In American government, the final word on the legality of legislation is the Supreme Court. When laws have conflicted with the Constitution, the Supreme Court has struck them down. The controversial issue of gun control is no exception. The most important gun control case in recent years (or very possibly ever) was District of Columbia v Heller.

The Supreme Court in Washington D.C. Photo courtesy of U.S. government.

Facts of the Case

The issue in Heller was a 1976 District of Columbia gun control law. This law made it a crime to possess an unregistered firearm and prohibited the registration of handguns. It further banned the possession of unlicensed handguns, with one-year licenses to be granted by the Chief of Police. The effect of these provisions was that it became illegal to possess a handgun not registered before the law took effect, and then those handguns had to be re-licensed every year. A final provision of the law required that lawfully-owned firearms be made temporarily inoperable for storage, which meant they had to be unloaded and disassembled or they had to have a trigger lock.

Heller was a D.C. special policeman who was denied permission to register a handgun that he wanted to keep at home. His suit against the law was dismissed in district court, but that decision was reversed by the D.C. Circuit Court. The U.S. Supreme Court agreed to hear the case on November 20, 2007.

Oral Arguments

In an extended oral argument, Washington D.C. argued that the Second Amendment applied specifically to a right to bear arms as part of a militia. This reading of the Second Amendment would allow virtually all forms of gun control, including the D.C. handgun ban. Concerns from several Justices over this interpretation stemmed from a belief that Congress had almost absolute authority over militias under the Constitution, including the power to disband them. It would thus be odd for the Second Amendment to prevent Congress from disarming them.

In regard to the requirement that guns be made temporarily inoperable while not in use, D.C. argued that such a requirement did not prevent the use of guns for self-defense. Both sides agreed that a right to self-defense exists, and D.C. argued that using a trigger lock would make a weapon useable in about 3 seconds, so it wouldn’t stop the owner from being able to defend himself.

Heller’s attorney argued that reasonable gun control measures were available to the government but that the handgun ban was unconstitutional because it unnecessarily infringed on a personal right to bear arms. He refuted the militia interpretation, arguing that the Second Amendment did in fact grant citizens an individual right to possess guns.

Heller’s side viewed the right to bear arms not only as an important part of the right to self-defense, but also as an inherent right enshrined in the Second Amendment and dating back to the English Bill of Rights. Additionally, the argument relied on the notion of “original intent,” the idea that the framers intended a right for individuals to bear arms under the Constitution.

The Opinion

Justice Antonin Scalia wrote the majority opinion for the Heller case. He is pictured here in 1986. Photo courtesy of senate.gov.

Justice Scalia wrote the opinion of the Supreme Court in a 5-4 decision in favor of Heller. Scalia rejected the idea that the Second Amendment was limited exclusively to militia service, recognizing both a right to possess firearms and a right to use them for lawful purposes such as self-defense.

Scalia went on to note that several forms of gun regulation are acceptable under the Second Amendment. Some examples Scalia noted include concealed weapons bans, prohibitions on firearm possession by felons or the mentally ill, prohibitions on firearm possession in places such as schools and government buildings as well as regulations on the sale of firearms.

However, Scalia found that the D.C. handgun ban as well as the so-called “trigger-lock provision” were not acceptable. He found that the ban affected a class of weapons “that Americans overwhelmingly choose for the lawful purpose of self-defense.” Similarly, he stated that the “trigger-lock provision” made it impossible for a firearm to be used in self-defense and was therefore unconstitutional. Scalia chose not to strike down the licensing requirement, noting that it is acceptable so long as it is not enforced arbitrarily or capriciously.

The Dissents

Justices Stevens and Breyer each wrote a dissent. Dissents lack the force of law, but they are often instructive in examining the issues of a case. Justice Stevens focused on the Majority’s interpretation of the Second Amendment. In his dissent, he claimed that the Amendment did not protect the use of firearms for non-military purposes. Justice Stevens argued that the Majority had set aside normal standards of interpretation in its decision. He believed that the Majority had inappropriately ignored the first part of the Amendment: “A well regulated Militia.”

He also cited the term “bear arms” as meaning “to serve as a soldier, to do military service, to fight,” according to the Oxford English Dictionary. In other words, his reading was that the right was tied inextricably to military service. Justice Stevens also presented historical evidence to counter the Majority’s claim of original intent, including a 1792 militia bill that required every white male of suitable age to “provide himself with a good musket or firelock.” That requirement to own a gun also suggests a military purpose.

