Blog | Friday, November 10, 2017

Gun violence is a public health issue

The horrific massacre in Las Vegas hit the nation like an avalanche. A collective sense of shock and numbness descended as we all watched the terrible scenes of bloodshed on our television screens. Invariably in the days that followed, discussion turned to how to curb gun violence and stop a repeat episode from happening. We've all heard the statistics time and again: the United States is an extreme outlier from all other developed nations. We have more than 25 times the firearm homicide rate compared to other Western countries, and have more guns than people—owning almost half of all civilian guns worldwide. Staggering numbers.

Given the unprecedented nature of the killing spree, the events in Las Vegas also made worldwide headlines. Several friends in Europe texted and emailed me after the event, expressing horror and trying to gauge my own thoughts on America's gun violence. One British friend texted: “Why can't America just ban all guns? Is it not a civilized country?!” This was an interesting point of view. I have lived in America now for over 12 years, having grown up in a country, England, where firearms are virtually non-existent. Had you asked me right before I moved here, I would have probably posed a similar question. I didn't grow up in a culture that valued guns or had any concept that it was a right to own one.

I was a teenager when the UK had its last mass shooting incident. The Dunblane Massacre in Scotland in 1996 involved the deaths of 16 primary school children, all aged around five, along with one teacher, before the crazed gunman killed himself (tennis player Andy Murray happened to be one of the children in the school at the time). I remember how the tragedy shocked and united the country. Guns were not particularly easy to come by beforehand, but the Conservative UK government rapidly enacted swift legislation, and within a couple of years basically all handguns were banned. There has not been another firearm massacre in Britain since.

Over the years I've lived in America, we have unfortunately witnessed mass shooting after mass shooting. There was Virginia Tech, followed by the Aurora movie theatre, followed by Sandy Hook, followed by the Pulse Nightclub—to name only the most notorious. After each killing spree, the same discussion and debate follows, the same old opinions are voiced—and then, nothing changes. So after this latest massacre in Las Vegas, I am not particularly optimistic that great change will take place to help us avoid yet more tragedies.

If I take a step back, and try to understand why America is so different from other countries, I draw a few conclusions. Let me start by saying that my own personal viewpoint is shaped by my upbringing in an almost gun-free country. I think America, and the world, would be a much better place if there were simply no guns whatsoever. But seeing as we don't live in that utopia, we have to work from where we are.

The Second Amendment was written as part of the Bill of Rights, ratified by the states and then Secretary of State (and future President) Thomas Jefferson in 1791:

A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.

This was written shortly after the Revolutionary War. Keep in mind, the whole history of America started with the citizens of the colonies bravely taking up arms and rising against a tyrannical authoritarian King and a mighty army. Since then, we've had the Wild West and the concept of the “American cowboy.” Gun culture flourished throughout the 1800s, and remained part of the popular imagination. The right to own a firearm is something that has therefore been deeply ingrained into the American psyche for almost 250 years, as is the right to self-defense. The longer I've lived in America, the more I have grown to understand this unique cultural difference—and yes, respect it as well. I've had plenty of interesting dinner conversations with a wide variety of people, and very rarely have I ever met even the most liberal–inclined person, who argues for a complete ban on the right to own a firearm in the United States (even if they argue for stringent checks and restrictions). Very telling. Perhaps that will change one day, but for now it seems like the Second Amendment is an inseparable part of the national identity—however much a completely alien concept it may be in any other Western country.

The text my British friend sent about “Why can't America just ban guns?” also displays a lack of understanding about the nature of American democracy compared to Europe (other slightly unrealistic questions I've been asked over the years by European friends include: “Why can't America just slap on a huge national gas sales tax to discourage owning large vehicles and help bring down emissions?!”). The reality of “banning” things and passing radical national proposals tends to happen less in America.

Ironically, parliamentary democracies actually lend themselves to more drastic laws being enacted more swiftly than could ever be imagined here. Our system of checks and balances coupled with the rights of individual states, rightly or wrongly (and in my opinion rightly, especially for most other contentious issues), makes it much more difficult for any type of nationwide “ban” to ever pass—even if any idea started gathering significant support. Regardless, staying on the subject of “bans” for a moment, one of the least grounded arguments I've heard from gun enthusiasts includes the popular line: “Well knives and cars kill people, are you going to ban them as well?” The big problem with that logic is that kitchen knives and cars are not designed with killing humans in mind—whereas a firearm was invented specifically for that purpose. Not that a ban is ever seriously part of the debate in America anyway.

