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Cartoon by Tom Tomorrow - Gun talk
The latest issue of The Journal of the American Medical Association has again produced several articles about reforming our gun laws, and the different state and federal approaches to addressing reform in regard to mental illness.

A third article from a psychiatrist with personal experience, both with the NRA and its gun safety programs and with the trauma of gun violence, has my attention today. In it, the author, Dr. Paul Kettl, compares the message of using guns "safely and responsibly" that he remembers from a youth hunting course with the NRA to its present campaign of fear, misinformation and threats, and finds it wanting.

Part of this article is behind a paywall, but fortunately someone provided me with a hard-copy of the magazine. Let's take a look.

Here's how Dr. Kettl begins his article in JAMA, with a story from his scouting days that I think many of us can empathize with.

Ok, perhaps I'm not that empathetic
I was 15 years old, and after firing the shot, I could feel the kick of the rifle against my shoulder. Hearing the “pop” of the shot also gave me a thrill that echoed through my adolescent frontal lobe. I looked up, and the representative of the National Rifle Association who was running the session told us, “We are going to have some fun today, and we’ll do some more target practice, but we also are going to learn how to use that weapon safely and responsibly.”
I understand that these days, it can be difficult to get this point across that shooting and target practice can be fun. Although the psychiatrist relates gun use as part of the American way -- I have my doubts about that -- it's still prevalent enough that this aspect of it shouldn't be ignored. I've shot a gun once myself, and it wasn't particularly horrifying. Being taught enough to deal with the recoil to not get a headache from it was a plus. It's not that kind of shooting that worries me; it's the popping noise of gunfire in my neighborhood at night, and the noise of helicopters overhead, reminding me that no, that was no backfiring truck.

Dr. Kettl takes on the idea of gun ownership for security -- a means to feel better, really, as he puts it. Unfortunately, the data he presents suggests that guns in the home create far more suffering than they alleviate.

If you have a gun to "protect" your home, the person most likely to die from that gun is you. For every case of self-protection death with a firearm in the home, there are 37 suicides involving a gun in the home. The second most likely person to die from that gun is a homicide victim -- at your hands, four times most likely than a self-protection shooting. Way down the list is stopping that intruder breaking into your house, the imagined reason you bought the gun in the first place. In the United States, 32,000 people a year are killed by guns, and another 32,000 people a year are shot and injured. Firearms are an efficient and common way to kill people. You don't have to think much about it. Firearm-related homicide is more than twice as common as all other means of homicide put together.
Having heard all of the gun lobby's objections to this data, I can already imagine them being repeated here in response. There may be other 'self-protection' instances where no one was shot and killed. Suicide is just "a choice," some inevitable, unstoppable outcome. As if people at risk of committing suicide are some sort of cyborg self-terminators that absolutely will not stop, ever, until they are dead. The gun enthusiasts will seek to dismiss the suicides altogether, as if they somehow don't count -- which reminds me of a program I heard on NPR yesterday. On Talk of the Nation, they discussed the racial disparity of gun violence -- that gun deaths among whites tend toward suicide as much as gun deaths among blacks tend toward homicide, and what that does to their respective opinions.
KEATING: Well, it's kind of interesting, because then what really drove my story was not just the disparity in the rates, but how that applies to guns and access to guns. So the people that suffer homicide among relatives, family, friends, tend to have a very anti-gun attitude. And so that's prevalent in the city across all races and in the African-American in both cities and African-American community of predominately homicide for gun deaths, and there's a strong urge for gun control both in the urban environment and in the African-American community.

But then as you move out of the city, suburbs and then rural, where the gun deaths shift to suicide, you also shift to a much lower desire for gun control, much more support for gun rights. And so what really is interesting to me about that is that when people die in a gun homicide, the gun is vilified. The gun is blamed, and people want to stop the guns.

But in gun suicide, the gun is not blamed. The gun is actually considered, you know, not the problem, and it's that, you know, they tend to more put a stigma on the person, oh there was something wrong with him. So in the reporting on this, it was - you know, and in talking to the experts, when you go to the academic experts and those kind of people, they have a very strong conviction, and they look at the data about access to guns and suicide, and how much more suicide there is in places where there are a lot of guns.