Justice Breyer agreed with Justice Stevens’ reading of the Second Amendment, but he added that the right is not absolute. Justice Breyer appeared to be assessing the balance between state interest and individual rights — whether the state interest in gun regulation overrode any individual right to own a gun for military purpose. He said the D.C. law pursued government interests in protecting life and preventing crime, both repeatedly found to be compelling interests. Justice Breyer therefore found there was sufficient government interest served in the law, so it should have been upheld.

Aftermath

Following the Heller decision, D.C. began changing its gun laws. An amendment to firearms regulations relaxed several hurdles to gun registration, and provided for the creation of a list of “unsafe” handguns that could not be registered. The law kept a ban on automatic weapons and bottom-loading guns, which has already been challenged in court.

The ruling in Heller was extended when the Supreme Court ruled that the Second Amendment applied to the states as well as the federal government in McDonald v Chicago. That case caused a Chicago handgun ban to be returned to lower courts for a ruling in line with Heller.

There is not yet a consensus on what exactly Heller means for gun control. Some have called this victory for gun rights activists a hollow one because it affirmed that there are many regulations consistent with the Second Amendment. The media has often portrayed the case as an absolute recognition of gun rights, but the Court’s majority opinion is more nuanced.

What Does It All Mean?

Heller is not the clear-cut case that some would like it to be. While it threw out certain provisions of the D.C. gun control law, it also explicitly recognized the possibility of others. In his opinion, Justice Scalia did not produce any sort of Constitutional test by which laws could be measured. The future of the field of gun control laws seems destined to be determined by more lawsuits.

However, a good understanding of the Heller case is essential for anyone advocating for new gun legislation that would remain consistent with the modern interpretation of the 2^nd Amendment. The regulations specifically articulated by Justice Scalia would certainly be acceptable, and the oral arguments during the case reveal other regulations that also seemed acceptable to the Court, such as “safe storage” laws. Further, Heller did not rule out bans on certain classes of weapons. Justice Scalia emphasized handguns because they are so widely used in self-defense. An assault weapons ban could very possibly be found constitutional and consistent with the Heller opinion.

Likely the most important lesson from this case is that gun regulations must take individual liberty into account. The interpretation that individuals’ right to bear arms was limited to a military role only was dismissed in Heller.  The case left room for a balance between gun rights and gun regulation.

Further Reading: Here is a great project which reviews Supreme Court cases and provides links to oral arguments, opinions, and supporting briefs known as Amicus Curiae)

1. This is an important first step. It is gratifying to see the President both take direct action on a number of important gun-related matters, and publicly initiate the conversation about what needs to change to address the ongoing epidemic of gun violence in the United States.
2. We strongly agree with the need for a comprehensive legislative and executive agenda, one that attempts to solve gun violence by addressing gun access, gun safety, school safety, societal factors, and mental illness.  Reducing the threat of violence to our children will clearly require such a broad-based, comprehensive effort. Any flaws in individual proposals do not invalidate the entire effort.
3. There will be something for everyone to like, and for everyone to hate, in the proposals.  Given the current political climate, this may be inevitable.  Due to the absence of thorough research into the causes and effects of gun violence, there is little agreement about its remedies, beyond a desire to see it end.  To some, allocating $10,000,000 to research the connection between video games and violence seems like the worst kind of pandering to the NRA’s “it’s-everything-but-the-guns” narrative. To others, requiring background checks on all gun sales seems like the first step in a government takeover.
4. Some of the proposals concur in fundamental ways with recent policy proposals from Parents Against Gun Violence. One of the executive orders, for example, directed the Centers for Disease Control to initiate research into the health effects of gun access (PAGV Policy Plank #2, Empower Researchers), while a proposal to Congress urges legislators to allocate $30,000,000 for schools to develop emergency-response plans (Policy Plank #5, Protect Schools).
5. While President Obama implemented a number of executive actions, the biggest proposed changes will all require legislative action. All of the major funding allocations (with the exception of $20 million to encourage states to share background data) also have to go through Congress. In the coming weeks, concerned parents and citizens need to make sure that our voices and perspectives are heard in the legislative debates.

* Note that Obama actually signed only three executive orders (technically “presidential memorandums“) on Wednesday.  The 23 “executive actions” named in the Obama proposal describe general policy priorities that would not require Congressional approval for implementation. However, many of the proposed “executive actions” come far from implemented (or implementable) public policy at this point.

