been devoted to understanding the factors that lead some people to commit violence against themselves or others. Substantially less has been done to understand how easy access to firearms mitigates or amplifies both the likelihood and consequences of these acts.
For example, background checks have an effect on inappropriate procurement of guns from licensed dealers, but private gun sales require no background check. Laws mandating a minimum age for gun ownership reduce gun fatalities, but firearms still pass easily from legal owners to juveniles and other legally proscribed individuals, such as felons or persons with mental illness. Because ready access to guns in the home increases, rather than reduces, a family's risk of homicide in the home, safe storage of guns might save lives.2 Nevertheless, many gun owners, including gun-owning parents, still keep at least one firearm loaded and readily available for self-defense.3
The nation might be in a better position to act if medical and public health researchers had continued to study these issues as diligently as some of us did between 1985 and 1997. But in 1996, pro-gun members of Congress mounted an all-out effort to eliminate the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC). Although they failed to defund the center, the House of Representatives removed $2.6 million from the CDC's budget—precisely the amount the agency had spent on firearm injury research the previous year. Funding was restored in joint conference committee, but the money was earmarked for traumatic brain injury. The effect was sharply reduced support for firearm injury research.
To ensure that the CDC and its grantees got the message, the following language was added to the final appropriation: “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.”4
Precisely what was or was not permitted under the clause was unclear. But no federal employee was willing to risk his or her career or the agency's funding to find out. Extramural support for firearm injury prevention research quickly dried up. Even today, 17 years after this legislative action, the CDC's website lacks specific links to information about preventing firearm-related violence.
When other agencies funded high-quality research, similar action was taken. In 2009, Branas et al5 published the results of a case-control study that examined whether carrying a gun increases or decreases the risk of firearm assault. In contrast to earlier research, this particular study was funded by the National Institute on Alcohol Abuse and Alcoholism. Two years later, Congress extended the restrictive language it had previously applied to the CDC to all Department of Health and Human Services agencies, including the National Institutes of Health.6
These are not the only efforts to keep important health information from the public and patients. For example, in 1997, Cummings et al7 used state-level data from Washington to study the association between purchase of a handgun and the subsequent risk of homicide or suicide. Similar studies could not be conducted today because Washington State's firearm registration files are no longer accessible.8
In 2011, Florida's legislature passed and Governor Scott signed HB 155, which subjects the state's health care practitioners to possible sanctions, including loss of license, if they discuss or record information about firearm safety that a medical board later determines was not “relevant” or was “unnecessarily harassing.” A US district judge has since issued a preliminary injunction to block enforcement of this law, but the matter is still in litigation. Similar bills have been proposed in 7 other states.
The US military is grappling with an increase in suicides within its ranks. Earlier this month, an article by 2 retired generals—a former chief and a vice chief of staff of the US Army— asked Congress to lift a little-noticed provision in the 2011 National Defense Authorization Act that prevents military commanders and noncommissioned officers from being able to talk to service members about their private weapons, even in cases in which a leader believes that a service member may be suicidal.9
Health researchers are ethically bound to conduct, analyze, and report studies as objectively as possible and communicate the findings in a transparent manner. Policy makers, health care practitioners, and the public have the final decision regarding whether they will accept, much less act on, those data. Criticizing research is fair game; suppressing research by targeting its sources of funding is not.
Efforts to place legal restrictions on what physicians and other health care practitioners can and cannot say to their patients crosses an even more important line. Yet this is precisely what Florida and some other states are seeking to do. Physicians may disagree on many issues, including the pros and cons of gun control, but are united in opposing government efforts to undermine the sanctity of the patient-physician relationship, as defined by the Hippocratic oath. While it is reasonable to acknowledge and accept the Supreme Court's recent decision regarding the meaning of the Second Amendment, it is just as important to uphold physicians' First Amendment rights.
Injury prevention research can have real and lasting effects. Over the last 20 years, the number of Americans dying in motor vehicle crashes has decreased by 31%.1 Deaths from fires and drowning have been reduced even more, by 38% and 52%, respectively.1 This progress was achieved without banning automobiles, swimming pools, or matches. Instead, it came from translating research findings into effective interventions.
Given the chance, could researchers achieve similar progress with firearm violence? It will not be possible to find out unless Congress rescinds its moratorium on firearm injury prevention research. Since Congress took this action in 1997, at least 427 000 people have died of gunshot wounds in the United States, including more than 165 000 who were victims of homicide.1 To put these numbers in context, during the same time period, 4586 Americans lost their lives in combat in Iraq and Afghanistan.10
The United States has long relied on public health science to improve the safety, health, and lives of its citizens. Perhaps the same straightforward, problem-solving approach that worked well in other circumstances can help the nation meet the challenge of firearm violence. Otherwise, the heartache that the nation and perhaps the world is feeling over the senseless gun violence in Newtown will likely be repeated, again and again.
Published Online: December 21, 2012. doi:10.1001/jama.2012.208207
Conflict of Interest Disclosures: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
The reason this prohibition exists is simple.
As we saw with the rescinded Bancroft Prize for history a few years ago, so called research about guns is often politically motivated fabrication and falsehood only de-bunked with great effort.
If you're looking for a rational motivation for an insane act committed by a
mentally ill person then something's not right with your head, doc.
B.) These criminals almost never use a rifle of any kind let alone an "assault rifle". They are using cheap handguns that are frequently stolen. This is also verifiable using the FBI crime database.
B.)taking guns away from law abiding citizens will not decrease the incidence of murder in America and we have decades of scientific evidence that confirms this.
They keep trying to get the death rate down but
abortions are UP!
Hmmmm ..?? Never know why ..??
I wonder if it had anything to do with all the Satan Worship stuff they found in his bedroom ..?? Ya think!
