Showing posts with label gun control. Show all posts
Showing posts with label gun control. Show all posts

Friday, March 22, 2013

NPR - How A Patient's Suicide Changed A Doctor's Approach To Guns

This segment of All Things Considered aired on the local NPR station Wednesday evening. This struck me as a largely male issue -   men are more likely to be treated for depression by the family doctor than women (72-89% of females will see a mental health professional at some point, but only 41-58% of males will do so), men are more successful in committing suicide (by a margin of 4:1, even though more women attempt suicide, by a margin of 3:1), and men are more successful at suicide because they use guns (women tend to opt for overdose or cutting themselves).

When we finally look at the real numbers about guns and suicides, the debate about gun control is really an issue of suicide prevention, as noted by the Boston Globe:
In 2010, the last year for which complete numbers are available, the number of gun deaths by suicide in the United States outnumbered homicides 19,392 to 11,078. If you add up all American gun deaths that year, including accidents, 3 out of 5 people who died from gunshot wounds took their own lives. Those figures are not an anomaly: With just a few exceptions, the majority of gun deaths in the United States have been self-inflicted every year since at least 1920. This is a startling fact, and one that forces us to realize that, no matter what we may believe about the Second Amendment, the debate over how to reduce the death toll from guns is, to a great extent, a debate about suicide prevention.
Maybe if the men's rights folks took up an issue such as this, one that has nothing to do with feminism, more people would take them seriously.

How A Patient's Suicide Changed A Doctor's Approach To Guns


by ERIC WHITNEY
March 20, 2013

from CPR
All Things Considered
6 min 20 sec

Listen to the Story


Download
Transcript

Dr. Frank Dumont at his clinic in Estes Park, Colo.Barry Gutierrez for NPR

Dr. Frank Dumont knew one of his favorite patients was getting depressed.

When Dumont first started seeing him, the man was in his 70s. He was active and fit; he enjoyed hiking into his 80s. But then things started to change.

"He started complaining of his memory starting to slip," Dumont says. The man would forget where he had placed objects, and he'd struggle to remember simple words and phrases.

Dumont prescribed antidepressants and saw him every eight weeks or so.

Like a lot of people in the small town of Estes Park, 90 miles northwest of Denver, both Dumont and his patient were drawn to the ruggedly beautiful mountains there. One of them, called Longs Peak, is a cherished part of Dumont's life. He and the patient talked often about the picturesque mountain.

"He was one of those people where you see them on the schedule for the day and you just smile," Dumont says. "You just realize you get a chance to chat with someone who feels like a friend."

That's what their last visit was like. Dumont says he did ask the man whether he was having any thoughts of hurting himself, but got a very convincing no.

"What in hindsight struck me about that visit is that he brought me a gift, which was a geological survey marker from the top of Longs Peak," says Dumont. "It was a replica, but it was one of those things that was just another reminder to me of this connection that we had had."


Dr. Frank Dumont holds a gift from a patient who committed suicide with a gun. In hindsight, Dumont sees it as a farewell from the man who was one of his favorite patients.Barry Gutierrez for NPR

"And at the time it just seemed like a very generous gift that touched me," Dumont recalls. "And what I didn't realize at the time was that that was, I think, a farewell gift, or a bit of a parting gift, from him. Because I did not see him again. And the next that I had heard of him was from an emergency phone call from his wife about a month later, and she called needing to be seen. .... She had to come in and talk to me with how to deal with the fact that her husband had committed suicide."

Dumont's patient shot himself in the head with a rifle. Dumont was stunned, and guilt-ridden.

He says he always asks his depressed patients about suicide, whether they've thought about how they'd do it. But he now regrets not asking this patient specifically whether he had guns in the house.

Suicide prevention researcher Dr. Matthew Miller, at the Harvard School of Public Health, says Dumont sounds like a great doctor. "He was doing everything he could to try to keep this guy from making a suicide attempt, but what he didn't do was the second step, which is make it hard for him to die if he did make an attempt," Miller says.

