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McDonald Freaking Out the Medical Establishment

The condescending assholes over at the New England Journal of medicine seem to be trying to convince their profession that the sky won’t fall, and they throw in some condescension toward Mr. McDonald as well:

In all likelihood, [Mr. McDonald] will get his gun. Ironically, that handgun may not be the panacea he seeks. It will not address the root causes of the drug- and gang-related crime plaguing his neighborhood. Its promise of safety may be illusory, and it may just increase the risks of homicide, suicide, and accidental injury and death of those who live in or, like his grandchildren, visit his home. It may also create legal problems. If he kills a neighborhood thug in self-defense, the odds that he will be held blameless are slim: in every year from 2004 through 2008, less than 2.5% of handgun-related killings by private citizens were deemed justifiable homicides.4 McDonald has, how- ever, secured a measure of immortality; he will forever be as- sociated with the case that bears his name.

Can you feel the scornful stare down from the ivory tower? ┬áSo New England Journal of medicine apparently believe one of our nation’s veterans, who was quite competent enough to bear arms in defense of their freedom to look down on him, is apparently incapable or unable to properly secure firearms when children come over. He is also surely going to murder someone and end up in jail! Seriously. That’s what you are saying, Julie D. Canter, MD, JD, who wrote this article. I’m glad she’s not my doctor. I think maybe it’s high time Dr. Canter came down from the ivory tower and started looking at her fellow citizens as equals rather an inferiors. I think that would help her become a better person than she apparently is now.

27 Responses to “McDonald Freaking Out the Medical Establishment”

  1. Federal Farmer says:

    She’s just and MD, not a real doctor. Hows that for returning the scorn? lol.

    Mr. McDonald also has going for him one of the best use of lethal force statutes in the nation. De facto “Castle Doctrine” and “Stand Your Ground”.

    Though he does live under some of the worst SA’s in the state.

  2. GruntDoc says:

    Medical Journals Editorials are to practicing physicians what newspaper editorials are to regular people: an interesting view into the disconnects between those who do, and those who think they should be influential for no reason other than they have a job that prints ink.

    Interesting they don’t bother to look at all the states where this is already the norm, and note their doomsday predictions don’t actually happen.

    Goes against the narrative.

  3. Matt says:

    As a physician, I’m absolutely unsurprised and deeply disappointed by the NEJM articles. I knew they were coming, and cringed when I saw them. It’s clearly a political and partisan hack job, long on the Sturm und Drang and short on the science–what the NEJM should (in theory) be about. With 4 whopping citations, not one of them a well conducted study, no one should believe (or should have published) this tripe. Alas, they will.

  4. Sebastian says:

    I am glad to hear that it would seem the NEJM does not speak for the medical profession. Thanks for the comments.

  5. MJS says:

    Generally, doctors have as much credibility when it comes to firearms use and firearms law as Hardy, Kopel, and Cramer have when it comes to medicine (that is to say, none at all). The NEJM is way outside its area of expertise, but that won’t stop them from putting flawed anti-gun studies into their ‘peer-reviewed’ journal (their peers being other anti-gun doctors they are friendly with).

    Only the most easily-swayed people seem to think that a medical degree endows a person with authority of every subject under the sun.

  6. emdfl says:

    The NEJM stopped representing the views of mainstream medical practitioners more than 40 years ago when they climbed aboard the dhimmi party express train. They haven’t looked back since then and have been losing readers and writers ever since.
    My Father-in-Law was Chief of Medicine at the largest VA hospital in the country back then and told his daughter and I when this around 1967 when he canceled his subscription.

  7. Matt says:

    “Only the most easily-swayed people seem to think that a medical degree endows a person with authority of every subject under the sun.”

    Unfortunately, many of us doctors are among those most easily-swayed.

    The thing that kills me about this is that the NEJM is a NECESSARY journal. I’m starting my residency training, and while it’s no requirement, if I want to be at the edge of good medicine, the Journal (yup, people call it simply, “the Journal” and you know to what they’re referrinng) is a must read. Some of the original research articles in it are absolutely ground-breaking, and I can name a few off the top of my head that changed the way medicine is practiced. So I read. But I’m going to cancel my student subscription, use borrowed journals or library copies, because I hate to feed the political screeds that grace its editorials sections. I’m done sponsoring the pseudo-scientific politics.

