INJURY PREVENTION

FIREARMS

	From: John Holmes Date: 04.08.99 05:40 GMT ((part response to another thread)) What has it come to that our colleagues in America reflexly worry about being shot for doing their job?. Do you actually have a society where friends and relatives will be carrying handguns into your departments? Thank god I live in a society which has at least a notionally rational approach to weapons control. We still have shooting incidents in Australia but it certainly hasn't got to the stage where we even think about restricting people to the ED on the basis they might be armed and shoot our staff. Do the medical and nursing professions in the States actively lobby for gun control? John L Holmes Director Emergency Medicine Mater Hospital, Brisbane, Queensland
	From: Eric Frykberg Date: 04.08.99 21:14 GMT John-- Some do and some do not, and surprisingly many actively oppose more reasonable control of access to firearms by the general public. as is true in your country and every single other industrialized democracy in the world. The Eastern Association for the /surgery of Trauma, the American Trauma Society and the american Academy of Pediatrics are among the few major American medical societies which have published strong and heavily scientifically referenced stands against the current paradoxical level of largely unrestricted access to those firearms that most contribute to the horrendous mortality of our population from firearms. The CDC's National Injury Prevention and Control Center and the Institute of Medicine have recently published major treatises on the need for more rational control of firearm access. Interestingly, such major organizations as the American Medical Association, the American Association for the Surgery of Trauma and even the American College of Surgeons have specifically refused to take either any stance at all on this critical issue (AAST, AMA) or such a watered down "stance" that it accomplishes less than nothing (ACS) You explain it--I sure can't Eric Frykberg, MD Jacksonville, Fl
	From: John Holmes Date: 05.08.99 01:35 GMT Eric - Thanks for the feedback. Over here we look at the American experience with firearms with disbelief. Didn't someone once say that society was doomed when good men do nothing? We have lunatic right wing politicians advocating loosening of firearm control in Australia and we have our militias and conspiracy theorists advocating civilian armed resistance etc etc. On the whole such people are ridiculed in the media and thankfully our major medical organisations speak out strongly in favour of gun control. Having said all that I lost a good friend when a radiography (X-ray tech) student who had failed final exams shot up the X-ray staff in a hospital I was working in in Cairns North Queensland a few years ago. We always think our deep north parallels your deep south in many respects. At the end of the day, however, I guess we are fortunate in that the so-called right to bear arms is not enshrined in our constitution - though I suspect the original intent of your founding fathers has long since been distorted and manipulated by self interest groups. Cheers, John
	From: Jim Cowan Date: 05.08.99 03:10 GMT This is an example of what happens when you run a country via the "media". Remember, it was the "media" who started the Spanish-American war. A few facts that the hand wringing gun control nuts find uncomfortable; 1. Violent crime. The largest mass murder in US history was committed with a bucks worth of unleaded. 2. Safety. The most dangerous item you can own in a home is a ladder. (guns aren't even in the top 5) 3. Cause? Turning the loonies loose on the streets doesn't equal safety for the populace when your only solution is to "hide all the sharp instruments" from them. Jim Cowan Springfield, MO
	From: John Holmes Date: 05.08.99 05:14 GMT Oh dear. Well as a "hand wringing gun control nut" here's a few thoughts : 1. People with guns kill at a distance - depersonalisation makes it easier to kill 2. Guns make heroes out of cowards 3. People with guns can kill indiscriminately How tiresome it is to hear the sort of argument routinely trotted out by apologists for firearms - that guns don't kill, people do. How many cases of mass slaughter do we have to put up with before the Dr/Mr Cowans of this world will finally accept that guns make it a hell of lot easier to kill a hell of a lot more people. In Australia's tragedy at Port Arthur 2 years ago a lunatic armed with automatic rifles systematically murdered > 30 people. How many people would he have killed if he had only been armed with a knife? How brave would school student killers be without their guns? Yes Mr Cowan I'm a gun control advocate. And not just because I lost a close friend shot through the head - and there's no doubt her killer couldn't have done what he did without a firearm. I'm a gun control advocate because I value living in a society largely free from fear and where I can walk the inner city streets at night. Thank god we haven't yet in Australia developed the sort of siege mentality which seems to have Americans obsessed with fear of violence and the need for security - as witnessed by recent posts on the Open Door issue. John L Holmes Director Emergency Medicine Mater Hospital, Brisbane, Queensland
	From: Eric Frykberg Date: 05.08.99 12:05 GMT << 1. Violent crime. The largest mass murder in US history was committed with a bucks worth of unleaded. >> So? every year more than 35,000 are killed on our streets and in our homes by firearms--and more than 98% of these are innocent citizens not doing anything wrong (FBI Uniform Crime Reports, National Center for Health Statistics) No, guns are not the only cause of death from injury in our country--just the second most common << 2. Safety. The most dangerous item you can own in a home is a ladder. (guns aren't even in the top 5) >> Purely and simply mortality is higher with a gun in the home than in a home without a gun----and those killed are 43 times more likely to be household members than intruders. See Kellerman et al NEJM 1986, 1993, 1994 Oh and by the way, your reference for the above so interesting factoid? << 3. Cause? Turning the loonies loose on the streets doesn't equal safety for the populace when your only solution is to "hide all the sharp instruments" from them. >> I agree with this. Interesting how the crazy idea that 35,000 deaths each year must just be swallowed as the price of freedom--and the victims get blamed for being in the way
	From: Jeff B Date: 05.08.99 14:31 GMT << 2. Safety. The most dangerous item you can own in a home is a ladder. (guns aren't even in the top 5) >> I will assume this statement is made because there are more injuries from falling off ladders than from handguns (annually). Probably true, and I won't bother to refute that. Of course, more homes have ladders in them, and ladders are used more often than guns, and a minor slip from a ladder may result in a broken leg or sprained ankle, and let's not forget that ladders are not often kept locked up with the rungs locked in a seperate cabinet (like they should be, as most ladder rights activists proclaim. "I'm the National Ladder Association and I vote!") Churchill once said "There are three types of lies. Lies, Damn Lies, and Statistics." Maybe I haven't been in this field long enough, but I've never called for a trauma team activate for a ladder injury. Apologies for the sarcasm....well, not really. Jeff B., NREMTP Atlanta, GA
	From: Amy Kenna Date: 05.08.99 19:33 GMT If anyone has taken the hunter safety course, you are taught many many many ways to properly handle guns, and always being sure if your target and beyond is stressed as well as being in control of your muzzle or barrel of a gun at all times and safe storage and ethical use if the guns. Which in the courses case is hunting. In my home we have 5 high powered rifels with scopes, 4 shotguns, and two handguns. the ammunition to these guns is stored underneath the compartment where the guns are stored. Both compartments require a key to unlock. And we are talking a real lock, not a lock that can be picked with a paperclip or other such things. This is how I was raised, along with unloading a gun befoe getting into a vehicle and unloading the clip also before going into a house. If we are hunting our gun cases have locks on them along with 4 hinges that have to also be opened. we do not have a gun in the bedroom dresser drawer either. We certainly have the option but we have always chose not to do this. This is responsible gun handling and storage. I also believe that if a criminal is going to use a gun in commiting a crime they will find one. whether stealing from a friend or a parent that has one in the bedroom. Amy J. Kenna, NREMT-P
	From: Eric Frykberg Date: 06.08.99 02:43 GMT Amy-- This is often a line of reasoning one hears in the firearm debate, and it has definite merit--the guns you are talking about are not at all the ones targeted by the bulk of gun control measures being advocated or legislated, because they are not the ones that have anywhere near the contribution to violent death and injury in this country, mainly becuase the owners of these weapons are largely hunters and sportsmen who have learned like you responsible handling and storage and safe use. Learning the safe use of firearms is the most important way to cut down on injury and death from these weapons, and this is the basic premise of even the NRA's excellent safety programs. So--an obvious corollary of logic--why should ANY group then not agree that a condition of gun ownership must be a required demonstration, by written and practical testing, of their safe use, otherwise no go? And--any reckless or violent use of these weapons automatically should mean having the use of the weapon taken away. Firearms are the second most dangerous product on the Americna marketplace (after motor vehicles in terms of total deaths) but the least regulated, and the only product that is meant to kill--and for handguns, face it--the only product meant to kill other human beings when used as directed, having no other use! Therefore, why should we not at least have the same level of control of its harmful effects as motor vehicles, with mandatory licensing and registration and required demonstration of safe use? The logic here is unassailable, but always gets anwered by changing the subject to God-given rights, etc, as if that excuses the 35,000+ deaths each year. And the opposition to this rational approach is a glaring inconsistency in the logic of the stance taken by those against resonable control of firearm access to the public. You cannot on the one hand advocate increasing law and order, and gun safety learning, and then on the other hand oppose any measures that prevent both! Look at the phenomenal decrease in motor vehicle deaths over the past 30 years by implementing measures to restrict and control their use, and the phenomenal increase in firearm deaths over this same period during which no concerted effort has been made to reduce deaths--and those tried are actively opposed! The facts are unassailable-- ERF
	From: Charles Krin Date: 06.08.99 11:15 GMT <<Maybe I haven't been in this field long enough, but I've never alled for a trauma team activate for a ladder injury. >> I have...50 something black male helping paint a house- fell about 5 foot off of a scaffold, fractured femur first identified by the paramedics. By the time the intern (me) was allowed to start on the H&P, bilateral "rice crispies" were found under the skin...and there were a couple of embarrassed upper level residents. Got to put in my first chest tube on that patient as a reward for identifying the impending tension pneumothoracies... << How many people would he have killed if he had only been armed with a knife? How brave would school student killers be without their guns? - So true! - Ever hear of a drive-by knifing, or a schoolyard knifing massacre? ERF >> No, but there have been a number of "drive over" attempted school yard massacres...does this mean that all of us need to give up our cars? And aren't cars (in particular drunk/impaired drivers) one of the sources for high mortality among the truly innocent? This is even more reason for us to turn all of our deadly vehicles in. What, you say that the cars are not at fault? Well, in drug deals, the vehicles are held to be civilly liable and can be impounded, along with any cash and goods inside them...(abet on shaky 4th Amendment grounds)...so why not do the same with an impaired driver...or for that matter, all drivers. After all, almost everyone drives impaired at some point in time...from medications, alcohol, lack of sleep, whatever...Take the cars away now, before they hurt someone. (Yes, I realize that I am arguing from a standpoint of "reductio ad absurdum..." but that's what some of you folks are doing about guns...) Hey, let's take some personal responsibility for our own actions, and insist that the law makers and law keepers enforce responsibility on those who would break the law. I'm working on a longer piece, but have to dig some of the more interesting references out...like the article from one of the trauma journals that purported to reference an incident in Southern California where a drive by shootist made three successive head shots with a .357 Magnum revolver... Charles S. Krin, DO FAAFP Member, PGBFH
	From: Thomas Horan Date: 06.08.99 13:21 GMT no doubt about it guns are safe and scaffolds dangerous <<so why not do the same with an impaired driver >> At first I thought you were joking but now that I realize you were being sarcastic - I would just feel sorry for you were it not for the seriousness of your error in reason and humanity. Tom Horan
	From: Eric Frykberg Date: 06.08.99 18:43 GMT << ? This is even more reason for us to turn all of our deadly vehicles in. What, you say that the cars are not at fault? Well, in drug deals, the vehicles are held to be civilly liable and >> Charles-- You make a perfect point--autos are very dangerous--and thus we require written and practical evidence of our knowledge of their safe use, and licensure and registration, before being allowed to use them. If we are reckless or negligent in their use (i.e. vehicular homicide) then, precisely, the car is taken away from us. So, I agree with your obvious point that we should at least bring firearms, the second most deadly product on the American market, to the level of control of motor vehicles--and also recognizing that the purpose of a gun, unlike a car, is nothing other than to kill. Something so potentially dangerous must require licensure and registration after proving the owner's knowledge of safe use. But something tells me, Charles, that despite the inconsistency with your own logic above, you oppose these measures? Safe use, I assume, is nothing more than rhetoric to you? Proper enforcement of the law, especially against those criminals who would improperly use guns, is certainly also necessary--but of course we must realize that that by itself will not make much of a dent in the horrendous numbers of firearm deaths in this country, since 80% + have nothing to do with criminal activity (FBI Uniform Crime Reports--every year since 1983) ERF
	From: Charles Krin Date: 07.08.99 04:00 GMT << At first I thought you were joking but now that I realize you were being sarcastic - I would just feel sorry for you were it not for the seriousness of your error in reason and humanity. >> Tom, I've already replied to Eric on some of the other stuff. The point I was trying to make is that objects in and of themselves cannot by definition be "evil." Even a Swastika, the symbol, almost an embodiment, of one of the worst times of evil to befall the civilized world in this or any other century is not evil...just look at various Chinese and American Indian uses of the swastika that far predate the adoption by the Nationalist Socialist Party of Germany of the "crooked cross." My point remains that there is much that can be done under our current laws to curb both the misuse of firearms and motor vehicles without further tinkering with our society. This will remain true no matter what your opinion about my mores and morals. << Proper enforcement of the law, especially against those criminals who would improperly use guns, is certainly also necessary--but of course we must ealize that that by itself will not make much of a dent in the horrendous umbers of firearm deaths in this country, since 80% + have nothing to do with criminal activity (FBI Uniform Crime Reports--every year since 1983) ERF >> Eric, in the wee small hours of this morning, I re read one of your posts: you are arguing from a point that fire arms in general and hand guns in particular are "malum in se" (evil in and of themselves). I won't argue with you or even try to convince you otherwise...your stint in the Navy should have showed you the difference. We have previously compared notes on military service, so your attempted ad hominem falls flat- I have said or implied nothing endorsing the unsafe use of either motor vehicles or firearms. Someone else indicated that they felt that guns were evil in and of themselves because of a death in the family due to a gun...To you I give my most sincere condolences, just as I gave them to the families of two other patients today who were/did die. It's always tough for any of one who survives to understand why someone close to them died, no matter what the cause. For any one who is interested: We already have laws and taxes in place that regulate the firearms industry and shooting sports much heavier than the automobile industry...and the majority of those taxes go towards making the remains of the great outdoors available to everybody. To purchase any firearm these days, a person must submit to the equivalent of a National Agency Check for a Secret Clearance...and basically prove that they are innocent. The President recently trumpeted that "400,000 gun sales" had been denied, not mentioning that less than 24 dozen convictions have resulted from these incidents. Despite this dismal record of mis feasance, mal feasance and non feasance in office ranging from the President to the individual US Attorneys, the FBI and the ATF, it remains a Federal Felony, punishable by up to 5 years in prison for each offense, for a restricted person (including not only felons whose civil rights have not been restored but also persons convicted of certain misdemeanor offenses) to do things such as simply handling a firearm, attempting to purchase a firearm, or attempting to purchase firearm ammunition. Slam dunk convictions, you'd think, as "the thing speaks for itself" if the case gets any where near a court. I say again: these laws currently in place are NOT being enforced! In those areas (think of Boston, and Kansas City) where local agencies have obtained the cooperation of the Federal Attorneys, and have made sure that repeat felons get the Federal raps they deserve, violence of all sorts has gone down markedly. I've not seen anything like that cooperation here in Louisiana. My driver's license is recognized in every state and territory in the Union, all of the Canadian Provinces, and all of the states of Mexico. My permit to carry is not, even though I have completed the Peace Officers Standards and Training Council's prescribed course, and am a sworn deputy sheriff with full powers of arrest. Like you, I've also received a fair amount of firearms training in the military-what more do I have to do to prove that I can handle firearms safely? I have no problem with establishing a certain standard of training, outside of the interesting idea that if records are kept of who has training, then someone has a list of folks to visit...in the middle of the night...when no one else is looking. Pardon my near paranoia, but the Feds DO NOT have a good track record of keeping their word...just look at most of the American Indian reservations in the country.... The number of firearms deaths has dropped (reference your figures above- I'll have to check, but if 80% are not criminally related, I'll be surprised. Here in Northeast Louisiana, deliberate use of firearms by felons out weigh "accidental" injuries and deaths by a fairly large factor) despite the increase in the number of weapons and the increase in population with firearms available to them. In particular, both deliberate and "accidental" deaths and injuries have decreased somewhat in states with "Shall Issue" Concealed carry laws...and the folks at Handguns International hate that...which is why the national headlines don't trumpet the deaths anymore. For example: Nationwide, there has been *ONE* publicized case of a person with a permit to carry (in Texas) who has been involved in a "road rage" incident. Since the passage of the "shoot the carjacker" law here in Louisiana, there has been *ONE* incident where it was invoked...and prior to the passage, there was at least one publicized case of carjacking a month...and none since then. Eric, what about your own state of Florida? Last I looked, crimes against persons had dropped every year since the passage of the Shall Issue laws, except for one little blip involving out of town tourists in the first year or so after passage-this blip resulted in many Florida rental car companies changing the way that they identified cars...and in Florida being the first state to become a "shall issue" state for folks coming in for vacation as well. What happened to the predictions of massive problems with "gun toting grandmas?" "Shall Issue" states generally require at least some form of "Shooter's Education" prior to allowing the folks to carry, and many of those courses (curtesy of the National Rifle Association's Instructors Programs) involve substantially more than the minimum required by the jurisdictions. Here in Louisiana, for folks born after 1 November 1969, successful completion of a Hunter's Safety Course is needed prior to obtaining a hunting license as well (I've taken and helped teach the course-it's not as easy as you might think....) A driver's license? A ten question multiple choice test that my 8 year old should be able to pass...and some form of other identification saying you are you ... maybe a road test, maybe not...Now go back to compare renting a car (where all I need is a "valid" driver's license and a matching credit card with a couple of hundred dollars available credit)....and no background check...to purchasing a firearm. (Also remember that the folks who bombed the World Trade Center several years ago would have been a whole lot harder to catch if one of them had not gone back to get his deposit from the rental truck back, claiming that the truck had been stolen.) Recent JAMA articles indicate that a third fewer kids are involved in violence in schools, and a third fewer are carrying weapons to school compared to just 5 years ago...and also point out that it costs some US$ 17,000 to treat each gunshot wound. Last I looked, a large percentage of the victims were NOT innocent bystanders (if they are, why are you guys so worried about their assailants coming into your ED's trying to finish the job?). IIRC, from the Academy a number of years ago, a violent felon will commit between 3 and 5 violent crimes against persons and up to a dozen other crimes in a year. It only takes about US$ 40,000 to incarcerate one of these guys for a year, for a net savings of $30,000 to $50,000 per year. Reference your "schoolyard knifings," those suicidal weirdoes in Littleton committed at least 5 and possible as many as 40 different state and federal felonies based on current laws...including some that would be impossible to prevent even with the most draconian solutions proposed WITHOUT parental involvement...and anything more than cursory parental involvement should have alleviated the problem in the first place. The chap in Atlanta? What was that about his late wife and mother in law? Bludgeoned to death, like his last wife and children... Finally, three points: First, there are more things that you can do with a motor vehicle than with a firearm. However, some of the things that firearms do well (like hunting) are now needed because Mankind has managed to replace all of the other predators at the top of the food chain. Without the pressure of hunting here in the Central South, it's estimated that it would take less than three years for the dear population to boom and then crash from starvation, being hit. Without the taxes paid by hunters and hobby shooters, two-thirds of the tax support for wildlife resources would be lost. At what point do you have the right to insist that I give up a hobby that brings me pleasure and has, in 20 years so far, harmed no human (unlike at least one of our respected Solons with his car in roughly the same time period...). Second, under the heading of the "most good for the most people," the government has no obligation to protect an individual facing harm, but the right to self defense has been enshrined in Common Law at least since the Magna Carta. How do you propose the 90 year old widow secure her safety from the two legged predators in her neighborhood? How do you propose the 25 year old woman with two little children and an abusive spouse handle him as he takes an ax to the door...despite a judicial restraining order...and when the police are 10 minutes away? At what point do we accept that we as individuals might become fodder in the mill of society because we have given up our individual rights to self defense and self determination? You choose as you may, As for me and mine.... Third, at what point do you expect me to believe that the current crop of law enforcers would be allowed to be any better at preventing the bad guys from obtaining real machine guns and assault rifles as easy as they get drugs now, instead of some of the crap they have now? I expect that as the demand for illicit weapons grows, like the drug trade, those folks willing to break the law will continue to be better armed than the police. Individually, the LEO's are decent people....and most of the ones that I know are at least as dedicated to their jobs as you and I are to ours. On a larger scale, we cannot afford the kind of restrictions on our society that it would take to do the job you seem to be wanting done. I'll borrow Niven's Fourth Law again: "Freedom times Security equals some constant. The more Security you want, the less freedom you get." You want to push to decriminalize petty drug usage to free up places in jail to put some more of these guys that really are a menace to society, you will get my full support- put the small time users and user pushers into therapy and community service where they belong, reduce the profits from drugs by providing certified and taxed supplies to consenting adults (and requiring a bond for users to show that they can afford to take care of their own medical bills...), and then hit the folks hard who show that they do not want to be part of society. Do that for a year in a large segment of the nation, and show where there was no significant decrease in the number of firearms related injuries and deaths, and then come back and you'll get some more support from several of the diverse groups out there. ck
	From: Robert F. Smith Date: 07.08.99 06:19 GMT Amy, I echo Rick's statements re: the guns. Those of us who deal with the effects of pervasive firearm violence are not being burdened by the actions of well trained hunters. The bane of our live and those of our patients is the proliferation of cheap and deadly handguns or other weapons designed solely to kill other humans. Krin, If firearms were subjected to the same scrutiny and regulation as motor vehicles I think many of us who are concerned with the public health burden of firearms would be thrilled. Perhaps you would be willing to become an advocate for such a responsible change in policy. Robert F. Smith, M.D.,MPH Department of Trauma Cook County Hospital
	From: Jeff B Date: 07.08.99 06:33 GMT I agree whole-heartedly. In my brief five years in emergency medicine (mostly in EMS, though one was as a tech in Level II), I have seen ONE GSW from a weapon designed for hunting. ONE. And that was minor, comparatively (as though any GSW can be minor) with mostly muscle damage to the leg...# 7 shotgun shell....seems the patient was mistaken for a pheasant. OTOH, have seen many life ending injuries from 9mm, .38 cal, etc., because these weapons are used for one purpose. For those who disagree, why is it that gang members/psychopathic killers/etc. do not carry .22 single shot rifles? Answer? It works well for a squirrel, but not for humans. Cordially, Jeff B. Paramedic
	From: Charles Krin Date: 07.08.99 12:06 GMT << If firearms were subjected to the same scrutiny and regulation as motor vehicles I think many of us who are concerned with the public health burden of firearms would be thrilled. Perhaps you would be willing to become an advocate for such a responsible change in policy. Robert F. Smith, M.D.,MPH >> They are...look at what someone in your own state and city has to do to own one. Legally-Illinois in general, and Chicago in particular have some of the toughest laws in the country (after only Washington, DC, and New York). People who are inclined to disobey the current laws are NOT going to change under any of the proposed draconian solutions. Laws that would allow the police the liberty to apply those draconian solutions effectively enough to change those folks (short of them being arrested after an incident) would violate at least the Third, Fourth and Fifth Amendments (you'd practically have to put an armed trooper into each household). Interestingly enough, this would also provide the kind of security needed to answer my questions about what to do about those folks who need to defend themselves from two legged predators, but at what cost, both to society and to freedom? ck
	From: Eric Frykberg Date: 07.08.99 14:26 GMT << The number of firearms deaths has dropped (reference your figures above- I'll have to check, but if 80% are not criminally related, I >> Once again, Charles--FBI Uniform Crime Reports--comes out once each year, as well as the Vital Statistics Report of the NCHS of the CDC about 50% of all firearm deaths are suicides,(right there the biggest chunk--of course no crime at all) 44% homicides (over 70% involving people who know each other--domestic disputes, love triangles, etc) and 4%-5% unintentional Yes the number of firearm deaths has dropped from its high in 1993 of over 39,000 to now something over 35,000 (beginning right after the Brady Bill went into effect, interestingly)--but we are still 10% higher than in 1985 and the curve since 1960 is still climbing cinsistently higher--by definition an epidemic. That curve is marked by a number of sawtooths, ups and downs, so beware of assuming a trend--altho ket's hope the downswing continues << Tom, I've already replied to Eric on some of the other stuff. The point I was trying to make is that objects in and of themselves cannot by definition be "evil." >> Oh, really??? Then, Charles, why would you support, as your last post makes clear, outlawing drugs? A bag of cocaine is of no harm to anyone--it takes a person using it to cause harm--right? Drugs, don't kill people, people kill people! Don't outlaw that inanimate substance --punish the person who does the injecting! Please reconcile this for us? A three year old is lighting matches--what do you do? Punish the 3 year old? Begin an education process to teach him not to do that--reasonable, but of course that takes time to take effect--what do you do in the meantime to prevent the house from being burned down? You take away the matches! Now, matches are inanimate--they can by themselves cause no harm! Matches don't burn houses down, people do! It takes a person to light one, right? But Charles--you know that you will take away the matches--because without them, lives will not be lost nearly as surely as if that person had matches. In fact, the national statistics make clear, as do several studies (try Tale of Two Cities, NEJM 1988 out of Univ Washington), that equivalent populations without guns do not have a fraction of the homicide or suicide rate as do populations with guns--so your argument above is false--the gun itself is a clear vector of the disease--not the only one, to be sure, but clearly a contributor in and of itself, that must be restricted for the safety of society just like cocaine and matches are by folks like you ---again, another example of quite inconsistent thinking and flawed reasoning. << People who are inclined to disobey the current laws are NOT going to change under any of the proposed draconian solutions. Laws that would allow the police the liberty to apply those draconian solutions effectively enough to change those folks (short of them being arrested after an incident) would violate at least the Third, Fourth and Fifth Amendments (you'd practically have to put an armed trooper into each household). Interestingly enough, this would also provide the kind of security needed to answer my questions about what to do about those folks who need to defend themselves from two legged predators, but at what cost, both to society and to freedom? >> Charles-- Wrong! In 1994 a new measure was instituted in Indianapolis--using the very approach you advocate--in which the police began a campaign of using existing laws on the books to stop vehicles in high crime neighborhoods(by strictly enforcing laws involving broken taillights, failing to yield right of way or using turn signals, etc) and using that stop to legally search for weapons in plain sight. It was phenomenally successful, leading to a 50% reduction in homicides in that city just within 6 months--by doing nothing other, Charles, than taking away the guns! Of course you must advocate this, it is just what you advocate--reducing crime by going after the potential criminals! And guess what--the foundation of democracy has not crumbled in Indianapolis--there has been no loss of freedom or safety for the general population! How do you explain that? The success of that program led to it being adopted over the next 2 years in Baltimore, Kansas City, and New York, among others--and in every case, a significant and rapid decline in homicides in every city--and what a coincidence--right after this program went into effect (and the Brady Bill happened at the same time) across the country's major cities, violent crime figures acrooss the country dropped--as you pointed out--by taking away the guns from those who should not have them! The law worked! It has not "punished" the poor innocent citizenry by leaving them open to these wanton criminals--the overall homicide rate went down! In other words, without the gun, these criminals did not find other ways to kill--without the gun, the killing did not happen at all! (This last is nothing new--it is well known from several studies that this is the case) This is a real life refutation of your oh so high sounding conjectures above--please explain these facts to us? ERF
	From: Charles Krin Date: 07.08.99 17:17 << about 50% of all firearm deaths are suicides,(right there the biggest chunk--of course no crime at all)>> And if someone is committed to suicide? Will eliminating all firearms eliminate this form of death? How many "one vehicle accidents" occuring late at night should also be in this category? ck
	From: Robert F. Smith Date: 07.08.99 17:59 GMT Charles, Firearms are specifically except from regulation by Federal Consumer Safety agencies. The clothes your kids are wearing are not exempt from regulation because it is felt to be important that they not accidentally catch fire and burn to a crisp in 2 seconds. Your toaster is not exempt so you don't buy one that electrocutes you. I think guns are more dangerous than toasters and clothes. Do you? Individuals are not required to report sales of firearms to other individuals. Thus it is impossible to track a particular weapon used in a crime to a particular owner. Cars sales are required to be reported. The CDC is now forbidden to participate or fund health research involving firearms. On pain of death. I think over 35,000 Americans dying each year and representing one of the leading causes of lost years of future life in our country is a legitimate public health emergency. Do you? R. Smith, M.D.
