By Timothy Wheeler, MD
The Newtown school mass shooting has awakened the medical establishment’s long-dormant urges to order our lives in areas it knows nothing about. Now the American College of Physicians (ACP) is prescribing drastic measures against gun owners. If prescribing outside of a doctor’s area of competence is malpractice, then the editors of the ACP journal the Annals of Internal Medicine are guilty.
In a New Year’s Day editorial, (an earlier version is linked here) the Annals editors call for a new round of increased gun control to do something, anything, about such horrors as the Newtown shooting and gun-related deaths in general. But their lack of insight into this ancient problem of humanity (mass shootings are not a new thing, nor are they increasing in frequency) becomes apparent with even a little analysis. Here is a point-by-point discussion of their call to action against gun owners.
“Why does gun violence deserve physicians’ time and energy? Guns maim and kill.”
This simplistic statement reveals the ACP leaders’ fundamental lack of understanding of American gun owners. The gun control activist-coined term “gun violence” comes packaged with a rejection of the notion that there are legitimate uses of firearms. It divorces the awful result of gun crime from its perpetrators, leaving us with a disembodied force, like some infectious disease. This linguistic defense mechanism appeals twofold to the uncritical mind: it avoids the messy task of judging actual criminals, and it encourages a drastic cure of the problem with no concern about collateral damage to innocent people—namely gun owners.
“The American College of Physicians (ACP) Ethics Manual outlines…physicians should help the community and policy-makers recognize and address the social and environmental causes of disease, including human rights concerns, discrimination, poverty, and violence.”
The leadership of most, if not all, American medical organizations is dominated by liberal progressives who earnestly want to change the world to a more perfect place—according to their own vision. By contrast, the rank and file membership is mostly concerned with getting through a work day, diagnosing and treating disease and keeping their patients well. These traditional tasks of medicine are challenging enough in the best of environments. They are made far more complex and difficult by suffocating government regulation, hyperlitigious patients, and doctors’ own political naiveté. Supporting social causes can be fine and noble work, but exactly which causes to support and how should be the personal choices of a doctor.
“The relative silence of the health profession on matters related to gun violence is disturbing. The ACP last issued a position paper on firearm injury prevention in 1998 that identified gun violence as a public health issue, called for internists’ involvement in firearm injury prevention, favored strong legislation to ban automatic and semiautomatic assault weapons [sic]…and called for restrictions on the sale and possession of handguns.”
Since the ACP issued the first call for more gun control in 1998 many more Americans have formed clear ideas about why they want to own guns. All the states but Illinois have adopted laws allowing discreet carry of firearms for self-defense. And a federal court of appeals recently ordered Illinois to stop dragging its feet and to codify in its laws the same right for Illinoisans.
Since 1998 the Supreme Court has issued rulings affirming the individual right to own guns for self-defense. Since 1998 violent crime has dropped dramatically. And just two weeks after Newtown, at the height of anti-gun rights hatred, a Gallup poll still found a record majority of 74% of Americans opposing a ban on handguns, and a slim majority of 51% opposing a ban on the misleadingly named “assault rifles.” The ACP called for banning “automatic and semiautomatic assault weapons” back in 1998 and now seems to support such bans still. By now though, even the ACP should know that automatic firearms have been all but outlawed since the 1930s, and that since then they have almost never been used in crimes. ACP experts have had 14 years to get it right, but they still conflate machine guns with standard hunting, sporting, and home defense rifles. Their persistent misleading of the public about these commonly owned guns can no longer be considered an innocent error. We can only conclude that the ACP, like other gun control activists, are deliberately trying to prejudice the public by mislabeling modern sporting rifles “assault weapons” and “automatic rifles.”
“Requiring mental health screenings before gun purchases may seem overly invasive. Yet, our society is quite comfortable requiring a medical assessment before granting privileges for other activities, such as driving.”
This remarkable recommendation shows more than anything the astonishing disconnect between the cloistered urban academics who wrote it and America’s 80 to 100 million gun owners. One marvels at how such highly educated people could be so ignorant of the great expanse of America out in Kansas, Alabama, and even western Pennsylvania. The ACP leaders still do not accept that, unlike driving a car, owning a gun is a constitutionally protected right. It is not a privilege. They seem unable to grasp the logistical nightmare of requiring a mental health evaluation on tens of millions of otherwise normal, law-abiding people. The sheer arrogance of the ACP leaders in casually recommending a burden of proof of sanity on such a wide swath of good Americans boggles the mind. Fortunately our elected politicians understand the world-class folly of such an idea, even if our medical authorities don’t.
“A survey published at the same time [in 1998] demonstrated support for these recommendations among internists and surgeons. Yet, what followed has been lackluster.” (This refers to the 1998 position paper mentioned above that “called for internists’ involvement in firearm injury prevention, favored strong legislation to ban automatic and semiautomatic assault weapons [sic]…and called for restrictions on the sale and possession of handguns.”)
The ACP leadership seems puzzled that regular ACP members, the doctors out beyond the ivory tower, may not sign on to their expansive dreams of control. To be sure, the Annals of Internal Medicine telephone survey respondents overwhelmingly agreed with the ACP’s overall agenda, although there was reason to believe their answers were based on misinformation and ignorance. For example, one survey question repeated the standard anti-gun propaganda that automatic weapons are still a significant problem in modern-day firearm crime (Do you support the registration of automatic weapons?).
But when it came to putting belief into action in their practices, the respondent doctors weren’t so sanguine. The authors conceded that “…few currently include firearm safety counseling in their clinical practice. Less than 20% usually discuss firearm ownership or storage as part of safety counseling, 4% of internists and 2% of surgeons frequently talk to patients about having a gun in the house, and approximately 50% never discuss these topics.”—(Christine K. Cassel, MD; Elizabeth A. Nelson, RN; Tom W. Smith, PhD; C. William Schwab, MD; Barbara Barlow, MD; and Nancy E. Gary, MD, “Internists’ and Surgeons’ Attitudes toward Gun and Firearm Injury Prevention,” Annals of Internal Medicine 1998; 128: 226-227.)
This 1998 survey showed that busy practicing doctors, many of whom have little if any experience with firearms, in theory supported the notion of gun control as a form of public health intervention. But very few believed strongly enough to put theory into action with their patients. Doctors as a nationwide group tend to hold the same attitudes about guns as the population at large. Many sense the inappropriateness of doctors probing their patients about guns in their homes when their true motivation is to push gun control.
In summary, the very wording of the ACP leadership’s latest push for gun control shows how astonishingly ignorant they are about America’s tradition of gun ownership and its current political bent. Over the last 15 years Americans have become more comfortable with the idea of privately owned firearms. Their belief in the natural right of self-defense with those firearms has only strengthened. Their highest courts have repeatedly affirmed that right. They have enacted laws in every state to secure that right for everyday people. They have learned to trust themselves with the means to protect themselves and their families from violent crime.
But the American College of Physicians has learned nothing.
Timothy Wheeler, MD is director of Doctors for Responsible Gun Ownership, a project of the Second Amendment Foundation.