At the same time, we have engaged in intensive dialogue with concerned citizens from across the political spectrum.  Through this process of research and dialogue, we have developed a set of five policy planks that we believe can gain support across the political spectrum, and that provide a comprehensive approach to reducing gun violence. We encourage all concerned citizens to contact their representatives, senators and any other elected officials as well to advocate for these policy proposals. If you would like to sign the petition promoting this platform, click on the Change.org petition here.

As parents, we urge lawmakers and the President to consider the following:

Policy Plank 1.) Empower law enforcement

a.) Approve Andrew Traver, President Obama’s nominee for Director of the Bureau of Alcohol, Tobacco Firearms and Explosives.  Without a leader, the Bureau is hampered in its ability to enforce its congressionally mandated responsibilities, such as investigating and prosecuting straw purchasers who buy guns for criminals.

b.) Pass new legislation reversing the Tiarht Amendments. These amendments make it more difficult for police officers to effectively fight gun trafficking.  Among other obstacles, the Tiarht Amendments block the Justice Department from requiring that gun dealers conduct annual inventory checks.

Policy Plank 2.) Empower researchers

Remove current restrictions that prohibit the use of federal funds for research on gun injuries, regardless of how the findings of that research could be interpreted or used.  Unimpeded, rigorous research can help policymakers target legislation much more precisely, focusing on the particular strategies likely to make the biggest dent in gun violence.

Policy Plank 3.) Issue new regulations on the sale and manufacture of firearms

a.) Require that all gun sales be processed by a federally-licensed firearms dealer. Private citizens wishing to transfer a firearm to a new owner must complete the sale through the intermediation of a licensed dealer, including a permit application and background check at the time of sale. This will eliminate the so-called “gun show loophole” that enables firearms sellers and purchasers to avoid background checks.

b.) As PAGV analysis shows, there is a very strong correlation between firearm magazine capacity and total casualties in mass shooting incidents. Addressing magazine capacity is far more effective than an approach that focuses on banning one type of firearm or another.  Approve the high-capacity magazine ban proposed by Congresswoman Diana DeGette. In addition to prohibiting the sale of new high capacity magazines, include a ban on the after-market transfer of existing magazines with a capacity greater than ten rounds.

c.) Appropriate funds for a nationwide buyback program for high capacity magazines and unwanted guns. People who currently own high-capacity magazines will have one opportunity for remuneration, which will otherwise be lost when private transfers are banned. A nationwide magazine buyback will reduce the overall number of high-capacity magazines in the country. Compensation for voluntarily surrendered firearms and magazines should come in the form of a pre-paid debit card with an expiration date in the near future, ensuring that the money will be spent and will have a stimulative effect on the economy.

d.) Require that all owners of high capacity magazines who choose to keep them must register them by taking them to a law enforcement agency where they will be engraved with a serial number corresponding to a record of ownership in a national database. A registration fee will be collected for each magazine, to offset the costs to law-enforcement agencies.

e.) Require that any store that sells firearms must also sell gun safes.

f.) Add a line to the existing application to purchase a firearm, in which the buyer must affirm that he or she already owns a gun safe, or is buying one with the new gun.

g.) Require that, by 2020, all popular calibers of handgun ammunition be manufactured with frangible bullets designed to disintegrate when they hit a wall or other hard surface. This will apply to .25 ACP, .32 ACP, .380 ACP, .38 Special, .38 Super, 9mm, .40 Smith and Wesson, 10mm, .45 ACP, .45 GAP, .357 Sig., and other calibers as appropriate, but not to .357 Remington Magnum, .44 Remington Magnum, and larger calibers (which may be manufactured with a soft-tipped lead or polymer bullet appropriate for hunting). The use of frangible bullets will help to reduce the incidence of people accidentally killed by stray bullets.

Policy Plank 4.) Empower mental health care providers

Improve the ability of the mental health system to treat severely mentally ill people outside the constraints of the hospital system by creating and fully funding an Assertive Community Treatment (ACT) program in every major metropolitan area.

Policy Plank 5.) Protect schools

a.) Create a grant program through which schools may apply for funds to hire guards, offer professional development related to crisis management, or install equipment to secure schools and classrooms.

b.) Require all public schools to update their evacuation procedures and to plan new safety drills that prepare students and teachers for a response to an armed attack.

c.) Allow and instruct school counselors to coordinate with Assertive Community Treatment (ACT) programs in their region, informing mental health professionals of students believed to be a potential risk to themselves or others who should receive ongoing treatment.

d.) Endow these federal school safety initiatives through revenue collected from the existing Firearms and Ammunition Excise Tax, with rates adjusted as necessary to meet budgetary needs.

