If Jeremiah Barondess, the patrician elder statesman of the
New York medical community, has his way, the average doctor’s examination in
the near future will include questions not only about a patient’s consumption
of red meat and alcohol, but of ammunition, too. Dr. Barondess, who is
president of the august New York Academy of Medicine, thinks physicians should
know if their patients have guns in the house. Some 600,000 doctors nationwide
are seconding that opinion.
Under Dr. Barondess’ direction, an organization representing
approximately two-thirds of the practicing doctors in America is about to
inject itself into the national debate on gun violence. Inviting the wrath of
the gun lobby, the group not only will advocate further gun regulation, but
will urge doctors to ask their patients specific questions about guns in their
homes and tell them about the risks of gun ownership.
The Observer
obtained a copy of a report put together by the ad-hoc coalition called Doctors
Against Handgun Injury. In it, the group recommends that health professionals
engage in what it calls “upstream intervention”-that is, using regular checkups
as an opportunity to ask patients about firearm ownership and storage in their
homes. “To promote public safety, health professionals and health systems
should ask about firearm ownership when taking a medical history or engaging in preventive counseling,” the report
states. “Patients should be provided with information about the risks of having
a firearm in the home, as well as methods to reduce the risk, should they
continue to choose to keep them.” The recommendation was based on an analysis
of recent gun-related suicides, homicides and accidental deaths across the
country.
The group is also calling for more conventional measures,
such as mandatory background checks of purchasers at gun shows, limits on the
number of guns that can be purchased by individuals and a waiting period for
all gun buyers. This is the first time that such a large group of doctors has
taken a position on gun control. Doctors Against Handgun Injury is made up of
the American Medical Association, the American Psychiatric Association, the
American Academy of Pediatrics and 10 other organizations.
Dr. Barondess, an author and medical-school professor with a
reserved demeanor and a taste for starched shirts, tried to minimize the
political fallout over his group’s report, describing the findings as purely
clinical. “We are neutral politically, academically and intellectually,” he
said. “Without politicizing this, it is possible for medical professionals to
proselytize for this and point out the dangers of gun violence. Getting shot
and being dead is certainly a clinical issue.”
Whatever the group’s intentions, the recommendations come in
the wake of yet another public-school shooting-the early March incident in
Santee, Calif., in which two students were killed. The double murder, allegedly
carried out by a 15-year-old student armed with a handgun, has been seized upon
by both sides in the contentious debate over gun regulation. And while the
timing is coincidental, one of the organizers of Doctors Against Handgun Injury
conceded that the report is almost certain to provoke strong reactions all
around, and stiff resistance from the gun lobby in particular.
“The National Rifle Association will probably say that we’re
threatening gun rights, no matter what,” said Robert Seltzer, the group’s
executive director, who worked for almost two decades on Capitol Hill for a
number of Democratic Senators. “I’m sure they’ll say this is disgusting and
wrong and bad, and that we’re trying to take away people’s guns-which we’re
not.”
The proposals are
expected to receive strong support from New York physicians. “Disability and
death from injury are the No. 1 problem for children and young people in United
States, and a major piece of that is guns, so any objections wouldn’t even
register with me,” said Katherine Lobach, a clinical professor of pediatrics at
Montefiore Medical Center in the Bronx. “I would hardly see it as a problem
that doctors would be concerned with gun violence. I certainly hope that this
becomes common practice.”
It may, but certainly not without a fight in those parts of
the country where the gun culture is more prevalent. “I think in New York this
will all be pretty easy, but out west and even upstate, people and guns are a different
story,” Dr. Lobach said.
The gun lobby already staunchly opposes one seemingly benign
recommendation which would not directly affect gun owners-the collection of
data on gun accidents by the federal government. (Such a program was created in
1992, but funding was discontinued by Congress in 1997 after heavy lobbying by
the N.R.A.) Wayne LaPierre, the executive vice president of the N.R.A., has
described such measures as the “knock on the door in the middle of the night”
that will inevitably lead to tighter restrictions or even a ban on the
ownership of guns.
The doctors’ report also is likely to face opposition from
at least one group within the medical community. Doctors for Responsible Gun
Ownership claims a membership of about 1,300 physicians and exists, according
to its Web site, “because social activists in the medical and public health
fields have used their authority to misrepresent gun ownership as a disease.”
