Like many people, I followed the heartbreaking news from Buffalo, New York, and Uwalde, Texas. One cannot scroll through gunviolencearchive.org without being overwhelmed. Mass shootings – many seemingly motivated by anger and hatred and deserving news not only because they were carried out with the help of semi-automatic weapons – are now an epidemic.
One author of a letter to the editor made a comment that stung me: There is nothing we can do about anger and hatred. Probably this writer speaks from the spot that they have not been heard and understood.
I have witnessed dissatisfaction with friends and colleagues and with patients I see as a family doctor. What we offer each other is this: we can and must grieve. We must turn to those we love, and even to those we do not yet know.
Hatred comes from fear, and to dispel it, we must try to understand each other.
And in order to find solutions, we must also be objective. About 21,000 Americans died in 2021 from gun violence (excluding suicide). In 2019, about 1,600 Pennsylvania residents died from gun violence. By comparison, about 1,000 Pennsylvanians died in a motor vehicle accident that year.
Although some say guns are not necessarily a problem, a 2017 systematic review identified 34 studies evaluating the effects of firearms laws on firearms-related killings; he concluded that national and state laws that required background checks and required a permit to purchase firearms were associated with reduced mortality.
That is why I call for and welcome legislative action designed to promote public safety and common defense.
Then we need to think about what we are already doing that works better. One needs an initial check-up to drive a car in Pennsylvania, and an annual check-up to drive a bus or commercial vehicle. Thus, completing an annual exam and filling out a form is a regular process to ensure that our buses are safe on public roads. Shouldn’t we keep those who buy guns or ammunition to the same standard as those who drive our children to school?
There is a precedent. Some concealed carry laws and the Pennsylvania State Police’s Deadly Weapons Training Act require those who serve in public defense to pass a psychological exam before carrying a semi-automatic rifle. As a family physician in the Air Force, I have become accustomed to performing these federal assessments.
In both the civilian and military spheres, psychological examinations help to ensure that anyone who carries a weapon, loads a payload or otherwise works with the defense arsenal of our country or country is stable and safe in the performance of their work. This not only protects colleagues and civilians, but also ensures that appropriate treatment can be accelerated when needed. Shouldn’t we offer everyone, everywhere who carries a weapon, the same opportunity we give to those who wear a uniform?
Violence with weapons is a public health problem and access to health care must therefore be part of the answer. Thus, those who want or need to buy weapons and ammunition – especially semi-automatic weapons and ammunition – should not face any obstacles to screening assessment.
Individual assessments should be considered a public service and thus facilitated as much as possible. Not only would this effectively help to raise concerns, but annual reviews would provide an early opportunity to identify those with mental disorders who need help.
Finally, the implementation of background checks is currently demotivated; they are time consuming and pose a risk of losing business if potential problems are identified. Why not reverse this script? Let us recognize the trust we place in arms distributors and replace the role they play in our public safety.
One practical way to balance these costs would be to eliminate the exemptions from the federal tax on firearms and ammunition; Current exemptions from this sales tax include being an arms sales representative who sells less than 50 weapons per year.
Aren’t we all ready, when we buy weapons for personal protection, to contribute to the common defense?
Health services cannot remove anger and fear, but we can all try to listen and understand, and mental health services can deal with stress to help our community. Therefore, patients should have access to mental health services. Of course, any intervention to reduce gun violence can be life-saving, which we can all agree will be invaluable.
Dr. Corey Fogleman is a local family physician and vice president of the Lancaster City Health Council.