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Friday, June 19, 2015

Most gun deaths are suicides, not homicides

That's a strong case for gun control.
National Review's Charles C. W. Cooke disagrees with Martin O'Malley about gun control. That's fine. But in doing so, he winds up reinforcing a quite damaging myth about suicide:
Two thirds are suicides. https://t.co/JWGWutnt8I
— Charles C. W. Cooke (@charlescwcooke) June 2, 2015
Indeed they are. This matters, Cooke argues, because suicides and homicides aren't "morally comparable":
@McdougNathaniel @GovernorOMalley Moreover, suicides and murders are not morally comparable. The conflation is routine and it is deliberate.
— Charles C. W. Cooke (@charlescwcooke) June 2, 2015
It's a common viewpoint that suicide is ultimately just someone's choice. It may be bad, but it's not nearly as bad as homicide or death by disease, and certainly not a morally significant enough problem to justify gun control measures.
It's common, but it's wrong. Suicide is the terminal stage of a disease. It's a preventable death that we can, and should, prevent. And gun control is a necessary tool for doing that.
A life saved is a life saved
A suicide prevention sign on the Golden Gate Bridge in San Francisco. (Jamie McCaffrey)
Obviously there's tremendous variation in particular people's ethical frameworks, but where I come from, a death is a death. The friends and family of people who've killed themselves grieve just as the friends and family of people who've been killed by others grieve. The deceased is denied years of potentially happy life whether dead by his own hand or another's.
The only way a suicide could be somehow morally "better" than a homicide is if, in some meaningful sense, it serves the interests of the person committing suicide. In all but a few cases, this isn't true. There are some rare instances where suicide may be a viable option — when terminally ill, for instance — but for the most part it's a rational failure, a cognitive bias that places way too much weight on current pain and way too little on the welfare of one's future self. Depression is a liar intent on convincing you it'll never leave. But for many people, with treatment, it does leave. If those people never got to experience that future because a disease claimed their life early, the fact that the disease in question was depression rather than cancer or heart disease hardly seems relevant. It doesn't make the outcome any less tragic. It doesn't mean the victim was asking for it.
This may feel infantilizing or insulting — who are we to say that people who commit suicide don't know what's best for them? — but believe me, it's not. I can't speak for other people who've dealt with suicidal ideation, but I can speak for myself. I've oscillated between times like now, when my baseline tendency is to feel genuinely happy and fulfilled, and times like my senior spring of college, when life felt like an impossible burden to be endured and I ignored any indications that this might change. But it did change. One night I confessed to my roommate that I'd made a plan to kill myself; he instructed me that, whether I liked it or not, I was going to start seeing a psychiatrist at least once a week. I started getting treatment, and I got better.
If I'd followed through on that plan, I would've been making a rational decision for the moment. But I'd have missed out on years of happy life and, with luck, years more to come. I more or less know what's good for me. But depression doesn't. Honoring depression's wishes doesn't do me any favors. It doesn't respect my autonomy. What does help are efforts to reduce depression's power, to place roadblocks that keep it from making decisions that will permanently harm me.
Why suicide attempts with guns are more dangerous
Limits on gun ownership, it appears, can serve as that kind of roadblock.
While high rates of gun ownership are associated with higher homicide rates, the evidence around suicide is particularly strong. For example, a recent meta-analysis, which collated studies comparing suicide and homicide victimization rates for people with and without gun access, "found strong evidence for increased odds of suicide among persons with access to firearms compared with those without access and moderate evidence for an attenuated increased odds of homicide victimization when persons with and without access to firearms were compared."
Suicide is more common in places with more guns
There's a popular myth that suicidal people will find a way to kill themselves no matter what, and that closing off one method (like guns) will just lead to an increase in suicides through other methods (like hanging or overdoses). But most suicides aren't committed by determined people who can't be talked out of it. They're impulsive actions that can usually be prevented by small barriers. Many survivors say they deliberated less than a day, and sometimes for only a matter of minutes, before making a suicide attempt. Ken Baldwin, who survived a jump off the Golden Gate Bridge, once told the New Yorker's Tad Friend that as he was falling, he "instantly realized that everything in my life that I’d thought was unfixable was totally fixable — except for having just jumped."
Baldwin's change of heart isn't too unusual. Ninety percent or so of people who've survived suicide attempts do not end up dying by suicide. So blocking off particularly lethal suicide methods — ones where attempts almost always lead to death — saves life. Guns are an extremely lethal suicide method. The Centers for Disease Control and Prevention found that in 2001, 85 percent of suicide attempts involving guns resulted in death, significantly above other methods. A study looking at hospital admissions for suicides and suicide attempts in Illinois found that 96 percent of firearm cases resulted in death, while only 6.7 percent of cases involving cuts and 6.5 percent of cases involving poisoning did. "In the public-health community," Leon Neyfakh wrote in an excellent piece on guns and suicide for the Boston Globe, "researchers have widely come to regard it as a basic truth that access to a gun makes it more likely that someone who wants to commit suicide actually manages to do so."

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