A Simple Solution to Gun Control?

A Simple Solution to Gun Control?

When I read online commentary on gun control measures, I see opinion divided into two camps: Guns are the problem. Or mental illness is the problem. American gun violence is a complex matter, and the availability of guns and the prevalence of mental illness are both important factors.

Are we going to do something to reduce dramatically the availability of guns? All the evidence points to no. We have more firearms in the USA than we have people. We had a ban on semiautomatic rifles for 10 years, but it had little effect on supply, and it sunset without evident effect on crime, partly because these weapons are used in a tiny fraction of incidents in which people are killed with guns, even though they are used in a sizable proportion of mass shootings.  We may have another ban on these weapons as the public demand to “do something” escalates.  

Or we may not.

So, I have a simple idea that might make a small contribution. Small contributions have the disadvantage of being small, but sometimes they have the advantage of being workable, so consider this one in that light.

In the spirit of full disclosure, there are three things I should tell you about myself. First, I am a doctor specializing in emergency medicine, with a longstanding interest in public health, and I’ve read a lot about the public health perspective on gun violence. Second, I am a gun owner, and I have read a lot about American gun culture. I can tell you how gun owners think and feel, and I can explain the positions of the NRA and the other gun-rights advocacy groups that take an even harder line (believe it or not). Third, I am running for state Senate, so I think a lot about our current public health problems, including social problems, from the “there-ought-to-be-a-law” viewpoint. 

If a voter asks me what I will do, if elected, about gun violence, “I don’t know” is not an acceptable answer.

We live in Pennsylvania. In PA, doctors have a legal obligation to report to the Department of Transportation drivers who have medical problems that may cause them to have episodes of loss of consciousness that would be dangerous if they happen while driving. This affects mostly people with seizures, but diabetics with repeated episodes of low blood sugar, people with fainting spells of various causes, and alcoholics and other drug addicts who lose control of a vehicle because of an overdose are all reportable.

So how about this?  Why not ask a doctor who encounters a patient with behavioral problems such that, in the physician’s judgment, this person should not have access to firearms, to make a similar report to an appropriate government agency?

How would that work? Here are a few essential points.

  1. Doctors would need guidelines. So form a panel of experts to create them. What are the signs a doctor can recognize that mean a person is potentially dangerous in ways relevant to having access to guns? Require all licensed physicians to learn these guidelines. State medical boards already micromanage our continuing education, like requiring all licensed physicians to take two or three hours of online education about opioid prescribing and addiction, or child abuse, so this would be easy to do.
  2. Reporting in good faith would be legally protected.
  3. A person who is reported would be investigated regarding whether s/he should have the right to possess firearms restricted. There would be built-in due process involving appropriate parts of our legal system, with the right to appeal and the right to petition to have gun rights restored.

Would this identify everyone who is emotionally unstable and shouldn’t have guns? Of course not.  But what do we do now? The people who are disqualified are those hospitalized involuntarily because of mental illness, and those who are adjudicated mentally incompetent. That is a small portion of the population of people who shouldn’t have guns because they are a potential danger to themselves or others.  

And the expansion of the “pool” adopted during the Obama Administration, and reversed by Trump, that would have added people judged by the Social Security Administration as incapable of managing their affairs (financially) was vigorously opposed by both the NRA and the ACLU.  That should catch your eye, because the ACLU does not recognize a Second Amendment individual right, even after the Supreme Court explicitly did.

We need creative solutions. Lots of them. And they have to be solutions that can get substantial buy-in from interested parties on various sides of the issue. This is one. I will do my best, if I am elected to the Pennsylvania Senate, to fashion more that I think can be enacted in an American society that is starkly polarized on this issue.

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