Dr. Tim Wheeler, who heads Doctors for Responsible Gun Ownership, assailed the
recommendations of the newly formed coalition. “The reason that this group is
getting involved in gun politics has nothing to do with public health,” Dr.
Wheeler told The Observer from his home in California. (The N.R.A. referred calls
about Doctors Against Handgun Injury to Dr. Wheeler.) “Handgun ownership is not
a medical issue and never has been, but is politicized by political activists
and medical organizations. Most of the useful scientific research on handguns
is not in the medical field but in criminology, and these medical groups have
not only ignored but suppressed this information.”
Dr. Wheeler expressed
particular alarm at the prospect of doctors mixing lectures about gun ownership
into the standard checkup routine. “This is a real hot-button privacy issue,”
he said. “When doctors talk about guns for political purposes, they are
committing an unethical act, and their patients who are responsible gun owners
feel violated. Most of these doctors don’t know squat about guns. They don’t
know anything about personal safety, and they’re usually very hostile to gun
ownership for political reasons.”
Dr. Barondess’ vigorous assertions of respect for gun
owners’ rights-in an interview, he noted several times that many of the doctors
in his coalition owned firearms-may do little to assuage the likes of Dr.
Wheeler. But if he is in for heavy combat, Dr. Barondess will have some
experience on his side. He is no stranger to controversy.
Washington’s Dentures
Dr. Barondess was responsible for transforming the 153-year-old
New York Academy of Medicine from a sleepy repository for medical
antiquities-the medical library at its East 103rd Street headquarters boasts
both a 3,700-year-old papyrus and a set of George Washington’s dentures-into an
active policy organization. A 76-year-old native New Yorker, a professor of
clinical medicine at Cornell University Medical College and a co-author of The Oxford Medical Companion , he has
used his stature to weigh in on an array of issues and thus raise the Academy’s
profile.
Over the last decade, Dr. Barondess has spoken out on such
issues as care for AIDS victims and hospital conditions for the urban poor.
Most recently, he fueled a national debate over ergonomic standards in the
workplace, when a panel he chaired issued a report on the scientific basis for
such rules in January. Both the report-carried out under the auspices of the
National Academy of Sciences-and Dr. Barondess’ subsequent testimony before
Congress have been cited by unions, business groups, U.S. Representatives and
the federal Occupational Safety and Health Administration in support of their
arguments. Just before leaving office, former President Clinton issued new
regulations requiring employers to take action to prevent such ailments as
repetitive-stress syndrome. Congress overturned those regulations in early
March.
Dr. Barondess also gained attention in 1996 when he implored
Supreme Court Chief Justice William Rehnquist to prohibit the legalization of
doctor-assisted suicide. Before that, Dr. Barondess made his first major push
into the area of gun violence, declaring on behalf of a coalition of New
York–based medical officials that it had become an “epidemic” in the city and
surrounding area.
Dr. Barondess’ statements, whether on gun violence or
medical care in the inner city, appear to have a common thread: an expansion of
the medical community’s role in shaping public policy. “We are in the business
of helping to redefine health in ways that would include any kind of
population-based risks like, for example, handguns and workplace injuries,” he
said.
With his Doctors Against Handgun Injury, however, Dr.
Barondess has embarked on his biggest undertaking ever. He believes that the
coalition will be by far the largest organization of doctors ever to offer a
unified opinion on such a contentious issue. And although he refuses to discuss
something as vulgar as political considerations-“Let’s just say that some
political figures appreciate what I have to say more than others,” he
remarked-he can hardly doubt that, with George W. Bush in the White House and
Republicans in control of Congress, most of his group’s recommendations are
unlikely to become law anytime soon.
But Dr. Barondess believes that his group may be able to
change the tenor of the discussion over gun violence. “This is not in any way
about gun control,” he said. “We can think of handgun injury as being like a
disease that afflicts many people in our society, and we’re going to introduce
mandatory immunizations for this disease. Part of this mayhem is preventable,
and doctors are in the prevention-of-premature-death business. The number of
people killed by guns every year is indisputable, and criminal justice is not
the only way of solving this.”
