Posted on Mon, Jun. 16, 2008
C. William Schwab
is a trauma care physician
Brendan G. Carr
is an emergency room physician
We are all too familiar with how damaging handguns can be. Almost every night, medics bring us patients either lifeless or writhing in pain with multiple gunshot wounds.
The disruptive force of gun death is broadcast on the faces of the parents and grandparents as we look them in the eye to tell them, "I'm sorry, your son has died."
The effects of greater firearm lethality are seen daily in the emergency rooms across America, from big cities to rural towns. The impact of this trauma is reflected in the policy statement of our professional organizations.
The American College of Surgeons and the American College of Emergency Physicians support legislative and public health efforts to prevent firearm-related injuries and deaths. This includes the enforcement of current laws against possession, purchase, sale or use of firearms.
In 1976, Washington became the first major American city to ban handguns. But since that day, handgun technology has changed dramatically. In fact, the editor of Shooting Sports Retailer, a gun industry magazine, observed in 1997: "Firepower is increasing. So is the killing potential as guns shrink in size and concealability."
We hope the justices of the U.S. Supreme Court will take that fact into account when they decide this month whether the District's handgun ban is constitutional.
Here in Philadelphia, the deadly shift can be measured by the rate of violence in 2006, which resulted in more than 2,000 shootings, 400 murders, and 3,000 assaults with a gun. In 2007, Philadelphia had the highest homicide rate among the 10 largest cities.
Thirty years ago, the vast majority of handguns in America were relatively low-caliber five- and six-shot revolvers. Today, the modern handgun market is defined by increased lethality. The bulk of handguns manufactured are semi-automatic pistols: faster-firing weapons with detachable ammunition magazines that allow the gun to be reloaded in seconds. It is easy to see why the likelihood of inflicting wounds and the severity of the resulting injuries have increased.
On one end of the lethality spectrum are "Pocket Rockets," palm-sized pistols with ammunition magazines that can hold up to 16 rounds. At the other end are "assault pistols," larger, military-style weapons designed to lay down a wide field of fire, sometimes referred to as "hosing down" an area.
The killing power of most guns on the street are somewhere in between. There are literally hundreds of models of high-capacity pistols from a wide array of domestic and foreign manufacturers, each new, more powerful version pushing older models aside as gunmakers work to carve out their own territory in our nation's domestic arms race.
It has been more than 30 years since the D.C. handgun ban was passed. During that time, the handgun industry has changed, and the lethality of its products has increased. Yet debate over the fate of the D.C. law, and what a decision overturning it may mean for other localities across the nation, is often approached from Second Amendment absolutism, with little regard for how much things have changed since the time of the Founding Fathers.
As physicians, we know the reality of handgun violence. To acknowledge this reality and its impact in America today is to realize that the District of Columbia's law is one to be emulated, not undermined.
C. William Schwab is chief of the Division of Traumatology and Surgical Critical Care at the Hospital of the University of Pennsylvania. Brendan G. Carr is a Robert Wood Johnson Foundation Clinical Scholar at the University of Pennsylvania Medical School. E-mail them at Brendan.Carr@uphs.upenn.edu.
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