Michael R. Weisser's Blog, page 136

They Finally Get A Chance To Carry A Concealed Weapon In California. Or Do They?

Back in February, the 9th Circuit in California ruled that the state’s concealed-carry law was unconstitutional, a ruling which was hailed by the NRA and other pro-gun groups as a “major victory” in the campaign to extend the 2nd-Amendment ownership rights defined in the 2008 Heller vs. DC decision to carrying a gun outside the home. But while the judicial panel’s initial decision was stayed pending appeal to the full 9th Circuit (whose action may then result in the SCOTUS finally deciding whether the 2nd Amendment extends to CCW,) the court let stand the part of the law which allows the sheriff in each California county to set concealed-carry rules. Most of California’s counties, including San Diego, which challenged the current law, have decided to wait and see how the whole legal issue plays itself out.  But Orange County began accepting CCW applications immediately after the 9th Circuit ruling and has been, according to County Sheriff Sandra Hutchens, “overwhelmed” with the demand.

Sheriff Sandra Hutchens

Notwithstanding the fact that crime in Orange County has declined by 20% over the last ten years, it appears that most of the demand for concealed-carry permits is being driven by the conviction that walking around with a gun will make people feel more safe.  At least this is what the Orange County Sheriff says, and she should know since she has hired 15 part-time workers to handle the administrative load and the waiting time for the required interview that must precede issuance of the permit is now out to 30 months.

Wait a minute!  A “required” interview before the license is issued?  I thought that the 9th Circuit’s panel found California’s CCW law unconstitutional because it was only granted if an applicant could convince the police that carrying a concealed weapon was a necessity for business reasons or documented proof of the need for personal defense.  And when Orange County started accepting CCW applications, the Orange County Register stated that a permit would now be issued if a county resident simply stated that they needed to carry a gun for “personal safety,” without requiring any documentation of this claim at all.

So I decided to do what nobody ever seems to take the trouble to do whenever a law is passed regarding guns, namely, I actually read the text that defines the Orange County application process itself.  And the process is as follows.  In addition to the usual background check, fingerprints and let’s not forget the $200 fee, the applicant must also provide “documentation” that “good cause” exists for the license based on the following criteria: (1). “Specific evidence that there has been or is likely to be an attempt on the part of a second party to do great bodily harm to the applicant;” (2). “The nature of the business or occupation of the applicant is such that it is subject to high personal risk and/or criminal attack;” (3). “The occupation or business of the applicant is such that no means of protection, security of risk avoidance can mitigate the risk other than the carrying of a concealed firearm.”

There are a couple of more issuance criteria listed on the sheriff’s website but I think you get the point.  Sheriff Hutchens may say that she’s going to issue a license to everyone who says they want one, but Orange County is not about to deprive their law enforcement authorities from having the last word on who shall and who shall not walk around with a gun.  Which is hardly the same thing as saying that anyone who wants CCW will get it just by showing up at the police department with a clean background and a $200 check.

If the argument over whether the 2nd Amendment covers CCW ever gets to SCOTUS and if gun-nut Scalia writes another decision which cites the new California law as a valid protection of gun-ownership rights, the Brady Campaign and Shannon Watts will be able to arouse their followers over this NRA threat to safety, but the truth is that the law doesn’t really change things at all.  But what laws actually say never seems to concern either side in the gun debate. It’s a lot more fun to yell and scream than to sit down and figure out what, if anything, should really be done.

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Want To End The Argument Over Guns? Go Green.

Now that Mike Bloomberg has announced that he’s going to pour $50 million bucks into anti-gun campaigns, you can be sure that the argument over guns will heat up pretty fast.  One thing I’ll say for the former Mayor Mike is that he’s no shrinking violet, and if he decides he really wants to go after something, he makes his presence known.  So at the very least, whether he’s successful or not in expanding background checks or whatever other strategies he thinks will curb gun violence, we will hear some pretty angry comments coming from both sides.

