From: msmith01@flash.net
Subject: SNET: The Benefits of Firearms
Date: 16 Apr 2001 15:37:14 -0400
To: Mark 

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http://www.newsmax.com/archives/articles/2001/4/12/213756.shtml


The Benefits of Firearms

     Miguel A. Faria Jr., M.D.
     Thursday, April 12, 2001

Public Health and Gun Control: A Review
Part I: The Benefits of Firearms
Introduction: "A Gun in the Home"

I have related previously (Medical Sentinel, Spring and Summer 1997) how
the 1991 American Medical Associationıs (AMA) campaign against domestic
violence launched for public relation consumption went hand in hand with
the public health establishmentıs 1979 stated objective of eradication
of handguns in America, beginning with a 25 percent reduction by the
year 2000. (1-2) Toward that objective, in the 1980s, hundreds of
articles describing politicized, biased, result-oriented research funded
at taxpayers' expense were published in the medical journals. (3) One of
the principle investigators was Dr. Arthur Kellermann, who now heads the
Emory University School of Public Health.

 A significant portion of the gun control agenda, not only of the public
health but the entire health advocacy establishment, in fact, comes from
Dr. Kellermann's landmark articles, particularly "Gun Ownership As a
Risk Factor for Homicide in the Home," published in The New England
Journal of Medicine (NEJM) in 1993. (4) And yet, much of the
methodology, not to mention conclusions in the article, have been
questioned by numerous investigators. (5-7)

 Since at least the mid-1980s, Dr. Kellermann (and associates), whose
work had been heavily funded by the CDC, published a series of studies
purporting to show that persons who keep guns in the home are more
likely to be victims of homicide than those who don't. In a 1986 NEJM
paper, Dr. Kellermann and associates, for example, claimed their
"scientific research" proved that defending oneself or one's family with
a firearm in the home is dangerous and counterproductive, claiming "a
gun owner is 43 times more likely to kill a family member than an
intruder." (8)

 In a critical review and now classic article published in the March
1994 issue of the Journal of the Medical Association of Georgia (JMAG),
Dr. Edgar Suter, chairman of Doctors for Integrity in Policy Research
(DIPR), found evidence of "methodologic and conceptual errors," such as
prejudicially truncated data and the listing of "the correct methodology
which was described but never used by the authors." (5) Moreover, the
gun control researchers failed to consider and underestimated the
protective benefits of guns.

Dr. Suter writes: "The true measure of the protective benefits of guns
are the lives and medical costs saved, the injuries prevented, and the
property protected – not the burglar or rapist body count. Since only
0.1 - 0.2 percent of defensive uses of guns involve 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." (5)

 In 1993, in his landmark and much-cited NEJM article (and the research,
again, heavily funded by the CDC), Dr. Kellermann attempted to show
again that guns in the home are a greater risk to the victims than to
the assailants. (4) Despite valid criticisms by reputable scholars of
his previous works (including the 1986 study), Dr. Kellermann ignored
the criticisms and again used the same methodology. He also used study
populations with disproportionately high rates of serious psychosocial
dysfunction from three selected state counties, known to be
unrepresentative of the general U.S. population.

For example, 53 percent of the case subjects had a history of a
household member being arrested, 31 percent had a household history of
illicit drug use, 32 percent had a household member hit or hurt in a
family fight, and 17 percent had a family member hurt so seriously in a
domestic altercation that prompt medical attention was required.
Moreover, both the case studies and control groups in this analysis had
a very high incidence of financial instability.

In fact, in this study, gun ownership, the supposedly high risk factor
for homicide, was not one of the most strongly associated factors for
being murdered. Drinking, illicit drugs, living alone, history of family
violence, living in a rented home were all greater individual risk
factors for being murdered than a gun in the home. One must conclude
there is no basis to apply the conclusions of this study to the general
population.

 All of these are factors that, as Dr. Suter pointed out, "would
expectedly be associated with higher rates of violence and homicide."
(5) It goes without saying that the results of such a study on gun
homicides, selecting this sort of unrepresentative population sample,
nullify the authors' generalizations, and their pre-ordained conclusions
cannot be extrapolated to the general population.

 Moreover, although the 1993 New England Journal of Medicine study
purported to show that the homicide victims were killed with a gun
ordinarily kept in the home, the fact is, as Kates and associates point
out, that 71.1 percent of the victims were killed by assailants who did
not live in the victimsı household using guns presumably not kept in
that home. (6)

 While Kellermann and associates began with 444 cases of homicides in
the home, cases were dropped from the study for a variety of reasons,
and in the end, only 316 matched pairs were used in the final analysis,
representing only 71.2 percent of the original 444 homicide cases.

 This reduction increased tremendously the chance for sampling bias.
Analysis of why 28.8 percent of the cases were dropped would have helped
ascertain if the study was compromised by the existence of such biases,
but Dr. Kellermann, in an unprecedented move, refused to release his
data and make it available for other researchers to analyze.