  8. DirtCrashr says:

    When they say, Ironically, that handgun may not be the panacea he seeks. They really mean it’s not what THEY seek as a panacea – because addressing “the root cause” as far as drug- and gang-related crime isn’t something they can do either.

  9. Mikee says:

    Hey, quit beating up on NEJM – it was JAMA that published Kellerman, wasn’t it?

  10. Bob says:

    #(22) It takes more years to buy all the guns you want than it takes to be a doctor. But then again, try warding off a home invasion with a stethoscope and some Zyrtec and see how well you come out.- Bridgid

    From Bridgids’ .38 things I learned from Shooting http://mausersandmuffins.blogspot.com/2010/07/38-things-i-learned-from-shooting.html

  11. MJM says:

    Spoken by the people who gave us Oxycontin, Hydrocodone, and the Brave New World of drugged-down intellect. How Freudian that the author at NEJM thinks in terms of “cures.”
    Prediction: Gun Control will move further underground after McDonald and one form it will take is a stepped-up pseudoscience attempting to “prove” how pathological all of we gun owners are. We saw this with the Pediatric (journal) article weirdly comparing country kids and city kids in firearms-related deaths. I wanted to say, “And your point is…?”
    Thanks, Snowflakes, for the post.
    MJM
    mjm.luckygunner.com

  12. W.Richards says:

    It takes more years to buy all the guns you want than it takes to be a doctor. But then again, try warding off a home invasion with a stethoscope and some Zyrtec and see how well you come out.

    From Brigid @ Home on the Range

  13. Ash says:

    I didn’t have a problem with the NEJM editorial, which gives a reasonable overview of Heller and MacDonald from a doctors perspective and is pretty much what I expected.

    You’ve only quoted one paragraph of a three page article here. And I don’t really disagree with that paragraph, since guns do not address the root causes of crime, and there is no doubt that firearms ownership comes with risks, just like the exercise of any other constitutional right. If firearms ownership didn’t come with risks, then safety training would not be necessary. You can’t have it both ways.

    The numbers they quote on handgun deaths are from the DoJ (http://www.fbi.gov/ucr/cius2008/offenses/expanded_information/homicide.html) and I’m not aware of any challenges to their accuracy – if there is one, perhaps Sebastian or Matt who objected to the citations could post a link outlining objections to the DoJ numbers. It is also factually correct to state that gun violence is a public health concern, and a valid one in my opinion.

    IMHO the NEJM, being mostly composed of wealthy, white, liberal doctors who live in good suburbs, don’t perceive the self-defense benefits of the Second Amendment.. I can certainly understand that perspective, being as they are the people busy on the front line, up to their elbows in the blood of every idiot that shoots himself or another and is then carried through their door. Their opinion that ‘For their part, physicians should remain vigilant and address gun issues, such as access and storage, with patients, especially those who may be suicidal, have survived domestic violence, or live with children’ is eminently sensible as well. It’s the New England Journal of Medicine, not Guns & Ammo magazine. What did you expect?

