Wednesday, July 25, 2012

The Gun Debate

Several factors in the gun debate border on medical and safety topics for the general public. To that end, I've given a fair amount of thought to the matter. If you'll indulge the borderline political debate, the following explains my take on the issue, from a health perspective.

In the past, I've spoken at length to a few of my European colleagues who deal with the health consequences of blunt force and knife injuries with much higher frequency than gunshot wounds. Most of them attribute this to the gun laws of most European nations which require a full blown proficiency test and background check for owning a firearm.  It's easy to obtain or create a bladed or blunt weapon, so violent crime still exists. Murder happens, but neglecting military and paramilitary activity, fewer large scale massacres occur with regularity. Gun crime also occurs in the small scale, but not as frequently as here in the states. In fact, one German coroner with whom I spoke as a medical student, visited Kentucky on exchange to learn more about gunshot wound pathology, since he saw fewer than 70 gun crimes a year on average. 

This illustrates a pertinent point. Fewer people owning guns can minimize but not completely eradicate gun crime. As the popular saying goes "if owning a gun is a crime, only criminals will own guns." While I understand the sentiment and see the need for defining sides in a debate, a middle ground does exist that would satisfy people on both sides of the debate. 

The European system still allows the average citizen to own a gun, protecting the right to bear arms, but anyone requesting the permit must demonstrate an ability to use the gun properly, safely and with restraint. If, as several of those I've heard and seen arguing state, any limits prevent ownership, I will again point to the driver's licensing system already in place. Do we simply hand keys to a 16 year old and let them have free reign over a 2 ton pile of metallic death? No, we first insure that they are able to appropriately comport themselves as a driver. Tests, both written and practical, to prove proficiency in operation of the vehicle and knowledge of the traffic laws, give some semblance of assurance of safety. The debate still rages over whether this is adequate. Many states require formal driver's instruction and a permit period lasting months or years to protect the citizens on the road. Why should a gun, which carries significantly more responsibility and has similar power to end life quickly, be any different.

The average citizen (or the child thereof) could easily obtain appropriate instruction in the safe use and care of firearms and obtain a permit to do so, satisfying the desire to uphold the second amendment. However, not everyone will pass the test and background check(just like the driver's test, which has a reported 20% failure rate GMAC), especially those with a history of violent crime. It would also be useful to field questions to evaluate the psychiatric fitness of the owner, which also exist to a certain extent on the driver's test. That level of evaluation prevents unskilled users and possibly violent persons from simply walking into a store and walking out with an arsenal. The common defense and well-maintained militia still have access to firearms with which to defend their possessions and the country at large. And those of us who don't like being shot have some sense that, just like the slim margin of safety on the highway, we are safe in our homes. Or in a movie theater. Or at church. Or at a football game. Or at school.