1. Devote your Day of Service to a children’s charity or organization.

2. Teach a child a new skill–or ask them to teach you something!

3. Upload a photo of you hugging your child on our Facebook page.

4. Familiarize yourself with what the American Academy of Pediatrics says about firearm safety and children.

5. If you do have a gun at home, take this opportunity to double check that it is stored safely and cannot be accessed by anyone but a responsible adult.

You can also download our Child Appreciation Day press release.

Want to help spread the word? Check out our page on Child Appreciation Day to share memes on Facebook!

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contributed by Jennifer in California

On New Year’s Eve, I took my four young children and parents and sister to Old Sacramento to watch the family fireworks show at 9pm. The show was awesome, even though it was really cold!

We headed back to our friends’ house to celebrate the New Year in a warmer place. When we turned on the television to watch the ball drop, we were shocked to see that there had been a shooting at the place we had just left! A fight had broken out in a bar near where we had been watching the fireworks. It escalated, and someone pulled out a gun. One of the bar employees was shot and killed when he tried to intervene. The other man in the fight was also shot and killed. The gunman, a security guard, and a woman standing near the fight were also shot but not fatally.

This was all within 10 minutes of the time that we’d left that spot. If we had stayed 8 minutes longer, my children would have heard the whole thing. They might have seen it. They could have been hit by a stray bullet.

The gunman was caught and arrested by the police. The New Year’s celebration and fireworks show that was planned for Old Sacramento was cancelled. And I was angry.

Angry again. Just a few months ago, we moved into a new home because our family has grown. We chose the area because it was so quiet and there were a lot of families with children. Then a young man moved in three houses down the street and things changed. He threw a party one night that got out of control at about 2am. My three oldest kids were asleep and I was up feeding my infant son. My husband was at work. Suddenly, I hear seven gun shots next door. I was startled and grabbed my phone. I dialed 911 and ran into my daughters’ room. It’s in the front of the house, and I was afraid they might get hit by a stray bullet. As I was talking to the 911 operator, I grabbed one of my daughters and moved her to my room in the back of the house. I set my son down with her and grabbed my other two daughters and moved them too.

As I was talking to the operator, I looked out the window and saw a ton of people running down the street away from the party. I ran back into my room to calm down my kids. They were scared and crying. Then we heard more gun shots. My children screamed in fear. I was terrified, but needed to be calm. I did my best to soothe them and reassure them that police were on their way.

After a few minutes, the police knocked on my door. I let them in and they told me that they had cleared the area. They told me that nobody was shot, but the gunmen were gone by the time they got there. They checked my backyard to make sure it was clear and gave my children stickers. They told me that everything was okay now, but to call back if anything happened again. My children slept in our bed that night… and the next night… and the next night. It took a full week before they felt comfortable sleeping in their own rooms again. They still get scared sometimes.

A few days later, the shooter was arrested. I thought that would be the end of it, but it wasn’t. Two weeks later, it happened again. Same house, same situation. I called the police again. This time, someone had been hit. And a bullet had hit the wall of the house across the street. My friends live there, and the wall that was hit belonged to a child’s bedroom. She was okay, but her parents were furious. I would have been, too.

Since then there have been no more parties, and no more shootings. My children are still struggling with it though. They still talk about the shootings. They still express fear at bedtime and want to sleep next to me.

My reaction to these incidents has been anger. Safe neighborhoods aren’t safe after all. Safe family events are pretty dangerous, as it turns out. I’m so tired of all of this gun violence. I shouldn’t be scared to send my children to school, take them to a movie, the mall, to church or a holiday celebration. They should feel safe in their own home, but they don’t. I should be able to take my kids to public places or tuck them into bed at night and feel safe, but I don’t.  I feel paranoid. I feel like I have to keep my children close and be on the lookout for a madman with a gun. I have to be ready to duck and cover at any moment just in case there’s a shooting. Even in my own home, I have to be ready to jump into action to protect my kids.

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Every child has at some point been afraid of the boogeyman. A parent should be able to look under the bed or in the closet to reassure their child that there’s no boogeyman, that they are safe. I can’t do that. My children are scared of madmen with guns. And that is very real.

