Sean Philpott: Annus Horribilis

Dec 27, 2012

Sean Philpott

In Great Britain, where much of my family is from and still lives, there is an annual tradition known as the Royal Christmas Message. Begun in 1932 by then King George V as a radio broadcast, the tradition has evolved into an annual event in which the sovereign head of the British Empire delivers a speech on that year's events, as well as personal and national triumphs and tragedies.

I had planned something similar for this commentary, albeit on a much more modest and humble scale. After all, I am not the King of England. Rather, I am but a lowly Professor of Bioethics who happens to do a regular commentary on that small niche area he works in: science and health policy.

As I read back through my commentaries from the last year, however, I found myself at a loss about what to write. Moreover, one phrase -- also borrowed from Great Britain's royal family -- kept coming to mind. For many of us 2012 has been, in the words of Queen Elizabeth II, an annus horribilis.

Annus horribilis ...  a terrible year marked by such natural disasters as Hurricane Sandy and tenacious drought, and such manmade disasters as the shootings in Aurora and Newtown.

As I struggle to put words to paper, the recent tragedy in Newtown, Connecticut keeps coming to mind. In the almost two weeks since the shooting at Sandy Hook Elementary School left 20 children and six adults dead, tens of millions of words have been written on the topic of gun violence and mental illness.

Much about Newtown has been written by people who are a lot smarter and knowledgeable on these issues than I, leaving me with little productive to add to the conversation. Sadly, even about Newtown -- and similar shootings, such as the sniper attack on four firemen earlier this week outside of Rochester -- were written by single-minded folks with political agendas or simple-minded folks with little understanding of the complexity of the issues.

For example, new restrictions on guns (particularly the assault-style weapons used in Connecticut) are unlikely to have an immediate and measureable impact on gun violence in the US. The American market is already awash in legal weapons. Over 300 million firearms are privately owned in the US, nearly one for every man, woman and child, including an estimated 3 million assault weapons.

Arming teachers or putting additional security in schools is also likely to be ineffective (not to mention cost prohibitive). Armed guards were present at both Columbine High and Virginia Tech but were unable to prevent excessive loss of life, while a single deranged gunman was able to kill 13 and wound 29 others on a heavily fortified army base in Texas.

Finally, the abysmal state of mental health care in the US is a continuing and intractable problem. Most, if not all, of recent mass shootings were perpetrated by gunmen with undiagnosed or untreated mental illnesses. Despite this, mental health care is hard to come by, particularly for those who lack the means to pay for treatment. Even if we act now to reverse the trend of cutting publicly funded mental health programs, it will take decades or longer to get all of those who need care into treat. This is unlikely to happen given the current financial and political situation. The gun owners of America have one of the most well-funded and well-organized lobbyist groups in the world working for them, and the mentally ill do not.

At the December 16 vigil for the Newtown victims, President Obama noted that the tragedy highlighted the continuing problem of gun violence in the US. It is one of the leading causes of injury related death, second only to car accidents. Each year more than 30,000 Americans die of gunshot wounds, including more than 100 children under the age of 12. What happened in Newtown is, sadly, but a single drop in a bloody bucket.

The massacre at Sandy Hook Elementary has renewed a long-dormant and acrimonious conversation about gun control, and we have a very long row to hoe. There are no easy answers to the problem, but there are a few preliminary steps we can take.

We can start, for example, by demanding that our elected leaders revoke laws that current prohibit public funding of research designed to reduce gun-related violence. In 1996, the CDC's National Center for Injury Prevention and Control published a study that found that the risks of having a gun in the home outweighed the self-defense benefits. Under pressure from the NRA and other pro-gun lobby groups, Congress quickly moved to quash further research on this topic. Federally funded studies of gun violence are now prohibited by Public Law 112-74, which prohibits taxpayer dollars being spent on anything that may "be used, in whole or in part, to advocate or promote gun control."

We should similarly demand that our leaders reconsider laws that prohibit doctors from discussing gun violence with their patients. Despite objections from professional organizations like the American Medical Association, the Florida state legislature recently tried to pass a bill making it illegal for pediatricians and other physicians to ask patients or their parents whether they own guns. While a federal appeals court ruled this 'gun gag law' unconstitutional, Florida and several other states have reintroduced such laws under pressure from gun-rights groups.

Gun violence is, first and foremost, a public health issue. We should begin treating it as such.

A public health researcher and ethicist by training, Dr. Sean Philpott is a professor of bioethics at Union Graduate College in Schenectady, New York. He is also the Chair of the US Environmental Protection Agency’s Human Studies Review Board, which reviews all research involving human participants submitted to the EPA for regulatory purposes.

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