  14. MJM says:

    Hello, Ash,
    I appreciate your providing perspective, but think you minimize the bias of the NEJM article and too easily overlook the article’s clever and deceiving use of “gun death” statistics.
    First, Sebastian copied/pasted only a short section, but linked to the entire editorial. That’s fair, don’t you think?
    Second, I found little useful in the legal analysis in the NEJM editorial, mostly finding an editorialized put-down of the majority opinion, with glorification of the dissenters. I read the dissenting opinion in its rambling entirety and found it mostly incoherent and disgustingly inconsistent with Justice Stevens’ lifetime exercise of judicial whim.
    As an example of that bias, the writer whines that Mr. McDonald’s gun will not address the “root causes” of crime in his neighborhood. Newsflash for the doctor-writer: Mr. McD does not intend to address whatever these amorphous “root causes” are. He intends to address crime one criminal at a time, only if and when confronted by the perp. At that precipice moment, his pistol is most effective to address the immediate cause of that crime problem. Blathering about “root causes” is a classic technique the Left uses in some attempt to dodge the need for the citizen’s right to personal self-defense–and personal self-defense was what most of the majority opinion was about.
    Stating that “gun violence” is a “public health concern” mixes violent crime concerns with mere accidents, and presumes that–because one is a doctor–one now has more say-so in all things gun. Hey, get busy, cure cancer, cure the cold, and come up with something that regulates blood sugar in diabetics better than needles and insulin. THOSE are real health concerns.
    The statistic “Gun violence results in 30,000 deaths annually”–if for real at all–mixes murder with accidents. The causes are completely different, and the remedies are completely different. Would the NEJM editorialist, therefore, endorse the NRA teaching firearms safety in public school health classes? She should, if truly concerned about firearms safety, but I doubt she’ll be meeting with the school board to get them to invite Eddie Eagle into the classroom. Likewise, if so concerned about “handgun violence” would the editorialist endorse capital punishment for intent-to-kill murders?
    Until such writers get serious about crime control, and get serious about teaching firearms safety, I find their clamoring tedious and shallow. I find Mr. McDonald, on the other hand, refreshingly real. Given the couple of men who illegally possessed handguns in Chicago, but nevertheless used them to good effect in self-defense just lately, her complaint that the majority opinion delved into “esoteric” legal arguments is silly.
    Safety? I think we all know the statistics on causes of accidental deaths in the country. Autos far exceed all others and gun accidents are minor compared to drowning, falls, etc. Tragic? Of course. Some sort of major health policy calamity? No. Remediable? Yes, and safety training is the answer–an answer that is anathema to such as the writer of the NEJM editorial.
    Finally, I do agree with you in this point: the doctor just can’t get the inherent right to personal self defense which, these days, means the right to carry a gun.
    So, while we shouldn’t expect NJEM to come off like Guns and Ammo, (That was pretty funny.) we should ignore pseudo-scientists when they foray beyond their intelligence, and Snowflakes called her out justifiably, I think.
    Mike
    mjm.luckygunner.com

  15. Hartley says:

    MJM, I’d say you nailed it.

  16. Divemedic says:

    MJM nailed, except for one thing: There were only 9,484 firearms murders in 2008 out of a total of 14,180 murders.

    http://www.fbi.gov/ucr/cius2008/offenses/expanded_information/data/shrtable_11.html

    The only way to get to that magic 30,000 number is to include suicides.

  17. +1 for Matt and Gruntdoc’s perspective.

    NEJM long ago ceased to be a non-biased, peer-reviewed medical journal. This was an editorial, not a study, but their inherent bias against guns and gun owners makes it ridiculously easy for shoddy “science” about guns to make its way through peer review as long as it fits their narrative.

    They’re not alone in their social engineering via medicine” “bent, either. Look for the American Academy of Pediatrics to start screeching in 3, 2, 1…

  18. Ash says:

    On McDonald, MJM objects to the NEJM article as “an editorialized put-down of the majority opinion, with glorification of the dissenters”

    I’ve just re-read those paragraphs and I’m not seeing that. Perhaps calling Breyer’s dissent ‘impassioned’ and ‘aware’ is a bit much, but most of what she wrote covers the opinions pretty equally as far as I read it. I’ve certainly read more slanted coverage.

    Regarding the statistics:

    The table on p2 on the NEJM article specifically excludes suicides and matches the number quoted above.

    Again, the 30,000 figure quoted above by MJM is taken out of context. The full quote is:

    “Gun violence is a major public health concern, resulting in more than 30,000 deaths and about twice as many injuries annually.”

    It’s a perfectly valid figure to quote. Regardless of whether it is homicide, accidental or suicide via firearm, all such deaths are considered public health issues along with tobacco, cancer, drug abuse, vehicle deaths etc and a medical journal is typically concerned with such. Public health journals have been writing about it for decades.

    I don’t believe that the NEJM’s opinion gives doctors any special powers to trample Second Amendment rights. However, I don’t deny the right of policy wonks to study and implement other ways in which public health issues can be prevented, and as MJM mentioned, education is certainly at the top of that list.