	From: Eric Frykberg Date: 07.08.99 18:59 << And if someone is committed to suicide? Will eliminating all firearms eliminate this form of death? How many "one vehicle accidents" occuring late at night should also be in this category? >> The answer to this question is well established--yes! The rate of suicide in populations without guns is far lower than in very similar populations with guns--i.e. without the gun, other forms of suicide are not used and the suicide largely does not happen--again see the Univ Washington study entitled A Tale of Two Cities, comparing two very similar cities, Seattle and Vancouver, in which the only difference lies in the virtual inability of those in Vancouver to own or use handgun Suicide in 12-24 year olds in Vancouver are 10-fold lower than in Seattle--this is only one of many studies documenting this point Charles, you really should become acquainted with the facts before spouting off your media-fed sound bites that are so easily refutable And use facts, rather than conjectures to support your points, which you have yet to do even once For the 2nd part of your question--62% of all suicides in the U.S. are from firearms--I quoted you that about 49%-50% of all firearm deaths are suicides--so of course the one-car MVC would NOT fall into this category! ERF
	From: Charles Krin Date: 07.08.99 20:45 <<A bag of cocaine is of no harm to anyone--it takes a person using it to cause harm--right? Drugs, don't kill people, people kill people! Don't outlaw that inanimate substance --punish the person who does the injecting! Please reconcile this for us?>> Rick, that kilogram of cocaine, a few milligrams at a time, will go a long way to alleviating suffering while a surgeon is repairing faces and mucus membranes by providing an anesthetic and nearly bloodless field. Converted to "crack" and passed out a few milligrams at a time to kids, it's a tragedy. Beyond the conversion to cocaine base, is there any difference in the material itself, or just in the use? << A three year old is lighting matches--what do you do? Punish the 3 year old? Begin an education process to teach him not to do that--reasonable, but of course that takes time to take effect--what do you do in the meantime to prevent the house from being burned down? You take away the matches! Now, matches are inanimate--they can by themselves cause no harm! Matches don't burn houses down, people do! It takes a person to light one, right? But Charles--you know that you will take away the matches--because without them, lives will not be lost nearly as surely as if that person had matches>> And how did we go from the rights and responsibilities of presumably reasonable adults with no legal disabilities to the care and feeding of a three year old? I've already agreed that folks with legal disabilities should not be allowed weapons- they've proved that they cannot fit into the requirements of society....that they are not responsible adults. <<try Tale of Two Cities, NEJM 1988 out of Univ Washington>> Rick, I'm in the process of digging that one out again. IIRC, there have been some methodological arguments on the population breakdowns, and once you correct for the numbers of crime related actions in the inner city portion, much of the difference drops out. <<For the 2nd part of your question--62% of all suicides in the U.S. are from firearms--I quoted you that about 49%-50% of all firearm deaths are suicides--so of course the one-car MVC would NOT fall into this category! - ERF >> Rick, There have been a few instances that I've been involved in (at least peripherally) where it turned out that the deceased was under significant stress...enough to raise the question of just exactly why "he fell asleep at the wheel." In general, Medical Examiners, Coroners and Police Investigators hesitate to call a suicide in this kind of circumstance if there is no note...and it gets written up in the statistics as an "accident." <<Firearms are specifically except from regulation by Federal Consumer Safety agencies. The clothes your kids are wearing are not exempt from regulation because it is felt to be important that they not accidentally catch fire and burn to a crisp in 2 seconds. Your toaster is not exempt so you don't buy one that electrocutes you. I think guns are more dangerous than toasters and clothes. Do you?>> Robert, I've never questioned that guns are more dangerous than toasters or clothes, at least in careless or malign hands. Then again, despite the use of Ground Fault Interrupters and other safety factors promoted by the CPSC, we still occasionally see someone trying to fish a piece of toast out with a metal fork...or a kid will back up to an open gas heater in a worn out flannel gown... << Individuals are not required to report sales of firearms to other individuals. Thus it is impossible to track a particular weapon used in a crime to a particular owner. Cars sales are required to be reported.>> Cars are required to be reported so that taxes can be levied on the sale, (that's actually what the license tag is legally an indication that you've paid your taxes.) It is possible for serial numbers to be traced on a fair number of transactions that occur legally-the ATF requires all registered dealers to prove who they've sold to, and what the serial numbers were-most legal weapons have started with a registered gun dealer. Private transactions, including passing on heirloom weapons and exchanges between individuals, do not require more than good faith on the part of the seller at this time, and if it were as easy to register the transfer of a firearm as it is to register the transfer of a motor vehicle, you might find more private sellers willing to put up with the paper work. Unlawful transactions of either firearms or motor vehicles remain unregistered in any case. <<The CDC is now forbidden to participate or fund health research involving firearms. On pain of death.>> On the pain of death or the pain of loss of financing? << I think over 35,000 Americans dying each year and representing one of the leading causes of lost years of future life in our country is a legitimate public health emergency. Do you? >> Agreed. Now we just need to discuss what changes you are willing to accept in your lifestyle and what changes you are desirous of shoving down someone else's throat. Ladies and Gentlemen, while we all perform triage at some times of our professional lives, the last time I looked, "the good of the many outweighing the good of the one" was not a part of our civil code...but, in some ways, the antithesis of it. Do we not have room left in our society to allow for acceptance of personal risk and responsibility? Do you really think that it will be possible to take all of the risk out of life...to allow everybody to die in bed at home of old age? Are you willing to take the responsibility of living someone else's life? This is basically what you are asking to do. Think about it from that point of view for a while. ck
	From: Jim Cowan Date: 08.08.99 02:52 GMT <<Wrong! In 1994 a new measure was instituted in Indianapolis--using the very approach you advocate--in which the police began a campaign of using existing laws on the books to stop vehicles in high crime neighborhoods(by strictly enforcing laws involving broken taillights, failing to yield right of way or using turn signals, etc) and using that stop to legally search for weapons in plain sight. It was phenomenally successful, leading to a 50% reduction in homicides in that city just within 6 months--by doing nothing other, Charles, than taking away the guns!>> Interesting how you jump to these assumptions. I would look to the same situation and say it succeeded because the police enforced existing laws. This is all the NRA or any of us have ever asked for <<The rate of suicide in populations without guns is far lower than in very similar populations with guns--i.e. without the gun, other forms of suicide are not used and the suicide largely does not happen>> This is absolutely amazing...you are now claiming banning guns will stop suicides? Is there no end to the depths you handwringing gun control nuts will sink? You appear to have an irrational fear of guns that is so pervasive you are incapable of rationale dialog on the subject. <<The CDC is now forbidden to participate or fund health research involving firearms. On pain of death.>> Thats because the handwringers on their staff produced a study that was shown to be "questionable"...they then refused to release the data used for the study and the people who pay the bills at the CDC took exception to that. Jim Cowan Springfield, MO
	From: Eric Frykberg Date: 08.08.99 03:44 GMT << This is absolutely amazing...you are now claiming banning guns will stop suicides? Is there no end to the depths you handwringing gun control nuts will sink? >> Jim-- You need to read the posts more clearly--I claimed NO SUCH THING! First. I never advocated in any way "banning guns"! Doesn't it tell you something when you have to misquote in order to advance your stance? I said--and check it if you like--that populations without guns have a hugely lower suicide (and, in fact, homicide and overall death) rate than populations with access to guns, all else being equal, or similar. This is not me saying this--as was also clear in my post, I was relating the results of a number of population-based studies which show this--and not a single one has ever yet shown this NOT to be true--the Tale of Two Cities study in the NEJM in 1988 is one particularly high-powered study I cited which shows this. So Jim--don't argue with me--argue with the science--interestingly, this is something you too don't seem able to do--not yet a single reference to support any of your conjectures and media-based sound bites, nor to refute the studies I have cited--does not that also tell us all something? You obviously don't agree with this--fine--then show us your data that supports you, rather than castigating the messenger, which is a pretty desperate ploy indicating you have nothing else. << Interesting how you jump to these assumptions. I would look to the same situation and say it succeeded because the police enforced existing laws. This is all the NRA or any of us have ever asked for. >> Jim-- I agree with this--but how do you relate merely stopping the car by itself for a broken taillight would drop the homicide rate? Obviously, the guns that were found and confiscated had to play a role, given that in these cities guns accounted for over 70% of all homicides--the guns get taken away, and voila! The homicides go away! This is a great example of how better law enforcement works--but it works by removing guns that should not be there! (The people stopped largely did not get arrested--guns were only confiscated) Thus showing the gun itself does make a difference over and above the person who pulls the trigger. << Thats because the handwringers on their staff produced a study that was shown to be "questionable"...they then refused to release the data used for the study and the people w >> Jim-- It is particularly galling and inconsistent of you to in one breath ask for a "rational dialog" on this subject, then in the next start name calling(which not one of your posts has been free of)--it amazes me that a grown adult should use such adolescent tactics--what are you so insecure about? Could it be you can not live up to a real debate? You certainly haven't up till now--again, not a single reference to support anything--just a lot of negative bashing of everything said without logic or reason. Let's start out with a simple question to you--and let's all see if you ever answer it--Exactly what study from the CDC was found to be "questionable"? and in a free society, since when does some "question" about the merits of a study EVER then mean that that author can never again research a topic? Does that sound like scientific freedom of inquiry or free speech? Please name one scientific journal that would demand that an author of a study with questionable conclusions, which is good enough to be published after peer review,,must never again be allowed to research? This clearly smacks of people who are very afraid--irrationally so--of even seeing --oh my God!--data--when that data does not conform to their preconceived view of the world. If the data is wrong--or the results "questionable"--then just ignore it--discount it! As we do every day with innumerable studies in the literature. Why do you favor censoring the mere attempt to gather data? And finally--name us all one study in the medical literature which does not have any "questionable" facts, analysis or conclusions--just one perfect study! I'd love to hear from you this answer! ERF
	From: Pedro Oscar Rezende Cunha Date: 08.08.99 05:20 GMT Well, we all know that fire arms wounds and cars(and others land vehicles) accidents are the major cause of deaths in trauma. We also agree that since both are able to kill/hurt people, they should be used under certains rules. We seem to disagree when talking about the right to own a fire arm or a car. The very principle of a fire arm is to hurt and kill (maybe you don't agree, but think why every single day fire arms are becoming more powerfull). Of course they can be used to hunt, as a sport and so on, but it's not the main use of them. The principle of a car is to take you around faster. Of course it can be used to harm and kill, but it's not the main use of them. So, you want to have an object that the main objective is hurt and kill? Ok, so you must understand that owning such thing is not for everyone. So, you want to have something that will take you around faster? Ok,so you ALSO must understand that owning such thing is not for everyone. What's the difference between both situations ? The difference is that who owns a car does not own it to promote violence. Who owns a gun does , even if your goal to to protect yourself from crimminals. I am not talking about banning fire arms, i am just asking for people to stop and think that such thing can't be owned as it was a fire work.I think that if youy want to have a gun, you should prove that you can use it safely. If we have to take drive lessons and make a tests { sight, psico and driving)to be a driver,i think that is fair to ask for lessons about owning a gun and tests to use it, not talking about the need of a non-crimminal past. Since most ( 80% +) of the deaths related to fire arms wounds are not related to crimes, just making it harder to own a gun will slow down the the deaths caused by fire arms . Pedro Cunha medical Student, Brazil
	From: Jim Cowan Date: 08.08.99 15:54 GMT The fact of the matter is, it's illegal for a felon to own a handgun. It's illegal to carry them in cars within easy access of the driver, it's illegal to sell or transfer them without proper permits and it's illegal to brandish them in a threatening manner. The fact also is, that we do not enforce these laws. Felons carry guns all the time..most of the crime involving firearms is committed by persons with lengthy criminal records who have no legal right to own or carry a firearm, yet they do so. Washington DC is the murder capital of the US and handguns are virtually banned totally....yet they are used daily in crimes by people who are then released on bail or parole. We don't need any more legislation that only effects people like me or other legal gun owners...we need to crack down on the criminal element. <<(The people stopped largely did not get arrested--guns were only confiscated) Thus showing the gun itself does make a difference over and above the person who pulls the trigger ERF>> You do understand that the police cannot confiscate a gun unless it's being carried illegally....therefore, why were the people were not arrested if the guns were confiscated? <<So Jim--don't argue with me--argue with the science--interestingly, this is something you too don't seem able to do--not yet a single reference to support any of your conjectures and media-based sound bites - ERF>> The evidence (which is available from dozens of different sources including the common almanac) shows that guns are not a leading cause of accidental death. They rank somewhere below poison gas and vapors and medical treatment. Handguns were 0.1 per 100,000 and all firearms were 0.4. Now how do you argue with that? Jim Cowan MO, Springfield
	From: Jim Cowan Date: 08.08.99 16:26 GMT <<Exactly what study from the CDC was found to be "questionable"?>> On March 6, 1996, three physicians and noted criminologist Don B. Kates were given an opportunity to testify before the House Appropriations Subcommittee on Labor, Health and Human Services, and Education. Testimony focused on the CDC/NCIPC's use of "suspect data, skewed study populations, dubious research models, and result-oriented research". The panel was also informed that NCIPC researchers violated accepted scientific practice by refusing to release and make available to other researchers their original data for further critical analysis -- an indispensable part of genuine peer review. In a letter to Senator Arlen Specter, Dr. William Waters of Doctors for Integrity in Policy Research protested the "overt political activism of the NCIPC staff and their federally-funded researchers.... [T]here seems to be a tacit assumption -- perhaps even foundational concept -- among many public health researchers that firearm prohibition/control provides a ready solution to many of society's ills. We believe that this view is expressed in the NCIPC's approach to the problem of violence, since the research performed is fantastically narrow in scope, excludes most of what is known about violence in human societies from consideration or study, and is often performed using abysmally poor methodology." When supporters of NCIPC's findings and funding are challenged, Dr. Waters observed, they take refuge in tautology: "There seems to be a tendency on the part of those defending the NCIPC to simply reiterate figures depicting the problem of firearms violence/injury as justification for the agency's existence." Concerned about the political corruption of public health research and possible violations of the public trust, DIPR representatives sought to educate key members of Congress and the Senate; others took the case directly to the public via local and syndicated radio and television shows, including National Empowerment Television (NET). A critical breakthrough occurred when Dr. Timothy Wheeler, president of the California-based Doctors for Responsible Gun Ownership, appeared on the CBS program This Morning to debate Dr. Jerome Kassirer, editor-in-chief of NEJM. Dr. Kassirer had defended the supposed objectivity of the CDC-supported gun studies in a previous NEJM editorial. Dr. Kassirer's defense of the CDC provided an opportunity for Dr. Wheeler to display, on camera, a copy of the anti-gun issue of the Injury Prevention Network Newsletter cited above. The cover of that issue, which bore the title "Women, Guns and Domestic Violence," displayed an illustration of a menacing handgun blasting away at the defenseless female symbol. Wheeler was also able to share some of the "neutral" recommendations offered within that tax-funded newsletter. Here is a sampling from the publication: Put gun control on the agenda of your civic or professional organization. Release a statement to the media or explain in your organization's newsletter why gun control is a women's (or nurses' or pediatricians') issue. Ask TV and print media to name the gun manufacturer in every story it runs involving gun violence. Organize a picket at gun manufacturing sites, perhaps with posters showing pictures of victims of gun violence.... Work for campaign finance reform to weaken the gun lobby's political clout. Boycott publications that accept advertising from the gun lobby or manufacturers.... Get media attention for your events. Encourage your local police department to adopt a policy prohibiting officers from recommending that citizens buy guns for protection. Federally subsidized CDC researchers also became directly involved in anti-gun rights agitation. For example, NCIPC-funded researchers and staff served as faculty at the Handgun Epidemic Lowering Plan (HELP) "strategy conferences," held in Chicago in 1993 and 1995. Those meetings assembled "like-minded individuals who represent organizations [that seek to] use a public health model to work toward changing society's attitude so that it becomes socially unacceptable for private citizens to have guns." Dr. Katherine Christoffel, one of the founders of these conferences, is known for her anti-firearms activism. Dr. Christoffel has stated, "Guns are a virus that must be eradicated. We need to immunize ourselves against them." Taking the pathological perspective on guns to its most ridiculous extreme, Christoffel has declared: "Get rid of the cigarettes, get rid of the secondhand smoke, and you get rid of lung disease. It's the same with guns. Get rid of the guns, get rid of the bullets, and you get rid of deaths." Another conference on firearms violence held in 1992 at the University of Iowa was underwritten in part by CDC/NCIPC funds which had previously been allocated to the study of rural injuries and farm occupational hazards. Significantly, the only non-academic faculty member invited to the 1992 conference was Sarah Brady of Handgun Control, Inc. A similar event, "National Violence Prevention Conference -- Bridging Science and Program," was held at the University of Iowa in 1995; the CDC/NCIPC co-hosted the event with the University of Iowa Injury Prevention Research Center, and NCIPC Director Mark L. Rosenberg offered the event's inaugural speech. These are just a few of the reason the CDC's funding was cut and congressional efforts made to keep the CDC in the business of science and disease prevention and out of social activism and anti-gun hysteria. Jim Cowan Springfield, MO
	From: Robert F. Smith Date: 08.08.99 16:45 <<As has been stated before Robert...you have no constitution right to own a car. Jim Cowan>> Legal Issues - Second amendment : “A well-regulated Militia being necessary to the security of a free State, the right of the people to keep and bear Arms shall not be infringed.” As the Chief Justice of the US Supreme Court said in an interview in Parade magazine, “this amendment protects the formation of citizen militias and was not intended to ensure the absolute right of anyone to keep any type of firearm“ He argued that while we should not prohibit the legitimate uses of guns for protection or recreation, guns should be regulated in much the same way as cars if we are to minimize firearm injuries and death. Legal Issues - Courts The Supreme Court has addressed the issue of the Second Amendment and the right to bear arms three times: U.S. v. Miller,1939 -only federal laws that interfere with state militias would be invalid Presser v. Illinois in 1886, state laws are unaffected by the Second Amendment. Quilici b. Village of Morton Grove, 1972 upheld the right of a local municipality to restrict gun ownership Litigation - No federal court has ever invalidated any gun control law as a violation of the Second Amendment.
