“Medical Journalism” is Neither

(from murraysreview.com)

(from murraysreview.com)

The American Medical Association, via its flagship publication Journal of the American Medical Association, is turning up the heat. Apparently unable to comprehend the shifting American dynamic toward increasing respect for gun owners, they’ve featured several recent commentaries beating the dead horse of the  “public health gun crisis”.

The November 14 edition of JAMA features 2 articles flogging the ‘public health firearm epidemic crisis’, to mix metaphors only a little more than they do.

One is a Viewpoint: “The Las Vegas Shootings—Underscoring Key Features of the Firearm Epidemic”. James Schulz, PhD, Siri Thoresen, PhD and Sandro Galea, MD, DrPH use that tragedy to highlight “several issues that mandate attention in public and academic conversations around” mass shootings.

Their first point is that not only the 59 deaths but also the 104 wounded victims are significant public health matters, pointing to 24,000 non-fatal gunshot wounds yearly in the United States. The physical and financial costs of care and disability are certainly great, as is emotional harm to survivors and first responders like Post-Traumatic Stress Disorder. But as always, they ignore the number of lives and injuries, not to mention property, saved by somewhere from 500,000 to 2.5 million self-defense gun uses each year against criminal assaults.  There is little reason to doubt that the cost in lives and dollars saved in those cases outweigh the ones that were not prevented. Besides, when DGUs cause hurt, it is to perpetrators who deserve it.

They get back on track discussing interventions to minimize the emotional trauma to families and the community following mass shootings. Norway developed a response to the Utøya Island mass shooting based on “proactivity, continuity, and targeted interventions.” Outreach was made to everyone who could be identified as vulnerable via Norway’s public health service. This would be harder to accomplish in the United States’ more localized service delivery systems, but the reason is not “a 1996 amendment to an omnibus spending bill that barred firearm research that can be used for policy advocacy.” It barred anti-gun advocacy paid for by the Centers for Disease Control (and, later, by the National Institutes of Health).

This supposedly medical discussion crosses the line into absurdity by regurgitating the calumny that Heller was a politicized decision due to “3 decades of advocacy by particular corporate interests whose incentive is to manufacture and sell more firearms.” These are people who will always deny the Second Amendment’s plain language and think they should decide which industries get to promote activities that use their products. That’s simply unconstitutional and anti-capitalist.

The Journal’s accompanying editorial, “Death By Gun Violence—A Public Health Crisis”, goes much further in its anti-gun assertions. No surprise, coming from the dean of hoplophobic “research”, Frederick Rivara, MD, MPH of the University of Seattle. JAMA claims to be “dedicated to improving the health of people . . . by addressing the most important public health problems harming people and publishing the best science that can be done.” But focusing on “gun violence” is a diversion from, say, the hundreds of thousands of patients killed due to medical mistakes each year in the United States.

And blaming the 1996 Dickey amendment for a 14 year drop in firearm studies cited is a sly evasion of reality. There are more “gun violence” studies published than ever—but that’s among far more medical subjects demanding funding now than in 1998. And, just perhaps, decreasing numbers of citations of previous “gun violence” research may reflect increasing wisdom on the part of those seeking valid citations.

So JAMA editors continue to say “Physicians should ask about guns in the home . . . and advise about removal.” (A good current discussion of this is Vik Khanna’s “Should Doctors Screen Their Patients for Gun Violence?”). They want: “More background checks; more hotel, school, and venue security; more restrictions on the number and types of guns that individuals can own; and development of ‘smart guns’.” And they continue to imagine that the cause of “firearm deaths in the United States . . . is guns.” We won’t get anywhere in reducing gunshot trauma as long as organized medicine refuses to look beyond the instruments to the people who so misuse them.

Finally, for now, check out the very next issue’s editorial, only a week later. They just can’t let it go. The lead author of the previous week’s editorial, Howard Bauchner, MD, also helped author “Firearm-Related Injury and Death: A US Health Care Crisis in Need of Health Care Professionals”.

Yes, “here we are again with another editorial about the public health crisis of firearm-related injury and death.” They are at least correct that “if on one day more than 50 people died and over 10 times that many were harmed by an infectious disease in the United States . . . [t]here would be a rush to identify the cause, develop interventions, and refine them continually until the threat is eliminated or at least contained.” Yet they can’t grasp (or won’t admit) that this thinking has nothing to do with firearms, which are in no way comparable to infectious organisms.

The organisms at issue are the humans who kill, often with firearms. Their culture media are, precisely in fact, their cultures—of criminality, violence, drugs, gang membership and (for suicides) stigma, which distance them from prevention.

Their predictable, prejudiced advice is for education “from [only?] health care professional organizations” and to promote “gun control”. “Ask your patients if there are guns at home” and “if your patients believe having guns at home makes them safer, despite evidence that they increase the risk for homicide, suicide, and accidents.” Are they referencing the past quarter century of prejudged, methodologically unsound studies with illogical conclusions that academic centers of anti-gun expertise have churned out?

Even Britain is piling on. It claims that its draconian gun control laws solved its gun crime problems, although they’re increasing dramatically as violent crime overall there rose even faster.

“Gun Deaths and the gun control debate in the USA” in The Lancet October 21 also jumps off from the Las Vegas mass shooting to complain that our “CDC and NIH currently cannot investigate whether limiting access to guns would” prevent suicide. Again, that’s not only false but it’s a ridiculous question. Of course, limiting access to guns (and other lethal methods) would reduce the incidence of completed suicide. Eliminating guns entirely would eliminate all gun deaths.

The right questions are how to tell who should be liable to removal of such personal property, what constitutes sufficient reason, and how it can be done with the due process that every American (if not Brit) deserves. (For another perspective on The Lancet’s editorial, see “Gun control: The Assault on Congress by the medical journals” by Miguel Faria, MD.)

The November 21 JAMA editorialists are right this far: “[S]ilence is not the answer.” Those of us who know better than these amateurish professionals have to keep speaking up loud and proud about America’s exceptional character, beginning with our individual rights and liberties.


Robert B Young, MD

— DRGO Editor Robert B. Young, MD is a psychiatrist practicing in Pittsford, NY, an associate clinical professor at the University of Rochester School of Medicine, and a Distinguished Life Fellow of the American Psychiatric Association.

All DRGO articles by Robert B. Young, MD.