  19. dusty says:

    A gun absolutely does “address the root causes of the drug- and gang-related crime plaguing his neighborhood”, just not in the ways that liberals want or imagine guns should.

  20. Geodkyt says:

    Ash,

    Classifiying suicide and (more importantly) ACCIDENTS as “gun violence” is incorrect. Period. Or is NEJM and JAMA we going to start discussing fatal drug overdoses (both accidental and suicidal) as being the same as the murder by poison?

    I’ll even acknowledge the idea that LAWFUL self-defense shootings (including when cops shoot bad guys) qualifies as “violence”. (Although, to be honest, my thought is “Meh. And your point would be. . . ? Dead bad guy, live good guy, it’s a GOOD THING!”)

    But as utilized by political hacks (such as VPC, the Bradies, and the hacks who think their MD grants them wisdom and therefor their childish phobias are reality and their ignorance is actually expertise), it is a blatant, and generally knowing, lie.

    I don’t care for self-appointed, paternalistic, patronizing, “experts of ignorance” (who, frankly, kill more people every year with mistakes on the job than lawfully possessed guns do), using LIES to try and strip Americans of civil rights the Aristocracy of the Alabaster Tower feel the commoners don’t need.

  21. Paul Jones MD says:

    http://www.goldmanismail.com/attorneys-Julie-Cantor.html shows Dr. Cantor co-authored the amicus curaie brief supporting the City of Chicago in MacDonald vs. Chicago as her practice is as an attorney. I don’t know if she pracices as a physician as the above site only addresses her law practice.
    jpj3

  22. MJM says:

    That figures, Paul. Thanks for the extra info. Looks like my profession has to shoulder at least half the blame. Ha. Let’s make that haughty lawyer-doctor instead of doctor-lawyer.

  23. Sebastian says:

    Yes… thank you. Posting that tomorrow for all to see.

  24. Julie Cantor says:

    Wow. Hi everyone. Thanks for your thoughts. Let me try to respond to some of them:

    @Federal Farmer — Yep, pretty scornful.

    @GruntDoc — I agree that the NEJM’s post-Heller doomsday predictions (see post-Heller NEJM editorials) have not yet come to pass, and I pointed that out, rather bluntly, in the piece.

    @Matt — Any piece published in the NEJM’s “Perspective” section can only have 5 cites. That’s their rule. If this piece was published in a law review, it would have had upwards of 100 cites, and I would have added a footnote about every 4-5 words for support. The citation limit is the downside of publishing a Perspective. Here’s the policy: “Perspective articles cover a wide variety of topics of current interest in health care, medicine, and the intersection between medicine and society. We welcome submissions and proposals. Perspective articles are limited to 1000 to 1200 words and usually include one figure. There is a maximum of 5 references.” [http://authors.nejm.org/help/Articles.asp] And re: skipping the editorials and reading the rest of the Journal — certainly an option. You can have the TOC sent to you for free and then just click on the evidenced-based articles that interest you and are relevant to your particular practice.

    @Sebastian — Agree.

    @MJS — Although the NEJM did publish my piece, it is not a NEJM Editorial. That’s a different kind of piece. [See the website I listed above with @Matt for information about the different kinds of articles.] It does not represent the views, per se, of the NEJM.

    @DirtCrashr — Re: “They” — I wrote for myself, not the NEJM editorial board, so there’s no “they.” Seemed to me that McDonald wants to protect himself with his handgun. It will certainly not clean up the neighborhood. If you’re saying that he’s not getting a gun for that purpose, then fair enough.