I have written over 130 posts on guns, both on my blog and on Huffington Post, and I try to align myself with the words of the late Senator Daniel Patrick Moynihan who said, “everyone is entitled to his own opinion but not to his own facts.” I wish there were more acknowledgement of these wise words in the current debate but there’s not.  No matter which side grabs the microphone, opinions always seem to trump facts.

So I’m wondering if there isn’t a different way to approach the whole issue and look at the question of guns not from emotions, but from the perspective of their real value; i.e., what it is that a gun can really do.  Because the biggest problem in the gun debate, it seems to me, is that both sides justify their attitudes towards guns based on rationalizations that fly in the face of reality and simply aren’t true.  The idea that the 2nd Amendment is a sacrosanct, inalienable, God-given gift that cannot be limited in any way is Csimply not true.  It is enumerated as one of many Constitutional rights, and like every other Constitutional right, can be defined and limited by laws.  Conversely, the idea that America is some kind of weird outlier among Western nations because of its embrace and love of guns is also not true.  In fact, the United States is the only Western country in which hunting (and therefore ownership of guns) was extended to all citizens regardless of social class.  In the rest of the Western world, particularly our mother country, England, hunting (and therefore gun ownership) was limited to the Monarchy and the aristocracy; the common folk could actually be executed if they were found hunting or poaching on private land.

Gun ownership in the United States is embedded in the traditions and history through which the country was explored, hunted, settled and farmed.  The government encouraged this process through the 1862 Homestead Act,  but while vast swatches of the western half of the country was being settled by gun-toting folk, we were also creating the greatest industrial economy in the world, fueled by European immigrants who settled in enormous, urban-industrial enclaves like Chicago, St. Louis, Philadelphia and New York.  Guns weren’t part of the urban landscape back then, and they aren’t part of it now.  And these two very different histories and traditions aren’t acknowledged or even understood by the advocates for either side in the current gun debate.

But I have an idea for how his might change.  Turns out there are now more than 40 million American households that grow at least some of their own food.   This is an increase of 17% in just the last five years.  Now the gun industry has done pretty well over the same period, but that’s because gun owners are buying more guns, not because the percentage of people who own guns is really going up.  So I’m thinking that if so many new people are getting into farming, even if it’s only a tiny farm in their back yards, maybe the ones who aren’t gun owners will begin to appreciate the reason why Americans always had guns.  And this could lead to a recognition that we all have certain things in common, historically and traditionally, that speak to the value of guns. You certainly can’t say that either side understands or is saying this now. So here’s their chance.

 

 

 

Watch Out Gun Owners: Bloomberg’s Out To Get Your Guns!

I can see it now.  The NRA annual meeting is about to kick off in Indianapolis and I’ll bet you dollars to doughnuts that every speaker at the banquet and other public events will be told to say something nasty about Mike Bloomberg’s new campaign to “get rid” of guns.  What’s going on is that Bloomberg has announced that he’s going to spend 50 million bucks to bankroll a new organization, Everytown for Gun Safety, to build a grass-roots movement across the country that will mobilize voters to enact background checks at the state level to counteract the NRA whose power at the federal level has prevented an expansion of national background checks from taking place.

Bloomberg and many other gun-control activists are convinced that the key to cutting down the rate of gun violence is the ability of the government to keep guns out of the hands of disqualified individuals (felons, mentally ill, etc.) by requiring pre-transfer clearance for anyone who wants to acquire a handgun regardless of whether the transfer occurs in a retail store, a gun show, or two people simply standing in the street.  The evidence supporting this argument can be found on the Everytown website, and it goes like this.

According to Bloomberg’s organization, in 2010 there were 14 states plus DC that required background checks for all handgun sales, and together these states had a 3.17 rate (per 100,000) for gun deaths, whereas the remaining 34 states (CO and DE were excluded due to new laws) registered a gun homicide rate of 5.09; a difference between the two groups of 38%.  If Bloomberg’s group is correct in asserting that universal background checks would bring the gun homicide rate in the country as a whole down to 3.17, we would be talking about at least several thousand less gun deaths each year, and that ain’t chopped liver, even if you’re the former Mayor of New York.

