I’m an existentialist philosopher, so I tend to have deep conversations with people. Unfortunately, a few of those people I had conversations with aren’t with us anymore.
I didn’t know at the time of those conversations that, later in life, they would kill themselves. Suicide was never brought up. Instead, they seemed to struggle with meaning, battling inner demons, or just dealing with life. If I had thought they were suicidal, I would have tried to get them help. But, alas, I was just as surprised as anyone to hear the news of their suicide.
The other thing they had in common was that they all chose to use a firearm to end their lives.
Let’s go over some statistics from the CDC WONDER tool (I also cover these statistics in my book):
- Over 50 percent of all firearm deaths are suicides.
- Firearms are used by 50 percent of suicide victims.
- The age range for firearm suicides covers all age brackets reasonably evenly. For example, almost 75 percent are 35 or older, and over 25 percent are on Medicare aged 65 and older.
Common Arguments and Rebuttals
Without being insensitive to the people who have lost loved ones due to suicide, I would like to cover some common arguments that are made and rebuttals.
Argument: Firearms cause suicides. Rebuttal: Given the sheer number of firearms in America, well over 400 million, if firearms were an agent of cause, the population of America would have dwindled to almost nothing by now. In addition, other factors influence suicide. For example, the government’s response to the COVID pandemic created a period of isolation for our youth. https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2022-058375/190657/Youth-Suicide-During-the-First-Year-of-the-COVID. Taking into account future suicides, missed cancer screenings, missed medical treatments, and other missed appointments, the government response to COVID will likely kill more people under 65 years old than the virus itself did.
Argument: Firearms, like cigarettes and opioids, are a public health problem primarily because of suicides and homicides. Rebuttal: Tobacco and opioid health impacts were known by the manufacturers and deliberately withheld from the public for as long as possible. In contrast, firearms are not, nor have they ever been, misrepresented as anything but lethal weapons.
Argument: Firearms in the home dramatically increase the odds of a woman’s murder and the suicide of any family member. Rebuttal: This one gets things backward, like the O.J. Simpson trial. The prosecution in the O.J. Simpson trial argued that O.J. Simpson abused Nicole, and many abusers go on to murder their victims. The defense argued that wasn’t the case – most abusers do not go on to murder their victims. The defense was correct, but the prosecution didn’t offer a retort. The key is that murder is a rare event. So you have to frame the question differently: If a woman is murdered, what is the likelihood that her murderer was also her abuser? It turns out that percentage is relatively high.
Since suicide is a rare event, similar to murder, the question becomes this: For the people who commit suicide, why did they use firearms 50 percent of the time?
Cause versus Decision
For this question, the firearm is not the agent of cause; its use is the outcome of a decision process.
I think we will have a better understanding of why by asking a few more questions:
- Did the victim use an object to facilitate their death?
- Was the object obtained explicitly for that purpose?
- Was the object obtained legally?
- Was the object reasonably easy to get?
- Were there any special requirements needed to obtain the object?
- Was any knowledge beyond easily found public knowledge required to know how to use the object?
- Was the object easily capable of producing a painless death?
- Was the object easily capable of producing a quick death?
- Was cost a barrier that had to be overcome to obtain the object?
- Did the victim have previous experience with the object?
Compared to other objects, it is easy to see why firearms would be the top result of this decision process. However, it is also essential to understand the use of firearms would drop if another object had better answers. As a thought experiment, imagine a drink made of commonly available materials that resulted in a painless sleep within a few seconds and then death. If that recipe went viral and documentaries were made, the public would have common knowledge of it. One aspect of this thought experiment is that firearms use in suicides would be reduced, but suicides as a whole would stay the same or increase because victims would be choosing another object than firearms.
The real work, however, isn’t in thought experiments. It is by helping people overcome suicidal thoughts and to be able to lead an enriching and rewarding life.