I've seen this exact same difference of opinion here. Even though guns are a documented risk factor in suicide. Even after explaining how the gun facilitates the suicide when the impulsive thought strikes. How taking the gun away will save lives. About how many people attempt suicide but go on to live normal lives, versus the ones who pick up a gun -- nearly all of whom become part of that statistic, 32,000 dead in a year, because guns are so effective at killing people. Even after explaining all of this, the blinkered mindset of they will find a way continues to persist. In spite of the evidence, in denial of it.

Even Dr. Kettl in the JAMA article mentions this particular quality of guns -- their ease of use, how handy they are when that impulse strikes, how irreversible their effects are. And more.

Guns make it too easy to take a life. Impulsive thoughts or threats of violence against oneself or others become fatal if a handy means of implementing those thoughts is all too easily accessible. Firearms provide those ready means. But we also have semiautomatic weapons with large ammunition clips designed for maximum killing. Handguns are sold without checks at gun shows, or on the streets. Those who are overtly psychotic can purchase them without a worry on the street or at those large gun shows.
...or from websites like ArmsList, as I've found. The ultimate expression -- and utter failure -- of the honor system in obeying the law, which we're told is a valid alternative to more credibly founded record-keeping for background checks. ThinkProgress investigated the particular problem of online gun dealers back in February. Dr. Kettl doesn't mention that part of the gun trade. But he does mention the common-sense policies promoted by the President and Democrats in Congress, to make background checks for guns as routine as they already are for taking an airplane flight or even just for voting. Policies like taking away access to guns from people who suffer from dangerous mental illness. Where is the NRA to be found here, the NRA that supposedly is interested in using guns "safely and responsibly"?
But it doesn't look like many of these safety measures will be put into place. The reason is not that they wouldn't save lives, or prevent trauma pouring into our emergency departments, or assuage grief seen in our mental health offices. The reason is fear and misinformation propagated by a public discussion dominated by fear and threats. The National Rifle Association let me down. What it taught me as a teen was to use guns "safely and responsibly." I believe that the NRA is not teaching that now nor following the tenets of safety or responsible gun use in its public policy stance. Instead, it uses fear and condemnation to avoid even the most sensible, obvious changes needed in our gun laws. In Florida, a law threatened physicians if they even asked about guns present at home with the family. And then, after that law was struck down, the NRA appealed that decision in federal court.
So, as it turns out, the NRA youth programs about gun safety? Not so much, once you've grown up. And since the proliferation of guns and gun violence has been treated like a public health crisis in recent issues of JAMA, which I've written about here, perhaps this message, this evident fakery from the NRA should be viewed as the hook. Much like the deceptive advertising from cigarette companies targeting young people to get them hooked on smoking. I suspect that Dr. Kettl wouldn't go that far with it, though. There is value in promoting safe and responsible use of guns, when they're going to be used. But I see the NRA as tainted. A poisoned well, and they've polluted it themselves.

The desire for security is in one sense the freedom from danger, from fear. And I can cite again the example of Charlton Heston, addressing the National Press Club on behalf of the NRA:

Sign at the 2011 Rally to Restore Sanity in Washington DC that reads
It is America's First Freedom, the one right that protects all of the others. Among freedom of speech, of the press, of religion, of assembly, of redress of grievances, it is the first among equals. It alone offers the absolute capacity to live without fear.
In spite of their protests otherwise, gun enthusiasts fighting for unfettered access to guns and gun proliferation exhibit this fear in their desire for security. The NRA's conspiracy theories and scare tactics about government tyranny and gun confiscation exude this fear; they create it, they nurture it. The NRA cultivates fear, and their harvest can be seen in the frantic gun enthusiasts buying everything off the shelves at gun stores, putting guns on back order, guaranteeing months or years of continued profit for gun manufacturers. They are being farmed, harvested for profit.

It is a sad contrast, to compare this fear-mongering to the story from Dr. Kettl's youth, of target practice and safety lessons and, yes, fun with guns. In advocating gun safety and responsible, progressive change in gun laws, I'm with the researchers, the scientists. Our emphasis is on saving lives -- whether it's gun violence and homicide by gun, which the rural folk seem to dismiss as some particular urban blight that they can safely ignore; or cases of suicide, which actually hit hard in rural areas, hard enough to make them deny the gun as a risk factor.

That denial doesn't resemble courage; that would mean confronting, overcoming fear. It smacks of cowardice instead. It's a shame to see that, thanks to the NRA, cowardice may win the day and prevent change for the better.

Originally posted to The Tytalan Way on Wed Mar 27, 2013 at 11:06 AM PDT.

Also republished by Shut Down the NRA.

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