2051 2023 L17-Public health-Gun violence-GN
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Cornell University *
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2051
Subject
Medicine
Date
Jan 9, 2024
Type
docx
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Uploaded by BaronGuineaPig6072
2051 2023 Public Health and Gun Violence-Guided notes
Today
-
Public health
-
Gun violence
-
Guns in the US
-
What can health professionals do?
Public health focuses on
health issues that affect populations
.
(Why is gun violence a good example of a public-health issue?)
“Public health identifies and measures threats to the health of populations, develops
governmental policies in response to these concerns, and seeks to assure certain health and
related services” (Jonathan M. Mann, “Medicine and Public Health, Ethics and Human Rights,”
6)
Write:
Take a look back to the topics we’ve covered this semester. It might help to look at the
syllabus. Write down all the issues that have a public health component. Pick one and say how it
is a public-health issue.
If you have extra time, list some other public health issues you can think of.
1
(Why is public health less dramatic than bedside medicine?)
Gun violence
From: Henry J. Sloan et. al. (1988) “Handgun Regulations, Crime, Assaults and Homicide: A
Tale of Two Cities,”
New England Journal of Medicine
319(19) 1256-1262.
(Why are Seattle and Vancouver good cities to compare?)
(What was the single biggest difference in crime statistics between the two cities?)
“Virtually all of the increased risk of death from homicide in Seattle was due to a more
than fivefold higher rate of homicide by firearms.” (Sloan et. al.)
Guns in the United States
(What is the
ethical
question dilemma at the heart of gun ownership debates?)
2
Statistics:
-
48,117 firearm-related deaths in the United States in 2022
-
Firearm deaths were the 12
th
leading cause of death in the US, ahead of motor-vehicle
accidents.
-
Suicides with guns accounted for about 27,000 deaths and homicides about 17,000.
-
The states with the highest gun ownership rates also had the highest numbers of gun
deaths.
-
Researchers have shown that firearm-related deaths are now the leading cause of death
among US children and adolescents.
(What subset of the population is most affected by homicides with guns?)
(What subset of the population is most affected by suicides with guns?)
(How has the US Supreme Court and the federal and state governments repeatedly ruled on
restrictions of guns?)
What can health professionals do?
.(How can gun violence be viewed through a deontological/duty ethics lens?)
(How about through a consequentialist lens?)
3
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“However, autonomy can be understood to possess much richer dimensions. How, for example,
is the autonomy of citizens respected when they sense that it is no longer safe to ride public
transportation? How is the autonomy of children acknowledged when they cannot plan in
neighbhorood parks even during the daytime?” (Leigh Turner (1997) “Bioethics, Public Health,
and Firearm-Related Violence: Missing Links Between Bioethics and Public Health,”
Journal of
Law, Medicine & Ethics
, 25. Page 44).
Write:
What’s she saying and how is she opening up the idea of autonomy? How does this idea
of autonomy make the concept of autonomy more complicated?
(How does Holland discuss public health and the relation between individual rights and the
public good?)
In 2018, the
Annals of Internal Medicine
published a paper that made a strong set of
recommendations (note: I’d have you read this article, but it is ridiculously paywalled). These
recommendations, among other things, called for physicians to speak out:
“The medical profession has a special responsibility to speak out on prevention of firearm-
related injuries and deaths, just as physicians have spoken out on other public health issues”
4
(Butkus et. al. (2018) “Reducing Firearm Injuries and Deaths in the United States: A Position
Paper from the American College of Physicians,”
Annals of Internal Medicine
169: 704-707.
Some recommendations included:
-
Counseling families about the danger of guns in the home, especially in homes with
children, mentally ill family members, dementia, substance abuse problems, etc.
-
Discouraging state and federal authorities from preventing physicians from speaking out.
-
Training physicians in the general rules of firearm injury prevention.
-
Encouraging physicians to work individually and through professional associations to
advocate for national, state and local efforts to “reduce the risk of preventable injuries
and deaths from firearms, including background checks.”
-
Supporting regulations on the purchase of firearms, including requiring criminal
background checks and gun safety courses for purchasers.
-
Supporting regulations that would discourage gun ownership by known domestic
violence offenders.
5
“The ACP has pressed for adoption of policies to reduce the number of deaths and injuries
related to firearms for more than 20 years and is disheartened by the lack of action to protect the
American public” (Butkus et. al. (2018), p. 707.
The NRA’s answer was that doctors should “stay in their lane” (that’s a quote).
The APHA statement on gun violence:
-
Keep tracking numbers.
-
Keep conducting research on how laws and policies impact gun ownership and violent
crime
-
Develop better gun policies. The APHA does go to the place of calling for regulation. But
it hides that statement toward the bottom of its broader call.
-
And it calls for better laws around protective orders, including laws that allow law
enforcement to remove firearms from people who are considered a risk to themselves or
others.
“He was paralyzed from the neck down and could not feed himself, toilet himself, dress himself,
or turn over in bed. He will live the rest of his life in a nursing home, all paid for by the
taxpayers, as he is a Medicaid patient” (nurse Kelly Bernado, quoted in
Mother Jones
, April
2015).
6
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