Physician, Heal Thyself: JAMA Highlights Firearms Policies That Don’t Work

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By Thomas E. Gift, MD

“Firearm Policies That Work” just came out February 25 in the Journal of the American Medical Association. The authors are April Zeoli, a new name from the Michigan State University’s School of Criminal Justice and Daniel Webster, an old hand at anti-gun research from the Center for Gun Research and Policy at Johns Hopkins’ Bloomberg School of Public Health. Which is where Zeoli did her graduate work. Both the title and the Bloomberg source in particular tell us what to expect.

And that’s what we get, from the very first paragraph. Our total “gun deaths” rank second only to Brazil in the world. Of course, our per capita rate is much more respectable, ranking midway in the world, since we are Earth’s third most populous nation. (We won’t bother to mention the problems of incomplete reporting of the number of shootings in much of the less developed world. And comparing these human costs to the benefits in lives saved and injuries prevented by defensive gun uses just does not fit the one-track thinking of such “experts”.)

Not yet out of the first paragraph, they go on to say that “laws restricting access to firearms for individuals at high risk of the future commission of violence, based on their previous behaviors, may reduce firearm-related injuries and deaths. . . thus, there remain opportunities for enactment and implementation of these laws . . .” Is that too obvious?

The paper’s agenda is to reinforce the idea that more laws “may” reduce shooting casualties, and we should take every opportunity to pass them. “May” is the weasel word that reveals their own awareness that more laws won’t necessarily do that—and we well know that with 20,000+ plus gun laws already in place, the evidence shows that more laws can’t.

They get something right in pointing out that past behavior is the only useful indicator of future behavior, meaning violence for this discussion. Listing studies that demonstrate that’s true for firearm use adds nothing substantial, but implies there is something special about violent men using firearms that they couldn’t accomplish otherwise.

Be alert to their reference to “case control studies”, too.  In these, rather than examine real-world changes in trends of the possibly dependent variable (e.g., shooting deaths, violent crime, etc.), researchers choose and shape control comparisons to fit the study topic. You know what it means when researchers get to make up their own control sets, right?

Further on, we learn that “the odds of intimate partner homicide were higher among violent male intimate partners who had access to a firearm . . .” Does that mean that access to a gun promotes homicide? They might like us to think so.

But it also can mean that more violent males who would murder are more likely to get and use guns. Or that when a gun is present there’s more chance of a shooting than when a gun is not available (a tautology). Association is not causative, which the word “odds” implies. (See our “Reading ‘Gun Violence’ Research Critically” here if such manipulations interest you, with its companion article here.)

They like states that also prohibit gun ownership for histories of misdemeanor violence convictions. But they have to admit that “[e]vidence of the relationship of misdemeanor violence firearm prohibitions with nonpartner violence is mixed” at best.

They tout adding dating partners to the roster of restraining order-eligible parties, and denying firearms along with those orders. Yet their own numbers show that when this “broader group of high-risk individuals are prohibited from firearm access” there is actually a slightly higher rate of intimate partner homicide, with an insignificant improvement from the calculated baseline rate. “Mixed” evidence, indeed.

Throughout the paper, research comparing one state to another, or somehow calculating the effects of a law after it is enacted, is proffered as definitive. (For example, here.) But the only meaningful control for an intervention is the change in trend of the study variable in the same place before and after the intervention.

Otherwise, it is comparing apples with oranges. And even then the problem of confounding, sometimes unknown variables can exist during the same time period that are more likely causes of change than the studied variable may be. Just because associations are seen does not prove they are primary cause and effect.

A final swipe is taken at the substantial body of research that clearly shows that expanding concealed carry is not even associated with greater homicide or violent crime rates. John Lott has done yeoman’s work for years on this, and the most recent (contradicting their claim) and excellent study of nationwide trends came from DRGO author Mark Hamill, MD.

So round and round and round we go, where we stop nobody knows.

 

Thomas E. Gift, MD is a child and adolescent psychiatrist practicing in Rochester, New York, an associate clinical professor of psychiatry at the University of Rochester Medical School, and a Distinguished Fellow of the American Psychiatric Association.

This article originally appeared at drgo.us and is reprinted here with permission. 

comments

  1. avatar Ed Schrade says:

    Not about gun control, just control.

  2. avatar raptor jesus says:

    Hello from Rochester, inside the People’s Republic of New York, under the rule of Governor Soprano.

    1. avatar GS650G says:

      The Godfather and Murphy in NJ might have to implement exit taxes pretty soon. Connecticut too.

      1. avatar SAFEupstateFML says:

        Wouldn’t matter much here most of the wealthy that are not running the show have houses out of state and would beat the deadline by a country mile the moment it was debate. Moreover our current budget suggests a lot of that already happened pre salt cap

  3. avatar MB says:

    250,000 deaths a year due to negligent or incompetent doctors. You are much more likely to be killed by a doctor treating you than a gun.