    @MJM — Re #11 — Freudian? Re: #14 — All I said about the plurality opinion was this: “Justice Samuel Alito’s plurality opinion, referencing a physician-assisted suicide case, explained that the right described in Heller is ‘deeply rooted in this Nation’s history and tradition’ and is ‘among those fundamental rights necessary to our system of ordered liberty.” That was it. Not sure how you come to the conclusion that that’s “an editorialized put-down of the majority opinion” from there.
    – Not sure how I “glorified” the dissenters either. I just offered a very brief summary of the Breyer dissent. And there were two dissents — one from Breyer, which RBG and SS joined, and one from Stevens, which no one joined.
    – I get it that you and others don’t like the “root causes” comment. That’s ok. Of course, you chide me later for not being serious about crime control. Would addressing poverty help with the crime in the first instance?
    – And the public health community has long considered gun violence one of its issues — friend of mine just treated a guy who shot himself in the femur when loading his new handgun. Yep, it was an accident, but it still required a lot of treatment.
    – The gun death stat is from the DOJ (see link with @Ash, #13). I did say “deaths” and didn’t parse it.
    – I would endorse Eddie Eagle, but I haven’t seen data about the program actually working. The literature out there says just the opposite. You can argue that those studies were poorly designed, biased, etc., so let me know how they should have been designed differently. Maybe someone can implement your study. But if some school has time to have an Eddie the Eagle program, then great. Just seems like a waste of time to me — same with any “say no to drugs” program. That one didn’t work either.
    – I didn’t say that the majority opinion saw “esoteric.” I said that to physicians, the 200+ page debate about a constitutional law issue and the role of the Court itself may seem esoteric, i.e., reserved for pointy-headed legal academics.
    – On car deaths — You are completely right. There is a more than fair argument that if we are serious about curbing rates of accidental deaths, we should ban cars. People see cars as essential (i.e., I need to get to work and there is no bus or subway, and it’s too far to walk….) and guns as frivolous. But to people who think guns are essential to daily life, that argument falls flat.
    – The “pseudo-scientists” and “foray beyond their intelligence” are pretty mean. As are #22 and #24. Ouch.

    @W.Richards — If you do a combined program and a 3-year residency, then it takes, at the very least, 9 years to become a doctor. Most people slog through many more. But you’re right — no one becomes a doctor b/c they think it will keep the criminals at bay.

    @Ash #13/#19– Thanks.

    @Paul Jones — The information about the brief is in the disclosure form I provided with the article — see link at the end of the article.

    @Sebastian — Not sure these comments meet the “dinner party at someone’s house” and the no “nastiness, vitriol,” etc. standard, but I’m all for free speech and it’s your blog.

    Last thing: Everyone should read this paper by Kahan, Braman and Grimmelmann, if you haven’t already — http://ssrn.com/abstract=1000449. It talks about the general disconnect among the various parties in the “Great American Gun Debate.” We all have a tendency to cling to data that support our world view and dismiss data that do not. The authors suggest finding a cultural and political middle ground. It’s an interesting read.

    Thanks for reading the NEJM piece. Nice to see how it came across.

    Best,
    Julie

  25. Melancton Smith says:

    Julie, thanks for coming to a, mostly, hostile crowd and responding.

    With respect to Eddie Eagle…it must be something that is bringing the accidental death rates down for guns while over a hundred million new guns have been added into civilian hands. I think awareness and training are the source for that and I see Eddie Eagle as a great way to train kids to react properly to a found firearm.

  26. MJM says:

    You got guts, Julie. You’re a good sport. Maybe not haughty after all.

    Your NJEM piece strikes me as smug, from an anti-Second Amendment bias. Maybe–like gun owners posting here–writing to NJEM is a friendly audience experience for you, and the rhetorical flourishes get ratcheted up.

    But, your rebuttal here is definitely NOT haughty, so I’ll take “haughty” back.

    For the rest of my reactions to your NJEM piece, though, I’ve considered your rebuttal points and–I’ll stand.
    Glad you came here to write back.

    I looked at the Social Science Research Network page you linked to. It’s sort of interesting, but, again, the academic community wants to steer all debates toward theses, dissertations, and publications by–guess who?–academia! I suspect their article is a way of saying “Gun owners are so blinded by their ignorant preconceptions that it’s no use talking to them about facts in the traditional argument way,” but the abstract doesn’t quite put it that way. I do point out that they are selling their ” Factual Enlightenment Model,” other “models,” and finally–Hey! Line up to buy this one!–their “Breakthrough Politics Model,” which shows how “persuasive empirical proof can dispel culturally influenced states of false belief once policy options are invested with social meanings that make them compatible with diverse cultural orientations.”
    Ugh! Let them apply for all of the federal research grant money they want. They really don’t get it.
    I’m not interested in some sort of B.F. Skinnerian, “psychologists should rule the world,” Beyond Freedom and Dignity conclusion. Indeed, they are really convincing me even more that I MUST insist on the individual, personal, right to keep and bear arms. Otherwise, people who want to rule over others will take over. But, of course, I could just be so dysfunctionally enculturated in the Way of the Gun as to be utterly incapable of attaining this superior (empirically based) enlightenment of which they speak. Now, if only we were all social sciences researchers…or at least if the masses would just listen to the social science researchers.