	From: Jim Cowan Date: 08.08.99 16:48 GMT Let's not forget one important concept. There is a body of evidence that firearms prevent more crime and injury than they cause. Studies have shown that literally millions of incidents occur annually in which impending rape or assault was avoided by the mere presence of a firearm. If we carry this out to the implications involved, it begs the question, will banning legal firearms save lives or place many citizens at the mercy of the criminal element. I think this is the "hinge" point of the issue. If we are going to deal with the science, let's deal with all of it.....exactly what are the implications of firearm ownership...do they help or hurt, and should they continue to be a constitutionally protected right? The most comprehensive study ever done on this issue was the Kleck study in which data was examined from every county in the United States. I would also add that unlike the CDC studies, this data is available for independent review. Florida State University Dr Gary Kleck, using surveys and other data, has determined that armed citizens defend their lives or property with firearms against criminals approximately 1 million times a year. In 98 percent of these instances, the citizen merely brandishes the weapon or fires a warning shot. Only in 2 percent of the cases do citizens actually shoot their assailants. In defending themselves with their firearms, armed citizens kill 2,000 to 3,000 criminals each year, three times the number killed by the police. A nationwide study by Kates, the constitutional lawyer and criminologist, found that only 2 percent of civilian shootings involved an innocent person mistakenly identified as a criminal. The "error rate" for the police, however, was 11 percent, over five times as high. Those are the simple, verifiable facts gentlemen. You may not like living in a violent society but you do, you may not like guns, but they exist as a constitutional right. If you wish to change that, you will need to do better than another HCI hysteria campaign, and you really need to be certain you are going to make things better, not worse. Your concerns as trauma surgeons involve those 2,000 to 3,000 cited above while the rest of us, the potential victims, want to keep the 98% avoidance factor. Jim Cowan Springfield, MO
	From: Jim Cowan Date: 08.08.99 17:09 <<Of course, there is nothing in the constitution that says anythign about >>maintaining an air defense force either. There weren't very many cars around (read: Zero) when the Constitution was drafted. Jeff B., NREMTP >> So ban the Air Force...you won't have any resistance from constitutional scholars at all. Guns however, are afforded a level of constitutional protection. With whats going on right now, the gun control advocates feel they are on a moral crusade against a benighted, barbaric citizenry. This is demonstrated not only by the ineffectualness of gun control in preventing crime, and by the fact that it focuses on restricting the behavior of the law-abiding rather than apprehending and punishing the guilty, but also by the execration that gun control proponents heap on gun owners and their evil instrumentality. As criminologist and constitutional lawyer Don B. Kates, Jr. and former HCI contributor Dr. Patricia Harris have pointed out, "[s]tudies consistently show that, on the average, gun owners are better educated and have more prestigious jobs than non-owners.... Later studies show that gun owners are less likely than non-owners to approve of police brutality, violence against dissenters, etc." We must understand that the antipathy many liberals have for gun owners arises in good measure from their statist utopianism. This habit of mind has nowhere been better explored than in The Republic. There, Plato argues that the perfectly just society is one in which an unarmed people exhibit virtue by minding their own business in the performance of their assigned functions, while the government of philosopher-kings, above the law and protected by armed guardians unquestioning in their loyalty to the state, engineers, implements, and fine-tunes the creation of that society, aided and abetted by myths that both hide and justify their totalitarian manipulation. The liberal elite believe that they are philosopher-kings. They believe that the people simply cannot be trusted; that they are incapable of just and fair self-government; that left to their own devices, their society will be racist, sexist, homophobic, and inequitable -- and the liberal elite know how to fix things. They are going to help us live the good and just life, even if they have to lie to us and force us to do it. And they detest those who stand in their way. The private ownership of firearms is a rebuke to this utopian zeal. To own firearms is to affirm that freedom and liberty are not gifts from the state. It is to reserve final judgment about whether the state is encroaching on freedom and liberty, to stand ready to defend that freedom with more than mere words, and to stand outside the state's totalitarian reach. Jim Cowan
	From: Eric Frykberg Date: 08.08.99 17:17 GMT <<You do understand that the police cannot confiscate a gun unless it's being carried illegally....therefore, why were the people were not arrested if the guns were confiscated? >> Ask the police drpts of Kansas City, New York, Indianapolis, Baltimore, etc << Washington DC is the murder capital of the US and handguns are virtually banned totally....yet they are used daily in crimes by people who are then released on bail or parole. >> To once again get beyond the sound bites-- In the first year after the strict handgun bans were instituted in both Wash D.C. and New York City, the homicide rate in both cities plummeted by 25%--then rose back up to thier previous levels--interesting that you and others using this statistic never mention or try to reconcile this fact. After that first year, virtually all guns used in violent crimes were no longer from NYC or D.C. (in other words, the law was effective) but from outside those cities--most commonly from right across the border in Virginia, and second most commonly from Florida--the perfect argument for uniform federal laws restricting access to handguns, which would keep down this border-crossing phenomenon and, as happened in the cities, homicides as well. << Quote: i.e. without the gun, other forms of suicide are not used and the suicide largely does not happen-- Unquote: >> Jim-- What this means is that since the total suicide rate went down, those due to guns did not go on to try suicide by other means, which is the classic argument against resticting guns--that those using them for suicides will find another means--had nothing to do with those using other means to begin with--the numbers speak for themselves, and you continue assailing them without any data of your own! We are all still waiting for your data.... << The evidence (which is available from dozens of different sources including the common almanac) shows that guns are not a leading cause of accident >> Another classic dodge, again showing you are parroting others (specifically this dodge comes out of Wayne LaPierre's book Guns Crime and Freedom) rather than thinking for yourself. Firearms are the second leading cause of death by injury in this country--pure and simple and indisputable--after motor vehicles--in 1997, something just over 35,000 deaths from firearrms, and about 42,000 from motor vehicles. No other single agent accounts for more deaths--again, very simple and well documented--I gave you my source--the National Center for Health Statistics, Hyattsville, Md, Fingerhut and Warner,Injury Chart Book, Health United States 1996-1997--while once again you gave NO specific source--just the handy "a number of sources"--another classic dodge promoting the Big Lie. No almanac says anything different, including the 1998 World alamanac I have open on my lap right now--check it! You are comparing apples and oranges in a classic misrepresentation. No one said a thing about "accidental"(meaning unintentional) deaths--Those figures above are for TOTAL firearm deaths in this country--not unintentional which accounts for only 4% of those--so naturally by slyly injecting the outmoded and misconstrued word "accidental" (which no authority anymore uses, as it misrepresents "injury" which is largely not accidental), you make a false and misleading point. Total firearm deaths (which are mostly intentional--suicides and homicides) must be compared with TOTAL motor vehicle deaths(which are mostly unintentional) to be accurate and compare proper entities, and they in fact they are the second highest cause of death by injury. I refer you also to the 1998 Institute of Medicine document Reducing the Burden of Injury which also emphasizes this point and also points to the many authoritative references documenting this. The numbers are very clear--no other cause of injury death (NOT just accidental death) comes near to 35,000--if you disagree, please tell us what that is, and show us your SPECIFIC source, as I have and we will both write to that massive conspiracy against freedom, the Institute of Medicine, and tell them they made a mistake--Jim Cowan says so! Another point--those are national figures--in 20 states, including Florida, Texas, Louisiana, Maryland, firearms are now the leading cause of death by injury (Florida Dept of Health, Tallahassee, and NCHS), having surpassed motor vehicles in 1994 for the first time in our history! It is no coincidence that those states with the least restriction on access to firearms have the highest deaths from firearms (and again most of those deaths are not of evil criminals lurking in dark alleys--they are of innocent citizens like you and me and have nothing to do with criminal activity) It is evident you continue to refuse to reconcile your stance with the wealth of data available--you are obviously very emotionally wedded to your stance, and have lost all ability to be objective and honest--so go ahead and continue to spout your slogans and name-calling--at least the bulk of us on this list now realize from whence you are coming.... << These are just a few of the reason the CDC's funding was cut and congressional efforts made to keep the CDC in the business of science and disease prevention and out of social activism and anti-gun hysteria. >> Thank you--now once again Jim I will ask the questions you have yet to answer--name a single published study out of the CDC or NCIPC which was found to be "questionable"--you idi not do that, Then please justify why an organization must be censored from collecting data merely because you feel its conclusions are biased? Why do you not collect your own data to refute it, like science has worked now for centuries? Since when is information of any kind so bad we can not even be exposed to it? And--you also still failed to name a single study in the medical literature which is perfect and without "question" as to its data, analysis or conclusions. You would have fit in very well in the Inquisition, the last time I know of where data gathering was censored just because a self-appointed group of judges did not like what it showed. No, come to think of it--Hitler also did that with his book burning << Let's not forget one important concept. There is a body of evidence that firearms prevent more crime and injury than they cause >> Jim-- Once again I will not let you get away with this shoddiness--please cite for us the study! This may work at your local American Legion crewshop, but not here--tell us what these studies are! You of course (I will do it for you, since obvioulsy you do not know) refer to Gary Kleck's study out of Florida State University, which was a telephone survey of almost 5000 gun owners (i.e. a biased group to begin with) indicating a number of instances in which the gun was reported to be used defensively in what was extrapolated to be some 2 million instances nationally. What you fail to reconcile this with, however, is that the much more scientifically accurate National Crime Victimization Survey of the US gov't found this to be only in the range of 62,000 cases in a year nationwide--several orders of magnitude off the mark (see the book Cease Fire, excerpted in Rolling Stone Magazine March 10, 1994) Also, using your own reasoning with the CDC--this study was criticized for its flawed methodology by the Nat'l Research Council of the Nat'l Academy of Sciences (obviously another left wing conspiracy!)--so according to your argiment, that should mean that Florida State University and Kleck should now be censored from ever resaearching this topic again--it is clearly "questionable" is it not? I will also bet you never even read this study, have you? A Harris poll of Wisconsin citizens in 1992 showed over 80% in favor of stricter control of gun access to citizens, and guess what--38% of gun owners themselves also answered this way! No poll, state or national has ever showed anything different! The american population appears to also disagree with you! ERF
	From: Eric Frykberg Date: 08.08.99 18:11 GMT << The Supreme Court has addressed the issue of the Second Amendment and the right to bear arms three times: U.S. v. Miller,1939 -only federal laws that interfere with state militias would be invalid Presser v. Illinois in 1886, state laws are unaffected by the Second Amendment. Quilici b. Village of Morton Grove, 1972 upheld the right of a local municipality to restrict gun ownership >> Robert-- No--you left out the last Supreme Court 2nd Amendment case--U.S. v. Lewis, upholding the challenged constitutionality of the 1968 Gun Control Act But your poiints are all right on--every court decision ever rendered on the 2nd amendment has upheld the constitutionality of proper restricitoin of access of the public to firearms. Thus, since only the courts can interpret what the Constitution says, it is clear the Constitution does not allow unrestricted ownership, use, sale or manufacture of firearms. That of course is why firearm advocates NEVER bring these laws to court--isn't that strange, if they decry their illegality? Just another in a long line of inconsistencies and flawed reasoning ERF
	From: James S. Cowan Date: 08.08.99 19:14 GMT I am puzzled. You seem to have access to information none of the current researchers on firearms and homicides do. Which "handgun ban" are you talking about? The Sullivan act took place in New York in 1911. I am unable to find any decrease and subsequent increase related to any legislation. Can you please clarify this? Which years dropped and which years increased based upon what legislation? To address your point on weapons migrating across borders let me cite a study specifically addressing this point. The report "A Statistical Comparison of Homicide Rates in the Prairie Provinces and Three American Border States" was released in October, 1994. It was concluded that the regulation of possession of personal arms by private citizens has little or no effect on homicide rates. There is a common misconception in Canada that there are no gun controls in the United States. Federal law, except for the recently passed Brady Bill and control of interstate and international trade in firearms, remains constrained by the Second Amendment to the Constitution. However, several states have enacted their own gun control laws, and there is a plethora of local ordinances in those states which permit them. The gun laws of New York, and especially of New York City are stringent by Canadian standards, and Canadian firearms legislation appears to have been influenced by the older New York statutes, of which the keystone, the Sullivan Law barring the carrying of deadly weapons, dates from 1911. A permit is required to purchase a handgun anywhere in New York State, and applicants undergo a rigorous screening process which may take up to six months. In New York City, permits are also needed to purchase long guns for which the waiting period is 30 days. In spite of the restrictions, the state homicide rate is, on average, five times higher than in Canada. In New York City it is ten times the Canadian rate. There is no provable explanation for this anomaly, but it is reasonable to suppose that the presence of organized crime, a flourishing narcotics trade, racial tension, extreme poverty and a collapsing public education system are all contributing factors. In the District of Columbia, the sale of handguns is prohibited, permits are required to purchase rifles and shotguns, all firearms must be registered and owners must have possession permits. No other jurisdiction in the free world has a more rigid system, yet the homicide rate by 1991 had reached an astonishing 80 per 100,000 citizens - probably the highest for any jurisdiction in an industrialized nation. In the United States, the degree of control of firearms is directly proportional to the amount of violence in a particular jurisdiction. Thus Illinois, (especially Chicago) and Michigan are quite restrictive, whereas several western states with relatively peaceful societies are effectively "wide open". Minnesota, North Dakota, Montana and Idaho are mostly rural and are economically, socially and demographically very similar to western Canada. They were chosen for a comparative evaluation partly for that reason and partly for their minimal legislation relating to firearms. All four states require permits to carry concealed weapons. North Dakota bars machine guns and fully automatic rifles and Montana permits possession of machine guns only on the owner's premises. Minnesota has a seven day waiting period for the purchase of a handgun, and permits are required to carry them even if not concealed. The age of responsibility for unsupervised use of a rifle or shotgun is 14 years in Montana and 15 in the other states. Beyond that, the only controls are practical, local ordinances with respect to being armed at a public gathering, discharging a firearm within town limits and so on. Control of long guns was introduced in Canada in 1978. Because Manitoba, Saskatchewan and the three most westerly American states have small populations, relatively small changes in the number of homicides cause very erratic variations in the rate per 100,000. In Minnesota, with a population of more than 4 million, annual variations are minimal. It was observed that homicide rates are decreasing in all jurisdictions except Minnesota. A dramatic decrease in Idaho reflects high rates (5.4 per 100,000) in 1978 and 1979, and a very low rate (1.8) in 1991. However, even if these three erratic values are rejected, the trend remains sharply downward. Of the individual jurisdictions, Montana had the most homicides per capita over the fifteen year period with an average of 3.8 per 100,000 citizens. Manitoba was second highest at 3.6, followed by Idaho at 3.4, Saskatchewan and Alberta, each at 3.1, Canada at 2.7, Minnesota at 2.4 and North Dakota at only 1.3. The consistently low rate for North Dakota is approximately the same as in Japan, where there is virtually no private ownership of firearms. Among the four states and the three provinces studied, North Dakota is the most rural. It has a slowly declining and presumably aging population, few of the extractive industries that attract unattached young men to Montana and Alberta, and no large cities. The majority of North Dakotans have firearms in their homes. To nullify the erratic effects of sampling from small populations, the four American states were treated as one single entity, and the three prairie provinces as another. It was observed that, since the introduction of gun control in Canada, there have been, on average, more murders per capita per year in the prairie provinces (3.2/100,000) than in the four northern tier western states, which had an average of 2.7 per 100,000 - the same as the average for all of Canada during the same period. The rate for the four states combined has been slowly rising. The trend for the prairie provinces and for Canada has been falling. The foregoing illustrates the absence of a simple cause and effect relationship between crime rates and restrictions on possession of firearms on the civilian population. I do not have any detailed studies done on countries outside of North America, but this data, based on readily available public information, does suggest that homicide is a societal problem, unrelated, or at least only marginally related, to public access to firearms. Jim Cowan Springfield, MO
	From: James S Cowan Date: 08.08.99 19:28 GMT You are not familiar with the Kellerman studies? They were underwritten by the CDC and were released as authoritative studies on the effects of gun ownership. Once they were discredited, the actions I have already explained were taken against the CDC including a funding cut. Since at least 1986, Dr. Kellermann and his associates, have published several studies purporting to show that individuals who keep guns in the home are more likely to be victims of homicide than those who do not. The Kellermann studies have been published in the New England Journal of Medicine (NEJM) and JAMA amid great fanfare, and their "findings" have been eagerly recited in the mainstream press. One of Kellermann and company's most famous "findings," which were reported in a 1986 NEJM paper, is that an individual who keeps a gun in his home "is 43 times more likely to kill a family member than an intruder." Although the study received relatively little critical scrutiny, its chief finding was quickly canonized by the press. One of the few qualified observers who carefully examined the 1986 study was Dr. Edgar A. Suter, chairman of Doctors for Integrity in Policy Research (DIPR), who refers to the dramatic risk-benefit ratio as Kellermann's "43 times fallacy." In a critical review published in the March 1994 Journal of the Medical Association of Georgia (JMAG), Dr. Suter cited "methodologic and conceptual errors" in the Kellermann study, such as prejudicially truncated data (that is, convenient omission of certain facts) and a reliance on non-sequiturs. He also noted that in the study, "the correct methodology was described but never used by the authors." Moreover, by confining the study to the body count, Kellermann failed to consider the protective benefits of guns. A proper tally of those benefits, Suter noted, would include instances that do not involve the use of lethal force. According to Dr. Suter, "The true measure of the protective benefits of guns are the lives saved, the injuries prevented, the medical costs saved, and the property protected -- not the burglar or rapist body count. Since only 0.1% -- 0.2% of defensive gun usage involves the death of the criminal, any study, such as this, that counts criminal deaths as the only measure of the protective benefits of guns will expectedly underestimate the benefits of firearms by a factor of 500 to 1,000."
	From: James Cowan Date: 08.08.99 19:59 GMT So when you claim Dr Klecks data source was a "phone poll" what of the supporting analysis of incident files of 1979-1985 (National Crime Survey public use computer tapes ICPSR,1987b) or is this just another example of you formulating strong opinions on something with which you have a marginal familiarity? I have been involved in this issue since 1968 and know quite a bit about it. I find it amusing that you denigrate a survey done by criminologists of almost 5,000 households in all the states except Alaska yet cite a Harris poll as authoritative regarding public opinion? Are we to only accept "polls" that agree with you and ignore "surveys" that do not? Actually, yes Virginia, I have read Klecks study at length. Enough to know you are trying to snow your audience. Dr Kleck has published multiple studies and has written a book on this topic. (which I have not read) You are incorrect (again) His work involves quite possibly the single most involved study ever done on this issue. Jim Cowan Springfield, MO
	From: Eric Frykeberg Date: 08.08.99 20:25 GMT << Dr Kleck has published multiple studies and has written a book on this topic. (which I have not read) You are incorrect (again) His work involves quite possibly the single most involved study ever done on this issue. >> It's called Point Blank--I have read it, as well as the critique of the data by the NRC ERF
	From: Dan Caruso Date: 08.08.99 22:56 GMT Pedro, Being a card-carrying NRA member, I agree with you... Those of us, who want to have handguns, who feel they can act responsible with them, should have no problem, waiting to purchase a gun if it involves classroom instruction, fire-line instruction, mandatory waiting periods, etc... Trying to ban all the guns will never happen... Sorry, to those who think it will... There are though, many of us, who feel responsible, who can take not to promote violence etc... while owning a gun... It is, in the end, the person at the end of the trigger, or knife handle, or baseball bat who is the killer... Dan Caruso Phoenix, AZ
	From: K Kepler Date: 10.08.99 03:34 GMT << studies consistently show that, on the average, gun owners are better educated and have more prestigious jobs than non-owners....>> The Bubbas here in Texas will be glad to hear that. George Hennard must have been the exception, unless you consider construction work prestigious. The illiteracy rate in Texas is 12.3 % (3% higher than the national average), so I find that data hard to swallow. But even if this is true of the "average gun owner", it is the non-average gun owner who is probably the most likely to shoot the gun off along with his/her mouth. And if we are all so safe from these folks, why is it that almost EVERY public building/hospital/etc. has numerous signs posted everywhere: "Firearms prohibited on these premises" ? KKepler, RN
	From: Arthur Lam Date: 10.08.99 05:39 GMT <<This is absolutely amazing...you are now claiming banning guns will stop suicides? Is there no end to the depths you handwringing gun control nuts will sink? You appear to have an irrational fear of guns that is so pervasive you are incapable of rationale dialog on the subject.>> I think the person who post this message should read it again. From my point of view, I think the discription of "You appear to have an irrational fear of gun control that is so pervasive you are incapable of rationale(sic) dialog(sic) on the subject" fits the gun nuts perfectly. It is truly amazing to me that otherwise seemingly educated individuals do not see the absurdity of free access to hand-guns without control or registration. I would like to thank Dr. Fryberg and Dr. Smith for their clear, lucid thoughts, ones that were outlined with logic and backed up with data. It is also gratifying to read in the last issue of Time Magazine that the public attitude is finally changing. I sincerely hope that most physicians will vote for representatives who support gun control, particularly the hand guns. It is indeed high time that we recognize that this common good is well worth the sacrifice of a few individual rights. Arthur Lam M.D. Seattle, WA
	From: Arthur Lam Date: 10.08.99 05:41 GMT <<The fact of the matter is, it's illegal for a felon to own a handgun. ...We don't need any more legislation that only effects people like e or other legal gun owners...we need to crack down on the criminal element.>> This is tiresome rhetoric that we have heard too many times. We do not want to find the felon who owns a handgun illegally; we want to prevent it before the fact. And how do you enforce this law when even background is vehemently objected by people like James Cowan. We do not want to find out who carries the gun illegally in the car; we want to make it impossible for anyone to have a gun in the car so that road rage involving gun use can be eliminated. And please tell me how you can enforce this law; random search of every car? We do not want to know about illegal transfer of guns; we want every gun registered and transfer documented. We do not want to arrest a person brandishing a gun; we want to prevent that individual from ever having access to a gun. The two little boys in Arkansas, the two students in Columbine high school, the student in Springfield, Oregon, Miller in the recent Alabama shooting. Please tell me who among them are known felons? Hand guns are banned in Washington D.C., but you can buy them in Virgina and Maryland. Why don't you tell us how far you have to go from D.C. to Virginia and Maryland? And who don't you mention Canada who has similar culture but no guns and a much lower homicide rate despite a much higher unemployment rate? We NEED more and better gun control legislation, and I sincerely hope it will happen. I am tired of seeing the carnage in the ER and in the OR. Arthur Lam M.D. Seattle, WA
	From: Sandra Daniels Date: 10.08.99 07:43 GMT Interesting to read the debate thus far. I have the luxury of living in Western Australia. We have very tight gun laws. To purchase a gun one has to have signatures of two property (farm) owners who will allow you to shoot on their property; a rifle club membership or be involved in industry such as professional hunter. Any person who owns a gun must keep it under lock & key at all times unless in transit. Victoria/New South Wales & Queensland have more liberal laws and there is often a "migration" of guns from these states but the penalties are high. A recent moratorium on high powered guns required owners to surrender them for cash rebate unless they had a definate use (hunters). The up side to all this ..... criminal and homicidal/suicide shootings are few. Most people go through their whole lives without even getting to see a real gun. In emergency/orthopedic/spinal cases I have seen only 7 cases in 18yrs. Sandy Daniels Perth, Western Australia
	From: Daniel Edgecombe Date: 10.08.99 21:02 GMT This is in an interesting point but there are two interpretations of your anecdote... is it because the gun laws are tight and restrict the holding of firearms to responsible persons or is it just because they restrict firearms by detering people from buying and registering them that you have seen such a low number of firearms incidents?