 Likewise, Prof. Gary Kleck of Florida State University has written me
that knowledge about what guns were kept in the home is essential, but
this data in his study was never released by Dr. Kellermann: "The most
likely bit of data that he would want to withhold is information as to
whether the gun used in the gun homicides was kept in the home of the
victim." *

 As Kates and associates point out, "The validity of the NEJM 1993
studyıs conclusions depend on the control group matching the homicide
cases in every way (except, of course, for the occurrence of the
homicide)." (6)

 However, in this study the controls collected did not match the cases
in many ways (i.e., for example, in the amount of substance abuse,
single-parent versus two-parent homes, etc.), contributing to further
untoward effects and decreasing the inference that can legitimately be
drawn from the data of this study. Be that as it may, "[t]he conclusion
that gun ownership is a risk factor for homicide derives from the
finding of a gun in 45.4 percent of the homicide-case households, but in
only 35.8 percent of the control households. Whether that finding is
accurate, however, depends on the truthfulness of control group
interviewees in admitting the presence of a gun or guns in the home."
(6)

The Problem with Scientific Surveys

 Professor Gary Kleck has written extensively that false denial of gun
ownership is a major problem in these survey studies, and yet Kellermann
and associates do not admit or mention this fact. (9) And this is
critical. It would take only 35 of the 388 controls falsely denying gun
ownership to make the control gun ownership percentage equal that of the
homicide case households. As Kates and associates write, "If indeed, the
controls actually had gun ownership equal to that of the homicide case
households (45.4 percent), then a false denial rate of only 20.1 percent
among the gun owning controls would produce the thirty-five false
denials and thereby equalize ownership." (6)

 Consider the fact that Kellermann and associates' pilot study had a
higher percent false denial rate than the 20.1 percent required to
invalidate their own study, and yet he and his associates concluded that
there was no "underreporting of gun ownership by their control
respondents," and their estimates, they claim, were therefore considered
not biased. (4)

 In the Medical Sentinel, we have considered this type of bias** in
response to a 1996 JAMA gun ownership survey. We reported on question
#20 of that survey: "If asked by a pollster whether I owned firearms, I
would be truthful, 29.6 percent disagreed/strongly disagreed." (10) So,
according to this survey, 29.6 percent would falsely deny owning a
firearm. We know that nearly one-third of respondents intentionally
conceal their gun ownership because they fear further confiscation by
the police, as has happened in cities such as Washington, D.C., Detroit
and New York.

 One must conclude on the basis of these errors that the findings of the
1993 Kellermann study are invalidated, just as those of 1986 are
tainted. Nevertheless, these errors have crept into and now permeate the
lay press, the electronic media and particularly the public health
literature and the medical journals, where they remain uncorrected and
are repeated time and again and perpetuated. And because the publication
of the data (and their purported conclusions) supposedly come from
"reliable" sources and objective medical researchers, it's given a lot
of weight and credibility by practicing physicians, social scientists
and law enforcement These errors need to be corrected to regain the loss
of credibility of public health in this area of gun and violence
research.

Are There Benefits of Firearms?

 What we do know, thanks to the meticulous scholarship of Prof. Gary
Kleck and Doctors for Integrity in Policy Research (DIPR), is that the
benefits of gun ownership by law-abiding citizens have been greatly
underestimated. In "Point Blank: Guns and Violence in America" (1991)
(11), a myriad of scientific publications, and his latest book,
"Targeting Guns" (1997) (9), Prof. Kleck found that the defensive uses
of firearms by citizens amount to 2.5 million uses per year and dwarf
the offensive gun uses by criminals. Between 25 and 75 lives are saved
by a gun for every life lost to a gun. Medical costs saved by guns in
the hands of law-abiding citizens are 15 times greater than costs
incurred by criminal uses of firearms. Guns also prevent injuries to
good people and protect billions of dollars of property every year.
(5)***

 Incidentally, the health care costs incurred by gun shootings have been
greatly exaggerated. DIPR, in an article published in the June 1995
issue of the JMAG, estimated that the actual U.S. health care costs of
treating gunshot wounds is approximately $1.5 billion, which amounts to
0.2 percent of annual health care expenditures. The $20-$40 billion
figure, frequently cited by the mass media and even medical journals, is
an exaggerated estimate of lifetime productivity lost where criminals
are given inflated, unrealistic life productivity estimates, as if their
careers were suddenly expected to blossom into that of pillars of the
community (12) with projected salaries equaling those of managed-care
CEOs. Yet, despite these major detractions, the health advocacy
establishment clings to the erroneous figures and extrapolations of Dr.
Kellermann and other public health researchers and use these erroneous
figures in propounding health and gun control policies, to the detriment
of public policy.

