6 - Law and Policy Approaches to Keeping Guns from High-Risk People  pp. 153-184


By Jon S. Vernick, Daniel W. Webster and Katherine A. Vittes

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INTRODUCTION

Public Health Problem of Gun Violence in the United States

The United States is often described as a nation with a car culture. Many Americans love their cars and find life difficult to imagine without them. There were approximately 250 million registered highway vehicles in the United States in 2006.

If this is evidence for a car culture, then the United States certainly has a gun culture as well. There are an estimated 280 million guns in private hands in the United States, nearly one gun for every man, woman, and child. Approximately two-thirds of these guns are rifles and shotguns, used mostly for hunting and sport. Nearly all of the rest are handguns whose owners cite personal protection as the primary reason for ownership. About 38 percent of U.S. households contain at least one gun, with a higher prevalence of ownership in southern and southwestern states as well as more rural parts of the country.

The social consequences of the ubiquity of guns in the United States are profound. Firearms were associated with about 100,000 fatal and nonfatal shootings in the nation in 2006. Of these shootings, about 65 percent were instances in which one person intended to harm another (approximately 13,000 homicides and another 52,000 nonfatal assaults). The remainder includes 20,000 acts of self-directed violence (suicides and suicide attempts) and more than 15,000 unintentional or accidental shootings, including 600 deaths.

Reference Type: notes

Richard A. Epstein , Let the Shoemaker Stick to His Last: A Defense of the “Old” Public Health, 46 Persp. in Biology & Med. (Supplement) S138 (2003)
Ross D. Silverman , No More Kidding Around: Restructuring Non-Medical Childhood Immunization Exemptions to Ensure Public Health Protection, 12 Ann. Health L. 277 (2003)

Reference Type: notes

Reva B. Siegel , Dignity and the Politics of Protection: Abortion Restrictions under Casey/Carhart, 117 Yale L. J. 1694, 1712–1733 (2008)
Linda Greenhouse , How the Supreme Court Talks About Abortion: The Implications of a Shifting Discourse, 42 Suffolk L. Rev. 41, 44–48 (2008)
Dean M. Hashimoto , Science as Mythology in Constitutional Law, 76 Or. L. Rev. 111 (1997)
B. Jesse Hill , The Constitutional Right to Make Medical Treatment Decisions: A Tale of Two Doctrines, 86 Tex. L. Rev. 277, 296–304 (2007)
Reva B. Siegel , The New Politics of Abortion: An Equality Analysis of Women-Protective Abortion Restrictions, 2007 U. Ill. L. Rev. 991 (2007)
Ronald Bayer and Amy Fairchild , The Genesis of Public Health Ethics, 18 Bioethics 473, 485–492 (2004)
Ronald Turner , Gonzales v. Carhart and The Court's “Women's Regret” Rationale, 43 Wake Forest L. Rev. 1, 22–31 (2008)
Justin D. Heminger , Comment, Big Abortion, What the Antiabortion Movement Can Learn From Big Tobacco, 54 Cath. U.L. Rev. 1273, 1290 (2005)
David C. Reardon et al, Deaths Associated with Abortion Compared to Childbirth - A Review of New and Old Data and the Medical and Legal Implications, 20 J. Contemp. Health L. & Pol'y 279, 281 (2004)
Joel Brind et al, Induced Abortion as an Independent Risk Factor for Breast Cancer: A Comprehensive Review and Meta-Analysis, 50 J. of Epidemiology and Community Health 481 (1996)
Angela Lanfranchi , The Science, Studies and Sociology of the Abortion Breast Cancer Link, 21 Issues L. & Med. 95, 98–101 (2005)
Joel Brind , The Abortion-Breast Cancer Connection, 21 Issues in Law & Med. 109, 135 (2005)
Karin B. Michels et al, Induced and Spontaneous Abortion and Incidence of Breast Cancer Among Young Women: A Prospective Cohort Study, 167 Arch. Intern Med. 814 (2007)
Katherine DeLellis Henderson et al, Incomplete Pregnancy is Not Associated with Breast Cancer Risk: The California Teachers Study, 77 Contraception 391 (2008)
A.J. Kitchen et al, Is There a Link Between Breast Cancer and Abortion: A Review of the Literature, 50 Fertility 267, 270 (2005)
J. Kilkarni , Depression as a Side Effect of the Contraceptive Pill, 6 Expert Opinion on Drug Safety 371–74 (2007)
Wendy E. Parmet , Dangerous Perspectives: The Perils of Individualizing Public Health Problems, 30 J. Leg. Med. 83, 96–99 (2009)
Wendy E. Parmet , Quarantine Redux: Bioterrorism, AIDS and the Curtailment of Individual Liberty in the Name of Public Health, 13 Health Matrix 85, 100–104 (2003)