    1. avatar Fully Involved says:

      Serious question: what is the point of this arbitrary analogy?
      Yes, everything in life has risks. If you don’t accept the risks of medical intervention, then refuse it.

      1. avatar MB says:

        @Fully If I have to explain it to you I guess you don’t care that these ant-gun doctors are acting like they are experts on everything, including guns and 2A rights. Most will never see a gunshot wound in their entire medical career. And the ones that do will tell you it’s a rare occurrence. My surgeon was a combat surgeon in Gulf War and in Iraq and Afghanistan, he saw it all saved countless lives and lost some too. He supports the 2A because that’s what freedom is. I guess you want some “expert” dermatologist deciding how you can defend your family. No wonder the country is screwed….And I don’t accept the risk of being in public or at home unarmed.

        1. avatar Fully Involved says:

          I agree with you that simply being a physician does not give one expertise in matters involving the 2nd Amendment (particularly when they’re arguments are based on deliberate academic misdirection) and I believe it’s wise that you don’t accept unnecessary risk by arming yourself both in public and in your home. That being said, you still haven’t answered my question.
          As it stands, when physicians and researchers make the argument “guns are bad” (particularly when it’s based on faulty evidence and deception), I am not convinced that the appropriate counter argument is “No U” (i.e. “doctors are bad”) as it does more to undermine the Second Amendment then defend and promote it.
          My point is, with all due respect MB, that we can do better.

  4. avatar Timothy Toroian says:

    How about you “may” have cancer. We’ll just wait and see what happens. Take away freedom for may??!! Did they discover that about 25% of all gun violence takes place in four cities; Chicago, Detroit, Baltimore, and the nation’s capital? Or that about 50% of all murders take place in about 5% of the counties in the country?

  5. avatar Quasimofo says:

    This is tangential, at best, but it feels good to see a Rochesterian show up on this site. I grew up there and still have family and friends there, and every time I visit the situation gets a bit sadder. NYS gov’t really only cares about NYC, and I joke with the folks back home that there will come a time when NYers outside the NYC metro will have to blow the bridges and cut the water lines just to be heard by Albany.

    1. avatar Jim Bullock says:

      Hey, I’m in Smugtown, too.

      Interesting peripheral and granular successes in the region, say since 2000 or so. Of course swamped by the down-state eminations. And don’t get noticed or The Hereditary Proconsul will knee-cap it, n install his clients. And every grand, imposed scheme for “betterment” works out as you’d expect.

      There’s a large cohort here that doesn’t get that “patronage” means they own you … for their benefit, not yours. I don’t mind a whore; I object to a cut rate one.

      O T O H, how much fun was saying “Thanks” to Chucky, just so I could add “let’s hope we can keep Albany from knee-capping this, like they did the Photonics center.” Only took 6 months to beat back the necroticism from shaking his hand. Totally worth it for the #moarpopcorn

      Smugtown has, unfortunately, a two – fer: the ministries n ministrations from downstate, and the gate-keeping / rent extraction mindset of people who’s “success” was getting installed in one of the big three – Kodak, Xerox, B & L – or their pilot fish, then making sure they stayed there. Parasites don’t help the organism function.

      They started trying to figure out how to do stuff, about 2000. But, they’re bad at it, so a game of inches, on generational time scale, I think.

      Interesting talk at RocGrowth tonite: distinct approach to potential hemp products industry. Not govt, or “economic dev.”

  6. avatar Ralph says:

    Hey, docs. Before you lecture us about “gun violence,” try washing your fvcking hands so you don’t make your patients sick. Or is that too much to ask from you little tin gods?

  7. avatar GS650G says:

    Someone I know in Florida broke his hip. They didn’t clean the OR properly and he ended up with blood born pathogens that killed him 5 days later.

    maybe the 5 million dollar lawsuit will get them to clean the rooms better.

    1. avatar Pg2 says:

      Or maybe they won’t. They don’t have time to give a shit. Part of the cost of doing business.

  8. avatar C.S. says:

    We have so many laws, nobody can be expected to know them all and follow them… But isn’t that the point? Basically the government and political class can arrest and ruin anyone if they don’t like them.

    1. avatar GS650G says:

      Read harvey Silverman’s Three Felonies a Day

      1. avatar tdiinva says:

        That is BS. The average person does not encounter a felony statute on a daily basis. If you own a business or farm maybe but otherwise no.

        1. avatar GS650G says:

          The book title is a bit leading but the premise of the book is there are so many laws, and laws contradicting laws, that even well meaning people with no malice aforethought can commit crimes. Show me the man and I’ll show you the crime is more true than one realizes.
          Financial and tax laws are particularly hard to navigate and everyone speeds on the highway eventually. If you have your own business you’re almost a gangster.

        2. avatar strych9 says:

          “The average person does not encounter a felony statute on a daily basis.”