	From: Eric Frykberg Date: 10.08.99 22:31 << The up side to all this ..... criminal and homicidal/suicide shootings are few. Most people go through their whole lives without even getting to see a real gun. In emergency/orthopedic/spinal cases I have seen only 7 cases in 18yrs. >> Sandy-- And amazing as it sounds, the walls of democratic society have not come tumbling down in Australia, have they, have they? Nor in England, Scotland, Germany, Sweden, Japan, France, Spain, Canada, Norway, Belgium, etc...... In fact, I would consider them stronger than in the U.S. where so many of our young have been gunned down before their lives and productivity to society have even begun! Where you do not have to worry about protecting yourself from someone else with a gun by getting your own gun--but by nobody having guns to begin with! What a simpler and less violent solution! ERF
	From: Mary James Date: 11.08.99 08:11 GMT Dear readers, As a kid I use to read Readers Digest - Life in these United States for the humorous stories that were written about life.........it seems that the humor that was found on those pages has now changed into sensational, media magnet stories that would be better titled, "Trauma in these United States" As we rant and rave about guns and bombs and etc....etc.....we must not forget the very fact that behind those weapons are oxygenated brains with minds of some kind that probably use to laugh at humorous stories too...... A gun is a gun.... A human is a very complex, thinking entity......I find it hard to believe that this discussion is taking place on a trauma-list......really.....haven't we all seen GSW's??? I saw a little boy today go to surgery in our hospital for hours because someone with a brain made the decision to use a machine gun........ Trauma in these United States should not be about guns - but rather about reality......GSW to right buttock with exit wound..etc...etc.... Come on - let's get back to the patient's bedside and talk to them and their families...leave the law enforcement to the police...........Yeah??
	From: Eric Frykberg Date: 11.08.99 13:23 GMT Sure--this makes great sense! What business is it of physicians to try to prevent disease and the loss of life--what jerks Salk, Father Damien, Louis Pasteur, Sabin must have been to think that prevention of disease and death should be a physician's mission! This mindset--the ostrich syndrome--is what gives our noble profession the reputation it has in the realm of public health. Where was the medical profession in the fight for improved safety engineering and seat belts in cars? Or in the initial fight against AIDS (hint--fighting over whether these people should even be treated for fear of the docs getting infected!)? Or in combating drunk driving? In these and so many other public health issues we were Johnny-come-latelies--it took gressroots efforts from citizen groups who finally got fed up with the carnage to take the ball themselves--no sense ever waiting for the AMA or ACS to do it (they're still cowering with their heads in the sand on firearm deaths!)--MADD, NHTSA, Ralph Nader's group, etc are the real heros in so many life-saving interventions--the public knows when and when not to depend on the medical profession in the area of public health, and here you see the mindset behind that! ERF
	From: Gianna Scanell Date: 11.08.99 15:43 I totally agree. Before being a physician, each and everyone of us is a person, member of our crazy society. While some of us argue that guns don't kill, many innocent people get kill by guns, in the hands of sick pathologic individuals who always have existed and always will, but who now have free access to guns. The people who want to keep guns around are also responsible for these killings.
	From: Mary James Date: 11.08.99 16:01 GMT How you take my message out of context........it is hard to understand. Obviously, there is no easy "fix" to the fact that someone can shoot harmless children.... Prevention of terrible crimes is obviously important but without the exact germ to attack which antibiotic would you give?? I'm sorry if I offended you.....it was not my intention.....just had a long day......I really do believe that prevention programs are extremely important......just not sure if there is a program that can be developed out of these tragedies....... MJ
	From: Robert F. Smith Date: 11.08.99 17:40 GMT I was thinking about the pleas to stop talking about firearm violence on this list. During the previous 24 our trauma service saw 22 patients. 8 of these were gunshot wound victims, 3 stab wound victims and 2 victims of blunt assaults. One of the things that makes me most proud to be a part of the Trauma Community is the way these practitioners have changed the traditional medical model. They have accepted the difficult challenge that simply treating each wound as a medical problem is an insufficient response to the epidemic we are facing. Instead of taking the easier traditional doctor or nurse roles, many have taken leadership roles in trying to do something to make these injuries less likely recur or happen primarily. For those of you who feel it is boring or inappropriate to discuss firearm violence on this list I guess I would ask you to think about what it is like for our patients. When it is no longer an issue of interest to them then I won't talk about it anymore. Robert F. Smith, M.D., MPH Chair Division of Prehospital Care & Prevention Department of Trauma Cook County Hospital
	From: Bjorn Pret Date: 11.08.99 18:41 I've refrained from joining this particular thread until now, although members may recall my initiating a similar discussion a year or so ago. The main reason for my present abstinence is that I don't have much to add to the well-rehearsed positions expressed on either side, at least not this time. I've seen this movie before, and I know how it ends; or, rather, doesn't end. Inappropriate? Certainly not. Boring? Well, yeah, a little. Any thread'll get that way after awhile; don't be offended. Get used to it. I bore tons of people. <<For those of you who feel it is boring or inappropriate to discuss firearm violence on this list I guess I would ask you to think about what it is like for our patients. When it is no longer an issue of interest to them then I won't talk about it anymore.>> I have thought about our patients. Seems to me that the best way to serve them might be found in avenues other than debating the Second Amendment over and over again on a rather modest and isolated medical list server. Batch up the arguments in your favor and forward them to your elected representatives. Join (or start) a local community action committee with similar convictions as yours. Write a letter or two to the editor of your local paper. Spend more time with your kids. Mind you, it doesn't matter much to me personally whether you post or not; I started deleting most of these messages unread about three days ago. But I'll ask you: how many minds has this thread, on this list, changed? Pret Bjorn, RN, etc. Bangor, ME, USA
	From: Charles Krin Date: 11.08.99 23:31 GMT <<Interestingly, such major organizations as the American Medical Association, the American Association for the Surgery of Trauma and even the American College of Surgeons have specifically refused to take either any stance at all on this critical issue (AAST, AMA) or such a watered down "stance" that it accomplishes less than nothing (ACS) You explain it-- I sure can't >> OK, Rick, let's go over this one again. We are just gonna have to disagree on this one. First: Most weapon related violence is perpetrated by folks who already have had problems with the law. It's common enough now that it doesn't even make the evening news, but contributes to the gruesome statistics that you have quoted in the past. Those episodes where the violence hits the news are a reflection of aberrations in suburbia. This could even cover the recent tragedy in Atlanta, where it turns out that the chap's previous wife and mother in law died under mysterious circumstances several years ago.... Second: Laws already on the books relating to those folks (previous felons) are tough but not enforced on a regular basis. Witness the "400,000 denied gun purchases" recently trumpeted by the President. Where are the corresponding "400,000 weapons related convictions?" It is a US Federal Felony for a person with legal or mental disabilities (including at this time persons convicted of misdemeanor abuse) to even hold or attempt to purchase a firearm or ammunition of any sort, punishable by up to 5 years in a Federal Penitentiary for each separate offense (one hand gun and a box of 25 cartridges could be considered as up to *26* separate offenses!). If those denials were not proper, then you have up to 400,000 folks with their CIVIL RIGHTS being violated. Despite the number of folks around here being locked up for repeat offenses, I don't remember the US Attorney getting involved in any of the cases, despite a "slam dunk" conviction...e.g., you were convicted of this crime, you have a previous history, you used a weapon, therefore the US Marshall's Service will be waiting for you in three years when you've done your state time... Third: Much of the weapons related violence involving young people revolves around the money available through the drug trade, which in turn is related to the current enforcement policies of the Federal and State governments. Change the rules, slack up on the small dealers and users, clear the jails and penitentiaries of folks convicted of small time drug use/abuse, and go after the ones using the guns and masterminding the big shipments. Then you should see a concomitant reduction in gun violence. It worked in Boston, and Kansas City...In addition, what makes you think that the folks bringing in drugs can't afford to bring in weapons? They've got nothing to lose from disobeying the law, do they? What makes you think that they will obey any new ones? Fourth: The much ballyhooed problem of "running gun fights" by people who applied for and got Concealed Carry Permits has not happened! There has been *ONE* incident that has made the national news in the past 5 years, from Texas, and some evidence that he should not have gotten his permit. The "Shoot the Carjacker" Law here in Louisiana was another that was supposed to provoke a rash of shootings...there has been *ONE*, and that was ruled to be justified. On the other hand, prior to that law going into effect, there was a publicized carjacking somewhere in Louisiana at least once a month, often with the owner/driver being seriously hurt in the process. Rick, how many CCW folks in the State of Florida have gotten in trouble in the last 10 years? And what happened several years ago, that resulted in many of the rental car companies changing the way that they marked their cars? (Hint for those of you who missed this: the bad guys stopped going after folks who looked like they might be Florida residents (and therefore might be armed) and started to concentrate on folks from out of the state, and those in rental cars....after a bunch of rich Germans were assaulted, the rental agencies reportedly stopped clearly marking their cars...) Fifth: It was the law abiding subjects of Australia that turned in their weapons, by and large, at a marked disadvantage. I've been given to understand from another party that personal violence in Australia has actually gone up somewhat since that time...while recently released reports (In this week's JAMA, as noted in the national news) indicate that the number of kids carrying weapons and involved in violence in schools has actually dropped by a third or more in the past five years...and the FBI figures that gun violence continues to drop here in the US. Despite the "right wing" label that our Australian correspondent slapped on the gun owners, I understand that there is a movement at the local levels to oust some of the "left wing" folks who wanted more gun control. It comes down to philosophy: the US was founded on the idea of individual freedom and responsibility...and those of us who still support those ideals are labeled as bad people. The current denizen of the Wight House (and yes, that's a joke...) is as much a Socialist as Lenin when push comes to shove...the idea of "Big Brother" knowing what is best for the individual, and taking responsibility and freedom away from the individuals to "assure the greatest good for the greatest number" of people...I'll invoke Niven's Fourth law in response: "Freedom times Security equals some constant. The more Security you have the less Freedom you enjoy..." Now explain to me again why I should give up a hobby that I happen to enjoy? I have received extensive training via the military and the local law enforcement types on the care and feeding of the weapons, I keep mine locked up when not in use, I enjoy getting out and punching holes in cans and paper targets on an irregular basis, and I am working with my mother in law, and brother in law to ensure that my sons and nieces can be trusted with firearms, as well as being responsible for their own selves when they get old enough: this includes schooling on proper care and use of the weapons, as well as teaching them to hunt responsibly. (Without hunters here in the central South, the deer population would soon grow too large and start to starve....the other major predators which used to help keep them in check having been long eliminated...) Keeping the two legged predators in check has been subjected to some interesting statistical analysis by both Gary Kleck and John Lott...and again, what's happened in most of Florida in the past five years, Rick?
	From: Eric Frykberg Date: 12.08.99 00:42 GMT << First: Most weapon related violence is perpetrated by folks who already have had problems with the law. >> Not true--again, argue with the FBI--after all, what could they possibly know about it--by the way, you gave no reference for where you got this info from? << Third: Much of the weapons related violence involving young people revolves around the money available through the drug trade, >> Not true--most involves regular citizens like you and I in episodes of domestic disputes, love triangles, etc--you keep straying off the track, and never give any references for where your info can be verified--I wonder why? << Fifth: It was the law abiding subjects of Australia that turned in their weapons, by and large, at a marked disadvantage. I've been given to understand from another party that personal violence in Australia has actually gone up somewhat since that time.. >> Oh finally! A reference! And I know this is about as good as it will get! << Now explain to me again why I should give up a hobby that I happen to enjoy? I have received extensive training via the military and the local law enforcement types on the care and feeding of the weapons, I keep mine locked up when not in use, I enjoy getting out and punching holes in cans and paper >> Again--a favorite tactic--set up a straw man just so you can knock it down. Neither I nor anyone on this list ever once said you should give up your gun, or that all guns should be banned--so you are arguing with yourself << us who still support those ideals are labeled as bad people. The current denizen of the Wight House (and yes, that's a joke...) is as much a Socialist as Lenin when push comes to shove...the idea of "Big Brother" knowing what is best for the individual, and taking responsibility and freedom away from the individuals to "assure the greatest good for the greatest number" of people...I'll invoke Niven's Fourth law in response: "Freedom times Security equals some constant. The more Security you >> Anyone else feel like me, that somehow I've been transported to the Twilight Zone? ERF
	From: Arthur Lam Date: 12.08.99 01:33 GMT Dear Dr. Krin, when are you going to understand that we have no objection to you owning a gun, a "responsible" individual with proper training. But I object to you (used in a generic sense) losing control in a rage (Miller in the recent incident in Alabama), object to you leaving it around so kids or anyone irresponsible can get access to (Jonesboro, Arkansas, etc.), object to anyone without the maturity to handle a gun (Springfield, Oregon). We need to register every gun, licensed every gun owner, none of which would prevent you from pursuing your hobby. By the way, if you read the JAMA article, it suggests that the decrease in gun violence coincides with the passing of the Brady law. Arthur Lam M.D. Seattle, WA
	From: John Holmes Date: 12.-08.99 01:49 GMT << Fifth: It was the law abiding subjects of Australia that turned in their weapons, by and large, at a marked disadvantage. I've been given to understand from another party that personal violence in Australia has actually gone up somewhat since that time.. >> Well Dr Krin, if interpersonal violence has gone up in Australia, those of us who live and work here haven't noticed it! The data published by the Australian Institute of Criminology show a significant decline in homicides since the firearm recall legislation from 2.0 /100,000 (1996) to 1.7 / 100,000 (1998) (we are NOT claiming causality here). Some other facts: Total firearm deaths: USA (1995) 13.7 per 100 thousand pop. Australia 3.1 per 100 thousand. Firearm homicides: USA (1995) 6.0 per 100 thousand pop. Australia 0.5 per 100 thousand. In Australia 21% of homicides are committed using firearms. Interestingly, in the Northern Territory, where firearm ownership is widespread and relatively unregulated, the firearm related homicide rate is 5 times the national average. Thanks Rick for flying the flag of sanity over there in the States. But as Pret says - I doubt if anybody's opinions have been altered by the large correspondence on this subject recently. There seems to be a peculiarly American mindset on this issue - unfortunately (to quote a cliche) there are none so blind as they who will not see. One thing's for sure however. - it's great to live in an environment where people are largely free from the fear of being blown away. In fact for most of the time we don't even think of it here! Dr John L Holmes Director Emergency Medicine Mater Adult Hospital, Brisbane, Australia
	From: Charles Krin Date: 13.08.99 12:33 GMT OK, I didn't mean to restart this argument, but, Rick, the things that are needed to "eliminate guns in America" (as HGI among others have put it) would require: A: total BAN on all firearms AND ammuntion-ownership, sale and manufacture. B: total confiscation of all known firearms without compensation to the legitimate owners (even the equivalent of the pittance that owners of condemned property in the path of the new freeway receive would bankrupt your efforts). C: the equivalent of a door to door search of America looking for unregistered firearms. The worst part about it is that anyone with the knowledge of a high school chemistry lab and metals shop would be able to start a black market, not to mention the folks bringing stuff in from outside the country....you don't think that they'd be any more willing to obey the firearms laws than the drug laws? (I know, you're going back to eliminating "known victim violence." Funny, but most of the stuff we see here in Northeast Louisiana that falls under the heading of "known victim" also falls under the heading of "drug related.") Now, how can you expect me to reconcile that with the idea that you don't want to take mine away since I've been "properly trained?" In this day and age of "political correctness," I'd rather not be known as "elitist" -- it sets you up as another target.. ..
	From: Eric Frykberg Date: 13.08.99 13:18 I'll say it again--you don't seem to get it I and most other responsible organizations (read the EAST and AAP position papers for starters--you really might learn something!) have never advocated "banning" or "eliminating" all guns--we have very clearly been advocating a greater level of control of the access and use by the general population. we all agree that there is no need to ban all guns--most do not significantly contribute to death and injury. Once again--you seem to like arguing with yourself!
	From: Robert F. Smith Date: 13.08.99 13:41 Charles, Listening is a skill you should think about developing. Or in your case maybe reading. Please do a couple things. 1) Pull up the quote from the list discussion where anyone (other than you) has talked about "eliminating all guns". 2) Instread of regaling us with your personal opinions belilefs and insights as to the true nature of crime in America, maybe you could actually look up some facts from the NCJB, FBI or Unifrom Crime reports or data from your own State or municipality. Then share that information with us as well as the source and how to get it. In your professional life do you like to base your treatment on readings of textbooks and peer review journals or do you prefer to swap anecdotes with the guys? R. Smith, M.D.
	From: Thomas Anthony Horan Date: 13.08.99 15:09 The only good sense that Charles has written in several weeks of diatribe is contained in A and B, a shame he is too blind to believe it-- oh I Know the constitution etc etc --- In Britian they have speakers corners for people like Krin who can exercise their freedom to speak , while entertaining the passers bye. However, the entertainment value of his repetitious nonsence has long since past.
	From: Amador Date: 13.08.99 20:50 GMT why not take away all restrictions on owning any arms in the US? (it is easy for me to say as I live in Australia and am happy to be here), but the right to bear arms, methinks was originally thought with things like muskets and independence from a foreign power in mind, since the NRA wants to extend it to Uzis and what not, why not go all the way and allow any kind of weapon to be owned by a US citizen (within the US that is). yes, this is sarcasm. The US firearm culture is a good example of what not to do for the rest of the civilized world, I, for one, am scared enough to never plan to live there or to raise children there and I think of myself as an average law abiding citizen without any weapons, if the NRA wants to create a social climate where only law abiding citizens with weapons and criminals with weapons can co-exist, and your politicians allow it, I guess it's your problem but I sincerely hope that this philosophy is not exported elsewhere.
	From: Mande Toubkin Date: 13.08.99 20:28 GMT Sandra you have no idea how lucky you are i see mor gunshot wounds in one month than you have seen in 17 years i live in Johannesburg, South Africa where it is easy to get hold of a weapon for a few rands probably 20 dollars. Iwork at 1 if the 3 level one trauma units in our area and we only see patients who have medical insurance so our numbers are nothing compared to the state hospitals. Gunshot wounds don't even cause a stir any more. I have added our stats for the Milpark Trauma Unit for you to see enjoy the tight control so many lives are lost in south africa because of poor control We have it so bad here that even our gorilla at the zoo in johannesburg was shot by a fleeing suspect. Gunshot Statistics Mande Toubkin Deputy Nursing Director Trauma Unit, Milpark Johannesburg
	From: Danny McGeehan Date: 13.08.99 20:58 GMT Being a UK graduate and having worked in SA and I was on the specialist register in General surgery there. I know exactly what you are talking about. Every few years I go to visit ex-colleagues there, the level of violence gets worse. Last April where we were staying there were 8 murders a day. I have watched the violence escalate from the sharpened bicycle spoke to the rocket launched grenade and the AK 47 in little over 15 years. That is why the Docs and the Nurses from that beautiful country are sadly getting out. I see no solution to it. Danny McGeehan Stafford, UK
	From: James Cowan Date: 14.08.99 00:39 GMT I have already provided so many facts everyone is sick of hearing about it. I have replied off-list to these last few messages but it is apparent to me that this is an emotional debate and facts do not enter into it except as cannon fodder for a point- counterpoint debate. To me the issue is straight forward. 1. Gun control doesn't work. Only total gun bans would make any difference at all and that will never happen in the USA. Our most violent cities have the strictest gun laws..yet all we hear are excuses for why they fail and why we need more and more of something thats failing. 2. The problem with violence in our society isn't the tool the violent use. The problem is the violent people. I own many guns, I have never shot anyone. The idea is repulsive to me. It is to all decent people. The idea is not repulsive to the violent. Their inability to get a gun doesn't stop them from that ideation. One of the problems we have with self-defense courses is that good people can't shoot their attackers even to save their own lives. They simply don't have it in them. Obviously we are dealing with two strata, two levels of humanity. As simplistic as it sounds, it does seem to come down to the good guys and the bad guys. 3. The issue can't be reasonably debated because of the massive misinformation campaign here in the states. To have some of the users of this list to formulate such opinions about guns is similar to my formulating strong opinions on surgical techniques. Examples are the famous "43 times more likely" myth, the "main cause of death" myth, the "dangerous to own" myth...none of which are true, yet are continually cited and questioning them is like questioning the Bible in a Southern Baptist convention...it results in a level of hysteria that eliminates any possibility of reasonable discourse. Those of us who own guns and who shoot for sport frequently, are often simply amazed by some of these ideas..like what constitutes an "assault rifle" and that they are somehow more dangerous than other rifles. (the winner of the house to house combat competition at Gunsite a few years back used a 30-30 level action rifle, he beat all the "assault rifle" users) More hits, more accurate, better score. Yet even users of this list have claimed semi-automatic rifles have no purpose other than to kill. (Virtually all of the annual competition in many sports requires semi-autos) So what it boils down to is an issue that is not debatable until both side try to see the other point of view and do it from an informed stance, not one of emotion. Jim Cowan Springfield, MO
	From: Ken Mattox Date: 14.08.99 01:10 GMT I have not gotten into this discussion for fear of being misunderstood and it is as polarized and full of emotion as religion, sex, birth control, abortion, and politics. But here goes. I would totally concur that in any are of society there must be societal, governmental, neighborhood, and individual responsibility. I would like to substitute the word responsibility for control, in all of the discussions on this issue I have read here the past 3 weeks. It seems to me that a major area of breakdown is in this area of responsibility. We can debate until the cows come home about the WHY, but major institutions in this country have undergone tremendous change: home, church, court, schools, entertainment, participant sports, spectator sports, etc. The institutions which used to engender personal responsibility have often not done so. Second, very little discussion has occurred here regarding our criminal justice system, which by the way, in our method of protecting personal liberties, I am convinced is the very best in the world. However, justice is NOT swift and often not sure. One can debate whether one is judged by their peers, whether there is ethnic equality in the courts, and whether the rich have a better chance of not paying for their crimes except with dollars for lawyers. I do not want to focus on those issues. I wish merely to raise the question of gun irresponsibility due to a breakdown in justice, whatever that involves. I do know that I saw more public display of guns in open souks in Saudi Arabia, than I have ever seen in this country. Purchase of a gun, knife, sword, etc., was very very easy. However, use of those instruments, often carryovers from past wars, to shoot another human was and is very very very rare. For if one is caught after killing another human (and being caught is virtually always sure as there is no place to run) one looses their own head at then end of the noon prayer on Friday. Justice is sure and swift and public. I am sure that many on this web site would give many arguments against this form of justice, and I very well might lead the pack, but use of guns there in no way rivals our per capita shooting of fellow man. One might also argue that occasionally innocent persons are put to death when justice is too fast in the Middle East. I could equally argue that many more innocents are put to death by the murderers in the West due to a lax criminal justice system. The reason for this argument is to put onto the table, some additional issues which were not part of the vitriolic and polarized repetition of bias. k
	From: Eric Frykberg Date: 14.08.99 14:31 Dr Mattox-- As I said in a number of my posts, of course it is important to fight crime and have swift and sure justice, and of course many agree that this is not ideal in our country--and also that individuals must be held accountable for their behavior--but it is interesting how you fail to relate that to the issue of the horrendous level of firearm deaths in the U.S. which far outstrips that of any other industrialized democracy in the world. I can though--clearly those who own, sell or manufacture those firearms most contibuting to death and injury are not being held accountable for the deaths those firearms cause--our mindset is that these deaths (of which only a minority occur in a criminal context--less than 20%) are simply a price to be paid for "freedom" (said as the shoulders shrug and the hands go up in the air in a gesture of "How can we be blamed for that?") So Dr Mattox--those are very good points you bring up
	From: Ravi Date: 14.08.99 16:44 James, In my community (particularly the state of Tamil nadu,South India) with a population about five times any one of the states in the US, the only thing I can get with some difficulty, is an application form for a small gun -revolver, forget pistols. After that, the application winds its way to the senior most cop, the Director General of Police, and then it is rejected. Period. No gun. In 25 years of surgical practice I have not seen a single serious GSWs. I have seen two minor injuries when some one with a gun (license got in those 'good old days') accidentaly pressed the wrong button, treated as out patients. So, no guns no GSW. No guns, no violent crime culture. At the worst I have seen a few knifings. Bleeding noses. Not that every one is a saint. But the violence is limited to a lot of shouting till one person gets a sore throat. The police do get their share of murders -usually crimes de amour -crimes of passion, but too few to make life interesting. They watch 'COPS' or similar serials on TV to get their kicks. The cops dont carry guns. DISCLAIMER---I have no published data. I have not published this. I have no 'proof' as a scientist. But have been in a busy surgical practice in a large facility till I got bored. So, in the spirit if a purist if a list member wants to get violent, flame me on the list till you get sore fingers typing. But no one dies unless bored to death. Ravi Madras, South India, on the Coromandel coast where the monsoon has set in.