Reference Type: notes

Kant Patel & Mark E. Rushefsky , Health Care Policy in an Age of New Technologies 29 (2002)
Carmen R. Green et al., The Unequal Burden of Pain: Confronting Racial and Ethnic Disparities in Pain, 4 Pain Med. 277 (2003)
Lawrence O. Gostin , Public Health, Ethics, and Human Rights: A Tribute to the Late Jonathan Mann, 29 J. Law, Med. & Ethics 121, 121 (2001)
Mark A. Rothstein , Rethinking the Meaning of Public Health, 30 J. Law, Med. & Ethics 144, 144 (2002)
Diane E. Hoffmann & Anita J. Tarzian , Dying in America – An Examination of Policies that Deter Adequate End-of-Life Care in Nursing Homes, 33 J. Law, Med. & Ethics 294 (2005)
Wendy E. Parmet & Jason A. Smith , Free Speech and Public Health: A Population-Based Approach to the First Amendment, 39 Loy. L.A. L. Rev. 363, 372 (2006)
Ruth Webster , Judith Lacey & Susan Quine , Palliative Care: A Public Health Priority in Developing Countries, 28 J. Pub. Health Pol'y 28, 29 (2007)
L. De Lima , C. Sweeney , J. L. Palmer & E. Bruera , Potent Analgesics Are More Expensive for Patients in Developing Countries: A Comparative Study, 18 J. Pain & Palliative Care Pharma 59 [2003])
Jan Stjernswärd , Viewpoint, Palliative Care: The Public Health Strategy, 28 J. Pub. Health Pol'y 42 (2007)

Reference Type: notes

David R. Williams , Race and Health: Basic Questions, Emerging Directions, 7 Annals of Epidem 5, 322–33 (1997)
Joe Feagin , Slavery Unwilling to Die: The Background of Black Oppression in the 1980's, 17 J.Black Stud. 173 (1986)

Reference Type: notes

John G. Culhane , Beyond Rights and Morality: The Overlooked Public Health Argument for Same-Sex Marriage, 17 Law & Sexual 7, 27–37 (2008)
Dan A. Black et al., The Economics of Lesbian and Gay Families, 21 J. Econ. Perspe 53 (2007)
Shoshana Grossbard & Lisa K. Jepsen , The Economics of Gay and Lesbian Couples: Introduction to a Special Issue on Gay and Lesbian Households, 6 Rev. Econ. Househ 311, 319 (2008)
Catherine Kenney , Cohabiting Couple, Filing Jointly? Resource Pooling and U.S. Poverty Policies, 53 Fam. Rel. 237, 244 (2004)
Anita Bernstein , For and Against Marriage: A Revision, 102 Mich. L. Rev. 129, 140–41 (2003)
Anita Bernstein , Afterword: Narrowing the Status of Marriage, in Marriage Proposals: Questioning A Legal Status 233 (Anita Bernstein ed., 2006)
Cynthia Grant Bowman , Social Science and Legal Policy: The Case of Heterosexual Cohabitation, 9 J. L. Fam. Stud. 1, 13 (2007)
Amy L. Wax , The Family Law Doctrine of Equivalence, 107 Mich. L. Rev. 999 (2009)
Gilbert Herdt & Robert Kertzner , I Do, but I Can't: The Impact of Marriage Denial on the Mental Health and Sexual Citizenship of Lesbians and Gay Men in the United States, 3 Sexuality Research & Soc. Pol'y 35, 35–37, 40–41 (2006)

Reference Type: notes

Sara Fenstermaker Berk & Donileen R. Loseke , “Handling” Family Violence: Situational Determinants of Police Arrests in Domestic Disturbances. 15 Law & Soc'y Rev., 317, 317–346 (1980)
Carol Kennedy Chaney & Grace Hall Saltzstein , Democratic Control and Bureaucratic Responsiveness: The Police and Domestic Violence, 42 American Journal of Political Science 745, 750–751 (1998)
Linda Ammons , Discretionary Justice: A Legal and Policy Analysis of a Governor's Use of the Clemency Power in the Cases of Incarcerated Battered Women, 3 J.L.& Pol'y 1, 30 (1994)
Evan Stark , The Battered Mother in the Child Protective Service Caseload: Developing an Appropriate Response, 23 Women's Rts. L. Rep. 107, 107–131 (2002)
Patricia Tjaden & Nancy Thoennes , Prevalence and Consequences of Male-to-Female and Female-to-Male Intimate Partner Violence as Measured by the National Violence Against Women Survey, 6 Violence Against Women 142 (2000)
John Schafer et al., Rates of Intimate Partner Violence in the United States, 88 American J. Public Health 1702, 1702–1704 (1998)
Walter S. DeKeseredy , Current Controversies on Defining Nonlethal Violence Against Women in Intimate Heterosexual Relationships: Empirical Implications, 6 Violence Against Women 72 (2000)
Richard M. Tolman , The Development of a Measure of Psychological Maltreatment of Women by their Male Partners, 4 Violence & Victim 159, 159–177 (1989)
Minna Piispa , Complexity of Patterns of Violence against Women in Heterosexual Partnerships, 8 Violence Against Women 873 (2002)

