Doctors for Gun Control

Article excerpt

Just weeks after the Supreme Court issued its blockbuster opinion in the landmark Second Amendment case District of Columbia v. Heller, two prominent medical journals were in print with an editorial and two articles asserting that guns at home are a major public health problem.

First off the press was the July 31, 2008, New England Journal of Medicine editorial "Guns and Health," citing statistics from the Centers for Disease Control and Prevention on the number of injuries and deaths from handgun use. Five weeks later, the same journal published "Guns and Suicides in the United States," by the Harvard School of Public Health's Matthew Miller and David Hemenway, summarizing studies purporting to establish a direct relationship between suicides and household gun ownership. Four weeks later, Georgetown University law professor Lawrence Gostin expanded on the guns-cause-violence theme in "The Right to Bear Arms," a brief paper on gun control law and politics that appeared in JAMA: The Journal of the American Medical Association.

The articles and editorial raise two important questions: Is there persuasive empirical data that lawful gun ownership makes the public less safe? If so, would public safety be enhanced by tighter gun controls? There is a rich academic literature examining those questions, and the literature indicates "No" for both questions.

Disappointingly, neither the NEJM nor JAMA wants to discuss those peer-reviewed studies. Indeed, when I offered to write a short article in response to the NEJM editorial, my offer was declined. When I volunteered to convert the short article into an even shorter letter-to-the-editor, that too was declined. Other lawyers have written for the NEJM, but none represented Mr. Heller before the Supreme Court as I did. Perhaps view-point discrimination explains the one-sided coverage of this issue by both the NEJM and JAMA. So I will share a few of those counter-arguments here.

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GUNS AND SAFETY The NEJM's editors cite, with justifiable concern, CDC data on handgun-related injuries and deaths. But the editors ignore a comprehensive 2003 CDC report on the efficacy of firearms and ammunition bans, restrictions on acquisition, waiting periods, registration, licensing, child access prevention laws, and zero tolerance laws. The report's conclusion: There is "insufficient evidence to determine the effectiveness of any of the firearms laws or combinations of laws reviewed on violent outcomes."

"Research has shown," the NEJM editorial claims, "that fewer restrictions on handguns will result in a substantial increase in injury and death." To the contrary: a 2004 National Academy of Sciences review of 253 journal articles, 99 books, and 43 government publications evaluating 80 gun-control measures concluded that "existing research studies ... do not credibly demonstrate a causal relationship between the ownership of firearms and the causes or prevention of criminal violence or suicide."

The NEJM editorial writer does offer one citation to specific data on the relationship between guns and public health: a 1991 NEJM article ostensibly documenting a 25 percent decline in gun-related homicides and suicides immediately after the District of Columbia enacted its 1976 gun ban. But that study has been discredited for its biased selection of comparable jurisdictions, failure to adjust for D.C.'s declining population, disregard of other explanatory variables, and selective choice of time periods. Further, a 1996 paper in the Law and Society Review found that if the study, which ended in 1987, had been extended by just two years, the observed decline would have disappeared.

Interestingly, the District exempted pre-existing handguns from its 1976 ban. If handgun availability were positively linked to suicides, one would expect suicides to decline progressively as owners gradually sold, discarded, or removed pre-1976 guns from the city. …