	From: James Cowan Date: 14.08.99 16:44 GMT <<world. I can though--clearly those who own, sell or manufacture those firearms most contibuting to death and injury are not being held accountable for the deaths those firearms cause>> That's because from a scientific standpoint, you cannot draw a cause and effect relationship. That is unless you also wish to draw similar parallels in other aspects of death and trauma....drunk driving caused by cars, domestic violence caused by marriage or cohabitation, falls caused by altitude, etc, etc, etc.... Since you wish to make changes, the burden of proof falls to you to show a cause and effect relationship as well as a change to benefit ratio supported by factual evidence..in exactly the same way you would require of a medical procedure alteration or a policy change. The presence of physicians does not cause malpractice, but if physicians were banned, logically we would have no physicians harming patients. Cars don't cause drunk driving, but if we banned cars we would have no drunk driving, guns don't cause gun violence, but if we ban guns we will stop gun violence. All of the above are true, but are they rational? The same argument used for one can be used for another. Draw a cause and effect, prove it and you have a case..otherwise you are simply offering up another opinion in the endless stream.
	From: James Cowan Date: 14.08.99 17:49 GMT That is not the experience here. Our societies are different and we live under different cultural influences. Here our major cities have a real problem with gang violence. The situation you refer to in which people shout at each other? Here it is considered a mark of significant disrespect and if the offender is allowed to walk away unharmed, it is considered a black mark against the machismo or masculinity of the individual being shouted at. We have rap music that glorifies the culture of violence, we have school children who think they are cowards unless they "punch out" people whom they disagree with, and from there it escalates into shooting someone that punched you out. Our children are slipping back into the "gang wannabe" culture and when you try to stop it they think you as a parent simply "aren't cool" you "don't understand". From that climate of parental alienation is an easier jump into the real thing, drive-bys, drugs, violence to get what you want. We have bumper stickers on cars that say "Parent of Honor Roll Student, Hillcrest High" and other bumper stickers that say "My kid can beat the crap out of your honor roll student" It's a different culture with different values and some parents are contributing to the problem. Our law enforcement personnel refer to "crip gunships" in which heavily armed african-americans guard drug shipments from within heavy American automobiles, generally very expensive ones at that. Their logic is "why should I work at Mc Donalds for 5 bucks a hour when I can do this for $5,000 a week?" "OK, so I get shot, everybody dies someday". The police refer to it off the record as NON crime. (Nig*** On Nig***) but of course they deny it later. The AA kids who go to school are accused of "acting white" and are ridiculed by their peers. The police here know that stopping a crip gunship will result in a shootout, guaranteed. All the occupants have multiple felony arrests, are legally out of jail and are illegally armed and have nothing to lose. To them, this is a business, nothing more, nothing personal. They are not dependent upon local firearm availability, they can get guns anywhere, Mexico by the case, South America, it doesn't matter. The US has thousands of ports of entry and enough border patrol to cover 5% of them. A single cargo carrier off one merchant ship provides enough drugs and guns to keep a "territory" stocked for months and getting caught is simply the cost of doing business, plus there is a very good chance you will be released within months anyway. Bikers generally are aware that you can make a run into Mexico and bring up enough coke to kick back for a year. Getting arrested is a risk, but the real risk is getting shot up in a drive-by shooting from people who also sell drugs in what they consider their "territory". The police are a distant problem. The gun violence Eric cites is significantly due to this atmosphere, illegal use of firearms already illegally owned. The police do what they can but they work for a society sinking into chaos and stratified into "people who have" and "people who take." Guns are the tools used by both sides, one to defend and one to take....gun control only effects the people who defend. OK, we have too many gun deaths and too many violent acts by gun violence. Nobody who honestly knows whats going on seriously thinks passing another gun control law will make any difference at all. The curious thing is....the one thing all these people fear, the organized crime figures, the gangs, the routine drug couriers (who throw in a case of Glocks per buy)...is legalization of drugs. Their sole fear. The market goes away overnight. But we then trade gun trauma for drug abuse. Is it a good trade? I don't know. I do know that our current state is similar to the crime caused by our efforts to ban liquor in the past. Maybe we will eventually be willing to try something new....
	From: Eric Frykberg Date: 14.08.99 20:15 GMT << guns don't cause gun violence, but if we ban guns we will stop gun violence. >> There you go James--now you've got the idea--I'm glad you finally agree In the absence of guns, total deaths are reduced significantly, since most deaths (most homicides and suicides in the U.S.) are caused by guns. And this is not conjecture--there are a huge number of studies showing this to be true--The Tale of Two Cities study in 1988 in NEJM is a starter (see? I back up my assertions with referenced facts,,,) Of course, once again you are setting up your straw man--no one on this list is even advocating that "we ban guns"--just reduce the extent to which certain guns (mostly handguns) can be accessed by the general population You keep wanting the debate to be something it is not--I guess because you can't argue with the real issues << But we then trade gun trauma for drug abuse. Is it a good trade? I don't know. I do know that our current state is similar to the crime caused by our efforts to ban liquor in the past. Maybe we will eventually be willing to try something new.... Jim Cowan Springfield, MO >> Jim-- How about letting the rest of this list in on a hint about your background? This is a list of healthcare providers--are you one? Do you have any experience whatsoever in the care of injured people? Have you ever in your life gotten up in the middle of the night to directly care for a victim of a gunshot wound? If so, when was the last time? How many do you treat in a day, week, or year? It helps to know from whence your ideas come--it tells us the degree of credibility of these ideas. Words are easy. Armchair warriors are a dime a dozen Just wondering.... Eric Frykberg, MD Jacksonville, Fl
	From: Mathias Kalkum Date: 15.08.99 23:49 GMT Ken, to me the whole discussion seems to be futile, just because of a few simple facts (some of them were pointed out by you and others very well): * it´s not a gun that kills, but people. * unfortunaltely people tend to kill other people more and more often * this is going ahead with a loss of influence / acceptance of major moral institutions like home/religion/sporting life/etc... But I disagree in your conclusion, you tear out of the saudi arabian example: from a european point of view, the US penalty-system is very harsh - but it is not able to lower firearm violence rates. I strongly believe the only way to achieve this aim is to ban guns strictly! It is the only way of prevention that works. This having said I will go on and delete most of the messages regarding this thread unread. Dr. Mathias Kalkum Department of Surgery Tirschenreuth County Hospital, Germany
	From: Rachel Rene Date: 16.08.99 01:44 Well, since we are still talking about this, I have some questions. By the way, I lost a family member (16-year-old honor student/class president) in a senseless double homocide (unsolved) involving fatal GSWs. How many GSW deaths are there each year? How many are accidental? Suicide? Homocide? I am assuming the most are homocides. The ones that are pre-meditated and are committed by antisocial sociopaths...those are the ones I want to focus on. I realize that victims are just as dead no matter what kind of killer they encountered. (see above). I am suggesting a sort of differential approach to the problem. Killing cannot be stopped, I do not believe, by broad, sweeping bans, or by types of punishment. But perhaps we can arm ourselves with information to recognize a sociopath EARLY, before the arc of violence leads to loss of life. For example, a red flag in kids is cruelty to animals. Why do we ignore this behavior, when we know the eventual outcome? Stanton Samenow (Inside The Criminal Mind) points out the following MYTHS: Criminals don't know right from wrong/Criminals are the hapless victims of oppressive social conditions/Crime is contagious/Crimes of passion are cases of temporary insanity/Watching violent television programs brings out violent behavior in children. He believes that "to embark on a program that is truly corrective, we must begin with the clear understanding that the criminal chooses the crime." Doesn't this suggest that the criminal would find a way to kill, even if he did not have a gun? Have there been any studies attempted on violence before the making of guns? How can anger be recognized early, early, early...before it is so enormously costly to society? Are we able to intervene in any way? Rachel Rene RN Seattle
	From: James Cowan Date: 16.08.99 04:02 The data most of the users of this list will accept is found at: http://www.cdc.gov/nchswww/releases/99facts/99sheets/97mortal.htm The entire report is large but it is interesting. Contrary to what has been stated here homicides are down. Homicide as a cause of death ranks 13th, lower than kidney disease. Where the line is being drawn here for purposes of a "trauma" discussion, they define "injury related deaths" of 146,000 (out of over 2 million deaths) 32,000 of which were firearm related. 54% of that number were suicides, 41% were homicides. (Firearms deaths are down 5.4% in the last year) The moral of that story? That big Mac & fries is going to kill you way before a MAC-10 does. Age related data....(Robert, you may wish to avert your eyes): Highest rate of homicides? Black males 15-24 at 104 per 100,000 Highest rate of suicides? White males over 85 at 45 per 100,000. Overall rate was 12 per 100,000. What other things killed people last year? Heart disease 271 per 100,000 Cancer 201 per 100,000 CVA 59 per 100,000 COPD 40 per 100,000 etc, etc, etc. Of course, overall the age related data shows accidental deaths down 20%, homicides down 6.7% and suicides down 4.8%.
	From: Rachel Rene Date: 16.08.99 05:47 I am shocked at the percentage of GSW suicides. This is orders of magnitude greater than what I would have guessed. Would a gun ban or have prevented 17500 suicides last year? Doubt it. Of course this does not address near fatalities and injuries, emotional and financial cost related to GSWs.
	From: John Holmes Date: 16.08.99 06:07 GMT Mr Cowan - have you ever heard of the non sequitur argument? From your line of reasoning you could just as easily say that being born has a higher mortality rate than homicide. Get real - it's ludicrous for you to compare organic disease with homicide. If you want to be intellectually honest then compare like with like - such as homicide rates in countries with gun control vs homicide rates in your country. . Dr John L Holmes Director Emergency Medicine Mater Adult Hospital, Brisbane, Australia
	From: Amador Date: 16.08.99 13:15 I was trying to follow your argument that banning things solve unwanted problems, like banning cars solve drink driving etc... for that we need a society that do not wish to "need" cars, which have never been intended to be driven by drunks or to be used as weapons, but firearms are intended to be used as instruments to kill easily and at a distance (nothing manly about that IMHO), you can used them to save somebody (by killing someone else), or to scare baddies away (replicas would be just as good for this last thing, and that's their intended use too!), you can also use a gun to pound meat or to mix the sugar in the coffee and I am not the person to tell you that you don't have that right, but is that really its intended use? a knife is another good example of this kind of argument, it's main use is to cut things (with very few exceptions) but of course it can be used to kill, so in that case you should be able to make laws about the proper use and types of knives allowed, but guns, again, are only used to kill, to save a person you might have to kill another if you use a gun, no guns, no gun killings, it's as simple as that, and this simple concept provides safety to a heck of a lot more people than you can on your own with your automatic or whatever you like to pack. But as I said, if you prefer to live in a country where massacres, fear and paranoia are deemed fair prices to pay for the right to own a weapon, I cannot argue with your logic, I just don't want your personal values to escape your country and find their way to the powers that be over here. Amador medical student yr 2 University of Queensland, Australia
	From: James Cowan Date: 17.08.99 00:05 GMT <<I am shocked at the percentage of GSW suicides>> If you pull up the international numbers, the USA isn't doing too bad. This is just suicides in general without any specific mechanism; (According to the World health Organization and as of 1994) Italy 5.8 per 100,000 USA 11.8 Germany 13.9 Sweden 14.2 Japan 15.1 France 19.3 Russia 41.2 Please note that several of those countries have strict firearm controls or outright bans.
	From: Eric Frykberg Date: 18.08.99 01:48 Of course this does not tell the real story of this debate--look at FIREARM deaths, or even at suicides caused by firearms, and the entire relation turns around! << * it´s not a gun that kills, but people. >> Hmmmm--here we go again-- It's also not a bag of cocaine that kills, is it? But I would wager you have no problem with outlawing that inanimate substance--cocaine--even tho it takes a person to make it do its dirty work? And I would bet you have no problem with taking the matches, or lighter, or knife, away from the 3 year old, even though those are all inanimate objects, not able to do any harm unless a person is on the other end? Why then do you take it away? How does that attack the problem? Or--the classic true story that is the basis of modern public health--the cholera epidemic in the 18th century Philafdelphia which was found by one man to be due to one water pump with contaminated water being used for the water supply of an entire neighborhood. After an exhaustive education campaign to try to get the people to stop using the pump--which failed--they just kept using it--guess what? He removed the pump handle! An inanimate object! By itself was causing no harm! It took people to make that pump do its harm! But guess what happened. The epidemic just went away! No further deaths! No, it did not stop crime, and it certainly blocked each person's individual "freedom" to keep killing their families--but the basic problem of deaths was immediately stopped! How ridiculous to think that an inanimate object could by itself be a contributing factor to a large number of deaths! If my assumption is correct--please reconcile why your irrational application of this same philosophy somehow DOES apply to the gun? I'd love to hear it! << Just to set the record straight it was John Snow who plotted cholera cases in London (Not Philadelphia) on a map in 1854 and discovered that those who took water from the Southwark and Vauxall Water company's Broad Street Pump had an incidence of 5/1000 Cholera cases in six weeks compared to those receiving water from the Lambeth Water Co amongst whom the incidence was 0.9/1000 in the same period. (rr=5.55) He removed the handle from the pump and the epidemic ceased. >> Massey-- I stand corrected on the city in which this happened--thank you--but the message remains quite clear
	From: Charles Decrevecoeur Date: 19.08.99 14:28 GMT How about a broad generalization that's probably very close to the mark? The sick obsession with owning masses of firearms for "self-protection" (do you really need to be able to buy more than one gun a month?) suggests more of a mental and/or emotional problem is at the root of the matter. These individuals all want to be Wild West gunfighters and are nothing more than anachronisms so lacking in emotional security, self-esteem and self-worth that this fantasy is all they can cling to. Grow up, get some sort of life. Guns are a penis substitute, and there must be quite a number of woefully inadequate owners out there. This issue belongs in the political arena. I find it better to use the delete key than to read ad nauseum these pathetic attempts at justification. You can't argue with a gun owner's obsession, so ignore it. Hopefully he will go away and find somewhere else to shriek. Charles Decrevecoeur Firefighter/Paramedic
	From: Mathias Kalkum Date: 19.08.99 15:54 Eric, please re-read my message again. You will find the words: << strongly believe the only way to achieve this aim (that is: lower firearm violence rates) is to ban guns strictly! It is the only way of prevention that works.>> I own no gun, I do not have the faintest interest in guns and I don´t understand people who have (my wife would not hesitate to say the same about me and my computer...). To me a gun is a dangerous and - friendly spoken - very ambivalent tool that has to be banned into strictly observed areas e.g. as the police / armed forces / maybe even supervised gun clubs. The reason why I declare this discussion as futile is that obviously neither money (municipal buy_a_gun_from_the_citizen programs), social/bureaucratical (education in how_to_handle_a_firearm, minimum time between purchase and delivery etc.), nor efforts of justice (up to death penalty) have had any influence on firearm violence in the US. And the only way of preventing people from beeing hurt / killed (simply keeping firearms out of the citizans availability) keeps beeing avoided (as the devil avoids holy-water - to paraphrase a nice bavarian expression...). I apologize, if I could have been mistaken - do we differ that much in our point of view? Mathias
	From: Eric Frykberg Date: 19.08.99 18:39 << I question your rationale on total suicide rates being influenced by firearm availability when the rates for countries with limited availability are so high. Japan for example, France almost double what it is here. >> Jim-- Here is where you fail to even try to read what is being said--it is not "my rationale" Go back to the facts and data which I am relating! Unlike you, I am not making this stuff up or parroting what I've heard or read others say--look at the data, then try to reconcile it with what you just have to believe! Read the Tale of Two Cities paper in 1988 NEJM, as well as Kellerman's study on suicdes in homes with vs without guns! In France and Japan (World Health Organization figures) the percentage of all suicides caused by guns is only 25% or less over the past decade--in the U.S, it is over 60%!
	From: James Cowan Date: 19.08.99 22:26 We have already been over this. Kellermans "studies" were the reason the CDC's funding was cut. His refusal to permit genuine peer review should be enough for any serious scholar of the issue to question his work. I have not read the "tale of two cities". I will do so.
	From: Eric Frykberg Date: 19.08.99 23:48 Jim-- You apparently do not understand at all the concept of peer review--not being a physician makes this understandable. Maybe you forgot what I said--these studies and more were published in the New England Journal of Medicine, probably the most rigorous peer-reviewed journal in the entire medical literature, with a rejection rate in excess of 90% of all articles submitted to it. Please explain to us what you mean by not submiting his work to "genuine peer review"--what or whom do you consider a peer ? In the field of science, anyway, any article published in a major journal has been thoroughly vetted by peer review==I'm not sure what field you are reading your information in Following are a small sample of peer-reviewed studies published on this topic which are the basis of all the assertions we have made recently, for those interested in information rather than cliches: Kellermann AL et al: Suicide in the home in relation to gun ownership New England Journal of Medicine 1992;367:467-472. Bureau of Justice Statistics: Criminal Victimization in the United States 1994, Wash, D.C., NCJ 162126 Brent DA et al: The presence and accessibility of firearms in the homes of adolescent suicides. Journal of American Medical Assoc. 1991;266:2989-95. Brent DA et al: Firearms and adolescent suicide: a community case-control study American Journal of Diseases of Children 1993;147:1066-1071. McDowall D, et al: A comparative study of the preventive effects of mandatory sentencing laws for gun crimes. Journal of Criminal Law and Criminology 1992;83:378-394. Sloan JH et al: Handgun regulations, crime, assault and homicides: A tale of two cities. New England Journal of Medicine 1988;319:1256-1262. Zimring FE, Hawkins G: Crime is Not the Problem: Lethal Violence in America New York, Oxford University Press, 1997. Weil DS, Knox RC: Effects of Limiting Handgun Purchases on interstate transfer of firearms. Journal American Medical Assoc 1996;275:1759-61. Wilkinson DL, Fagan J: Understanding the role of firearms in violence--the dynamics of gun events among adolescent males. Law and Contemporary Problems 1996; 59:55-90. Teret SP, et al: Support for new policies to regulate firearms: results of two national surveys New England Journal of Medicine 1998;339:813-818. Ikeda RM et al: Fatal Firearm Injuries in the United States 1962-1994 Natl Center for Injury Prevention and Control 1997, Violence Surveillance Summary Series, No. 3 Fingerhut LA, Warner M: Injury Chartbook, Health, United States 1996-1997. Hyattsville, Md, National Center for Health Statistics 1997 Cummings P et al: State gun safe storage laws and child mortality due to firearms J Am Med Assoc 1997;278:1084-1086 Cook PJ, Ludwig J: Guns in America: Results of a National Survey on Firearms Ownership and Use 1996, Wash D.C., Police Foundation Centers for Disease Control and Prevention: Rates of homicide, suicide, and firearm related death among children--26 industrialized countries. Morbidity and Mortality Weekly Reports 1997;46:101-105 CDC: Deaths resulting from firearm- and motor vehicle-related injury--United States, 1968-1991 MMWR 1994;43:37-42 ERF
	From: Jerry Eckert Date: 20.08.99 05:20 GMT <<In France and Japan (World Health Organization figures) the percentage of all suicides caused by guns is only 25% or less over tha past decade--in the U.S, it is over 60%!>> I don't see what the significance of this statistic is, especially without considering the per capita suicide rate. And even that will be affected by many factors unrelated to firearms. If someone wants to commit suicide they will try using whatever "tools" are available. If there are no guns, they'll use something else. Of all the arguments against firearms/handguns, this is one of the weakest. Jerry Eckert
	From: Eric Frykberg Date: 20.08.99 11:35 GMT Jerry-- This is simply not true--another example of the big lie so effectively used by Hitler--say a falsehood with enough authority enough times, and someone may actually believe it. The key to supporting my assertion is you fail to provide any data whatsoever to prove this statement--how exactly do you know this? Please cite the study out of the volumes of literature on suicides out of the sociology, medical and epidemiology literature that shows this? If you can not, that pretty much tells the story. It is evident you are speaking from a perspective of ignorance (which is not meant to be derogatory--meaning you are simply not aware of the volumes of studies which prove you wrong) Sloan et al: New England Journal of Medicine A Tale of two cities 1988;319:1256 Shows a 10-fold higher rate of suicides among 12-24 year olds in Seattle, where guns are widely prevalent, vs Vancouver, a virtually identical city in terms of socioeconomic strata, demographics (they even watch the same TV programs), but in which guns are virtually inaccessible to the general population Brent DA et al: The presence and accessibility of firearms in homes of adolescent suicides JAMA 1991;266:2989 Brent DA et al: Firearms and adolescent suicide: a community case control study Am J Dis Children 1993;147:1066-1071 These are just for starters--virtually all studies on this issue show the same thing, without exception--when guns are not available, the overall suicide rate is significantly lower (the same has been shown for homicides and unintentional firearm deaths), which clearly demonstrates that, in fact, without the gun, the suicide is NOT carried out, at least not nearly to the same degree as when a gun is available, If what you say is true, then in populations without guns there would be no difference in the suicide rate. You are once again mouthing a bunch of cliches heard elsewhere, without taking the time to actually look at the data yourself--if you want to seriously debate, then at least be serious about it Show us your data! If we don't hear from you, that will be answer enough!