So if we start from this point, that all law-abiding Americans will continue to have a right to bear arms, the question then becomes: how do we reduce the number of firearm tragedies? Even the most ardent Second Amendment folk, would agree that there have to be some sorts of restrictions on who can own a weapon and how devastating it can be. For instance, an obviously mentally disturbed person should not be able to just walk into a store and buy a gun. And on the other hand, even the most psychologically intact person, should not be able to buy a tank or a missile system.

So let's now ask, what are the issues that concern gun-enthusiasts so much? Taking out the NRA and its often controversial financial influence for now, when you speak to many people who legally own guns, what worries them is the notion of excessive government control and being “punished” for the actions of other people. They see themselves as law-abiding American citizens, don't trust the federal government, and view owning guns as a sign of their freedom. Indeed, having a deep suspicion and healthy mistrust of government is something uniquely American (also relevant to the health care debate). For the same reason, any proposal to exert any sort of additional control at all, including something like a central government registry of gun ownership (or in fact, central registries of anything), would be met with the same revulsion—a sentiment that does not exist to the same extent in Europe and many other countries.

A further viewpoint I've heard is that resistance to losing any sort of gun ownership rights whatsoever is based on the observation that throughout history—when any authoritarian government, dictator or regime comes to power—the very first thing they do, without fail, is disarm the population. Americans don't want to risk that. While this certainly may be true historically, and a very valid belief, the counter argument is that is we are living in a modern day democracy and if the federal government with its full arsenal ever truly wanted to come after us, no Second Amendment weapon would stand a chance against a tank or an F-16!

Finally, the pro-gun side of the debate simply contends that the other side doesn't respect or understand gun-owning culture, particularly in rural America.

On the other side, the pro-gun regulation lobby regularly argues that something needs to be done, however small, to curb the appalling statistics and reverse the tide of gun violence that makes America an outlier. They correctly remind us that the Second Amendment was written in a completely different era, when the Founding Fathers could not have envisioned how devastating weapons would become. There's a somewhat tongue-in-cheek viral internet video (you can view it here) where an actor portrayed what a modern day massacre would look like if we still had muskets, when the Second Amendment was actually written.

So where does that leave us?

Well, if the right to own a firearm is here to stay, which it almost certainly always will be in accordance with America's Constitution, the only way to reduce the tide of killing sprees is for compromise between two sides who both believe they are speaking from the heart. I'm sad to say that two weeks ago, I published an article on my organization's website which talked about this very issue—and predicted that the debate would flare up again if heaven forbid, there was another mass casualty incident. The article focused on the language of communication, and how the gun “control” side of the argument is making an enormous communication mistake by calling it “gun control” in the first place. It should be called “gun safety”—for a multitude of psychological reasons that will help the argument (you can read the article here).

It seems the most we can probably hope for in America is sensible gun safety measures restricting weapons of war (including making it illegal to purchase “bump stocks”), very stringent mental health and background checks, and self-reflection from our political masters about whether the lobbies that have so much influence, are truly representing their constituents. Hopefully, the need for public safety and the need to respect the Constitution and the feelings of our population who strongly believe in the Second Amendment, can be reconciled.

Let's finish then by coming back to Thomas Jefferson again, the founding father who ensured passage of the Second Amendment. If you go to the spectacular Jefferson Memorial in Washington D.C., you can read one of his many brilliant quotes up on the wall next to his statue. It reads:

“I am not an advocate for frequent changes in laws and Constitutions. But laws and institutions must go hand in hand with the progress of the human mind. As that becomes more developed, more enlightened, as new discoveries are made, new truths discovered and manners and opinions change, with the change of circumstances, institutions must advance also to keep pace with the times. We might as well require a man to wear still the coat which fitted him when a boy as civilized society to remain ever under the regimen of their barbarous ancestors.”

That's a quote that everyone should keep in mind in this debate.

Suneel Dhand is an internal medicine physician, author and speaker. He is the founder of DocSpeak Communications and co-founder at DocsDox. He blogs at his self-titled site here.