 To catch up with the lost ground on the gun and violence research that
has been accumulating in the criminologic and sociologic body of
literature in the last couple of years, we have to look not only to the
data collected by Prof. Gary Kleck and Dr. Edgar Suter, but also other
prominent investigators. Recent data by Prof. John R. Lott Jr., formerly
with the University of Chicago and now at Yale University, in his book
"More Guns, Less Crime: Understanding Crime and Gun Control Laws" (1998)
(13) has also been suppressed from dissemination in the medical journals
and public health literature, except for the Medical Sentinel. (1-2) In
his book, Prof. Lott studied the FBI's massive yearly crime statistics
for all 3,054 U.S. counties over 18 years (1977-1994), the largest
national survey on gun ownership and state police documentation on
illegal gun use, and he comes to some startling conclusions:

While neither state waiting periods nor the federal Brady Law is
associated with a reduction in crime rates, adopting concealed-carry gun
laws cut death rates from public, multiple shootings (e.g., those that
took place in Jonesboro, Arkansas, and Springfield, Oregon, in 1998; the
Columbine High School shooting in Littleton, Colorado, in 1999; and the
1993 shooting on the Long Island subway) – by a whopping 69 percent.

 Allowing people to carry concealed weapons deters violent crime,
without any apparent increase in accidental death. If states without
right-to-carry laws had adopted them in 1992, about 1,570 murders, 4,177
rapes, and 60,000 aggravated assaults would have been avoided annually.

 Children 14 to 15 years of age are 14.5 times more likely to die from
automobile injuries, 5 times more likely to die from drowning or fire
and burns, and 3 times more likely to die from bicycle accidents than
they are to die from gun accidents.

 Prof. Lott found that when concealed-carry laws went into effect in a
given county, murders fell by 8 percent, rapes by 5 percent, and
aggravated assaults by 7 percent.

 For each additional year concealed-carry gun laws have been in effect,
the murder rate declines by 3 percent, robberies by over 2 percent, and
rape by 1 percent. (13)

Suicide and 'Crimes of Passion'

 Let me now say a word about suicide and gun availability. Both Drs.
Arthur Kellermann and John H. Sloan have written about suicides and have
attempted to link these fatalities to the availability of guns in
articles published in The New England Journal of Medicine. (14-15) In
reality, the overwhelming available evidence compiled from the
psychiatric literature is that untreated or poorly managed depression is
the real culprit behind the high rates of suicide. The evidence is
authoritative on this point as classified in the Diagnostic and
Statistical Manual of Mental Disorders of the American Psychiatric
Association and any standard psychiatric text.

>From the social science of criminology, in fact, we solve the seeming
paradox that countries such as Japan, Hungary and Scandinavia, which
boast draconian gun control laws and low rates of firearm availability,
have much higher rates of suicide (2 or 3 times higher) than the U.S. In
these countries where guns are not readily available, citizens simply
substitute for guns other cultural or universally available methods for
killing themselves, such as hara-kiri in Japan, drowning in the Blue
Danube in Hungary, suffocation (with poisonous gases such as carbon
monoxide from automobile exhausts), or simply hanging, such as in
Denmark and Germany, or even drinking agricultural pesticides, as is
commonly done in Sri Lanka. And in these countries, citizens commit
suicide quite effectively by these methods at higher rates than in the
U.S. (11,16)

I believe the health advocacy establishment must consider the fact that
guns and bullets are inanimate objects that do not follow Koch's
Postulates of Pathogenicity (which prove definitely and scientifically a
micro-organism is responsible for a particular disease), and recognize
the fact that behind every shooting there is a person pulling the
trigger, who should be held accountable. The problem is more complex
than just easy availability of firearms and guns and bullets as
animated, virulent pathogens needing to be stamped out by limiting gun
availability, and ultimately, eradicating guns from law-abiding
citizens.

 And within the context of gun availability, much has been said about
the "crimes of passion" that supposedly take place impulsively, in the
heat of the night or the furor of a domestic squabble. Criminologists
have pointed out that homicides in this setting are the culmination of a
long, simmering cycle of violence. In one study of the police records in
Detroit and Kansas City it was revealed, for example, that in "90
percent of domestic homicides, the police had responded at least once
before during the prior two years to a disturbance," and in over 50
percent of the cases, the police had been called five or more times to
that dysfunctional domicile.

Surely, these are not crimes of passion consummated impulsively in the
heat of the night by ordinary citizens, but the result of violence in
highly dysfunctional families in the setting of repeated alcohol or
illicit drug use. It is also the setting of abusive husbands who, after
a long history of spousal abuse, finally commit murder and,
increasingly, wives defending themselves against those abusive husbands,
representing acts of genuine self-defense. (6)

Part II follows.

All references cited in this text are found at the conclusion of Part II
of this essay.

Footnotes:

* Personal communication via e-mail, 09/21/99.

** Because of the reluctance of some investigators, even those funded by
taxpayers to share scientific data with other researchers, the Medical
Sentinel, the official, peer-reviewed journal of the Association of
American Physicians and Surgeons (AAPS), established the open data
policy for public review of research impacting on the formulation of
public policy, http://www.haciendapub.com/press2.html.

*** This has been substantiated by a Department of Justice study in 1997
under the Clinton administration, which found that up to 1.5 million
citizens use firearms to protect themselves and their property yearly.








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