	From: James Cowan Date: 20.08.99 19:12 Yes Eric, your condescending tone aside, I am not a doctor, I am a mere therapist. Taking your amusing assertion that only "doctors" can understand peer review, logically then as a doctor I wouldn't understand guns or gun control would I? You are yourself guilty of the very things you repeatedly accuse others of. Aside from your condescending tone and overall ignorance of the subject matter, you consistently insist upon associating the facts with an individual while in reality the truth knows no author. Although this has already been covered repeatedly, I will restate for the record, Kellermans "studies" were discredited long ago simply because he refused to permit access to his original data. This is not just my opinion, the problems with his work have been the subject of congressional testimony. If you were truly as well versed with this issue as you would have the readers believe, you would know this. The CDC's anti-gun propaganda was so flagrant and outrageous that the Congress threatened to cut off its funding entirely. This is the data you cite. The Kellerman pseudo-study was refuted by several well-qualified sources, including sociology professor H. Taylor Buckner; Henry E. Schaffner, Ph.D.; and his sampling methods, methodology, analysis of data and conclusions have all been censured as unscientific.
	From: Eric Frykberg Date: 20.08.99 23:34 GMT And the New England Journal of Medicine, American Journal of Epidemiology, Journal of the american Medical Association. etc etc--I guess their clear peer review process is just part of this horrendous conspiracy concocted to make yur life miserable? I didn't note how you reconciled this point--you conveniently ignored it. So--you cavalierly flout those studies that have been criticized by others (I note also how you fail to cite who exactly gave all these criticisms and Congressional testimony)--who those others are apparently do not matter Well I will pose to you a question that you have already ignored once-- I'll try again-- Gary Kleck's studies have also had their methodology criticized as "flawed"--by the National Reasearch Council of the National Academy of Sciences --see Cease Fire by Sugarmann and Rand(see Jim--I tell you who the criticizers are and where you can find the data) So--why did you cite them so authoritatively???? According to you. criticism--by anyone apparently, it doesnl't matter--means that the study is no good==or does this just apply selectively to the studies you do not like? So why do you think Kleck's study that you cited means something, while everything ever written by Kellerman is a conspiracy against manhood (even tho amazingly you admit you have not read some of them?) Somebody--somewhere--"says" something and it is the TRUTH? Really--you must be more independent minded than that Can you not see why this inconsistency on your part leads to the assumption that your bias is clouding your judgement? We'd all love to hear your rationalization for these apparently contradictory stances
	From: Medix Date: 21.08.99 01:33 GMT I could not agree more, I also am getting a little sick of this, have gun vs not have gun chatter.
	From: Eric Frykberg Date: 21.08.99 03:12 GMT As one of the perpetrators of this thread, let me voice a comment? Karim has said this before, but apparently many of you have forgotten this. The value of this discussion list is that it is free and open--that has been, and is, its intent Maybe those who want this discussion stopped(censored?) are not aware yet of a remarkable device on your keyboard--it's called the "DELETE" button. And it is something you can hit on any topic that comes up--with your mouse. I know it works because I use it all the time for topics I am not interested in--and an awful lot of those come up here all the time. Yet I never even considered telling those who are interested to stop-- for no other reason than because I do not like it! Is that really what you want--and you would really unsubscribe because you do not like a topic or the length of time some choose to discuss it? Have you considered that perhaps free and open discussion is just not for you? Maybe you are better off unsubscribing? Please answer a burning question for me? If you don't "like" this topic--why in the world do you read the posts? How else would you be upset or "tired" of the topic unless you read the posts?--because if you just deleted when you saw the topic, it couldn't bother you at all! Could it possibly be that there is another motive at work here? I would estimate that the subject of prehospital volume resuscitation (one of many examples) has had a running thread here for months. It's interesting that in the years I've been on this list, the subject of firearms is the very first and only to generate this kind of sustained response----hmmmmm.....(for those interested--you should read some of the private mail we in this discussion have been getting--I've never seen that happen!) If no one is interested in a topic, we all know it dies very quickly. But if a group is, are we not free to pursue it (assuming we are talking of trauma-related subjects) Or should we stop when someone says stop, because THEY are tired of it? And who is to determine the level of "tiredness" that demands censoring? Let me guess--you, right? Karim--Ernie--any thoughts on this? ERF
	From: Karim Brohi (Trauma-list Moderator) Date: 21.08.99 12:14 GMT Absolutely. I'd say it again - but I'd be repeating yourself! I think we all know the value of the delete key - and it's judicious use can save you a lot of headaches, from 'nauseating' list threads to junk mail problems. However, the subject of firearms is one of the most important subjects relating to trauma care worldwide, and whether you are bored with the discussion or not, I have rarely seen or heard more coherent arguments given by both sides (with a few lapses it has to be said) that highlight the ideals and emotions of both sides. The problem may not relate to your practice directly, but unless you never venture out of your own safe, suburban back-yard then you need to open your mind to the bigger picture. All of you joined the trauma-list for exactly this reason (even if subconsciously) The gun control debate has been raging for decades, and is not going to be solved in a 6 message thread (despite the IQ's of the trauma-list members) It is interesting and informative to see the points thrashed out, as it is to be offered references and statistics supporting both sides of the discussion. I for one would prefer more list threads to be like this. I am sure that practically everyone on the list has an opinion on whether firearms should be freely available or not. May I suggest that you join the discussion - if only to voice your opinion and to allow us broader viewpoint? The problem is not confined to the USA, and you should perhaps take the time to think of the problems faced by South Africa which has a glut of weapons moving back into the country after the war with Angola etc and now gives it the highest murder rate in the world. The same problems is faced by many developing countries worldwide. It would be interesting and informative to hear a global perspective. I personally think that there is little debate. The point 'guns don't kill people, people do' is just so much crap. It is very difficult to kill someone with your fists, not in the least because the other guy as a 50/50 chance of him getting you first. If you get hit by a bullet you are far more likely to suffer serious injury than if you are stabbed. How many of the open abdomens and multiple organ failures on the ICU are stab wounds or blunt traumas? Not many compared to the gunshots. Go to Jamaica & witness a gang fight in a) Kingston and b) Ocho Rios. In kingston it's submachine guns and the bodies and devastation are everywhere. Shoot outs take place between large numbers of people and collateral damage to innocent bystanders is high. Kingston Public Hospital is behind barbed wire and if you work there you do not leave after 5pm. Go North to Ocho Rios where guns are less prevalent and machetes are the favoured weapon and fights tend to be more one-on-one and there is almost no collateral injury to bystanders. People get cut up but they don't die. Go to your own back yard, and tell me how many children the by-products of your society could have killed before being over-powered had they been armed with a knife rather than a gun bought in your local supermarket. Maybe you grew up with guns and cannot see outside the box, just as many white South-Africans grew up with Apartheid and accepted it because it was all they ever knew, until shown the other side of the coin. Many people in the world live in gun-free cultures, and seem to manage OK without their 'right to bear arms'. Here in the UK it is still a shock to see a policeman carrying a gun (part of specially trained squads who have at least 5 years duty behind them). Yes the gangs are still able to arm themselves, but it is much more difficult, and it is much easier to track the flow of weapons. And it is much, much harder for your common or garden nutter to get hold of one. We look on the USA (in this respect) as a country that hasn't grown up out of it's Wild West past - and we are pleased with our decision to have let you win the war of independence! (hit delete!) Karim Brohi Department of Surgery Trauma & Critical Care Unit Royal London Hospital, London, UK
	From: Eric Frykberg Date: 21.08.99 12:30 GMT << We look on the USA (in this respect) as a country that hasn't grown up out of it's Wild West past - and we are pleased with our decision to have let you win the war of independence! >> Careful, Karim-- you're getting a bit too personal, aren't you? :) ERF
	From: Tim Coats Date: 21.08.99 14:14 GMT Hey, I saw a gunshot wound the other day. Great excitement within the trauma system. Surgeons coming out of the woodwork from all directions to have a look, discusison topic for several days in the ER "I hear you had a shooting yesterday etc". The case will probably be presented at a trauma meeting due to its novelty value. Perhaps the Brits are just less prone to violence (although many former colonies would probably disagree!). I guess that gun control must be a topic for trauma surgeons to discuss at length, as it seems to make such a large difference to our working lives in different parts of the world. Tim. Timothy J Coats MD FRCS FFAEM Senior Lecturer in Accident and Emergency / Pre-Hospital Care Royal London Hospital, UK.
	From: Bill Burman Date: 21.08.99 16:04 GMT In 1985, in an editorial in the Journal of Trauma, Dr. Donald Trunkey (then chief of the Trauma Service at UCSF, San Francisco General Hospital) wrote: "50% of trauma deaths occur within minutes of the accident and the only way to reduce this carnage is through prevention. I urge every surgeon to become involved in prevention issues within their community." If you find the aspect of trauma medicine which addresses the majority of trauma deaths boring, perhaps you ought to consider not only hitting the "UNSUBSCRIBE" key for this trauma list - but also the "UNSUBSCRIBE" key to the practice of trauma care as well. Bill
	From: James Cowan Date: 22.08.99 02:45 Robert, let me cite a prime example of a Kellerman study along with it's conclusions and my rationale for questioning it's validity. My specific objection to the study is that the information does not support the conclusions drawn. "Gun Ownership as a Risk Factor for Homicide in the Home." New England Journal of Medicine. 329:15 1084-1091. 7 Oct. Kellermann, Arthur L., M.D. et al; Kellermann and his colleagues concluded that a person who had a gun in his or her home was 2.7 times more likely to be a victim of homicide than someone who did not (1087). They further "found no evidence of a protective benefit from gun ownership...(1087)." In my opinion, neither of these conclusions are justified on the basis of their research. They conducted their research by limiting their cases to people murdered in their own homes, thus excluding any instances where intruders were killed by the homeowner. Their information came from survivors who could be considered the victims proxy. In order to provide a control group they selected another person from the neighborhood of the same sex, race, and age group as the victim, and asked them the same questions they had asked the victim's proxy. While matched on the demographic variables, the control group was stunningly different on behavioral measures. Compared to the control group the victim group was more likely to: rent rather than own, live alone, drink alcoholic beverages, have problems in the household because of drinking, have trouble at work because of drinking, be hospitalized because of drinking, use illicit drugs, have physical fights in the home during drinking, have a household member hit or hurt in a fight in the home, have a household member require medical attention because of a fight in the home, have a household member involved in a physical fight outside the home, have any household member arrested, and be arrested themselves. Thus the victim group and the control group had very different lifestyles, with the victim group living a very high-risk lifestyle. In fact, Kellermann found that having a gun in the home ranked fifth out of six risk factors in the victims' lives. Using illicit drugs lead to a 5.7 times risk of being murdered, being a renter 4.4 times, having any household member hit or hurt in a fight 4.4 times, living alone 3.7 times, guns in the household 2.7 times, and a household member being arrested, 2.5 times. The entire "gun in the home is risky" analysis depends on one crucial figure, the percent of the control group (35.8%) that have guns in their homes. If this figure is underreported, the findings are false. There is good reason to assume this figure is low. First, many, many surveys report that around 48% of Americans have guns in their homes. The victim group, as reported by their proxies, had 45.4% gun owners. This figure is unlikely to be false: the victim is dead, in 49.9% of the cases by gunshot wound, the proxy cannot really lie about it. If indeed the control group's firearms ownership was inline with the national averages, Kellermans conclusions are unwarranted.
	From: Bill Burman Date: 23.08.99 05:02 GMT <<Perhaps the Brits are just less prone to violence Thank goodness they don't let them have guns at soccer matches.>> Another consideration. In Medical Economics for Surgeons, Oct 1989, Dr. James G. Haughton (then Medical Director of the Los Angeles County Martin Luther King Jr./Charles R. Drew Medical Center) wrote: "Ironically, the increase in serious gunshot wounds has put some trauma centers in our area out of business. Most victims don't have insurance and don't qualify for Medicare or MediCal . . . Three trauma centers in our immediate area have closed in the past two years, leaving ours as the only Level 1 facility there." Dr. Haughton articulates a major concern of US trauma center directors who understand that an unfavorable penetrating/blunt trauma ratio can lead to degradation and even demise of trauma centers which care not only for junkies, but also for firefighters and law enforcement injured in the line of duty. Such an attrition caused David Langness of the Hospital Council of Southern California to state in a Time Magazine article entitled "Trauma Care on the Critical List" , July 4, 1988: "It doesn't matter if you drive a Pinto or a Rolls Royce. You still can't get trauma care." JAMA August 4, 1999, reported that gunshot wounds cost the nation $2.3 billion a year in medical treatment, and almost half that sum is paid for with taxpayers' dollars. While the National Rifle Association has shrugged that off as being a trivial 0.25% of what is spent annually on US medical care, the mal-distribution of this loss to trauma centers is not taken into account. The US public may be facing a choice between the unrestricted right to a gun versus unrestricted access to a trauma bed. Bill Burman, MD (at one time briefly ran the orthopaedic trauma service at Kings County in Brooklyn, NY where up to 50% of the broken bones were due to bullets)
	From: Ian Civil Date: 22.08.99 09:42 GMT We had a GSW last week which engendered the same interest. Our police shot a "bad guy" who was brandishing a knife. and wouldn't put it down. Bullet (9mm from a Glock pistol) went through RLL of lung, through diaphragm, into liver, and took out right hepatic vein. To my surprise things worked well. 8 mins in ED and to OR. Got right thoracotomy and damage control laparotomy. Next day had right hepatectomy and is making a good recovery. The boys in blue remain camped outside his room and when ready for discharge he will be "helping them with their enquiries". This is the SECOND GSW we have had this year! We have had over 1000 blunt trauma patients however to date. I have been following this thread with interest. I accept the difficulties of removing handguns from a population that has them but they are the problem. Despite our lack of bullet wounds there are 250,000 registered shooters in NZ and a total of 1.3 million firearms. Thats a ratio of one firearm for every 3 people in the country. I think the issue must be that if a gun cannot be put in your pocket and easily used in a crime or a moment of passion then it is less likely to be a problem. Ian Civil Director, Trauma Services Auckland, New Zealand
	From: Robert Eager Date: 22.08.99 10:26 GMT Whatever the view held on the rightness or wrongness of gun ownership/control, isn't it a bit late to talk about a total ban? 1. People have access to guns (fact). 2. If a ban was put in place it would require obedience to the law and respect for the law for it to be effective (fact). If a person was already breaking major laws (drug trafficking for example) would they be particularly concerned with obeying a law which took away their means of either protection for themselves (from other drug runners or police) or their means of enforcing control of their territory? Doesn't it follow then that the benefit of gun control/bans isn't a reduction in gun related injury/death within and from the criminal community but rather a reduction in gun related injury/death within the law abiding community? Further, wouldn't a ban on guns also result in reducing the ability of the law abiding community to protect themselves from the law breaking community? Would a ban on guns then result in an increase in home invasions, assaults, rapes etc? If it didn't (ie if the law breaking community and the law abiding community were totally separated) then would the reduction in accidental deaths/suicides/deaths from domestic violence, be justification for banning guns? However, unless there is an dramatic increase in law enforcement and community protection by the law then isn't it a citizens right to protect him/her self? If it was a perfect world and there were no home invasions/assaults/rapes etc then there is still the issue of the right of a law abiding citizen to engage in a sport or recreation which s/he finds enjoyable (target shooting/hunting etc) as well as a farmers right to protect their property/crop from vermin. At what point do you take those rights away from everyone for the protection of those who are injured because a few don't have the ability to handle a weapon without shooting themselves or others? Wouldn't it be more logical to take the weapon from those who cannot demonstrate that ability? Just some thoughts. Regards, Rob (sitting firmly on the fence) ;o) Sydney, Australia.
	From: Amador Date: 22.08.99 13:22 <<Whatever the view held on the rightness or wrongness of gun >ownership/control, isn't it a bit late to talk about a total ban? not really, do you have children or grandchildren? do you care about their future? even if the present looks a tad dark for us? >1. People have access to guns (fact). >2. If a ban was put in place it would require obedience to the law and respect for the law for it to be effective (fact).>> It may also require to stop manufacturing weapons other than for military/police purposes and a few hunting guns if really necessary, it may also mean the banning of gun sales to the public, it may also mean that today's guns will be tomorrow's antiques and that they will become more and more scarce as time goes by... <<Doesn't it follow then that the benefit of gun control/bans isn't a reduction in gun related injury/death within and from the criminal community but rather a reduction in gun related injury/death within the law abiding community? Further, wouldn't a ban on guns also result in reducing the ability of the law abiding community to protect themselves from the law breaking community? Would a ban on guns then result in an increase in home invasions, assaults, rapes etc? If it didn't (ie if the law breaking community and the law abiding community were totally separated) then would the reduction in accidental deaths/suicides/deaths from domestic violence, be justification for banning guns? However, unless there is an dramatic increase in law enforcement and community protection by the law then isn't it a citizens right to protect him/her self?>> It might do that in the short term, but if the goal is to create a better future, it may be possible to leave policing to the police as a policy (lovely alliteration) and leave defenceless law-abiding creatures who don't own a gun (such as myself) with this only option , after all we can still use baseball bats, knives and chairs and other hard household objects against home invaders provided they also don't have a gun, if they have a gun they are, methinks, less likely to use it if they know you don't, and more likely to rob you, I agree, but then again, how common are gun related deaths in the event of home invasions or even armed robbery? even counting the cases where the owner of the premises was the gun owner, one finds that most gun deaths happen between and around people with guns, law-abiding or not. <<If it was a perfect world and there were no home invasions/assaults/rapes etc then there is still the issue of the right of a law abiding citizen to engage in a sport or recreation which s/he finds enjoyable (target shooting/hunting etc) as well as a farmers right to protect their property/crop from vermin. At what point do you take those rights away from everyone for the protection of those who are injured because a few don't have the ability to handle a weapon without shooting themselves or others? Wouldn't it be more logical to take the weapon from those who cannot demonstrate that ability? >> At what point? at the point when you consider it intolerable to balance the lives of people vs the right to shoot targets or vermin, you can shoot targets by stone throwing (much more sporting and physical) you can kill vermin with baits and any number of ways, it is much harder to kill a person in such a way, but with a gun, oh! it sooooooo easy! It is a matter of what kind of society we want to live in, if you consider that your right to shoot targets overrides the right of a child to go safely to HS, or the right of the same child not to be frisked and forced to pass through a metal detector every time s/he goes to school, if you think that the right of a farmer to shoot vermin overrides the right of a child to have the education budget spent on textbooks and learning facilities instead of armed guards, metal detectors, video surveillance and what not!, then you may have a point! this is what the NRA believes, all this and more may be an acceptable price to pay for the right to bear arms for them, but it is not for me, in fact, it seems quite silly! Amador
	From: James Cowan Date: 22.08.99 14:52 Perhaps....from the perspective of American society at large, many of us wish they would get the electric chair..or at least not be released on parole quite so quickly. A significant percentage (the majority?) of the trauma incidents that Bill Burman makes reference to involve felons. This morning as I brew my morning coffee and began reading my morning paper I am greeted with a front page article on local problems with teenagers vandalizing our town square. One teen has been arrested six times in the last few months for everything from assault to having an illegal shotgun. The night the reporter accompanied the police on rounds, the same teen was arrested and was out of jail and back on the square in 45 minutes. Eventually, he will shoot someone and again a hue and cry will be heard "where did he get the gun"...the real question should be, "why are we tolerating these animals in our midst?". <<At what point? at the point when you consider it intolerable to balance the lives of people vs the right to shoot targets or vermin, you can shoot targets by stone throwing (much more sporting and physical) you can kill vermin with baits and any number of ways, it is much harder to kill a person in such a way, but with a gun, oh! it sooooooo easy!>> This is not true. Have you ever been in such a situation? Do you know anyone who has? Shooting another person is a very hard thing to do for most people. One of the problems we have in teaching self-defense courses is that the vast majority of people, particularly women, cannot do it. They simply can't pull the trigger, often not even to save their own lives. I have had a gun in my face, I know what it looks and feels like. I have also heard that bizarre little clipping noise bullets make when they pass through leaves in trees around you when you don't even know you are being shot at until it dawns on you a few seconds later when you hear the distant report of a rifle shot. I would wait until I had some personal experience in such matters before I began saying what people will or will not do. I also take exception to your continual misstatements on what the "NRA believes". We NRA members have a saying, "I am the NRA"....if you want to know what I believe just ask me, but please stop speaking for me when you don't know what you are talking about.