But the moment that anyone come up with a plan to curb gun violence, I always try to figure out whether the plan really aligns itself with the data that is used to explain how and why it’s going to work. Or are we looking at what we often encounter in the gun debate, namely, a confusion between coincidence and causality which has a way of somehow obscuring the facts?  I’m afraid that in the case of Bloomberg’s continued love affair with background checks, it may be a little of both. Here’s what I mean.

Of the 14 states that required background checks for all handgun transfers, nine of them had rates of gun homicides lower than the national average going back to 1970 and before.  The fact that many of these states at some point instituted background checks at the state level wasn’t necessarily the cause of lower gun homicide rates because most of these states had lower homicide rates before any gun control laws were put into effect. For that matter, Mike Bloomberg’s own city, New York, had the most severe background check system,, the Sullivan Law, on the books since 1908.  But the city experienced a severe increase in gun homicide between 1988 and 1993, and then saw the greatest drop in gun violence of any major city in the United States over the next twenty years, a trend that started under Rudy Giuliani but increased even more during Bloomberg’s stint in City Hall.

Don’t get me wrong. Study after study has shown that when you pass gun control laws, the number of gun owners goes down, which no doubt leads to less guns, which probably results in less crime.  But Mike Bloomberg’s successful effort to make New York City safe from gun violence was not, according to his own testimony, due to any change in the laws.  It was the result of smart and aggressive policing and his 50 million bucks wouldn’t cover the costs of such a strategy across the river in Hoboken, never mind across the United States.

If The NRA Didn’t Exist, The Gun Control Crowd Would Have To Invent It

Today I received an email from the Violence Policy Center, a DC-based advocacy group that often partners with Brady and Bloomberg to push back against the legislative and legal initiatives of the NRA.  Like every organizational email I receive from both sides, the VPC wants dough.  But this particular message caught my eye because of what it said about the NRA’s upcoming Indianapolis show.

The VPC is upset not just in general about the NRA’s impending celebration of gun ownership, but in particular because the show is being held this year in a city that has an alarmingly high murder rate, many of these homicides, according to the VPC, committed with guns.  Here’s a quote from the email:  “Wayne LaPierre, Ted Nugent, and the rest of the NRA leadership will be in Indianapolis later this month for the NRA’s annual meeting which begins on April 25. We don’t expect they will mention the fact that Indianapolis has a murder rate higher than Chicago’s and that most of those killings are committed with guns.”

I’m not exactly sure what the connection is between the crime rate in Indianapolis and the fact that the Indiana Convention Center no doubt worked like hell to land the NRA show.  I also suspect that the decision to hold the show in Indianapolis was made years ago and who knows whether crime in Indianapolis has since gone up or down.  But if you think for one second that anyone who’s coming to Indianapolis to visit the NRA show gives a rat’s damn about crime in Indianapolis, you’re barking up the wrong tree.

The crowd at the NRA show is going to look just like the NRA membership everywhere else; mostly male, White, over the age of 50 and living in rural areas or smaller towns.  The NRA show is just a big gun show and these folks will do what they always do at those shows: play with the guns, eat a few treats, stand on line for a couple of hours to get Ted Nugent’s autograph, say hello to friends, then hop in their 4×4′s and drive back home.  They won’t spend a second in the city of Indianapolis, and if while they’re at the show a couple of more inner-city residents are gunned down, they won’t know about it and they won’t care.

Meanwhile, the NRA will treat them to a good dose of double-talk as to why they are really there.  They’ll remind the visitors that guns are the best line of defense against criminals and crime. There will be endless exhortations to fight back against a federal government that is out to grab their guns.  And if they need the ultimate proof that God is on their side, they can always line up for admission to the Prayer Breakfast before entering the exhibit hall.

