Friday, July 11, 2008

Guns, suicide, freedom, and responsibility: A serious answer to a serious question by Delaware's Hottest Blogger

Over at Delawareliberal there has been quite a 2nd Amendment brew-haha going on with posts here, here, and here.

Feeling somewhat besieged (and I would agree that I'm somewhat surprised as some of the invective), Delaware's Hottest Blogger (or, the blogger formerly known as "dv") raised A Serious Question about the implications of the Loftin-McDowall study on the link between handguns and suicide in the light of the DC gun ban.

Briefly, Loftin and McDowall found a slight but statistically significant decline in suicides in Washington DC immediately after the adoption of the now-defunct handgun ban. As the Washington Post reported it:

The researchers employed a simple procedure: They tabulated all the suicides that had taken place in Washington between 1968 and 1987. Colin Loftin and David McDowall found that the gun ban correlated with an abrupt 25 percent decline in suicides in the city.

Loftin and McDowall, who now work at the University at Albany, part of the State University of New York, also tabulated suicide rates in Maryland and Virginia over the same period, to test whether suicide rates just happened to be declining in the entire region. There was no difference in the suicide rate in the Maryland and Virginia suburbs before and after the D.C. gun ban. The researchers also tabulated the kinds of suicide that declined in Washington: The 25 percent decline was entirely driven by a decline in firearm-related suicide....

States with high rates of gun ownership -- Alabama, Idaho, Colorado, Utah, Montana, Wyoming and New Mexico -- have suicide rates that are more than double the suicide rate in states with low rates of gun ownership, such as Rhode Island, Massachusetts, New Jersey, Connecticut, Hawaii and New York, said Matthew Miller, an epidemiologist at the Harvard School of Public Health. The difference is not because people in gun-owning states are more suicidal than people in states where fewer people own guns, but that suicide attempts in states with lots of guns produce many more completed suicides.

"The evidence is overwhelming," said David Hemenway, a professor of health policy at Harvard. "There are a dozen case-controlled studies, all of which show the gun in the home is a risk factor for suicide for the gun owner, for the spouse, for the gun owner's children."

The point, as dv makes it at Delawareliberal [please be sure to read dv's original; I am seriously trying to excerpt so as to represent his views accurately], is apparently this:

I just don’t get it? The study (did I mention it took 19 years) was obviously very lengthy and conducted over a period of time where deep statistical analysis could be conducted and not argued against....

I kept reading this article done on a 19year study and i have a hard time arguing that guns are safe and we shouldn’t restrict them in some way....

So I keep reading the article and I have to ask myself why does it matter that:

people who have lethal means at their disposal are much more likely to kill themselves than those who lack such means.

what is the big deal. It’s just a study done over 19 years and used a few hundred thousand situations to come up with this stunning analysis.

OK, here's the problem, dv. Or problems.

The first is that this study is hardly the first or last word on the relationship of suicide to gun ownership.

Loftin and McDowall did NOT examine a few hundred thousand situations; far from it. The decline in suicides in DC over the course of the study was 25%, all right, but that decline was actually .6 suicides per month, or 7.2 suicides per year over a two-year period in a small, highly variable population. This is a problem, as the American Association of Suicidology points out:

Caution: Annual fluctuations in state levels combined with often relatively small populations can make these data highly variable. The use of several years’ data is preferable to conclusions based on single years alone.

The Loftin-McDowall study, utilizing only two years of data in a highly fluctuating population (apparently without controlling for the different socio-economic characteristics of the nearby cities) is clearly an insufficient sample.

As a matter of fact, the Loftin-McDowall study has not universally been accepted by social scientists as establishing the causal relationship claimed for it by its adherents.

Citing Loftin-McDowall and several similar studies, Linda L. Dahlberg , Robin M. Ikeda and Marcie-jo Kresnow in Guns in the Home and Risk of a Violent Death in the Home: Findings from a National Study [American Journal of Epidemiology, 2004], did not accept such a causal relationship as proven [emphasis added]:

Although an estimated 40 percent of adults in the United States report keeping a gun in the home for recreational or protective purposes (3), the risks and benefits of this practice are widely disputed in the literature (4, 5). Ecologic analyses have suggested a link between the prevalence of gun ownership and rates of homicide and suicide (6–8) and between regulations restricting access to firearms and rates of homicide and suicide (9–12). Although these studies are useful in demonstrating an association between access to firearms and rates of homicide and suicide at the aggregate level, it is not possible with this methodology to adequately assess whether access to a gun increases the risk of a violent death at the individual level.

Moreover, Loftin and McDowall exist in a sort of single-issue vacuum regarding guns and suicide, because most researchers will tell you that the situation is far more ambiguous.

For example, the American Foundation for Suicide Prevention notes that

Ninety percent of all people who die by suicide have a diagnosable psychiatric disorder at the time of their death.

Or, to take another example, a factor that people who use Loftin-McDowall to support a political agenda usually neglect to mention, is that suicide rates all across the country began to fall during the 1990s, and nobody is sure how to account for it:

From 1994 to 2003, suicide rates declined 30 percent in adolescents and young adults. Among older adults, the suicide rate fell 33 percent from 1987 to 2003.

This research, published in the American Journal of Public Health, suggested that physicians are actually looking at anti-depressants, not firearms access, as the most probable cause for the nationwide decline that existed over 15 years.

[What's really interesting about this is that the DC suicide drop that Loftin and McDowall investigate may not have been potentially gun-related at all, but could have been an early drift into the national trend, which wouldn't have shown up in their 1986-1987 study, because the eastern Atlantic states for whatever reasons didn't apparently begin to show the decline in suicides until around 1989.]