	From: Amador Date: 22.08.99 15:44 <<in such a way, but with a gun, oh! it sooooooo easy! This is not true. Have you ever been in such a situation? No, I haven't Do you know anyone who has?>> yes sir! I can say I do! :-) in Australia we don't have the same gun culture that you have in the US, but we do have lots of refugees from unluckier places such as El Salvador, East Timor, Afghanistan, etc.., I have friends from all of these communities, some of them with GSW scars (one of them has 4 of those in his chest and abdomen), I have a fair idea of what it means, and I do hope I never have to speak from my personal experience in this matter. <<Shooting another person is a very hard thing to do for most people. One of the problems we have in teaching self-defense courses is that the vast majority of people, particularly women, cannot do it. They simply can't pull the trigger, often not even to save their own lives.>> Please read my post well before you jump to conclusions, I didn't say that shooting was easy, I said that killing a person by using a gun is soooooo easy!, and I stand by that remark, using a gun may be psychologically harder than using your fists or a rock, but once you use it the results are so much more devastating. But your argument also validates my point, if you are not going to use it, why should you have it?, wouldn't it be better if nobody had it? << have had a gun in my face, I know what it looks and feels like. I have also heard that bizarre little clipping noise bullets make when they pass through leaves in trees around you when you don't even know you are being shot at until it dawns on you a few seconds later when you hear the distant report of a rifle shot.>> I do feel sorry for your experience, but do you seriously feel that it gives you moral authority over me, a person who has been only robbed twice at knife point? I cannot see the logic here if that's your intention, you do make the point that guns are a hell of a scary thing, far too scary, IMHO, to have around the house and in the hands of people other than police or military.. <<I would wait until I had some personal experience in such matters before I began saying what people will or will not do. why? I didn't say what people will or will not do, I said that it is easier, far easier to kill with a gun than with a stone, how can you prove me wrong on that? I also take exception to your continual misstatements on what the "NRA believes". We NRA members have a saying, "I am the NRA"....if you want to know what I believe just ask me, but please stop speaking for me when you don't know what you are talking about.>> point taken, I will rephrase it by saying that the NRA and its supporters seem quite happy/contented/resigned? to put up with what I consider intolerably restrictive security conditions for their children to study and to grow up in order for them to be able to preserve the right to bear arms, is it better put now? Amador
	From: Robert F. Smith Date: 22.08.99 17:22 GMT If it's so hard how come it happens between 100,000 to 250,000 times a year in our country? Get real.
	From: Frederic B Wilson Date: 22.08.99 17:46 Dear Jim, Let me set a few things straight in this discussion. << I have had a gun in my face, I know what it looks and feels like. I have also heard that bizarre little clipping noise bullets make when they pass through leaves in trees around you when you don't even know you are being shot at until it dawns on you a few seconds later when you hear the distant report of a rifle shot.>> First of all, your description makes it apparent to me that you have not, in fact , had the experience of being shot at by someone with a rifle. Let me set you straight. Rifles are a high velocity weapon with muzzle velocities typically greater than 2-3 thousand feet per second. The round is, therefore, supersonic. When it passes close by your ear it doesn't make a delicate little clipping sound. It makes a sonic boom. Not a big, crashing boom like a jet; it sounds almost exactly like the SNAP of a bull whip. If you have your wits about you, you can immediately begin rapid counting, "1,2,3,4,..." until you hear the "Bang" from the rifle which is more of a thump than a crack. The number you get to represents the approximate hundreds of meters from your position to the shooter, 4 hundred meters in this instance. By noting the direction you now have azimuth and range, both prerequisite to destroying the shooter. Military and law enforcement people are trained in these techniques. If you hear the report a few seconds later the shooter is most likely out of range and taking random, pot shots. Scary, but not particularly effective. <<I would wait until I had some personal experience in such matters before began saying what people will or will not do. I also take exception to our continual misstatements on what the "NRA believes". We NRA embers have a saying, "I am the NRA"....if you want to know what I elieve just ask me, but please stop speaking for me when you don't know what you are talking about.>> I am most disturbed about the name calling you resort to in the above paragraph, probably a sign of frustration at the person who had the temerity to disagree with you. To borrow from one of your NRA's own slogans, "Guns don't kill people, people kill people with guns." Take away the guns (Handguns and assault weapons, not hunting weapons) and people will have less readily available means of slaughtering each other. Another of your jingoistic little sayings is that "if guns are outlawed, only outlaws will have guns." Pardner, outlaws will have guns regardless, and, trust me on this, they generally don't have any compunction about pulling the trigger. In addition, the vast majority of the slaying occurring today takes place in our inner cities by young, immature teens and adults who have never bothered to consider the consequences of their actions like the lady in your example who couldn't pull the trigger even to defend herself. These kids are just out there to "bust a cap on yo' ass." Taking the weapons out of their hands by tightly controlling the sale, distribution, and registration of handguns and assault weapons makes eminent sense to most who have rationally thought this through. It makes at least as much sense as the laws we have requiring us to buckle our seat belts, wear helmets, and the myriad of other safety regulations we have put in place to protect society as a whole. But lets be fair. Let's keep this discussion going, but let's all agree to do a little research and support our assertions with the literature. Let the paper wars begin. Much safer than the real, shooting kind. Best regards, Frederic B. Wilson, M.D. Lake Charles, Louisians, USA Community Orthopaedic Surgeon
	From: James Cowan Date: 22.08.99 18:55 GMT <<places such as El Salvador, East Timor, Afghanistan, etc.., I have friends from all of these communities, some of them with GSW scars (one of them has 4 of those in his chest and abdomen), I have a fair idea of what it means, and I do hope I never have to speak from my personal experience in this matter.>> Having "friends" from countries who have experienced things is not the equivalent of personal experience. Odds are your friends would resent very much your suggestion that you have even a "fair" idea of what they went through. You may know a rape victim, but you do not know what she went through. You don't even have a "fair idea". <<Please read my post well before you jump to conclusions, I didn't say that shooting was easy, I said that killing a person by using a gun is soooooo easy!,>> I see, so you are going to beat them to death with it? <<point taken, I will rephrase it by saying that the NRA and its supporters seem quite happy/contented/resigned? to put up with what I consider intolerably restrictive security conditions for their children to study and to grow up in order for them to be able to preserve the right to bear arms, is it better put now?>> Is the stench of a dead fish any better if you claim it's a rose? The NRA has done more to protect our constitution, support law enforcement and educate children in gun safety than any other organization in the history of the world. Not just in America, but anywhere. There is a reason that millions and millions of Americans pay to become members. The NRA is not responsible for the untold thousands of convicted violent felons running loose in our society. Who IS responsible are the handwringing liberals who tout your very position and who turned them loose to begin with. It's also no coincidence that the majority of police officers in the US support gun rights and a great many are NRA members themselves.
	From: Eric Frykberg Date: 22.08.99 21:39 Jim-- Here you go again--not true! Virtually every survey done of individual police officers have shown the same as another professional group that sees this problem every day right up there on the front line--physicians--and both are overwhelmingly in favor of a greater and more rational degree of control of access to firearms.(Remember what you said about actually experiencing the problem?) You may be referring to the only survey of any group of police--the Nat'L Assoc of Chjefs of Police--who indicated a plurality in defiance of gun control, and that in one year in 1991. A survey of a particular isolated group does not have nearly the weight of a wide and open survey of individuals. Please--once again--tell us your source on this sweeping assertion you pass off as fact? Interesting to see you continue your adolescent name-calling--is that really appropriate? As far as constitutional rights--you keep saying that as if the 2nd amendment gurantees the unfettered use, sale, manufacture or ownership of any "arm" without restricition or responsibility (in another blatant rehearsed diatribe you obviously picked up elsewhere for its high sounding theme)--But of course--an interesting point you never have refuted because you cannot--the 2nd amendment says no such thing. The courts in this country have numerous times upheld gun control laws as completely constitutional under the 2nd amendment, and that such laws infringe on no one's constitutional rights . More to the point--not once--in the entire history of our country--not once--has any court from the lowliest local court to the Supreme Court ever struck down a law which limits access, sale, ownership, manufacture or use of firearms under the 2nd amendment. And such challenges date back to the 1840's, and as recently as the 1990's. What, you say, does it matter what a bunch of sheltered old feeble judges say? The answer lies in our own Constitution, which you so rigidly pay homage to--and that is "Everything"--because according to the Constitution, only the Courts can interpret what the Constitution says or does not say--not you, not me, not "legal scholars" or movie stars. You may disagree, but your mere opinion has no legal standing in the U.S. So please elaborate a bit on the real story when you start on the patriotic "right" to kill anything in sight without accountability. There is no such right of unfettered gun ownership or use. The best indication of the truth of this is the clear fact that no individual or organization who upholds "gun rights" has challenged any gun control measure that they so decry as "unconstitutional" in the courts. Ask yourself--why in the world would they not do this? Such an easy solution--seek redress from the Constitution itself as it provides! But--how interesting that such is never done! Why not, Jim? I,m sure your handy-dandy website of the NRA has another stock but blatantly distorting answer for that one--we'd all love to hear it for our amusement For a bit of education on this point see: Vernick, Teret SP: Firearms and Health--The Right To Be Armed with Accurate Information About the Second Amendment Am J Public Health 1993;83:1773 Sugarmann, Rand: Cease Fire, excerpted in Rolling Stone Magazine, March 10, 1994--an excellent overview of this and many other informative facts and figures regarding the firearm issue. EAST Violence Prevention Task Force: Violence in America--The Role of Firearms J Trauma February, 1995
	From: Robert F. Smith Date: 22.08.99 23:37 GMT <<The NRA has done more to protect our constitution, support law enforcement....than any other organization in the history of the world. Not just in America, but anywhere.>> Wow, I wasn't aware of that. Could you please provide specific details? The only evidence that I'm aware of ( and whihch I cited specific cases) are of the NRA's constent misinterpretation and attempted subversion of the constitution. Fortuneately no court has ever supported the position of your organization. More hand wringing liberal conspiracy? Why doesn't the NRA bring a case before the Supreme Court that asserts the right of citizens to unfettered possesion of firearms?
	From: Amador Date: 23.08.99 00:29 GMT <<Is the stench of a dead fish any better if you claim it's a rose?>> Was that my claim?, am I lying?, what is the NRA position on education and high school security then?, what is the NRA's position on how to spend the education budget then? what is the NRA's position on the type of restrictions students have to go through now?, we don't have those overhere, I would be horrified if my children had to attend to such a HS and probably would get out of the country as fast as possible <<The NRA is not responsible for the untold thousands of convicted violent felons running loose in our society. Who IS responsible are the handwringing liberals who tout your very position and who turned them loose to begin with.>> I have not touted any position on your penal system, but methinks that I could be justified in accusing the NRA and its supporters for creating and maintaining a climate in which it is extremely easy for felons to get access to a firearm, I can also join you in bemoaning a lax justice system which allows violent felons running loose. You see, my point is PUBLIC SAFETY FIRST, and that means both less firearms AND less criminals on the street, ideally NO firearms and NO criminals on the street. Don't jump to conclusions that because someone thinks guns and gun culture are stupid, it also means that the same person is going around freeing as many felons as possible, that only provides more excuses for the existence of the NRA :-) I'm withdrawing from making any more personal comments on the list, if you want to refute my arguments please do so on the list, but if you want to continue saying "what do you know? you never had a gun in your face!, you handwringing liberal!" or comments to that effect without addressing the question, please do so at my private email thanks
	From: James Cowan Date: 23.08.99 18:39 GMT <<First of all, your description makes it apparent to me that you have not, in fact , had the experience of being shot at by someone with a rifle. >> Spoken as a true urbanite. I just love it when the uninitiated begin explaining ballistics and firearms. This is an example of why the NRA has to take such a hard nosed stance on gun control. People with a little knowledge and a "lot" of ego formulating opinions on topics they have a marginal understanding of. Tell you what Frederic, you stand out on a nice dense thicket of woods somewhere and have someone kick a few rounds loose over your head from a distance. As the bullet passes through the leaves it sounds almost like a very rapid ticking sound that you can't really identify the source of. Then you hear the report...if you are lucky. As for the rest of your "how to" quotations....obviously another arm chair quarterback who once had some training but never actually had to apply it. What were they again....REMFs?
	From: Colleen Walsh Date: 23.08.99 23:45 GMT Fred: Being an ortho/trauma nurse (formerly of Lake Charles and Mobile), I agree that too many handguns, assault rifles etc are in the wrong hands. It is hard to see an 8 year old dying in our ER as a result of a drive-by. I wish I had all the answers, but only personal observations. I've lived and worked in "knife and gun club" settings, and it never gets easier. I agree with the theme that controlling handguns will not stop those who are on the shady side of the law from continuing to kill with handguns. I also cannot ignore the impressive statistics from countries that have restrictive guns laws. There are few issues in this country that polarize the masses as much as the gun control issue, (as well as members of this group) and I think this is the forum to discuss and exchange ideas, not necessarily ideologies.
	From: James Cowan Date: 24.08.99 01:18 <<First of all, your description makes it apparent to me that you have not, in fact , had the experience of being shot at by someone with a rifle. Let me set you straight. Rifles are a high velocity weapon with muzzle velocities typically greater than 2-3 thousand feet per second. The round is, therefore, supersonic.>> Frederick, you are debating guns and ballistics with someone who has done this his entire life...plus, your facts are flat out wrong and if you had bothered to even check the basics you would have discovered your error prior to wasting our time with drivel that now I have to waste time correcting. You are right in that supersonic rounds create shock waves that some people call sonic booms, but let me ask you....how long do you think a supersonic round stays supersonic? Say a common .308 at around 2800 fts of muzzle velocity? For about 1.5 seconds Fred, thats how long. Where is that bullet going to be when it drops subsonic? About 400-500 yards away. And what does the poor sap standing in some trees about 1200 yards away experience when that subsonic round passes by? Exactly what I damned well said. You just spent god knows how many words blathering on quite incorrectly about a phenomenon many shooters have experienced personally and in the case of the target masters in long range shooting competition, experienced every few minutes every day of the match. The round is only supersonic for the first fraction of it's journey, typically going subsonic at somewhere around 400-500 yards. Thats about 1.5 to 2 seconds into it's journey. The round itself however continues on for some time given the proper elevation....I believe some studies have been done with Doppler radar demonstrating a standard issue .308 NATO round (7.62 if you prefer) fired at 40 degrees of elevation will remain in the air for 30 seconds and travel 2.5 kilometers. I have graphs of this study and will e-mail attach them to anyone who is interested. That means the round is subsonic for at least 25 seconds or more and in passing anyone or anything leaves nothing but the distant report of the rifle. Unless of course you are standing in foliage or something else and can hear the round pass through the things around you. You are also in error on your sonic boom data...if you were able to run alongside a sonic wave in progress you would hear nothing. In fact, the so-called sonic boom that you hear is not so much that the bullet has broken the "sound-barrier" but rather the buildup of the radiant sound energy in one spot (that spot being the intersection of the mach cone with the observer, i.e., you). And these sort of envelopes are features of all waves in their respective mediums (e.g, a fast moving boat on water also has this "cone", in this case the bow wave). I have shadowgraphs of bullets in flight that clearly show the waves. They allowing you to visualize the pressure differences of the flowfield. One may distinguish at least three different shock waves. The first and most intensive one emerges from the bullet's nose and is called the Mach cone. A second shock wave originates from the location of the cannelure, and the third shock wave forms behind the bullet's base. Additionally one can also see a highly turbulent flow behind the base, which is called the wake. Now I'll make you a deal Fred, I won't make a fool out myself by blathering on about ortho issues, a topic I know nothing about, and you do me the same favor when it comes to weapons and ballistics.
	From: James Cowan Date: 24.08.99 01:39 GMT <<Wow, I wasn't aware of that. Could you please provide specific details? The only evidence that I'm aware of ( and whihch I cited specific cases) are of the NRA's constent misinterpretation and attempted subversion of the constitution. >> Subversion? If the NRA subverts the constitution, then Christians must subvert the Bible according to your definition. It never ceases to amaze me how you can formulate these opinions on things you don't know anything about. Yes, the NRA is who provides firearms instructor certification. Ask your local police department who educated their range masters? It's either the NRA or someone the NRA trained. The Eddie Eagle program is focused on children and involves visits by a walking talking Eddie Eagle cartoon character to public schools and organizations to teach gun safety. It's an award winning safety program for children and carries the message "if you see a gun, don't touch it, get away, tell an adult". There is even legislation before some state governments to make the Eddie Eagle program mandatory in elementary schools. State rifle and pistol associations work with the NRA to make the Eddie Eagle gun safety program available on video tape in video stores at no charge. The goal last year was to present the safety program to 1 million children and parents. They exceeded that goal. But I guess you didn't know any of that, did you? Yet you still consider yourself well informed on gun issues and the NRA... Robert, with all due respect, you and several others here are victims of your own preconceived ideas on guns and gun control that seem to have little to do with the truth...and you seem very comfortable with that unfortunate situation.
	From: James Cowan Date: 24.08.99 02:29 GMT <<Here you go again--not true! Virtually every survey done of individual police officers have shown the same as another professional group that sees this problem every day right up there on the front line--physicians--and both are overwhelmingly in favor of a greater and more rational degree of control of access to firearms. >> Please cite this "survey". It has been my experience that the political police officers, like Chiefs of Police, etc, support gun control, while beat officers do not. However, I will await your references. <<As far as constitutional rights--you keep saying that as if the 2nd amendment gurantees the unfettered use, sale, manufacture or ownership of any "arm" without restricition or responsibility (in another blatant rehearsed diatribe you obviously picked up elsewhere for its high sounding theme)>> Eric, you are just again substituting vehemence for substance. (and truth) It's my opinion that the 2nd amendment guarantees individual ownership and carrying of firearms. I believe the Supreme Court has ruled in it's 2nd amendment cases that specific restrictions on gun ownership are constitutional as long as they don't impede the right overall. For example, telling someone they can't carry a shotgun with a barrel less than 18 inches doesn't infringe upon their rights because they can still legally carry one with a 19 inch barrel. The "the people" referred to in the 2nd amendment are the same "the people" referred to in amendments I, II, IV, IX, X, XVII, XIX, XXIV, and XXVI. Now thats about as clear as I can make it.
	From: Frederick B. Wilson Date: 24.08.99 03:26 GMT I tell you what Jimbo. I'll place my 15 months as a platoon leader and then company commander in the 173rd Airborne Brigade (Separate) in Vietnam in 1969-70, with two Bronze Stars, and Combat Infantry Badge; my training as an Airborne Ranger; and my subsequent seventeen years in the U.S. Army before retirement as a Lieutenant Colonel up against anything you have to offer. If that makes me "unitiated...with a little knowledge and a "lot" of ego formulating opinions on topics they have a marginal understanding of" then so be it. No Jim, YOU try standing out on a nice dense thicket. I've been there, done that, and have the "t-shirt" as the expression goes. What I described in my response were the exact techniques we used, and the science they are based on, when I was in combat. So how do things look now, from your REMF perspective that is? BTW, I own exactly one gun, a Remington shotgun I use for duckhunting. Out of season I keep it locked up in a storage locker because I don't feel any need to sleep surrounded by weapons. I tried that once in Southeast Asia. It got old real fast. Still interested in your response, supported by the literature, to the "urbanite questions I posed. Roll On gun control. May sanity prevail. You have so eloquently reinforced my assertions that little more need be said. Let me say, however, as a combat veteran, that there is a marked difference between experiencing rifle shots going by your head in actual combat situations (typically less than 200 meters, especially in the dense thicket you referred to) and experiencing spent rounds several hundred meters later (not that they can't or don't kill or wound). Even Basic Trainees are taken down range in carefully controlled firing execises to have rifle rounds fired over their heads in order to learn what it sounds like and learn how to locate the direction and distance from which the round originated. But let's get back to the issue at hand. Why do we not, as a supposedly civilized society, have in place more adequate means of denying 16-year-old children access to assault rifles. I, and many others, assert that such restrictions don't represent a denial of the Constitutional Right to bear arms. They simply seek to reconcile the fact that "my right to freely swing my arms ends where your nose begins" or, in this case, paraphrased to "your right to freely bear arms ends where my flesh begins." There is a word for your technological drivel. It is called "Sophistry." Look it up. The last time I checked I was not able to outrun a rifle bullet. That must be why I've heard so many distinctive CRACKS as they went by me. Another sound you might add to your repertoire is the distnctive THWAP the bullet makes when it hits the person next to you. Or how about the grunts, gasps, groans, and shrieks they make after being hit. Most haunting, however, are the quizical faces and imploring looks and grimaces they make while you try to keep them from dying. Shame on you for placing some supposed right to behave irresponsibly with a weapon ahead of that.
	From: Eric Frykberg Date: 24.08.99 12:44 << It's my opinion that the 2nd amendment guarantees individual ownership and carrying of firearms. I believe the Supreme Court has ruled in it's 2nd amendment cases that specific restrictions on gun ownership are constitutional as long as they don't impede the right overall. For example, telling someone they can't carry a shotgun with a barrel less than 18 inches doesn't infringe upon their rights because they can still legally carry one with a 19 inch barrel. The "the people" referred to in the 2nd amendment are the same "the people" referred to in amendments I, II, IV, IX, X, XVII, XIX, XXIV, and XXVI. Now thats about as clear as I can make it. >> Once again, Jim--this is the classic understanding but not true--and again--your "opinion" has no legal standing. You need to read these opinions--they are numerous and very clear--and without exception make it clear that first of all, the 2nd amendment does not apply to individuals, but the collective (referring to the militia segment--and militia according to the court does not refer to you and I, as you like to think)--and does not apply to states but only to the federal Congress--which is why no state law restricting access to guns has ever, or will ever, be struck down as unconstitutional. And even at the federal level--your parroting of the NRA position on the meaning of the "people" also is not true--read the opinions of no less than the Chief Justice Warren Burger and Lewis Powell in US b Lewis in 1980 or in the Morton Grove, Ill case which specifically refute this self-serving perspective of what is meant by "people" in other rulings--a perspective advanced only by the NTA, which is not exactly a bastion of legal training in constitutional law. Please--once again--I left the references on this issue in my last post--read them--they provide a complete overview of the history of the courts' rulings on the 2nd amendment, the fact that not a single law restricting access of firearms in any way shape or form has ever been struck down on 2nd amendment grounds, and how these ruling are grossly distorted by the gun lobby. You also, as usual failed to once again answer the question as to the inconsistency in why no law restricting access to firearms, which are lambasted constantly as unconstitutional by gun advocates, is ever challenged in the courts--if indeed they are unconstitutional, your point will be proven! The fact that the NRA does not do this--despite clearly having the money to do it--simply shows they know what the outcome will be, giving the lie to your stance-- Please--tell us all why this is? And read up first on the court decisions you pontificate upon without ever having read them? << Still interested in your response, supported by the literature, to the "urbanite questions I posed. Roll On gun control. May sanity prevail. >> Fred-- You see--Jim has a particular aversion to real debate--he will not answer questions with any degree of honesty in which the answers go against his beliefs--he just ignores them hoping they wiloll go away, or until he can consult his website to find the stock answers provided there--apparently can not think for himself.