Want the truth? Both sides in the gun debate mobilize their followers by appealing to fear.  In the case of the NRA, it’s a fear of losing your guns, a fear of the government, a fear of crime.  For the Violence Policy Center and like-minded organizations, it’s a fear of guns.  As long as the two sides continue to appeal to their followers on the basis of fear, there’s really no chance that we will have a reasonable and responsible discussion about how to stop the killings that occur in Indianapolis and other cities and towns.

If we ever had such a debate, maybe it would turn out that we as Americans would decide that 30,000 gun deaths every year is a small price to pay for the fun of attending the NRA show.  Or maybe we would decide that the violence has to stop right now and the 2nd Amendment notwithstanding, everyone has to turn in their guns.  I don’t really care which way such a debate works out; all I know is that neither pro-gun nor anti-gun advocates are interested in kicking one off.

 

When It Comes To Guns, Physicians Need To Do What They Do Best – Be Physicians.

The American College of Physicians has just released a survey covering attitudes of its members towards  gun violence.  This was the second survey conducted by the ACP on medical attitudes towards guns, the previous having been published in 1998.  In the earlier survey, while 90% of the respondents believed gun violence to be a public health issue, less than 20% stated that they engaged in prevention counseling with patients.  The feedback from the most recent  survey was similar; most physicians consider gun violence an even bigger medical problem than they did previously, but a majority still do not consider themselves willing or able to intervene with patients who present evidence of being at risk for violent behavior with guns. In fact, three-quarters of the respondents said there was a need for more education of physicians to help them counsel patients in firearm injury prevention.

The survey results reported by the ACP are similar to feedback from other medical specialists.  In 2013 The American College of Emergency Physicians also published a survey on how emergency physicians felt about gun violence patients and, like the ACP, found that the vast majority of emergency physicians had never been formally trained regarding firearm safety counseling and did not believe that patients would see them as credible sources for gun counseling.

Gun violence appears to be the one public health issue for which physicians have not developed very clear guidelines for counseling and/or treatment.  In fact, there is no medical agency or association that has even issued a protocol for identifying patients who might be at risk for gun violence, either as perpetrators or victims.  While we know everything about gun violence victims after they are shot, physicians do not have the knowledge to appropriately intervene before the violence takes place.  Lacking the kinds of treatment guidelines that exist for other public health issues like obesity, smoking or substance abuse, physicians are forced to pretend that gun violence as a clinical issue doesn’t exist.

The ACP survey was followed by a Policy Position Paper in which the organization listed nine recommendations to help prevent gun violence and only the first two recommendations covered practice and counseling methods for physicians to follow in treating patients.  The other seven recommendations covered the usual legal/legislative solutions that have been advanced by every advocacy group that promotes policy initiatives to reduce gun violence.

Everyone should debate and support common-sense legal and legislative solutions to the problem of gun violence, but you don’t need four years of medical school followed by an internship and a residency to figure out how to advocate against guns.  What physicians should and must bring to the debate is exactly what they are not doing now, namely, using their unique skills and their equally-unique relationships with patients to deal with gun violence as a medical issue for which interventional counseling might yield significant results.

In a paper published last year, Shannon Fratteroli and colleagues pointed out that the greatest value of joining advocacy to medical treatment in discussions about gun violence is the fact that physicians are trained to communicate with patients about fear, they are “accustomed to helping people manage their fear of disease and death.”  As so much of the current gun debate is generated by fear – fear of crime, fear of violence, fear of government – physicians should bring their clinical experiences in managing fear to this debate and thus provide patients with sound and effective alternatives to using a gun.

 

 

Want To Do Something About Global Warming? Get A Gun.

I knew it would happen sooner or later.  Since global warming is being blamed for just about everything that has taken place in the last few years, it was just a matter of time until it would become the deus ex machina for explaining crime.  And since we’re talking about global warming, the news can’t be very good.  In fact, Matthew Ranson, the young scholar who has produced this research, is confident that by the end of this century, the general increase in temperatures will produce an additional 22,000 murders and millions of other additional violent crimes.  He bases this prediction on what he refers to as the “causal relationship between weather and crime,” data for which he has studied covering the last thirty years.

