WASHINGTON -- In the wake of Sunday night's deadly gun violence in Las Vegas, calls are growing for dropping the law that effectively stopped gun violence research by the CDC, but there is little expectation the Congress would support such a move.
"I do not think that this will move Congress to fund firearm research," Frederick Rivara, MD, vice-chair of pediatrics at the University of Washington in Seattle, said in an email to 乌鸦传媒. "I very much doubt they will do anything meaningful." Rivara co-authored a 2012 study published in the Journal of the American Medical Association which found that the research restrictions have stymied efforts to find preventive solutions for mass shootings.
The legislation, known as the Dickey Amendment, was enacted in 1996; it did not ban the research, but instead blocked the CDC from doing gun control advocacy, such as "accepting for publication obviously biased articles and rejecting any articles that found any positive benefits to gun ownership," according to Timothy Wheeler, MD, founder and past director of Doctors for Responsible Gun Ownership, who testified before Congress in favor of the measure. The practical effect of the law, however, was that the CDC stopped doing gun violence research entirely.
Over the years, efforts to reverse the law, which was instituted in 1996, have not gained any traction. There are at least three bills in the current Congress that would end the ban -- would strike the amendment, and two others, and its companion House measure, H.R. 1832, would appropriate funds to reinstitute gun violence research.
"There are basic, widely supported steps Congress could take right now to reduce gun violence in this country and treat it like the public health crisis it is," Sen. Ron Wyden (D-Ore.), a co-sponsor of the Senate bill, said in a statement emailed to 乌鸦传媒. "Lifting the ban on funding for gun violence research is certainly one common-sense action Congress could take."
Rep. Frank Pallone (D-N.J.), a cosponsor of H.R. 1478, agreed. "There are a number of common-sense steps we can take. Those include ensuring CDC has authority and funding to carry out research to better understand gun violence and public safety and ensuring NIH remains committed to funding research on violence with particular focus on gun violence."
Wheeler, a retired head-and-neck surgeon living in the Los Angeles area, disagreed. "This is a problem that cannot be solved with laws, as much as we would like," he said in a phone interview.
Research into firearms is ongoing and has been for decades, Wheeler said; "it's done by well-regarded criminologists who are uniformly dismissed or ignored by public health researchers. There's no reason to think that research is going to stop; it has gone on at its own pace. We continue to learn about firearms and violence, and that's a good thing."
Concerns About Research
There are two reasons that some people oppose gun violence research, according to bioethicist Art Caplan, PhD, founding head of the bioethics division at New York University Langone Medical Center in New York City. "One is that they worry that research will lead to restrictions, which isn't necessarily true -- research could lead to changes in gun policy but it doesn't mean that restricted access to guns would inevitably follow."
"The other reason is I think people worry that research will reveal unflattering aspects of gun ownership" such as wanting to protect themselves against a black uprising or the United Nations taking over, he said in a phone interview. But for Caplan, reversing the law is a "no-brainer."
"We're way overdue to reverse prohibitions on research on gun violence; it is ideological lunacy not to study this huge public health problem," Caplan said. "We're the only country that has these frequent mass shootings and we don't know why. And there's much that could be studied to advance gun safety."
However, he doubted that the law would be reversed. "A small chance would be my guess," he said, although "the fact that a country-and-Western event was targeted does bring home the issue to people who are more inclined to oppose research ... And I think the sheer numbers [of fatalities] do make a difference."
There are very few avenues for researchers to study the effects of firearm violence, and one of them was quietly discontinued last month.
Eric Sigel, MD, chair, violence prevention subcommittee of the Society for Adolescent Health and Medicine (SAHM), and professor, pediatrics, at the University of Colorado School of Medicine in Aurora, was working with a collaborative group from the University of Michigan in Ann Arbor on the effects of firearm safety in children, only to be informed 4 days later that the NIH was firearm research.
"There's always time to fund research into firearms, whether a tragedy has happened or not," he told 乌鸦传媒. "But it's a grey zone as to if the government plans on funding any future research."
But Sigel added that in light of the recent tragedy, he was "crossing his fingers" that the new limits on NIH funding might be reversed.
'A Public Health Crisis'
Following the Las Vegas shooting, prominent medical societies renewed their commitment to advocacy. In a statement, the American Academy of Pediatrics [AAP] urged its members "not to grow complacent" about their reaction to these types of tragedies, citing varying state laws about waiting periods, licensing, and registration.
"The [AAP] advocates for strong state and federal gun laws that protect children in every state in the nation," Karen Remley, MD, AAP CEO/vice president and Fernando Stein, MD, AAP president said. "We can start by working to advance meaningful gun safety legislation that keeps children safe."
Both the AAP and the American College of Physicians cited a ban on so-called "assault weapons" as a start. Jack Ende, MD, ACP president said that the organization has been on the record "for nearly 20 years" about the need to address firearm injuries and deaths as a critical issue of public health.
"Specifically, we call for a ban on the sale and ownership of automatic and semiautomatic weapons," he said in a statement. "We must acknowledge that lack of a U.S. policy to address gun violence is the reason we have much higher rates of injuries and deaths from firearms violence than other countries. Something needs to change."
Firearm violence as a public health issue was also addressed by the American Medical Association in a series of tweets posted after the shooting. "Gun violence is a public health crisis, evident by the senseless loss of life and injury in Las Vegas," the organization said in a pinned tweet, adding in an additional tweet that "action needs to be taken" to address the issue.
Megan Ranney, MD, spokesperson for the American College of Emergency Physicians, and attending physician at Rhode Island Hospital in Providence, told 乌鸦传媒 that bipartisan efforts are needed to examine not only research on the prevention of firearm injury, but how to handle the aftermath.
"I am hopeful that each of these tragic incidents serves as a chance for us as a nation to move beyond partisan rhetoric. We should encourage funding agencies to conduct scientifically rigorous research on prevention, and how to help physicians, nurses and the community at large process and overcome these events," she said.
Prevention is a cornerstone of an upcoming policy statement from SAHM about firearms. Tamera Coyne-Beasley, MD, SAHM president, said that prevention of firearm violence has been part of the organization's advocacy efforts for a long time. She added that she travels to Washington "at least once a year" in collaboration with other organizations to speak out on the issue.
"It's an issue that's going to require more than the research community to solve," she told 乌鸦传媒. "Firearm violence is a leading cause of death among adolescents and young adults, and most of it is preventable. Further research could significantly prevent more injuries and deaths."