JAMA and Gun Control

Author: 
James H. Wood, MD
Article Type: 
Correspondence
Issue: 
May/June 1999
Volume Number: 
4
Issue Number: 
3

In the December 23/30, 1998 issue of JAMA, Wintemute GJ, Drake CM, Beaumont JJ, Wright MA, and Parham CA, authored a pro-gun control article entitled, "Prior Misdemeanor Convictions as a Risk Factor for Later Violent and Firearm-Related Criminal Activity Among Authorized Purchasers of Handguns" (JAMA 1998;280(24):2083-2087). In the following letters, two physician respond to the editors of JAMA. We thought their response would be of interest to readers of the Medical Sentinel, particularly since physicians opposed to gun control as a public health issue are seldom given a chance to express their views in AMA publications.

 

Dear JAMA Editors,
As a member of both the AMA and NRA, as well as a previous contributor of scientific articles for JAMA,(1) I wish to call to your readers' attention several complicating factors and observations that may have adversely affected the data and analysis of the retrospective cohort study of prior misdemeanor convictions as a risk factor for later violent and fire arm-related criminal activity among authorized purchasers of handguns reported by Wintemute et al,(2) and the subsequent call for legislative restriction against individuals with prior misdemeanor offenses by Brady, Brady and Cole,(3) and a call for violence related papers by the editorial staff of JAMA.(4)

First, this association of prior misdemeanor convictions with later more serious new crimes holds true even if the subject never owned a handgun. Since handgun ownership is an inclusion criteria in this study, it should not be surprising for future offenses committed by these subjects to involve a handgun. By restricting inclusion criteria to only hand gun owners, this study's results give the slanted conclusion that those with at least one prior misdemeanor conviction are much more likely than those with no prior criminal history to be charges with a new offense.

Secondly, there is no comparison in this study with the control group of law abiding citizens, and those with at least one prior misdemeanor conviction who are not handgun owners. By restricting the study to only handgun purchasers, and not including a control group of non-gun owners, the readers of JAMA are not able to assess from this paper the influence of the correlation of previous crimes or misdemeanors with later more violent crimes.

Third, this paper completely omits study of comparison of criminal records of those with one or more prior misdemeanor convictions and those with no convictions regarding offenses involving firearms or violence where the subject never legally purchased a handgun. This latter illegal group represent the most desperate criminals that would be least affected by handgun legislation.

Most of the reference used in this paper are "opinion publications" and are not scientific papers that have adequate control groups. Care must be taken in avoiding extrapolations or generalizations from such papers that do not include an adequate control group for comparison. Such uncontrolled studies help to propagate myths about guns that can threaten people's safety by frightening them and preventing them from using the most effective means to defend themselves.

The references in this article by Wintemute et al do not mention the definite monograph, More Guns, Less Crime: Understanding Crime and Gun Control Laws by John R. Lott, Jr. from the University of Chicago Law School.(5) The inclusion of such references that dispel the myths about guns and crime must be included in the public policy debate. Lott's monograph strongly indicates that allowing citizens to own guns saves lives. Recent reports of a several fold increase in violent crimes occurring after the outlawing of handgun purchases by law abiding citizens in Australia should prompt the editorial boards of peer reviewed journals such as JAMA to require inclusion of reports of contrary data or articles in the discussion of such papers, and should certainly, when requesting editorial comments such as the Brady article, also include editorial comments from other noted authorities with contrary views.

Finally, in addition to performing additional studies to include an appropriate control group of non-gun owners for comparison, Wintemute et al should consider similar studies involving subjects with illegally obtained handguns and subjects who own other lethal weapons such as knives. Would the editorial by Brady, Brady and Cole(3) still advocate the prohibition of knife purchases or possession of knives by individuals convicted of a prior misdemeanor? Would they advocate a "Brady Law" for knife purchasers too?

References

1. Wood JH, Fleischer AS. Observations during hypervolemic hemodilution of patients with acute focal cerebral ischemia. JAMA 1982;248:2999-3004.
2. Wintemute GJ, Drake CM, Beaumont JJ, Wright MA, Parham CA. Prior misdemeanor convictions as a risk factor for later violent and firearm-related criminal activity among authorized purchasers of handguns. JAMA 1998;280:2083-2087.
3. Brady S, Brady J, Cole TB. Handgun purchasers with misdemeanor convictions. JAMA 1998;280-2120-2121.
4. Flanagin A, Cole TB. Violence, a neglected epidemic; call for papers. JAMA 1998;280-2121.
5. Lott JR, Jr. More Guns, Less Crime: Understanding Crime and Gun Control Laws, Chicago, IL, University of Chicago Press, 1998.

James H. Wood, MD 
Chief, Section of Neurosurgery
West Paces Medical Center
Atlanta, GA

Correspondence originally published in the Medical Sentinel 1999;4(3);77-81. Copyright©1999 Association of American Physicians and Surgeons (AAPS).

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