          While I would tend to agree that this statement logically has merit I would like to see the (currently non-existent) data on the subject.

          I would suspect that while not committing felonies on an average of a daily basis that people commit unintentional felony offenses on a much more regular basis than most people would think, especially in relation to paperwork.

        3. avatar Pg2 says:

          You’re probaly correct, 3 felonies/day seems a stretch, but the average person breaks multiple laws per day, not including traffic violations. The system is set up this way so people can be subjectively prosecuted.

      2. avatar Ralph says:

        I always try to meet my quota.

  9. avatar Garrison Hall says:

    Treating “gun deaths” as an “epidemic” or “pathology” is an old trick called the “medicalization of deviance”. It’s pretty easy to take already deviant behavior like drunkeness or drug abuse (as opposed to drug use . . .there’s a difference) and begin defining it as an illness that must be treated. Basically, the process takes formally mundane behavior which may or may not be aberrant and redefines it in medical terms. Gun controllers are working overtime to redefine mundane gun ownership as pathological behavior so that it can be medicalized thereby causing simple gun-ownership and use to signal a need for “treatment”. The problem, of course, is that gun-controller physicians are coming hard up against a constitutional mandated right. Still, if they can somehow convince the public and attendant politicians that gun-ownership is a mental illness that has to be “cured” they’ve just found a handy way to get around our constitutional protections.

  10. avatar GS650G says:

    Homosexuality was considered a mental illness long ago. It morphed from a disease to a lifestyle likely to be accepted into an unavoidable condition. They’ve been looking for the gay gene ever since. I look at it as a preference one is free to make but I don’t consider it the same as one’s skin color or any other proven trait. It certainly doesn’t give people enhanced rights nor should laws be tweaked to their advantage. Yet it’s a class and status that offers plenty of protections, empathy, support and prestige.

    The key is to move gun ownership into a realm of required lifestyles. We could enjoy full government protection from haters who gonna hate. A new condition could be created where people need firearms like someone needs a cat on an airplane flight.

    Right now if you are a gay black muslim woman in a wheelchair who has emotional security issues and you can’t work you are near the top of the stack in terms of rights. Now imagine a condition where there is violence around and a person is deemed on their own because they are not of a protected class. That could be the trigger than causes emotional issues. Now we just need someone to write a paper supporting the owning of guns as a means to combat insecurity without them claiming the person is too nuts to own them and it’s a done deal .

    1. avatar Garrison Hall says:

      “Homosexuality was considered a mental illness long ago. It morphed from a disease to a lifestyle likely to be accepted into an unavoidable condition.”

      This is a good point. One thing that activists seeking to use perceived deviance for their political gain fail to see is exactly what you said. People tend to think that once something is deviant, it becomes deviant for ever and ever. That’s not true at all. Some things can be deviant at one point and not deviant at another, causing medical judgement linked to one and not the other to be rendered inconsequential. Not many shrinks “treat” being gay as an illness any more.

  11. avatar tdiinva says:

    In order to claim that we have gun deaths like Brazil they include suicides. The US, UK and Canada have similar suicide rates despite having more restrictive gun polucies.

  12. avatar TFred says:

    “laws restricting access to firearms for individuals at high risk of the future commission of violence”

    Prior Restraint. Virtually all gun-control laws engage in some form of prior restraint. Prior restraint is treated as the metaphoric “third rail” when applied to all other civil rights, “but guns” is used to justify the difference, which relegates the Second Amendment to a second-class status.

    Will SCOTUS ever correct this? Some glimmers of hope in the coming months, stay tuned.

    1. avatar Ralph says:

      Prior Restraint is a First Amendment censorship doctrine. It has nothing to do with anything else. Nothing.

  13. avatar HoundDogDave says:

    The evidence is clear, the Coastal States with the most restrictive gun laws have far fewer alligator attacks than those that have more relaxed gun laws. That’s a fact look it up!

    1. avatar Troubled Soul says:

      I’m pretty sure our Gov Inslee is a reptile but I think he is more of a snake than an alligator.

  14. avatar strych9 says:

    “They get something right in pointing out that past behavior is the only useful indicator of future behavior…”

    Except that it’s not really useful. [Insert rant about how people function here.]

    1. avatar Geoff "I'm getting too old for this shit" PR says:

      “[Insert rant about how people function here.]”

      And don’t function…

      1. avatar strych9 says:

        They all function in one way or another. It’s a question of if their behavior tends to be socially acceptable, tends not to be or has outliers in either direction.

        The only ones this doesn’t really apply to are people who have some sort of hardwired pathology. Like a serial killer.

  15. avatar pg2 says:

    ER physicians save many lives. Outside of trauma care, routine medical care is Russian roulette, literally.

  16. avatar SS says:

    When these MD aholes start working on the 250,000 Americans killed through medical “errors” then they can squawk about gun control, until then they can FOAD

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