These people really do think we’re so gullible and stupid we can’t figure stuff out.
Pitiful!!!
Roughly 40% of gun deaths are suicide. The majority of the rest are gang-bangers and drug related.
they never want to talk about gang violence or the racial element. That’s all code word for racism to them even though it is undeniably factual.
The gun grabbers also conveniently avoid talking about gun free zones.
Yeah, they say they want a “conversation” about gun control but when it comes down to it, that’s the last thing they want.
INCONVENIENT FACT: Countries that allow private gun ownership have much lower overall murder, suicide and violent crime rates than countries with pervasive gun control laws.
EVIDENCE: According to no less an authority than the peer-reviewed Harvard Journal of Law & Public Policy, countries with stringent gun control laws have higher murder and suicide rates than those without.
DOCUMENTATION: “Would Banning Firearms Reduce Murder and Suicide?” A Review of International and Some Domestic Evidence by Don B. Kates and Gary Mauser, Volume 30, Number 2 of the Harvard Journal of Law & Public Policy, pages 649-694. (To download a PDF copy of the journal article, simply Google the title. It is available on the web free of charge.)
QUOTE: “If you are surprised by our findings, so are we. We did not begin this research with any intent to “exonerate” handguns, but there it is — a negative finding, to be sure, but a negative finding is nevertheless a positive contribution. It directs us where not to aim public health resources.”
INDIRECTION: The trick hoplophobes always use is to say that America has higher gun-murder rates than other countries, but a lot of those “murders” are criminals killed in the act of committing violent crimes. Compare absolute murder rates, and the result is “more guns, less murder.” (Source: GunFacts.info);
SECOND INCONVENIENT FACT: According to DOJ crime statistics, guns are used by US citizens 2.5 million times per year to prevent violent crimes like rape, robbery, home-invasion and carjacking, 99% of the time without a shot being fired. (Source: GunFacts.info)
THIRD INCONVENIENT FACT: “Assault weapons” (AKA semiautomatic rifles) are used in less than 1% of gun crimes. (Source: GunFacts.info)
QUESTION: If gun-free zones make people safe, then why don’t we declare the immediate vicinity of the President and Vice-President to be gun-free zones and send the Secret Service home? Or are gun-free zones good enough for our kids, but not good enough for our overlords?
METAPHOR: America has more private gun ownership than most other countries, so naturally there are more gun murders. America also has more hospitals than most other countries, so naturally we have more people dying in hospitals. Does that mean we should outlaw hospitals?
Kellerman seems intent on maintaining his stature as one of the leading pathological liars of the gun-control movement.
He really is reprehensible.
Of course we can’t figure stuff out.
We don’t have research staff or research grants.
Duh?
All these epidemiologically based studies (like Kellerman’s) suffer from the same basic defect: they not only conclude that correlation equals causation, but they assume a direction for the causation that has no real support. In fact, causation in the other direction is much more likely.
Specifically, they assume that possessing a gun somehow makes one more likely to get shot. It is much more logical to think that the fear of getting shot makes one more likely to possess a gun. It should therefore not be surprising that there exists the kind of correlation that Kellerman reports.
Using Kellerman’s logic, one could say that since many people die in hospitals, sick people should avoid hospitals at all costs.
Also, if I remember correctly, in Kellerman’s original study a large proportion of the subjects were either drug users or drug dealers. Participants in the illegal drug trade would likely have a greater-than-normal fear of being shot.
Zeko
His credulity strains belief. As someone who is not familiar with his past work this line tells me he is either a fool or thinks I am one. While that may be the properly stated ethical position, anyone who has followed politically charged research subjects, knows this ethical principal if willfully and repeatedly ignored.
Kellerman is one of the biggest liars among the anti-gun “researchers”. Non-crime firearms injuries (and even total violence have been decreasing for years WITHOUT the interference of the “medical professionals”, who have no business talking about “gun business”, of which they are, for the most part, grossly ignorant.
More like 60%. Several studies show no correlation between gun control and suicide rates.
marktwain linked Mass Killings Stopped by Armed Citizens on two of my recent threads. I verified all of its links. If someone tries to disable that webpage, I'm linking all of its links below current links and posts.
Two Cautionary Tales of Gun Control
Stopping the spread of deadly assault weapons--summary of Feinstein Bill, incl. registry requirement
Is it True Armed Civilians Have Never Stopped a Mass Shooting?
Mother Jones's Own Reporting Contradicts Its Conclusions on Gun Violence
Guns in schools can save lives - Disarming law abiding citizens left them sitting ducks.
I used the original titles, some are Wikipedia titles, for the links within Mass Killings Stopped by Armed Citizens:
Appalachian School of Law shooting
The Chronicle, Muskegon, MI, 8/23/95
Jeanne Assam and the New Life Church Shooting
Gun-shop employee prevents massacre(California, 1999) by marktwain!
A Massacre We Didn't Hear About
Statistics show concealed carry saves many lives, takes few
RV PARK KILLINGS: 'Witness shooter' recounts shootout with gunman who killed two in Early
Shooter with hit-list shot dead in AT&T store
College Student Shoots, Kills Home Invader
Victims Released; No Charges Filed Against Reno Man In Winnemucca Shootings
Parker Middle School dance shooting
Police identify man who shot, killed pastor’s mother at church
Clackamas Concealed Carry Showdown – The Full Story
P.S. Arthur Kellermann, one of the authors in the JAMA article, has written some of the most outrageous "studies" about guns in the medical literature, e.g. he equated the risk of criminal acquaintances getting killed with family and friends if someone kept a gun in their home.
Some noteworthy articles about politics, foreign or military affairs, IMHO, FReepmail me if you want on or off my list.
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