And I am angry that people are so willing to protect the rights of those who want to own a gun, but too scared to stand up and speak for those who can’t speak for themselves. Our children deserve that we speak up for them. I am not willing to just sit back and wait for people to realize that the situation in our country is out of control and needs to be changed. I want to be part of making that change so I can look my children in the eye and say without hesitation, “There’s no more boogeyman.”

For the thousands of Americans who die each year by gun suicide and gun accidents, these bills will have little effect—one bullet is enough to kill. There is ample evidence, however, to suggest that an effective ban on high-capacity magazines will reduce the number of deaths in gun homicides, especially in mass shooting scenarios.

This graph reveals the correlation between magazine capacity and number of casualties during mass shootings in recent history.

A seven-year-long study of gunshot victims observed an increasing incidence of gunshot victims who had been shot multiple times. The proportion of gunshot victims with two or more gunshot wounds grew from 26% in the early 80s to 43% by 1990[1]. Over the same span of years, semiautomatic handguns like the Beretta 92 and Glock 17 were replacing the .38 and .357 caliber revolvers that had been the most popular handguns in the United States in the preceding decade. The ammunition capacity in a fully-loaded handgun rose from typically six rounds to typically 15 rounds, and shooters exploited that advantage, shooting their victims multiple times and increasing the likelihood of fatal injury.

Parents Against Gun Violence researchers have identified 37 mass shooting incidents (excluding robberies and armed confrontations) involving more than 6 victims in the United States since 1945. In 35 of 37, the perpetrators carried semiautomatic weapons. In 33 of 37, the perpetrators carried magazines with a capacity greater than 10 rounds. In the recent mass shootings in Tucson, Aurora, and Newtown, the perpetrators sought out inordinately large magazines, including the 100-round drum magazine James Holmes used to shoot 70 people in a movie theater. These mass murderers clearly believe that a higher-capacity magazine will equate to more fatalities.

Opponents of the high-capacity magazine ban will point out that smaller capacity magazines can be rapidly exchanged, and will argue that such a ban will not slow or hinder a mass shooter. Online videos show expert shooters removing an empty magazine and replacing it with a fully loaded magazine with dazzling speed. Let’s remember, though, that these videos are impressive precisely because the reloading skills depicted are remarkably rare—it takes years of practice to achieve such proficiency, and the perpetrators of most mass shootings are young men with limited experience. There are cowboy trick shooters who can operate a single-action revolver or lever-action rifle with astonishing speed—but Annie Oakley doesn’t fit the profile of a mass shooter. We’re not seeking laws to stop Wild Bill; we’re seeking laws to stop Jared Loughner.

Indeed, in three instances[2], unarmed civilians have overpowered and disarmed a mass shooter during the momentary pause for a reload. (The smaller the magazine capacity, the more frequently the shooter must pause to reload, creating opportunities for potential victims to either take cover or fight back.)

We believe that, if mass murderers are unable to attain high-capacity magazines, the severity of their attacks will be reduced. Killers might still shoot people, but we believe they will be unable to shoot so many people so easily.

The question we should be asking now is not: “Are high capacity magazines especially dangerous?” (the answer is “yes”) but rather, “Will the currently proposed bans meaningfully reduce the availability of high capacity magazines?” A major flaw of the 1994 assault weapons ban is that it grandfathered in millions of guns and magazines that were purchased before the ban. In the months preceding the ban, demand for high capacity magazines soared, and manufacturers obliged, flooding the market with 20- and 30-round magazines. Unlike guns, magazines are usually not serialized, and require no specific record of custody. In many states, you could walk into a gun shop today with cash, and walk out with several 30-round magazines, without showing your ID or completing any paperwork. During the 1994-2004 ban, privately owned magazines were sold from one individual to another at gun shows and among acquaintances. It was more difficult and expensive to buy a high-capacity magazine during the decade of the ban, but only slightly so.

The full language of the new legislation is not yet available, but Sen. Feinstein and Rep. DeGette have indicated that they will seek also to ban the private transfer of high-capacity magazines from one individual to another.  (If you already own a 15-round magazine, you may legally keep it, but you can’t sell it to anyone else.) This is an improvement on the ‘94 assault weapons ban, but we believe additional measures could more effectively curb the aftermarket sale of existing high-capacity magazines. Here’s how:

First, proceed with the proposed ban on the sale of new magazines with a capacity greater than ten rounds of ammunition. Also ban the transfer of existing magazines (with more than 10-rounds capacity) from one owner to another. Illegal transfer of a high-capacity magazine should bear a serious penalty.

