Guns in the Medical Literature -- Introduction

Introduction

It is philosophical bias, rather than scientific objectivity, that characterize the debate on gun control. [1] Despite a pretense of scientific objectivity and method, the medical literature is no exception. As an example of the naked bias, consider the stated no-data-are-needed policy [2] of the New England Journal of Medicine. Consider the illogic and prejudice of its editor's recent proposal that if a little gun control does not work, then, certainly, more gun control is needed. [3] As this paper will document, errors of fact, design, and interpretation abound in the medical literature on guns and violence. Many have credulously restated the opinions of partisan CDC researchers, but given short shrift to the refuting data and criticisms. For matters of "fact," it is not unusual to find third hand citations of editorials rather than citations of primary data.

Though it has become quite fashionable to speak of an "epidemic of violence," analysis of recent homicide and accident rates for which demographics are available show a relatively stable to slightly declining trend for every segment of American society except inner city teenagers and young adults primarily involved in illicit drug trafficking. [See Graph 1: "US Homicide Rates 1977-1988" & Graph 2: "Selected Homicide Rates Comparisons"] Federal law makes gun purchase by teenagers illegal throughout the US. The teenagers and young adults most at risk for violence live in urban jurisdictions with the most stringent gun controls. The areas with the most severe gun restrictions have the worst violence and areas with the most permissive gun policies have the least violence. Long term study shows that homicide and suicide rates wax and wane independent of gun controls and gun ownership. [See Graph 3: "20th. Century US Homicide and Suicide Rates"] The gun accident rate has fallen steadily for decades and now hovers at an all time low. [4] [See Graph 4: "20th. Century US Firearms Accident Rates"] Though guns and ammunition meet none of Koch's Postulates of Pathogenicity, certain physician advocates of gun prohibition have played deceptively with the imagery of "the bullet as pathogen." [5] Using incompetent research or contrived and emotive imagery to promote a political agenda only obscures the real problems and impedes real solutions. The prohibitionists' undeserved pose of moral superiority is a distraction from objective analysis and is, therefore, an impediment to rational solutions.

Webster et al. [6] [7] use powerful images of children in carefully crafted comparisons to mislead us. Mentioning "Gunshot wounds are the third most common cause of injury deaths among children aged 10 to 14 years..." assiduously avoids noting that only the first leading cause of death amongst children, motor vehicle accidents, is horrific. [See Graph 5: "Children's Accidental Deaths"]

How do guns compare with other causes of death? [See Graph 6: "Actual Causes of Death"] The 1990 Harvard Medical Practice Study, a non-psychiatric inpatient sample from New York state, suggests that doctors' negligence kills annually three to five times as many Americans as guns, 100,000 to 150,000 per year. With sad irony it has become vogue for medical politicians to claim that guns, rather than medical negligence, have become a "public health emergency." [See Graph 7: "Estimated Annual US Deaths from Doctors' Negligence"]

Politicization of research cannot coexist with the scientific objectivity necessary for sound design and analysis of studies. Errors of fact, design, and interpretation abound in the medical literature on guns and violence. The medical literature is a relative newcomer to the public debate on guns and violence, yet the medical literature has virtually ignored all of the comprehensive scholarly evaluations of guns, violence, and gun control, such as the National Institute of Justice studies, [8] [9] the monumental review by gun control advocate Kleck (that in 1993 won the American Society of Criminology's Hindelang Award as "the most important contribution to criminology in three years"), [10] the cross cultural or other analyses by Kopel [11] [12] [13] or Kates, [14] Fackler's criticisms of voodoo wound ballistics, [15] [16] [17] and refutation [18] of the American Medical Association's gross distortions [19] on "assault weapons."

Those readers familiar only with the medical literature on guns should review the extensive criticisms of methodology and conclusions, [20] documentation of false citations, fabrication of data, and other "overt mendacity" in the medical literature on guns, [21] "sagecraft," [22] and thorough reviews of Centers for Disease Control bias. [23] [24] The medical literature's inbred selectivity demonstrates half-hearted, if any, effort at objectivity. Rather than balance the merits and demerits of gun prohibition, it is the purpose of this paper to expose representative samples of biased and incompetent research and to spur greater skepticism of "politically correct" results-oriented polemics. The taxpayer funding of such politicized research merits debate. For a discussion of the merits and demerits of gun registration, licensing, waiting periods, and bans, the reader is guided to the scholarly reviews cited above.

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