According to Ransom, there is a correlation between higher temperature and more crime due to what he calls the “social interactions” that produce crime, many of which tend to increase as temperatures become warmer.  These interactions include such things as more people being outside when weather gets warm, and a greater degree of intolerance towards various social stress-points when hot weather leads to feelings of physical discomfort which then leads to more aggression which results in more crime.

Using crime data from the FBI’s Uniform Crime Reports, Ransom is able to neatly correlate crime rates with mean annual temperatures throughout the United States.  He identifies 4 temperature zones basically running East-West from the northern border where the mean annual temperature is less than 55 degrees, to the extreme southern part of the country where the mean is above 75 degrees, and two other belts of 55-64 and 65-74 degrees in between.  Turns out that the rates for such common crimes as burglary, larceny and assault were all roughly 20% higher in the warmest as opposed to the coolest parts of the country, and that in all four zones the monthly rate for these crimes increased substantially during the warmest months of the year. Using the change in crime rates relative to increases in temperature, Ransom is able to predict what would happen to crime trends if mean temperatures move upwards over the next 85 years.

I’m not going to get into a detailed analysis of Ransom’s statistical methods which are quite impressive and take into account some of the discrepancies and inaccuracies of the information which often escapes discussion when scholars use crime data from the UCR.  But I do find it interesting that Ransom would base this entire paper on an assumption about the causality of crime which, it seems to me, discounts or ignores other factors that need to be addressed.  It just so happens that in many locations where he finds correlations between higher crime rates and higher temperatures, one could also make many other correlations, in particular having to do with demographics and socio-economic circumstances of the populations that live in those zones.   Despite Ransom’s assertion that criminals operate most frequently at times and places where they can escape detection following commission of the crime, summer months also yield much greater periods of daylight which, in turn, is often correlated with higher rates of crime.

Ransom uses data covering the last 30 years to make predictions about a period ahead of us that’s three times as long.  But I would have felt a little more accepting of his method had he acknowledged the fact that during the period covered by his data it appears that mean temperatures increased and yet serious crime in every category underwent a significant decline. On the other hand, it will be interesting to see how the pro-gun partisans in the gun debate react to Ransom’s work.  Because most of the noise supporting the 2nd Amendment comes from groups that just as vociferously deny the threat of global warming at all.  But if Ransom is correct and global warming will result in millions of additional serious crimes, shouldn’t the NRA align itself with the global warming crowd and use their argument to promote the right of law-abiding citizens to carry guns and protect themselves against crime?

 

He’s At It Again: Rand Paul Protects Gun Owners From Nothing

In February I wrote a post about Rand Paul’s effort to block the nomination of Vivek Murthy to be Surgeon General because of Murthy’s comments about guns.  Paul’s early efforts to inject himself into the 2016 Presidential race is being run on a shoestring, all the more reason why he needs to pander to groups like the NRA. But now Paul has taken several more steps to the Right and is sending out fundraising appeals for a lobbying organization – The National Association of Gun Rights – which calls itself the “conservative alternative” to the NRA.

This time around Paul is taking aim at an old enemy, the United Nations Small Arms Treaty and its outgrowth, a UN-sponsored project known as the International Small Arms Control Standards, a.k.a. ISACS.   The task of the ISACS is to create the actual methods and mechanisms to be used by treaty signatories on a voluntary basis to monitor and control illicit manufacture and shipments of small arms.  Despite the howling and yowling about the treaty by pro-gun groups, including the NRA, virtually all of the standards being developed to identify and track illicit movements of small arms are already in place for anyone who wants to bring guns into, or ship guns out of, the United States.