    The Second Amendment, and much of the rest of the Constitution, resulted from the founders’ understanding that there are many people out there who lust to rule over others, and they will do so by trickery, theft, mass murder and enslavement if we permit them. I see that as an ongoing, empirical, indisputable, historical fact and future reality, and I see the real-time, actual exercise of the right to keep and bear arms as an imperative check on that tyranny.

    MJM

  27. MJM says:

    I think it is worth adding to this discussion that science is not what it used to be. I say this because Dr. Cantor’s arguments repeatedly reference the numbers, the studies, the data–exhibiting a reliance on “the literature.”

    I respect–almost revere–the scientific method. The scientific method is one of the great inventions of western civilization. Rigorously applied and enforced, other scientists and the public can count on the results. I have some background in this and taught statistics for a year. I hardly scorn the application of the scientific method where it may be applied in accordance with its own strict bounds.

    However, people calling themselves scientists do not escape the human condition the second they don a lab coat. You can buy a used one real cheap. You can glom onto grant money and write all manner of useless studies while pursuing your degree and your agenda.

    I mean, seriously, between “social science” and “global warming” why should the public genuflect to those who display a form of science without the scientific method’s insistence on rigor?

    Dr. Cantor, you do exhibit either what I would call a naive faith in empiricism, or you are simply using the tired tactic of pseudo-science to argue your worldview. The post-modern culture loves statistics and studies. The argument goes like you made it above: “If the literature doesn’t say it, then I just don’t believe it and I transfer the burden of proof to you to show me studies otherwise.” In this way, you seek to define the argument’s resolution strictly in terms of social science research. Everybody else has nothing to say. But, this is foolishness.

    For example, you challenge me to produce the data showing that the NRA’s Eddie Eagle gun safety education program works, and you throw the holy “literature” word out there as some sort of end-of-argument idol. Please consider this.

    Eddie Eagle teaches children simply, If you find a gun, stop, don’t touch, leave the room, tell an adult. I don’t need some sociology PhD candidate trying to please a leftist professor to validate for me that such good safety training protects kids. Don’t play in the street; don’t touch the top of the stove; don’t run on the pool deck. Stop running with that upturned pencil in your hand! Do I need a study before I understand the value of telling kids how to identify dangers and avoid them?

    How about this, Julie? Why don’t you collaborate with the NRA and study the efficacy of the Eddie Eagle firearms safety instruction method?

    Your quote about teaching firearms safety to children is astounding: “…seems like a waste of time….” If you just must see some literature validating safety training, while not necessarily specifically directed into the topic “Does teaching safe firearms handling make handling firearms more safe? (Duh!) there are many studies validating the value of safety training. Do we really have to even question that?

    If the literature says–as you apparently believe–that teaching children firearms safety does not reduce firearms-related injuries and deaths, then …

    What I “heard” when you wrote “…seems like a waste of time…” was simply that you don’t know guns, you don’t like guns, and you are convinced that only the police and military should have guns, or at least that such criminal laws should be imposed on we gun-owning citizens that the practical exercise of the Second Amendment is banished. (That is the new Brady strategy.) Advocating firearms training for children impedes the gun control agenda, so you flippantly dismissed the notion of Eddie Eagle spending a few minutes in a classroom trying to save kids’ lives.

    The schools have plenty of time to teach little children “Heather Has Two Mommies,” and what homosexual sex would look like. They can learn to chant praises to Barak Obama. EE could be taught in a single hour–or less.

    I say again: Those who purport to care about firearms safety should 1) Learn to handle a gun safely and 2) advocate training, training, training, training and the age-appropriate level.

    Otherwise, MJM considers complaints about dangerous firearms hollow.

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