Second, organize a nationwide buyback program for high capacity magazines. People who currently own them will have the opportunity for remuneration, which will otherwise be lost when private transfers are banned. A nationwide magazine buyback will reduce the overall number of high-capacity magazines in the country.

Third, require that all owners of high capacity magazines who choose to keep them must register them, by taking them to a law enforcement agency where they will be engraved with a serial number corresponding to a record of ownership in a national database. A registration fee will be collected for each magazine, to offset the costs to law-enforcement agencies.

Just as the American Psychiatric Association issued their remarks last week, the American Academy of Pediatrics sent their own letter, which you can download here, to President Barack Obama and Congressional leaders on December 19.

The organization had published a report on firearm-related injuries affecting children in their journal Pediatrics in October, in which they wrote “The American Academy of Pediatrics continues to support a number of specific measures to reduce the destructive effects of guns in the lives of children and adolescents, including the regulation of the manufacture, sale, purchase, ownership, and use of firearms; a ban on semiautomatic assault weapons; and the strongest possible regulations of handguns for civilian use.”

Unsurprisingly, in their letter to political leaders, they were just as direct regarding policy proposals related to gun control, mental health and children’s exposure to violence:

•    ”New federal firearms legislation that bans assault weapon sales and the sales of high capacity magazines, strengthens mandatory waiting periods and background checks for all gun purchases and promotes strict gun safety policies is a necessary first step.
•    Next, the federal government must take action to improve access to services that meet the mental health and developmental needs of infants, children and adolescents, and ensures that children and families exposed to violence have access to a medical home and other community supports.
•    Finally, we must engage in a national dialogue designed to reduce children’s detrimental exposure to violence in their communities, environments and entertainment.”

We’ll be revisiting the full account of their policy report on firearms for a later blog post, but we also wanted to mention another article with similar recommendations. “Weapons of Mass Destruction,” published in the Archives of Internal Medicine, which is published by the American Medical Association, also offered commentary related to firearm regulation.
It begins with very strong words: “While our national leaders agonize about the threats in the Middle East from missiles, bombs, and automatic weapons that might fall into terrorist hands, they have remained eerily silent about the unlimited access to weapons of mass destruction in our own backyard. In a sickening recapitulation of terror wrought in schools, movie theaters, and malls, our nation grieves for the large number of innocents murdered in a few minutes by a single American gunman. Yet the gun lobby has successfully muzzled political debate about guns, shut down federal research on gun-related injuries, and promoted legislation that prevents physicians from asking patients about gun-related risks.”

After exploring some of the policy possibilities that could be proposed for legislation, the article points out that we need to fund more research and then urges some specific policies measures:

• “We can advocate for restoring the ability of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention to study gun-related injuries and fund these efforts generously.
• We can advocate for a comprehensive analysis of gun ownership by the Institutes of Medicine.
• We must resist all efforts such as a Florida law that restricts physicians’ ability to talk to patients about the risks of guns and routinely inquire about whether they own firearms.
• We can press our national leaders to require registration, background checks, and waiting periods for all gun purchases, not only for some of them.
• And we can push for requirements that make guns safer such as trigger locks that require a code to operate the weapon.
• We can argue for legislation to restrict the sale of large-capacity magazines and formidable amounts of ammunition. Nothing in the recent Supreme Court rulings prevents such state or national legislation.
• Even reducing the number of such weapons is not impossible, as illustrated by the 1996 Australian experience, in which a buy-back program substantially reduced the number of firearms in private hands and, to date, has eliminated mass shootings.”

One of the policy recommendations we are pursuing is the reinstatement of funds that have previously been used research firearm injury prevention, and we hope that politicians in Washington will finally begin listening to the trained medical professionals we entrust with our lives yet have ignored when it comes to the reduction of injury and death related to firearms.

Since much of the nationwide dialogue after this tragedy has involved discussions on mental health, it makes sense that the American Psychiatric Association issued their remarks. Dilip Jeste, MD, president of the APA, sent a letter December 20 on behalf of the organization to Senate Majority Leader Harry Reid, Senate Minority Leader Mitch McConnell, Speaker of the House John Boehner and House Minority Leader Nancy Pelosi.