But even if the U.N. Small Arms Treaty never gets passed by a two-thirds Senate vote, the U.N. (and of course Obama) are already “plotting” the next step, namely the imposition of the following “radical anti-gun initiatives” on every nation that signs the treaty including: (1). National “screening’ for everyone who wants to own a gun; (2). licenses required for all sales of guns and ammunition; (3). restrictions on the number and amount of guns and ammunition that anyone could own; (4). bans on magazines with capacities of more than ten rounds; (5). bans on concealed-carry licenses for self defense.

According to Senator Paul, this treaty and the Control Standards being implemented behind it amount to a complete loss of national sovereignty and an end to gun ownership in the United States.  Incidentally, the Senator not only knows what the treaty and the standards document contain, he also knows that the United Nations is “plotting” to put it all into effect. The only person I know who sees more plots going on around him than Rand Paul is Glenn Beck.  In the case of the U.N. Small Arms Treaty and ISACS, however,  it’s simply not true.

There is not a single word in either the treaty or the standards that have been drafted to date that mandates or even talks about anything having to do with legal, private ownership of small arms. The whole point of the U.N.’s small arms effort is to help countries, particularly in underdeveloped areas, control the shipment of small arms because so much of the anti-government violence and instability in these countries is fueled by underground or black-market supplies of ammunition and guns.  Many third-world governments (e.g., Somalia) simply do not have the resources to either monitor their own borders or maintain stability because it’s so easy to transport and distribute small arms.  Recall that our troops paid a heavy price because even we couldn’t control shipments of illicit small arms into Afghanistan and Iraq.

I have no objection to Rand Paul seeking aid and comfort from political allies like the NRA or the NAGR.  I donate money to the candidates of my choice, so why should I be upset when a politician whom I don’t particularly respect hits up people who might be aligned with his point of view?  But going after the gun vote is one thing, inventing reasons for my support out of whole cloth is something else.  There is not a grain of truth to what Rand Paul is saying about the U.N. Small Arms Treaty, and he’s insulting me and every other NRA member by sending out a fundraising appeal loaded with statements that are just wide of the mark.

 

 

The NRA Has Found a New Physician Friend

Recently the medical news service Medscape published a video editorial about gun safety by Art Caplan, who runs the Division of Ethics at NYU’s Langone School of Medicine. The editorial content was hardly unique or different from similar statements that have been made by virtually every major medical society, namely, that the existence of several hundred million guns constitutes a health risk that cannot simply be ignored because of a 2nd-Amendment right to own a gun.

Caplan’s editorial has just been challenged on Medscape by Dr. Gregory Hood, an internist from Kentucky, who’s a rising star in the medical establishment, having just been named Governor of the Kentucky Chapter of the American College of Physicians.  Incidentally, the ACP  stated that “physicians need to be able to have frank discussions with their patients and parents of patients about firearm safety issues and risks to help them safeguard their families from accidents,” in a letter sent to the U.S. Senate during the debate over a new gun law following Sandy Hook.

While there appears to be a consensus among Dr. Hood’s colleagues about medical risks from guns, he evidently doesn’t share their concern.  This is particularly true given the fact that “ there will always be the inevitable threat of acts of violence and terrorism, whether by guns, fists, or other measures,” against which, according to Doctor Hood, “we must acknowledge the inherent right of law-abiding citizens to take reasonable precautions against such threats.”  The issue isn’t hundreds of published, peer-reviewed articles that show a link between access to guns, safely stored or not, and medical risk.  The real problem is allowing the good, law-abiding citizen the right to protect himself from terrorism with a gun.

What really seems to bother Dr. Hood is his belief, probably true, that most physicians have little first-hand knowledge about firearms and therefore risk violating best practices by counseling patients about an issue for which they cannot be considered to have much objective knowledge.  But that’s not a problem because medical professionals can always turn for guidance to the real experts on gun safety, namely the NRA.  According to Dr. Hood, the NRA’s Eddie Eagle program has “instructed” more than 25 million children in gun safety since 1988, and the program’s signature phrase, “STOP. Don’t Touch. Leave the Area. Tell an Adult” shouldn’t be bandied about by well-meaning researchers like Art Caplan and various medical professionals who aren’t skilled in the ways and means of guns.

