Firearms in America: No Easy Answers

Gregory A. Hood, MD


November 29, 2018

In This Article

A Serious Public Health Issue

In the recent wake of the horrendous, tragic mass murder at the Tree of Life Synagogue in Pittsburgh, and the shooting at a country dance bar in California, organized medical societies have again, understandably, called for further action on firearm safety.

It's a call that has happened many times before, over decades, following many acts of evil. Physicians and policy-makers are making these pleas with impassioned, structured arguments. And, as before, these calls may not result in meaningful change.

There are different cultural perspectives and identities involved in the underlying issue of firearm ownership rights. However, when it comes to the all-too-common acts of violence that have been occurring with disturbing frequency, there are many points of common belief within which dialogue may be established and common ground explored.

Chief among these points is that any perpetration of mass violence is an utterly abhorrent, inexcusable abomination. The terrible specter of violence against innocents energizes those of each perspective—whether or not they are supportive of gun ownership rights—to wish to take action to prevent the next unjustified death, whether it be a single life or many.

To make progress in the efforts to reduce the frequency and impact of mass-casualty events, I believe that we must acknowledge that there are people of good character, and of good intent, who may differ on their personal preferences with regard to the Second Amendment. There are many measures that can be used to reduce the odds of successful attacks of this nature, many of which could be found on common ground.

There are two somewhat different issues here. One, about which probably everyone feels unanimously, is the terrible specter of people using guns for mass violence against innocent victims. The other aspect has to do with whether or not individual homeowners have the right to own firearms for their own defense, as stated in the Second Amendment.

How Does Culture Factor In?

If true and correct progress is going to be made, a distinction must be recognized in the discussion of firearm ownership/safety. This distinction is rooted in another vital clinical skill in healthcare, which is that of "cultural competency."

At first, this may seem to be an unusual assertion to make, given that this is, on the surface, a principally American question, posed by American doctors, about events in our country. However, in today's society, people are deeply divided, if not severely fractured, when it comes to their beliefs and attitudes.

Cultural competency is an essential skill for medical providers because of today's diversity among patient populations, and especially when the clinician doesn't wholly share the culture or cultural experiences of those whom they treat. Culture, the shared beliefs and attitudes of a group, shapes ideas of what is acceptable behavior, what constitutes misbehavior or illness, and what are acceptable responses or treatments within a particular society, or segment of society. Those who support firearm ownership are a culture, just as those who are against firearm ownership may, broadly speaking, possess a culture as well.

Here, I want to point out that I refer to two cultural subsets, based on those who support firearm ownership and those who do not. The material possession of a firearm, or not, is a secondary variable that isn't equivalent to one's beliefs on the issue of firearm rights.

Here in Kentucky, I know of a number of physicians who carry firearms in the exam room every day. Indeed, the pro-firearm culture and the anti-firearm culture cut across most other cultural lines in America as well.

Even the medical establishment doesn't speak with a fully unified voice in this matter. There are specific organizations that enumerate reasons to support the right to bear arms and to be judicious in expanding gun control, and put forth proposals to avoid mass shootings from the perspectives of physicians who are also members of other cultural groups.

It's important that we, as healthcare personnel, do not engage in stereotyping or overgeneralizations, either in the policies of our medical organizations or in our exam rooms.

Within most every socioeconomic, demographic, and other cultural identifiers, there are those who support firearm ownership and those who do not. Therefore, it's important that we, as healthcare personnel, do not engage in stereotyping or overgeneralizations, either in the policies of our medical organizations or in our exam rooms.

Where the issue of firearm ownership differs from the subcultures of smokers, for example, is that whereas the consumption of tobacco can be understood by all to be a habit, a choice, an addiction, and so forth, many people view firearm ownership in an entirely different light.


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