Are the healing professions doing enough to curb gun violence?

Is the medical profession doing enough about gun violence?

Are any of us? This is the question that we all must ask ourselves, in the wake of the incalculably sad massacre of little school children in Newtown, Connecticut.

I have struggled for days now to find the right words—how can I, or anyone else for that matter, find the words to describe the indescribable shared grief we have about the indescribable horror of that day and its aftermath? But I have to say something, we have to say something. Something about what this says about our country, and its repeated inability to rise to the occasion to address the causes and consequences of gun violence. Silent reflection in the face of tragedy is a necessity for most of us. But silence in the public policy arena means acquiescence to the cynical and powerless view that there is nothing that can be done to prevent the next Sandy Hook, or Virginia Tech, or Aurora, or Columbine.

President Obama found a way to speak truth to the people of Newtown, and to the country. He said that “This is our first task — caring for our children. It’s our first job. If we don’t get that right, we don’t get anything right. That’s how, as a society, we will be judged. And by that measure, can we truly say, as a nation, that we are meeting our obligations? Can we honestly say that we’re doing enough to keep our children — all of them — safe from harm? Can we claim, as a nation, that we’re all together there, letting them know that they are loved, and teaching them to love in return? Can we say that we’re truly doing enough to give all the children of this country the chance they deserve to live out their lives in happiness and with purpose? I’ve been reflecting on this the last few days, and if we’re honest with ourselves, the answer is no. We’re not doing enough. And we will have to change.”

We are not doing enough. We will have to change.

So, those of us who work for, or are members of health professional societies that are dedicated to improving health and well-being of the American people, must ask ourselves, are we doing enough? Is the medical profession, the healing profession, doing enough? How will we be judged?

My employer, the American College of Physicians, has been on record since 1996 (policy reaffirmed in 2006) calling for policies to prevent firearm injuries, including a ban on assault weapons, like the one used in Sandy Hook. Banning assault weapons and high capacity ammunition may not prevent tragedies like Sandy Hook, but simple logic tells us that there would be fewer casualties resulting from them. Most recently, ACP has called for “best practices” to reduce injuries and deaths from firearms, as well as the right of physicians to ask patients about firearms in the home.

Some members of Congress, who previously had the highest ratings from the National Rifle Association, agree that the time has come for “rational gun control” and “meaningful action” on guns including even a ban on assault weapons. But many others remain opposed to any new restrictions on gun ownership.

We also have to acknowledge that even if future sales of assault weapons were banned tomorrow, there are millions of them that would legally remain in persons’ hands, because they were acquired before the ban. Some will end up in the hands of people who want to inflict the maximum harm to others, but most won’t. We have to acknowledge that most gun owners, including owners of assault weapons who use them only for recreational target-practicing, would never harm anyone or wish harm on anyone. They too care about their children and that they care about ours.

An evidence-based analysis would have to acknowledge that the deaths from homicides reached a 50 year low in 2010, even as restrictions on gun ownership has been loosened across the country and even without a ban on assault weapons. An evidence-based analysis would also acknowledge that a good part of that decline may be due to better emergency care for trauma—large numbers of people are still getting shot, but not as many of them are dying from it. An evidence-based analysis would acknowledge that it isn’t just the massacres we need to care about, it is the men, women and children who are murdered or injured everyday on city streets and buses and workplaces and in their own homes.

An evidence-based analysis would also acknowledge that many disturbed and potentially dangerous people don’t have access to mental health services in the United States. It would acknowledge that the vast majority of those with mental illness pose no threat to others. An evidence-based analysis would acknowledge that people with mental illness benefit from having the loving support of their families. But it would also acknowledge that being in a loving family, and having access to mental health services, does not guarantee that very distributed persons will be able to control their violent impulses. Just read this heartbreaking account from a loving Mom about her challenges in controlling her sometimes violent son, despite having access to mental health services.

To be clear, I believe, and ACP believes, that limiting access to assault weapons and high capacity ammunition can help reduce the death toll. But it is just one piece of the puzzle. We will need to carefully examine all of the evidence that we can find on the most effective strategies to minimize deaths and injuries from firearms, and strive to seek a national consensus to implement them.

But the complexity of the problem and possible solutions should not be used as an excuse to delay action or to accept the status quo. “No single law — no set of laws can eliminate evil from the world, or prevent every senseless act of violence in our society, “observed President Obama yesterday. “ But that can’t be an excuse for inaction. Surely, we can do better than this. If there is even one step we can take to save another child, or another parent, or another town, from the grief that has visited Tucson, and Aurora, and Oak Creek, and Newtown, and communities from Columbine to Blacksburg before that — then surely we have an obligation to try.”