If it were the case that Dr. Hood was just a flack for the NRA I could forgive his flight into fantasy about the NRA’s commitment to gun safety and let it go at that.  But Gregory Hood has an impeccable educational background, he’s obviously trusted and respected by patients and peers, his voice and opinions carry some weight inside and outside his profession.  So I’m going to take his comments very seriously and reply to them in a direct and serious way.

The fact is that the NRA has absolutely no idea whether a single child has ever been “instructed” in gun safety either in school or at home.  Hood’s figure of 25 million children comes from the NRA, it has never been validated by an independent source, and it is based on the number of Eddie Eagle pamphlets that the NRA claims it has mailed out over the last twenty-five years. That’s not instructing anyone in anything, and Hood should be embarrassed for pretending that this “program” does anything more than promote the NRA.

I really wish that guys like Greg Hood would stop hiding behind their cloak of professional integrity and admit, once and for all, that their primary interest is in protecting the access of their patients to guns.  I have no quarrel with that position, incidentally, because if you haven’t figured it out by now, I’m a gun owner myself.  But if we are ever going to have a serious and honest debate about whether guns are a public health risk then everyone has to come clean.  At this point Dr. Hood needs to be a little more candid about the reasons for his concerns about guns.

It’s Time To Figure Out Why Shootings Like Fort Hood Really Occur

Every time there’s a mass shooting we get the usual calls from the pro-gun and anti-gun groups about what we need to do to keep Americans from killing one another.  The pro-gun folks say that everyone should be walking around with a gun, the anti-gun groups say that we need tighter controls.  I don’t notice that either side can produce a shred of evidence to support their position, by the way, but that doesn’t stop them from always repeating their bromides every time a terrible shooting incident takes place.

I have a different view of the situation.  First, shootings like the one that took place at Fort Hood have the potential to be much worse if the shooter was a better shot.  At the end of his rampage Spc. Lopez was confronted by an armed MP whose presence may have made him decide to end his own life before more damage could be done.  But the reason that only three people were killed and 16 were shot but evidently will live is because Lopez wasn’t really such an expert with the Smith & Wesson pistol that he brought onto the base.  The fact is that a 45-caliber weapon is very lethal; the Army should know, it used a 45-caliber pistol as its basic service handgun for more than 60 years.  ”One shot, one kill” is the way that soldiers trained with that gun.  The toll at Fort Hood could have been much worse whether everyone was walking around with a gun or not.

We also learn, however, that by the time Lopez purchased the gun on March 1st, he had already come under medical attention at the base, was being treated for depression and while he was stocking up on a sleeping pill known as Ambien, he was also stocking up on ammunition for his gun.  But according to the Secretary of the Army, John McHugh, he gave “no sign” during a recent psychiatric exam that he might become violent.

So everybody’s off the hook.  President Obama and Governor Perry finally find an issue to agree about – they both want to get to “the bottom” of the problem and fix things so it won’t happen again. The Army medics did an exam and couldn’t find anything wrong.  And let’s not forget the poor gun shop owner in Killeen who probably saw his shop invaded and turned upside down by a regiment of ATF agents who were hoping they could come up with something he did wrong.

I’m beginning to wonder whether we have any idea what goes on in the brain of someone who seemingly out of nowhere pulls out a gun and tries to shoot everyone in plain sight.  Connecticut authorities spent a year trying to figure out Adam Lanza and came up with zilch. The Navy Yard shooter liked to play video games – gee, what a telltale symptom that must be. The guy who shot Gabby Giffords still hasn’t authored his best-selling book.  Come to think of it, America’s best-known mass shooter, David Berkowitz, a.k.a. Son of Sam, is still sitting in an upstate correctional facility telling reporters that people shouldn’t be allowed to walk around with guns.