	From: James Cowan Date: 24.08.99 15:07 GMT You have a lot of company Fred...you must be the 10,000th "combat veteran" I have run into who is a self-professed firearms expert. Every gun show has a few dozen of them. They always were deep in the bush, were decorated, usually wounded and you can always recognize them. The older ones usually recite the "tumbling bullet" theory. The younger ones talk about cancer. Now you were saying something about sonic booms? <<Why do we not, as a supposedly civilized society, have in place more adequate means of denying 16-year-old children access to assault rifles. >> 1. 16 year old children cannot legally buy guns of any kind. 2. Assault rifles do not constitute a statistically significant problem. This is a myth that has become generally accepted as truth. 3. We have in place so many forms of denial now that those of us who participate in the shooting sports wade through an ocean of paperwork, permits, applications and checks. Lets enforce the ones we have before we decide they are not enough. <<I, and many others, assert that such restrictions don't represent a denial of the Constitutional Right to bear arms.>> I agree to a point. I have no problem with existing permits, etc. I do have a problem with federal efforts to ban import or manufacture of items that are not a problem based strictly upon their appearance. With your experience, you know the firepower of an AR-15 is nothing next to the Mini-14 in a .308, yet one is banned because it's black and looks ominous and the more powerful weapon is not because it has a wooden stock. You have to know how absurd that is. <<The last time I checked I was not able to outrun a rifle bullet. That must be why I've heard so many distinctive CRACKS as they went by me.>> I have already explained why you heard what you heard. Is the issue served by your bringing up painful memories that many of us here would prefer to leave in the past? I suggest we stick to the facts and the science and leave the emotion out of it.
	From: Bill Burman Date: 24.08.99 17:48 GMT <<You have a lot of company Fred...you must be the 10,000th "combat veteran" I have run into who is a self-professed firearms expert. Every gun show has a few dozen of them. They always were deep in the bush, were decorated, usually wounded and you can always recognize them.>> This is a really disgraceful and disrespectful reference to those who have put their lives on the line to presumably protect the rights of all US citizens. I am sure this NRA shameless arrogance is the reason why former President George Bush and others have burned their NRA cards. Dr. Eric Sterling, Director of the Oakland CA Highland Almeda County Trauma Service circa 1989 said that GSW patients represent 2% of the hospital population and consume 40% of the blood transfused. If this is true, the National Rifle Association's insistence on unrestricted access to the implements of serious bloodletting - in this era of an unprecedented blood borne public health crisis - equates them with the most irresponsible elements of society - amongst pimps, prostitutes, promiscuous unprotected homosexuals and dirty-needle drug addicts - in terms of the proliferation of Hepatitis C, B and HIV. At the close of this chapter of medical history, the NRA may well emerge as the "Typhoid Mary" of the AIDS epidemic.
	From: Pret Bjorn Date: 24.08.99 20:07 GMT Jim, have you no idea what damage this juvenile ranting does to your marginal credibility? Put your tongue back in your mouth, pick up your email software manual, and figure out how to send messages like this off-list. Pret Bjorn, RN Liberal Conspiracist Bangor, ME
	From: Frederick B. Wilson Date: 25.08.99 00:15 Dear Jim, I was profoundly saddened by your response. Despite all of the swirling controversy that has existed about Vietnam I had always maintained that those with whom I served, and I, did so with honor and integrity. I vo;unteered to serve in the Army, volunteered for Airborne training, Ranger school, Infantry OCS, and virtually everything else I did while in the Army. It really never occured to me that someday I would face the realization that part of what we served to protect was an institution that makes a mockery of true liberty (the NRA) by crafting its own razor-thin interpretation of our most fundamental document. An interpretation not supported by the courts of the land from the evidence offered in this discussion thread. I finished my military career in the Army Medical Corps as an Orthopaedic Surgeon before going into private practice.In that capacity I both studied the ballistics of and injury patterns of a broad variety of weapons. It is a shame that everyone who disagrees with you is presumed to be an idiot. It makes meaningful dialogue nearly impossible. I would highly commend tou to take the opportunity to do a literature search of the National Library of Medicine through PubMed so that you might educate yourself to the consequences that we in medicine see over and over in this the most violent industrialized society on the face of the earth. How bewildering it must seem to the cultured and educated people of other countries, to read of random drive-by shootings, killing sprees by teenagers in our own schools, death by gunshot wounds as a leading cause of death among young black males, and the other evils inexticably connected to the ready availability of firearms in this country. How profoundly sad I feel at this time that a person such as yourself would disparage those years of service and all that I thought they had stood for. Let me humbly suggest that you get down on your knees tonight and pray to your God for forgiveness for having taken all that sacrifice, and blood, and tears expended by all those "combat veterans" so lightly. Jim Cowan, you have proven to me that you truly have no shame.
	Wrapping it up...
	From: Karim Brohi (trauma-list moderatorr) Before this all degrades (more) into personal feuds/insults I am going to try to draw this thread to a close. In doing so I am going to invite the main participants of the discussion (you know who you are) to write a closing statement on the subject, the discussion and your suggestions for change (and anything else). This is not an excuse to spark the whole thing off again - so make them concise but full CLOSING arguments. The whole discussion, with refernces, stats & links will be archived on the web site so you can relive it again & again (digitally remastered so to speak) Karim
	From: James S. Cowan The firearms issue needs to be viewed on the basis of factual evidence. What is sadly missing is a sense of perspective. We are a nation of 273 million people who own around 200 million firearms. Those firearms were involved in about 400,000 crimes last year total. (Department of Justice Stats) That means that even if a different gun were used in every crime and we considered even the legal uses as illegal. (cops shoots armed felon, we count both guns as being involved in a crime) That means that 99.8% of the guns in the USA are NOT involved in a crime. And thats a conservative estimate. The people are far more revealing. one in 50 Americans cannot vote because of a felony conviction, 1 in 13 African-Americans males cannot vote because of a felony conviction. We are a crime ridden, violent society and it's self-evident that our problems go far deeper that which weapon our criminals use that day or which one the honest citizens use to defend themselves. I realize these things make great headlines and sell papers, but they are not a main component of life for most Americans. So first let's look at accidental deaths. The National Safety Council publishes annually the number of accidental deaths in the US...and firearms are down around 7th or 8th. Your changes of being killed by poison, drowning, falls, all are far more than being killed accidentally by a firearm. You have twice the chance of suffocating. So lets move on to intentional deaths. Please note the word "intentional". That means that someone intended the victim to die, or the victim intended to commit suicide. My primary problem with the anti-gun crowd is their refusal to face the fact that these are violent people who act violently. Passing some sort of law telling them they can or can't do anything is amusing but not much else and "hiding all the sharp instruments" from them is nothing but a form of denial. The fact of the matter is, we live in a violent society with a lousy value structure but the criminals are still a tiny minority. The real problem is that we let that tiny minority run the country. Our judicial system is nothing but a revolving door. From 1960-1980, the number of prison inmates per 1,000 violent crimes dropped from 738 to 227, and the crime rate tripled. Each year more than 265,000 felons convicted in state courts are not sent to prison. Only 29% of convicts are in prison: 71% are on parole or probation, free on the streets. Something we can thank our liberals for. Thanks to those same liberals, Imprisoned criminals now serve only one third of their sentences, on average: for murder, 7.7 years; rape, 4.6 years; robbery 3.3 years; and aggravated assault, 1.9 years. Every day in America there are 14 murders, 48 rapes and 578 robberies by convicted criminals on parole or early release from prison. The average career criminal commits more than 180 crimes a year (Rand Corp.), contributing significantly to the nearly 14 million violent and property crimes last year. (FBI) Yes, we have a violent society and a crime problem and almost all of it can be traced back to a fraction of our population who commit the vast majority of our crime. Is it better in Japan? Depends on what you value. Different value structure, an efficient criminal justice system, fewer protections of the right to privacy, and fewer rights for criminal suspects than exist in the United States. Japanese police routinely search citizens at will and twice a year pay "home visits" to citizens' residences. Suspect confession rate is 95% and trial conviction rate is over 99.9% . The Tokyo Bar Association has said that the Japanese police routinely "...engage in torture or illegal treatment. Even in cases where suspects claimed to have been tortured and their bodies bore the physical traces to back their claims, courts have still accepted their confessions." Neither the powers and secrecy of the police nor the docility of defense counsel would be acceptable to most Americans. Widespread respect for law and order is deeply ingrained in the Japanese citizenry. This cultural trait has been passed along to their descendants in the United States where the murder rate for Japanese-Americans (who have access to firearms) is similar to that in Japan itself. Other gun control myths: "We have a problem with guns and the deaths of children" Fact; Those "children" are often anyone less than 21. An example is an individual named Artemio Corredar. Artemio used to control crack spots in the Bronx making $5,000 to $10,000.- a day. He tells how his partner got shot and died, and how he went for revenge and killed some of his opposition. All these criminals are counted as innocent victims of gun violence. It gets better, Artemio Corredar was arrested for the murder, but later acquitted. A month after being released and returning to drug dealing he was shot and paralyzed during a drug deal. Now he is part of an anti-gun group called the "Gunrunners". He travels to school auditoriums lecturing people on the dangers of guns. How ironic that someone who used to rely on a gun to carry out his criminal enterprise now blames it for his misfortune. Second myth: "gun control works in other countries" Countries with guns everywhere have low homicide rates, like Switzerland, Israel, and Norway. Guns actually have little if anything to do with it. High crime countries or areas are high crime in everything, gun and nongun crime. The inverse is also true, low crime countries and areas are so regardless of how many firearms are present. Third myth: "We have a problem with violent crime" Actually, we have a problem with violent criminals. A violent crime doesn't occur without one, but they do occur without guns...all the time. The vast majority of homicides are committed by people with criminal records, and curiously enough, the vast majority of homicide victims also have criminal records. Fourth myth: "Gun control reduces crime" This is perhaps, the greatest myth that is perpetrated today by national gun ban groups. No empirical study of the effectiveness of gun laws has shown any positive effect on crime. To the dismay of the prohibitionists, such studies have shown a negative effect. That is, in areas having greatest restrictions on private firearms ownership, crime rates are typically higher. If gun laws worked, it would be evident in areas in which they are harsh and very restrictive. When these examples are cited, there is always an excuse, but what there isn't, is an example of it working. Instead, the handwringers uniformly blame the absence of tougher or wider spread measures for the failures of the laws they advocated. Fifth myth: "The police support gun control" A series of polls were conducted by the National Association of Chiefs of Police of every chief and sheriff in the country, representing over 15,000 departments. In 1991 the poll discovered for the third year in a row that law enforcement officers overwhelmingly agree that "gun control" measures have no effect on crime. A clear majority of 93% of the respondents said that banning firearms would not reduce a criminal's ability to get firearms, while 89% said that the banning of semi-automatic firearms would not reduce criminal access to such firearms. Ninety-two percent felt that criminals obtain their firearms from illegal sources; 90% agreed that the banning of private ownership of firearms would not result in fewer crimes. Seventy-three percent felt that a national waiting period would have no effect on criminals getting firearms. An overwhelming 90% felt that such a scheme would instead make agencies less effective against crime by reducing their manpower and only serve to open them up to liability lawsuits. In the U.S., after President Clinton, Attorney General Reno, and others announced support for registration and licensing, police response was immediate and non-supportive. Dewey Stokes, President of the Fraternal Order of Police said "... I don't want to get into a situation where we have gun registration." Other law enforcement officers responded even more strongly. Charles Canterbury, President of the South Carolina FOP said, "On behalf of the South Carolina law enforcement, I can say we are adamantly opposed to registration of guns." Dennis Martin, President of the National Association of Chiefs of Police reported, "I have had a lot of calls from police chiefs and sheriffs who are worried about this. They are afraid that we're going to create a lot of criminals out of law-abiding people who don't want to get a license for their gun." Myth number six: "the only purpose of a handgun is to kill people" There are an estimated 75-80 million privately owned handguns in the United States that are used for hunting, target shooting, protection of families and businesses, and other legitimate and lawful purposes. By comparison, handguns were used in an estimated 13,000 homicides in 1994--less than 0.02% (two hundredths of 1% ) of the handguns in America. Many of these reported homicides (1,500-2,800) were self-defense or justifiable and, therefore, not criminal. That fact alone renders the myth about the "only purpose" of handguns absurd, for more than 99% of all handguns are used for no criminal purpose. By far the most commonly cited reason for owning a handgun is protection against criminals. At least one-half of handgun owners in America own handguns for protection and security. A handgun's function is one of insurance as well as defense. A handgun in the home is a contingency, based on the knowledge that if there ever comes a time when it is needed, no substitute will do. Certainly no violent intent is implied, any more than a purchaser of life insurance intends to die soon. The gun control issue is not as complex as it seems, but when the facts take a back seat to ideology the truth is what suffers. Jim Cowan Springfield, MO
	From: John Holmes You know - during the cold war there was this concept that if America had enough nuclear bombs and if Russia had enough nuclear bombs then no-one would start a war because of the inevitable Mutual Assured Destruction which would ensue. MAD. It seems to me that the philosophy of MAD still exists in America, except that rather than preventing violence, the ready availability of weapons undoubtedly promotes it . Armed criminals, armed police. Armed guards in hospitals. Armed children. Armed everyone! Therefore what we non Americans see (as dispassionate observers) is Mutually Assured Destruction - of your institutions, of your children, of your society. Why is America so violent? Why. of all "civilised" democracies do you stand out by killing and maiming each other so regularly? Even your judiciaries and governments perpetrate violence with judicial poisonings and electrocutions. Sure keep guns for sport and hunting. Then lock 'em away. You don't need guns for protection in a truly civilised society. Violence begets violence and guns, more than any other single factor, allow violence to happen. I've read Jim Cowan's frequent posts on this thread with a mixture of bemusement, amusement and outrage. As an apologist for the NFA he demonstrates what an outrageous influence that organisation has in America. Wake up America - before your society irretrievably breaks down. You don't need all this shit. Here endeth the lesson. Let's get back to medicine. Dr John L Holmes Director Emergency Medicine Mater Adult Hospital, Brisbane, Australia
	Addendum
	From: Bill Burman Karim Without intention to inflame/prolong the www.trauma.org firearms discussion to any greater extent, I have just received the correspondence pasted below from Arthur Kellermann which provides counterpoint to slanderous references to his important work which are in the www.trauma.org firearms thread and various NRA websites. I will leave it to your discretion as to how best to work this in as I believe this could be the only web-based record of his rebuttal. As many aspersions are cast upon the work of those who conclude that we would be safer without guns, the NRA data - called for but constantly lacking in this debate, has not been available for critical analysis. At the very bottom of this post I have pasted an article by Ed Magnuson, Time 8/21/89 "Do Guns Save Lives?", an examination of the methodologies of NRA "scientists" such as Blackman and Kleck, which I believe should be appended to the www.trauma.org firearms violence archive. My source for the statement by Dr. Eric Stirling (misspelled his name as Sterling) in my post about the NRA and the propagation of AIDS (GSW patients are 2% of hospitalized patients consuming 40% of transfused blood) - was an article in the New York Times 2/21/89 entitled "Epidemic in Urban Hospitals: Wounds from Assault Rifles." Thank you. Bill
	From: Arthur Kellerman Bill, short responses follow. I have been answering this garbage for years. Fatigue is definitely the goal. > From: "James S Cowan" > Subject: CDC data et Kellerman studies > Date: Sat, 21 Aug 1999 20:50:25 -0500 >Robert, let me cite a prime example of a Kellerman study > along with it's conclusions and my rationale for questioning > it's validity. > My specific objection to the study is that the information > does not support the conclusions drawn. > "Gun Ownership as a Risk Factor for Homicide in the Home." New England Journal of Medicine. > 329:15 1084-1091. 7 Oct. Kellermann, Arthur L., M.D. et al; > Kellermann and his colleagues concluded that a person > who had a gun in his or her home was 2.7 times more > likely to be a victim of homicide than someone who did > not (1087). They further "found no evidence of a protective > benefit from gun ownership...(1087)." > In my opinion, neither of these conclusions are justified > on the basis of their research. > They conducted their research by limiting their cases to > people murdered in their own homes, thus excluding any > instances where intruders were killed by the homeowner. > Their information came from survivors who could be > considered the victims proxy. Case control methods permit the detection of protective benefits as readily as risk effects. I did a study of the ratio of "self-defense" killings to home suicides, accidents and homicides. It was 43:1. A later study that examined both fatal and non-fatal self-defense shootings versus fatal and non-fatal suicide attempts, assaults and accidental shootings in the home yielded a somewhat lower number - 22:1 (J. Trauma, 1998;45:263-267.) > In order to provide a control group they selected another > person from the neighborhood of the same sex, race, and > age group as the victim, and asked them the same questions > they had asked the victim's proxy. While matched on the > demographic variables, the control group was stunningly > different on behavioral measures. Compared to the control > group the victim group was more likely to: rent rather than > own, live alone, drink alcoholic beverages, have problems > in the household because of drinking, have trouble at work > because of drinking, be hospitalized because of drinking, > use illicit drugs, have physical fights in the home during > drinking, have a household member hit or hurt in a fight in > the home, have a household member require medical > attention because of a fight in the home, have a household > member involved in a physical fight outside the home, have > any household member arrested, and be arrested themselves. > Thus the victim group and the control group had very different > lifestyles, with the victim group living a very high-risk lifestyle. In addition to matching cases and controls, we adjusted for behavioral risk factors using conditional logistic regression. The adjusted odds ratio for homicide in relation to gun ownership was actually higher than the crude odds ratio. > In fact, Kellermann found that having a gun in the home ranked > fifth out of six risk factors in the victims' lives. Using illicit drugs > lead to a 5.7 times risk of being murdered, being a renter 4.4 > times, having any household member hit or hurt in a fight 4.4 > times, living alone 3.7 times, guns in the household 2.7 times, > and a household member being arrested, 2.5 times. So? This does not reduce the significance of keeping a gun in the home as a (modifiable) risk factor, particularly since 40% of American homes contain one or more firearms. > The entire "gun in the home is risky" analysis depends on one > crucial figure, the percent of the control group (35.8%) that have > guns in their homes. If this figure is underreported, the findings > are false. There is good reason to assume this figure is low. > > First, many, many surveys report that around 48% of > Americans have guns in their homes. The victim group, > as reported by their proxies, had 45.4% gun owners. This > figure is unlikely to be false: the victim is dead, in 49.9% > of the cases by gunshot wound, the proxy cannot really lie > about it. > > If indeed the control group's firearms ownership was inline > with the national averages, Kellermans conclusions are > unwarranted. The figures cited are for the nation overall. Gun ownership in cities is typically lower than in small towns or rural areas. For a thorough discussion of this issue, read my paper, something I doubt the critic has actually done. DO GUNS SAVE LIVES? Ed Magnuson TIME 8/21/89 "After cabdriver Iran Bolton picked up an early morning fare at a Phoenix, Ariz., night spot, the customer held a broken bottle to her throat and forced her to pull into a deserted area. Robbing her of $70, the thug pushed the woman out of her cab and threw her to the ground. When her assailant ordered her to crawl in the dirt, Bolton responded by emptying her small pocket semi auto into him. He died later in a hospital." Each month American Rifleman, the journal of the National Rifle Association, features about a dozen such accounts of armed citizens defending themselves against criminals. Based on newspaper clippings submitted by NRA members, the stories dramatically show how a gun can sometimes prevent a crime and perhaps even save a victim's life. The gun lobby lands on mushier ground, however, when it leaps from such examples into a far broader argument: that more lives are saved than lost by the firearms Americans acquire to protect themselves and their property. The NRA emphasized that claim in a two-page newspaper advertisement attacking TIME for its report [July 17,1989] on 464 gun deaths that occurred in the US in a single week, chosen at random. "Legally owned firearms saved the lives of far more Americans than those lost during [TIME's] seven deadly days' ", the advertisement stated. "According to Dr. Gary Kleck of Florida State University, every year some 650,000 Americans use firearms to thwart criminal assault. That's 12,500 a week." Even Paul Blackman, Research Coordinator for the NRA, concedes that the advertisement "stretches the data". He adds, " I don't know of any criminological study that has tried to quantify the number of lives saved based on the number of guns that were successfully used for protection." Kleck says his study did not consider the question of lives saved. Nor did he conclude, as the NRA claims, that a crime or an assault had been "thwarted" in each of his estimated 645,000 ( the ad upped it to 650,000) annual instances of a protective use of a gun. Kleck notes that his study may have included incidents in which a homeowner merely heard noisy youths outside his house, then shouted, "Hey, I've got a gun!" and never saw any possible attacker. Still, Kleck estimates that an assailant or the defender actually fired a handgun in nearly half the cases. If so, 322,000 incidents each year involved great danger, and the potential victims credited their gun with protecting them. That is about 10 times the number who die from guns annually in the US. "It is possible that guns save more lives than they cost," Kleck says. His numbers are based on a poll conducted by Peter D. Hart Research Associates. It asked 1228 US voters whether in the previous five years any member of their household had "used a handgun, even if it was not fired, for self protection or for the protection of property". Roughly 4% said they had done so. Projecting that percentage onto the number of US households in the five years covered by the poll (1976-1981), Kleck came up with the estimate that handguns had been used protectively 3,224,880 times or 645,000 times a year. Comparing that with surveys that included rifles and shot-guns, he estimated that all types of guns are used defensively about a million times a year. Is his analysis valid? "I certainly don't feel very comfortable with the way he's used the data", says Hart Research president Geoffrey Garin. While Kleck based his findings on the Hart survey, his analysis of the circumstances under which guns were used came from other studies. Protests Garin: " We don't know anything about the nature of the instances people were reporting." Says William Eastman, president of the California Chiefs of Police Association, about the Kleck conclusions: "It annoys the hell out of me. There's no basis for that data" There is far more research on the question of who is most likely to get killed when someone keeps a gun at home. In a 1986 study called "Protection or Peril?", Dr. Arthur Kellermann, A University of Tennessee professor of medicine, and Dr. Donald Reay, chief medical examiner of King County in Washington, concluded that for each defensive, justifiable homicide, there were 43 murders, suicides or accidental deaths. Out of 398 gunshot fatalities in homes in King County between 1978 and 1983, only nine were motivated by self defense. The one week survey by TIME found a similar ratio on a national basis: only 14 of the 464 gun deaths resulted from defensive firing. An alarming 216 were suicides, 22 were accidental, and many of the rest involved homicides among people who knew each other well rather than citizens gunned down by strangers. Such statistics do not refute the argument that a gun, even if it is not fired, can save a life by discouraging a murderous attacker. Still, Tulane sociologist James Wright points out that guns have a limited usefulness in preventing crimes. About 90% of crimes in homed occur when the resident is away, he notes, while violent crimes often take place on the streets. Says Wright: "Unless you make a habit of walking around with your gun at all times, you're not going to stop that either". A relatively balanced view of the gun question comes, suprisingly, from Kleck. "The vast majority of the population lives in low-crime neighborhoods and has virtually no need for a gun for defensive reasons," he says. "A tiny fraction has a great deal of reason to get anything it can get that might help reduce its victimization." Even the American Rifleman accounts of how helpful a gun can be in saving a life may not always tell the full story. In the case of the cabdriver Bolton, the NRA magazine failed to report how chance, rather than her pistol saved her life. Bolton told the Arizona Republic that after she wounded her assailant, he grabbed her gun, pushed the barrel against her neck and pulled the trigger several times. What really saved Bolton was that she had emptied the chamber. Said she:"I kept thinking that maybe there was a bullet still in it and it would go off at any minute". If that had happened, the incident undoubtedly would not have appeared in the Rifleman.