The point? I don't care how statistically intense the Loftin-McDowall study was, it did not establish a causal link, has not become the accepted standard interpretation in the social sciences, and does not provide a sound foundation for sweeping changes in public policy in and of itself.

My second point is that even if you grant every conclusion reached by Loftin-McDowall, it does not follow that the proper remedy is government regulation of handguns.

This is actually the heart of the argument, and I again return to the Washington Post article:

There are many ways to read the Second Amendment to the United States Constitution, but all the versions point to one core idea: Americans have the right to own guns to protect themselves against outside threats, whether the danger comes from a school shooter, a vicious mugger, a robber breaking into a house, a lawless neighborhood -- even the government itself.

What the authors of the Second Amendment did not foresee, however, is that when people own a gun, they unwittingly raise their risk of getting hurt and killed -- because the odds that they will one day use their gun to commit suicide are much larger than the odds they will use their gun to defend themselves against intruders, muggers and killers.

This all versions point to one core idea, the idea that guns are a form of self-protection and that's why we should be allowed to have them, is--savor it, a technical term coming here--utter bullshit. Individual protection from muggers or rapists had, as I have already pointed out once this week, nothing to do with the 2nd Amendment. The 2nd Amendment specifically had to do with an armed populace as a political counterweight to potential state tyranny.

The idea that the authors of the Second Amendment did not foresee increased suicide rates (or automatic weapons), and that if they had, they would certainly have provided for the government's ability to restrict such bad things is--again a technical term--also utter horseshit. The Framers definitely were not Libertarian individualists in the modern sense, because they did believe in the right of the State ("state" being used here like Connecticut or Delaware, not as an abstract reference) to regulate social behavior--sumptuary laws in Massachusetts, sodomy laws in Virginia, etc. etc.

And the Framers also lived in a political/intellectual world wherein the regulation or even outright prohibition of various items was considered acceptable--as long as it was done for economic reasons (to stimulate manufactures or channel trade in certain directions).

But the Framers would not, did not, consider acceptable (or even conceivable) the idea of regulating the items you could possess because you might hurt yourself with them. They knew that certain drugs were vices that destroyed people's lives--but they didn't see that as the government's responsibility to prevent. They knew that people committed suicide with pistols, but again, they didn't see that as a reason for the government to ban firearms.

What they were convinced of, and stated in not uncertain terms, was that an unarmed populace would eventually slip into subjection if only the government could own guns. So they willingly accepted all the potential downsides of spousal homicide and occasional riotous rebellion in order to establish the right to keep and bear firearms as an absolute right.

Maybe they were wrong. They were certainly wrong about the whole let-the-runner-up-in-the-election-become-Vice-President-thing.

But, on the other hand, maybe they were right. Examine the whole history of the US, leaving in the Whiskey Rebellion, the renter uprisings in New York, the post-Civil-War fights for control of the Baltimore waterfront neighborhoods, the armed Black resistance to the KKK and Jim Crow governments in parts of Mississippi and Alabama, the armed veterans' movements in post-1945 Tennessee and Kentucky, the Black Panthers' insistence on the right of minority citizens to be armed in the face of oppressive police-state tactics, and--yes--the militia nutters out in Montana and Wyoming....

People who think that firearms ownership has not played a part in the dynamic of restricting government power against individual liberty, or preserving people from systematic oppression by government or other groups within US history simply haven't studied very much US history in the first place.

This whole passion for common sense gun control is actually very much an Eastern liberal establishment thing, a value not at all shared by most people (including liberals) west of the Mississippi. Two weeks ago I was conducting a workshop on the Articles of Confederation for a group of teachers in rural Washington. It was the week that the Supremes struck down the DC gun ban. These were liberal teachers: they believed in universal health care, windfall profits taxes on oil companies, and massive infusions of Federal funding into public education. But they were--to a person in a group of forty--passionate about the idea that nobody was going to take away their guns. They lived in low-crime communities; many of them hunted.

But what they said to me repeatedly was some variation of "when they take our guns, they'll take our freedom next."

What specifically bothers me, dv, about your post is that you make the whole question pretty one-dimensional: gun ownership has been shown to entail certain risks to gun-owners and their families; therefore government should step in and through law or regulation reduce that risk.

It is a far more complex question than that, and the supporting evidence (used by both sides, I freely admit) is never as convincing as you think it is, when you selected it primarily because it agrees with what you thought in the first place.

On the other hand, I applaud you (and I am quite serious about this) for continuing to address the question head-on and with intellectual honesty.

I don't usually agree with you, but I always know where you stand.

And we can work from that.


LiberalGeek said...

Ya see, that's why I love the Delaware blogosphere. A great post, Steve. I'm glad DV drove you to it... :)

Brian Miller said...

Let's assume, for the moment, that the analysis being challenged is "unimpeachable."

Why does government have a right to attempt to tell an individual that he doesn't have a right to take his own life? What right does government have to tell people that their lives are government's to take, not their own?


Mike W. said...

That's a great point Brain, and one I'm in total agreement with.

Since I have a right to life, liberty, and the pursuit of happiness I also have the right to end my life in any manner I see fit.

Hube said...

Steve: Superb post. Proving yet again why this is the best written blog in the state! :-)

Anonymous said...

Great post. Nicely reasoned unlike dv reponses to comments.
His comment made me wonder about Delaware residents. You reassure me that there are people who can reason rationally.