I suspect that as many as 50% of the people who commit gun violence each year had contact with a medical professional within the last few months before the event.  In the case of suicides, which account for two-thirds of the victims of gun violence each year, the figure is probably closer to 90%. In the case of homicides we know that more than 80% of such killings grow out of ongoing arguments and disputes that, in many cases, landed one or both of the combatants in an ER or other medical facility getting treatment for an injury that will later provoke a response with a gun.

I think it’s time for physicians and other medical professionals to create and use better tools to identify, diagnose and treat patients at risk for the improper use of guns.  There is no law that requires physicians to maintain confidentiality if a patient presents evidence that he is an immediate danger to himself or others, and what could be more immediate than someone exhibiting symptoms of depression or anger who also has access to a gun?  Let’s put aside the endless arguments about the 2nd Amendment and agree that important scientific work in this area still needs to be done.

Docs Versus Glocks – Round 2 About To Begin

In 2011 the Florida legislature passed a law to protect the state’s gun owners from having to divulge any information about gun ownership during the course of a medical exam.  The law, which became known as ‘Docs Versus Glocks,’ soon became one of the main poster children of the pro-gun, anti-gun argument that really heated up after the carnage at Sandy Hook.  On one side stood the NRA, which touted the law as a defense of 2nd Amendment rights; on the other side was Brady and the medical community which viewed the law as interfering with the doctor’s right to know.  The law was struck down in 2012 by a Federal District Judge and was immediately appealed by the Gunshine State to the 11th Circuit which held a hearing in July, 2013.  Everyone’s expecting a ruling soon so I thought I would take the opportunity to discuss the case before all the real experts get into the act.

The law doesn’t completely deny physicians the ability to talk to patients about guns.  What the law actually says is that a physician “shall refrain” from inquiring about firearm ownership unless the practitioner “in good faith believes  that this information is relevant to the patient’s medical care or safety, or the safety of others….” Yet despite this caveat, the medical community attacked the law, declaring that its language would have a chilling effect on the ability of physicians to talk to their patients about all kinds of safety and health issues, not just about guns.  The District Court sided with the docs, calling the law a “legislative illusion” because there was no connection between questions asked about gun ownership and protecting the 2nd Amendment right to own guns.

While arguments over gun control at the federal level get all the headlines, it’s what happens at the state and local levels that really determines whether or not gun owners can get or keep their guns.  The Sullivan Law has been in existence since 1908, it’s almost impossible to own or carry a gun in New York City and 2nd Amendment ‘rights’ can go fly a kite.  In total dollars the NRA gives out less than half a million to state-level candidates and parties, but this is 30 times more than gun control groups give to the same races.  And in a state-level race where 200 or less votes can make the difference, getting your hands on an NRA phone list may carry the day. I’m not sure that the Florida legislators who voted for the gun bill knew or even cared what the law said.  But they didn’t want to be ‘scored’ by the NRA in the next election because they voted the wrong way.  Before the Tea Party showed up it really didn’t matter whether a Republican toed the line on gun issues because the NRA wasn’t about to support any Blue candidates anyway.  But now that a growing number of Republican office-holders face primary challenges from the Right, everyone on the Red side of the aisle is listening to the NRA.

As for doctors, it took them nearly a century after 1850 to become a self-regulating profession whose guidelines for practice and behavior were largely established and maintained by themselves.  And even though their professional autonomy has of late come into conflict with the market imperatives of insurors and other for-profit enterprises, they still retain sovereignty over defining how to deliver their services at the point that such services matter most, namely, in consultations with patients.  The fact that the Florida legislature didn’t bother to ask their own state Health Department for a recommendation on physicians talking to patients about guns tells me that the motive behind the law had nothing to do with concerns about the delivery of health care at all.  For that matter, it wasn’t that the law threatened doctors who talked to their patients about guns per se, it was the fact that any law which infringes on the professional autonomy of physicians to communicate with their patients threatens the validity of the Hippocratic Oath.

Let’s hope that the 11th Circuit understands what this argument is really all about.