In 2020, while As the Covid-19 pandemic raged on, the ever-growing epidemic continued to burn its path across the United States. Gun violence claimed the lives of 45,222 Americans in that fateful year, the worst year on record for gun deaths.
The path to each of these deaths is multi-layered and sophisticated. Every American killed by a bullet, every family grieving a loved one, deserves their own book. I never thought I would be the one to write a story like this.
I am an emergency room physician who owns a gun, a father and cousin of a man who was shot. If it weren’t for the National Rifle Association declaring in 2018 that physicians like me should “stay in my field” and remain noiseless about the effects of this scourge, I would not be writing about this topic. Yet gun violence consumes my life. I see victims of gun violence due to family tragedies—children, teens, and adults—almost every day.
Dealing with violence and death is the responsibility of anyone who has ever had to dress a gunshot wound, perform heroic acts in the operating room, meticulously care for the wounded in the intensive care unit, or admit defeat to loved ones. I have found no worse feeling than having to tell a mother or father that their child has been killed by a bullet. We have been practicing and refining evidence-based medicine for decades. Similarly, we should practice evidence-based health policy. When it comes to guns, some of that evidence already exists.
As a physician, I understand the limitations of science. The best research, at least in the biomedical realm, usually requires the results of randomized clinical trials, but conducting them for policy purposes is often not feasible. In public health, the next best option is a natural experiment, in which one jurisdiction implements a policy and a similar, nearby jurisdiction does not, and policymakers can observe the difference.
RAND Corporation The Science of Gun Policy—a synthesis of research on U.S. gun policy—typically relies on this type of research to inform its analysis. It is sometimes ambiguous, sometimes feeble, sometimes forceful in its claims about the impact of various policies that might affect lives in this epidemic of gun violence, but overall its analysis describes a myriad of policy levers that our current lawmakers could, and in my opinion should, rapidly implement at the federal, state, and local levels. The evidence suggests that we can save lives by doing the following:
- Background checks conducted by federally licensed firearms dealers on every firearm purchase
- Licenses and permits for people who want to buy weapons
- Raising the minimum age to purchase a firearm to 21
- Strict regulations to prevent access by children
- Low waiting times
- Domestic violence prohibition orders requiring surrender of firearms.
But I also believe there are two additional laws that should be repealed. Their presence in society should alarm doctors, advocates, and the people who write these laws.
Policy Rule #1: Reverse the “Stand and Defend” Rule
On February 26, 2012, Trayvon Martin, a black kid about my height and build, was walking through his Sanford, Florida, neighborhood after buying a pack of Skittles and a soda. He was practically being stalked by the captain of the local neighborhood watch. After an altercation—which the 911 dispatcher urged the overzealous neighborhood watchman to avoid—Martin was lying on the ground, shot dead by a single bullet that had pierced his heart and lungs.
All of this juvenile man’s hopes and dreams of becoming an aviator were dashed by a man who was ultimately acquitted of murder because of Florida’s self-defense law, which created a culture of approach, provocation, and killing. Self-defense certainly contributed to the juvenile boy’s death.