The letter, which you can download here, focused on two main points. First, as part of their responsibility to their profession, Dr. Jeste said “psychiatrists stand ready to do whatever we can to help alleviate the suffering caused by the tragedy and to help the survivors cope with life after a trauma of this unimaginable magnitude.”

But more importantly, Dr. Jeste followed that with a reminder that focusing too much on the mental condition of the shooter risks inappropriately increasing the stigma already associated with mental illness. “Stigma remains one of the greatest barriers to early identification, intervention, and treatment for Americans seeking help for mental illness, and we hope that Congress will avoid making generalized assumptions about persons now in or seeking treatment for mental illness,” Dr. Jeste wrote.

After noting that the “vast majority of violence” does not occur at the hands of individuals with mental disorders, Dr. Jeste said that those who do commit the crimes generally are not receiving adequate or appropriate mental health treatment. The statistics he notes are sobering: Public mental health spending has been reduced by $4.35 billion from 2009 to 2012, and 29 states have gotten rid of over 3,200 psychiatric inpatient beds since 2008.

He also brought up an issue which had been in the medical news recently related to doctors’ ability to discuss firearm possession and safety with their patients: “We are also profoundly disturbed by recent efforts in some states to curb or bar the ability of physicians, including psychiatrists, to prudently and confidentially inquire about the presence of firearms in the home when the behavior of their patients warrants such an inquiry,” Dr. Jeste wrote.

An article published in JAMA Pediatrics (formerly Archives of Pediatrics and Adolescent Medicine) provided the history of the Florida law that attempted to prevent doctors from speaking to their patients about firearms, concluding “Dialogue stemming from these questions will help families protect children from multiple forms of harm.”

A few days after sending that letter, the APA spoke up again to express their “disappointment” to the statement by the NRA and specifically the mental health stigmatization that NRA CEO Wayne LaPierre promoted with his comments. The APA wrote in their news release (pdf):

“The association objected to LaPierre’s assumption that horrendous crimes such as the one committed by shooter Adam Lanza are commonly perpetrated by persons with mental illness. In addition, he conflated mental illness with evil at several points in his talk and suggested that those who commit heinous gun crimes are ‘so possessed by voices and driven by demons that no sane person can ever possibly comprehend them,’ a description that leads to the further stigmatization of people with mental illnesses.”

Noting that “only four to five percent of violent crimes are committed by people with mental illness,” Dr. Jeste reminded the press that those with mental illnesses are rarely violent and are much more likely to be crime victims than crime perpetrators. Calling the use of the word “lunatic” by LaPierre “offensive,” Dr. Jeste said, “About one quarter of all Americans have a mental disorder in any given year, and only a very small percentage of them will ever commit violent crimes.”

The letter concludes with a statement from APA CEO James Scully, MD: “The idea that mental illness and evil are one and the same thing is simply a relic of the past and has no place in our public dialogue. People who are clearly not mentally ill commit violent crimes and perform terrible acts every day. Unfortunately, Mr. LaPierre’s statements serve only to increase the stigma around mental illness and further the misconception that those with mental disorders are likely to be dangerous.”

Illustration by Svilen Milev

The article, published December 21 in JAMA (the Journal of the American Medical Association), describes how the Centers for Disease Control and Prevention was silenced in the late 1990s when the CDC lost $2.6 million for research into firearm injury — and that was after Congress members failed to completely eliminate the National Center for Injury Prevention and Control as they had tried to do first.

It was no coincidence that the $2.6 million removed from the CDC’s budget in 1996 happened to be the direct amount previously budgeted for firearm injury prevention research. Though that precise amount was added back into the budget as the bill moved forward, it was “earmarked for traumatic brain injury.” The final bill even included the language “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.”

Such expansive language basically shut down any firearm research at the CDC, lest such research be considered something that advocated for gun control and thereby cost them their careers. And it didn’t stop there. Two years after a 2009 study funded by the National Institute on Alcohol Abuse and Alcoholism looked at the association between risk of firearm assault and carrying a firearm, Congress expanded the funding restriction to all agencies at the Department of Health and Human Services, including the National Institutes of Health.

The article is worth a thorough read to learn just how successfully pro-gun members of Congress and the gun lobby have managed to completely shut down well-funded scientific research into prevention of injury and death related to guns. It’s true that violent crime and gun-related crime has been on a continual decline in the U.S. over the past two decades. But any crime is too much, and it’s reasonable to expect we might have made even more progress had our top public health researchers and health-related government agencies been allowed the opportunity to research how.