Questions About The Victim
A runny nose is a symptom of a common cold. You can choose to deal with a runny nose by using Kleenex. You can also take over-the-counter cold treatments that may dry up that running nose. However, the underlying cause, the common cold, remains there. In short, you treat the symptoms, not the root cause. Luckily, our immune system usually takes care of the common cold in a few days, and that root cause is removed. However, there are complications. For example, a runny nose may look like a cold, but you have seasonal allergies. I remember visiting Tombstone in 2021 and seeing a shirt that said (paraphrasing), “Don’t worry, pilgrim, it is only allergies.”
Given that almost 75 percent of firearm suicides are 35 or older, and over 25% are 65 years and older, it makes sense to ask questions about what life circumstances might trigger suicidal thoughts.
For 35 and older:
- Loss of job
- Divorce
- Bankruptcy
- Death in the family
- PTSD
- CTE
For 65 and older:
- Terminal disease
- A medical condition that dramatically impacted the quality of life
- A disease where the treatment would kill the patient.
Readers may be surprised that I don’t mention depression. The problem with depression is that its so-called cure is for the patient to be placed on antidepressant medication. Unfortunately, these pills don’t seem to impact the quality of life of their users, not to mention they have side effects. https://www.usnews.com/news/health-news/articles/2022-04-20/in-long-run-antidepressants-dont-improve-quality-of-life-study. Here are two good quotes from the article:
Almohammed said the findings suggest that clinicians “might be relying on the use of antidepressant medications, while underutilizing or underestimating the role and impact of non-therapeutic interventions.”
The study findings didn’t surprise Dr. David Katz, founding director of the prevention research center at Yale University/Griffin Hospital, and president of the preventive medicine advocacy organization True Health Initiative. […] Katz stressed that doctors’ understanding of how the brain works — and how best to treat mental health disorders — is still “quite primitive.” While he agreed the study findings are “not a reason for patients to renounce pharmacotherapy,” Katz also suggested that medications might best be thought of “as only one part — and perhaps not the most important part — of a more holistic treatment plan.”
A pill isn’t going to save us. We have to get our hands dirty.
Guns & Ammo: 2023 Annual: Touched by Tragic Loss
I was pleased to read what was going on around firearms and suicide prevention in a recent Guns & Ammo magazine. A guest editorial in this magazine by Russell B. Lemle and Jasper Craven was quite timely. They detail various prevention programs that attempt to reduce the number of firearm suicides. They start with Joe Bartozzi, President and CEO of the National Shooting Sports Foundation, and continue from there.
One organization that seems absent is the CDC. On their Firearm Fast Fact page, they do mention securely storing a firearm. However, given what the NSSF is doing in partnership with firearm manufacturers, you have to wonder: Shouldn’t the CDC be doing that? After all, here is what they say regarding their role in Firearm Violence Prevention (my emphasis):
“CDC’s approach to preventing firearm injuries focuses on three elements: providing data to inform action; conducting research and applying science to identify effective solutions; and promoting collaboration across multiple sectors to address the problem.” – https://www.cdc.gov/violenceprevention/firearms/fastfact.html Accessed Feb. 2023
The CDC isn’t mentioned in the Guns & Ammo article, nor do the CDC mention any work they’ve done with the NSSF or any other organization around firearm suicide prevention. The CDC only notes secure storage as part of suicide prevention. As we’ve seen from the age range of firearm suicides, we shouldn’t believe that secure storage is a magical solution to the firearm suicide problem. It is, of course, a step in the right direction. However, it won’t prevent the suicide of someone who can legally go out and buy a firearm in any city in the state. Too often, it is assumed that most firearm suicides are children or teenagers caught in a difficult moment, and the availability of the firearm is what contributed to it. While this indeed happens, it is in the minority. Too often, I think, the people who consider firearm violence to be in the domain of public health don’t bother correcting that impression.
Sadly, I worry that the CDC already has a solution in mind for what they call firearm violence, and working with firearm manufacturers isn’t part of that solution. So, in my next post, I’ll subject the CDC’s firearm fast fact page to a critique.