|
Abstract
|
The sound of my grandmother's trembling voice lingers from that winter morning, almost 40 years ago now, when she called with awful news. My beautiful cousin Kristin had come home from college for the holidays and killed herself with a shotgun.
Kristin was a decade my junior, a homecoming princess and a talented pianist with a mischievous smile and whimsical sense of humor. To me, she was like a little sister. But for reasons unknown, persistent feelings of sadness and despair crept in and took root in her mind. Five days before Christmas, Uncle Jim found her beside the garage. She had left a note saying she wanted to be with God.
I was a new faculty member in a psychiatry department at the time, embarking on a career in which I would spend decades researching ways to prevent death and injury from guns. That spring, Uncle Jim and Aunt Helen drove halfway across the country to visit me; we sat on the couch together and flipped through a photo album of Kristin. Aunt Helen asked me what could have saved their youngest child. I suggested Kristin had succumbed to a fatal illness; it was no one's fault.
Today I would give a different answer. I would say Kristin died from a preventable injury with a firearm. I would add that a law prohibiting her access to a gun might have kept Kristin alive.
Extreme risk protection order (ERPO) laws, also known as red flag laws, provide a civil court process designed to prevent firearm injuries by temporarily disarming individuals who pose an imminent risk of harm to themselves or others. An ERPO also prohibits a person from purchasing or possessing a firearm while the order is in effect, typically for up to a year. ERPO laws are now being implemented in 21 states and the District of Columbia and have become a central component of a bipartisan strategy to reduce the toll of gun deaths.1-3
Yet within academia, as the article by Miller et al4 makes clear, questions persist: Do ERPOs actually save lives? If so, how many ERPOs does it take to save 1 life? Answering these queries together with empirical evidence is important both from the perspective of preventing gun violence and protecting gun rights.
A widely cited statistic from our group's research studies5,6 of suicide deaths among ERPO respondents in Connecticut and Indiana is that for every 10 to 20 ERPOs issued, 1 suicide was averted; in medical research parlance, this is the number needed to treat (NNT). Miller and colleagues4 deconstruct and recalculate our NNT on the basis of an alternative estimate of the probability that a gun owner who attempts suicide will use a gun rather than some other method of self-harm. The new estimate derives from these authors' analysis of suicide deaths among a large number of registered handgun owners in California. They conclude that a more accurate estimate of the NNT is 22. How should we think about this new estimate, and what does it mean for the existing widespread acceptance of our group's previous approximation?...
Language: en |