The second step, Miller says, is asking patients if they have guns in the house or access to guns. If someone tries to commit suicide without using a gun, they probably won't succeed.

"The likelihood of their dying is of an order of magnitude lower," he says. "Instead of there being a 90-plus percent chance of death, there's a greater than 90 percent chance that they'll live."

Miller wants to make it routine for family doctors to ask their patients about guns. One large study found that nearly half of all suicide victims had seen a primary care doctor within a month of killing themselves. So it's important for them to bring up suicide and possible means.

"We have to get people to stop thinking about these discussions as gun control in one way or another, but rather as a way of conveying useful information, so people make decisions that protect their family," Miller says.

There are lots of reasons family doctors avoid bringing up guns with their patients. They may not want to offend a patient, or they may be too busy checking off all the preventive screenings and tests on the list.

Not everybody wants gun advice from a medical professional. Edgar Antillon organized a pro-gun rally at the Colorado State Capitol earlier this year. He says he would resent a doctor bringing it up.

"Tell me to stay healthy, tell me my baby has colic, but I don't think it's their job to tell me about gun safety," he says. "They're not gun experts. They're not NRA members. ... And if they are, then I'll take it as advice from an NRA member."

But Dumont has spent a lot of time second-guessing himself since his patient shot himself. The doctor hopes small measures he can take will reduce the odds, just a fraction, that another one of his patients will die from suicide by gun.

"I have a lower threshold for asking follow-up questions, asking the same thing a different way," he says. "Or if I have any inkling, starting to push a little bit further, and say, 'Well, so you're not really thinking about it, but have you ever thought about how you would go about it if you were going to?' And I have a lower threshold for asking about a weapon in the home as well."

Dumont says he thinks more physicians would talk with their patients about guns if they got information about health risks associated with them. Medical journals and a federal board of experts regularly issue advice on prevention of obesity, car accidents and workplace injuries. But there's been a ban on federally funded gun safety research until President Obama restored it with an executive action.

This story is part of a partnership between NPR, Colorado Public Radio and Kaiser Health News.

Wednesday, January 23, 2013

Bookforum Omnivore - The Age of White Male Mass Shootings

This is an interesting collection of links on masculinity, guns, and gun violence from Bookforum's Omnivore blog. One article in particular jumped out at me so I included parts of it below the link collection.


The age of white male mass shootings

JAN 22 2013
9:00AM



One of the articles above, from the Southwest Journal of Criminal Studies, looks at the role of "hegemonic masculinity" in mass murders in the U.S. Here is the abstract, and then a section from later in the paper.

  • Deniese Kennedy-Kollar, Ph.D., Molloy College, Rockville Center, New York
  • Christopher A.D. Charles, Ph.D., King Graduate School, Monroe College, New York
Abstract 
This exploratory study examines the act of mass murder as an attempt by the perpetrators to lay claim to a hegemonic masculine identity that has been damaged or denied them, yet that they feel entitled to as males in American culture. Biographical information was gathered for 28 men who have committed mass murder in the United States since 1970 and examined for evidence of stressors to the perpetrators’ masculine identities. The majority of the sample demonstrated financial (71%), social (61%), romantic (25%), and psychological stressors (32%) and other stressors (18%) that indicated a failure to attain the hegemonic masculine ideal in American culture. There were co-occurring stressors such as financial-social, financial-psychological and social-psychological. These stressors suggest that the motivations for mass murders are numerous and complex. There is no psychological profile unique to mass murderers and many authors have speculated on their motivations. However, in this study, the range of interrelated stressors experienced by the majority of mass murderers threatened their hegemonic masculine identity and these men engaged in violence to protect their identity.

