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Monday, September 3, 2012



The Gun Deaths Not Talked About

In the past three weeks, there have been a number of high-profile shootings, including the murder of 12 people in Aurora, Colorado; six Sikh worshippers in Wisconsin; and a possible shooting spree prevented by a guard at the Washington, D.C. headquarters of the Family Research Council. In a routine that’s become empty, gun control once again became a news topic for a few days as a proposed way to “stop this from happening again,” as the tired phrase goes. Some correctly noted that far more people are killed in day-to-day gun murders than in aberrational shootings by psychopaths, so those gun deaths should be the real justification for gun control. But even these savvier commenters are wrong, in a way. The majority of gun deaths aren’t due to any type of homicide at all; they’re due to suicides.

Yes, 59 percent of all gun deaths are self-inflicted—18,735 people in 2009. That’s 51 people—over four Aurora shootings—per day. And yet suicide has never been what’s stoked discussion of gun control, and even in ongoing debates it’s rarely mentioned.
We talk about these deaths less for at least a few reasons. First, out of concern for families, most media outlets rightly report on suicides only if they happen in public or involve a public figure. Without a large event, the media is largely incapable of any sustained discussion on a topic. Because of this, common but individual suicides can never garner as much attention as rare mass shootings.
Second, people have a predilection to narratives with villains versus heroes or victims. This is why murders and suicides possibly instigated by a second party draw vastly more press. Think of the attention given to the Tyler Clementi suicide, for instance, or suicides encouraged by online bullies. Third, it’s impossible to quantify, but the historical taint of shame on those who commit and attempt suicide has probably had a lingering silencing effect. Because of these reasons and others, few ever use suicide prevention as a justification for gun control, even though it’s the tenth leading cause of death (homicide is 15th).
The simplest explanation for why reducing the amount of guns could reduce the amount of suicides is that guns are one of the only methods to combine high lethality with easy access. A few statistics show why lethality matters in attempting to reduce deaths. Depending on the year and study, only 2 to 5 percent of suicide attempts use a gun. Attempts that use intentional drug overdose or self-mutilation account for around 85 to 90 percent. This small number of attempted suicides using guns may partly explain the lack of attention given to suicide prevention as a reason for gun control. But self-inflicted gunshots are much more deadly. The 2-to-5 percent of attempts by gun make up over 50 percent of all “completed” suicides.
What we need, then, is to shift people from lethal to non-lethal methods. On ease of access, guns, apart from being more lethal, also give less time for suicidal people to reverse the decision they’ve made. A Houston study found that for 24 percent of suicide survivors, less than five minutes elapsed between their decision and the attempt. Most other readily available methods for impulsively suicidal people have nowhere near the lethality of guns, hanging being one notable exception. And though correlation is not causation, an article in The New England Journal of Medicine noted that:
There are at least a dozen U.S. case-control studies in the peer-reviewed literature, all of which have found that a gun in the home is associated with an increased risk of suicide. The increase in risk is large, typically 2 to 10 times that in homes without guns…. Moreover, the increased risk of suicide is not explained by increased psychopathologic characteristics, suicidal ideation, or suicide attempts among members of gun-owning households.

A common objection is that deeply depressed people intent on finding a lethal way to kill themselves will do so, no matter the regulation. Research is mixed on this question, but a World Health Organization study that surveys the literature accepts that using alternate methods probably does occur, especially with non-impulsive suicides. Because of this, the authors conclude that “preventive efforts are likely to have the greatest impact on the subgroup who carry out unplanned impulsive acts.” They find, however, that “perhaps 20 to 30 percent of all suicides in industrialized countries belong to this subgroup and might be preventable.” Further, many studiesof restrictions of drugs and poisons have found either no displacement of suicide attempts, or displacement to less lethal drugs like ibuprofen.
Suicide is a unique failure of modern society. The per capita suicide rate hasheld steady since 1955, even as medical advances have reduced most other causes of death significantly. Whatever the methodological or philosophical objections to restricting guns to reduce suicides, surely it is at least worth a debate.

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