* * * * *
Hegemonic Masculinity

Hegemonic masculinity is the socially supported and dominant masculinity, which informs normative male behavior and unequal gender practices seen in the subordination of women in the society. This dominant masculinity which is associated with power, high status, authority, heterosexism and physical toughness, and legitimizes patriarchy, not only subordinates femininities but also other masculinities deemed to be weaker in the society’s gendered order (Beasely, 2008; Connell, 1995; Lusher and Robins, 2009). Hegemonic masculine violence is not only confined to the urban milieu in the United States, because the socio-economic and political changes that also take place in rural areas, lead to internal and external male violent expressions which are strategic patriarchal practices used to create an imagined rural gendered hierarchy (Carrington and Scott, 2008).

Some critics of the hegemonic masculinity thesis suggest that it does not take into account the inequalities of class based power, and the political economy that produces and reproduces traditional physical male violence. This conceptual oversight means that hegemonic masculinity, is applied outside of relevant historical contexts and material processes, that make the use of the term hegemony a misnomer and the concept an inadequate explanatory factor for patterns of male violence (Hall, 2002). Moreover, the concept is also used in a monolithic way which ignores plural masculinities that take into account the heterogeneity of masculine identity and power (Beasely, 2008). Despite these criticisms, there is an evolutionary perspective which locates masculine violence in the descent of man. This perspective argues that violent masculinity is an expression of the survival of the fittest and the drive for reproductive success which has its genesis in human ancestral environments (Polk, 1998).

School is one of several social domains in which hegemonic masculinity is created and expressed in the contemporary era. Very few Americans link school shootings to the gender of the shooters (which is male) although criminologists have consistently argued that there is a relationship between masculinity and violence. The masculinity which influences male aggression and violence is socially constructed (Watson, 2007). In other words, the incidences of hate crimes, bullying in schools and school shootings among other violent expressions of masculinities are influenced by the approaches, processes and codes of the societal construction of men. Schools are very much reflections of this social construction as the bullying and school shootings just mentioned suggests. The ways of man making, which starts before the pre-K level and goes up to manhood, supports and approves subtle and physical expressions of violence. Therefore, the hegemonic masculinity taught in American schools jeopardises the safety of students and the society (Serriere, 2008).

The context of the inner city streets is also used by youth to express violent masculinities. Respect is central to male identity where masculine street behavior is driven by a code that regulates norms surrounding how grievances and conflicts are resolved. There is also an interaction driven ecology of danger, which is influenced by perceptions of threatening or deadly social interactions with rival males, whether they have hostile intentions and whether or not they are willing to use violence to hurt others (Wilkinson, 2001). The anatomy of violence is evident in the narrative of a young male, who was constructing his masculine identity which required the projection of a preferred presentation of self. This self presentation was achieved through creating boundaries about the use of violence, the reasons for fighting and whom one should fight. Masculine characteristics were made salient in the narrative by sorting and positioning the characters of the story. Several varying depictions of other men emerged in the discourse such as non-men, villain and hero. The foregoing discourse of violence, suggests that that masculine identity was constructed and negotiated through the gendered positioning of the negative other (Andersson, 2008).The use of the life history method to understand adolescent male violence, also suggests that boys use the ideals of hegemonic masculinity to construct their emerging manhood. This identity was buttressed in school by the institutionalized bodily and sexual practices that created subordinate masculinity which is linked to sexual violence and an opposition masculinity which is connected to assaultive violence (Messerschmidt, 1999).

The growing body of evidence in the literature that hegemonic masculinity is related to violence was contradicted by the findings of a study of the relationship between masculinity and violent and nonviolent situations. The findings of the study indicate that there is no relationship between violence and masculinity but the presence of a third party is a significant predictor of violence (Krienert, 2000). In keeping with the overall trend of the data on violent masculinity, the positive presence of a father in the life of a son constructing his hegemonic masculine identity is a key means of preventing the emotional problems that triggers male violence (Pope and Englar-Carlson, 2001). The prevalence of male violence suggests that there is a crisis of masculinity which provides opportunities to stop the violence and challenge the masculinities supported by the status quo (Hurst, 2001). However, masculine violence continues unabated in the United States and the most blatant expression of this form of violence is the action of mass murderers.