Reference Type: notes

Lisa Hepburn et al., The U.S. Gun Stock: Results From the 2004 National Firearms Survey, 13 Inj. Prevention 15 (2007)
Kim A. Howard et al., Beliefs about the Risks of Guns in the Home: Analysis of a National Survey, 5 Inj. Prevention 284 (1999)
Stephen P. Teret et al., Support for New Policies to Regulate Firearms: Results of Two National Surveys, 339 New Eng. J. Med. 813 (1998)
Eric Gorovitz et al., Preemption or Prevention? Lessons from Efforts to Control Firearms, Alcohol, and Tobacco, 19 J. Pub. Health Pol'y 36 (1998)
Daniel W. Webster et al., Effects of State-level Firearm Seller Accountability Policies on Firearms Trafficking, 86 J. Urb. Health 525 (2009)
Daniel W. Webster et al., Relationship Between Licensing, Registration, and Other Gun Sales Laws and the Source State of Crime Guns, 7 Inj. Preven 184 (2001)
Howard J. Shaffer et al., The Epidemiology of Psychiatric Disorders Among Repeat DUI Offenders Accepting a Treatment-sentencing Option, 75 J. Consulting & Clinical Psychol. 795 (2007)
Sandra C. Lapham et al., Prevalence of Psychiatric Disorders among Persons Convicted of Driving While Impaired, 58 Archives Gen. Psychiatry 943 (2001)
Carl Keane et al., Drinking and Driving, Self-control, and Gender – Testing a General Theory of Crime, 30 J. Research in Crime & Delinquency 30 (1993)
G. William Lucker et al., The Prevalence of Antisocial Behavior Among U.S. Army DWI Offenders, 52 J. Studies on Alcohol 318 (1991)
Stephen P. Teret et al., Public Support for Innovative Gun Policies: The Results of Two National Surveys, 339 N. Eng. J. Med. 813 (1998)
Garen J. Wintemute et al., Risk Factors Among Handgun Retailers for Frequent and Disproportionate Sales of Guns Used in Violent and Firearm Related Crimes, 11 Inj. Prevention 357 (2005)
Susan B. Sorenson & Katherine A. Vittes , Buying a Handgun for Someone Else: Firearm Dealers' Willingness to Sell, 9 Inj. Prevention 147 (2003)
Jon S. Vernick et al., Regulating Firearms Dealers in the United States: An Analysis of State Law and Opportunities for Improvement, 34 J.L. Med. & Ethics 765 (2006)
Daniel W. Webster et al, Effects of State-level Firearm Seller Accountability Policies on Firearms Trafficking, 86 J. Urb. Health 525 (2009)
Daniel W. Webster et al., Effects of Undercover Police Stings of Gun Dealers on the Supply of New Guns to Criminals, 12 Inj. Preven 225 (2006)
Daniel W. Webster et al., Effects of a Gun Dealer's Change in Sales Practices on the Supply of Guns to Criminals, 83 J. Urb. Health 778 (2006)
Garen J. Wintemute , Gun Shows Across a Multistate American Gun Market: Observational Evidence of the Effects of Regulatory Policies, 13 Inj. Preven 150 (2007)
Emily F. Rothman et al., Batterers' Use of Guns to Threaten Intimate Partners, 60 J. Am. Med. Women's Ass'n 62 (2004)
Shannon Frattaroli & Jon S. Vernick , Separating Batterers and Guns: A Review and Analysis of Gun Removal Laws in 50 States, 30 Evaluation Rev. 296 (2006)
Elizabeth R. Vigdor & James A. Mercy , Do Laws Restricting Access to Firearms by Domestic Violence Offenders Prevent Intimate Partner Homicide?, 30 Evaluation Rev. 313 (2006)
Marjory S. Hardy , The Effects of Gun Admonitions on the Behaviors and Attitudes of School-Aged Boys, 24 J. Dev. & Behav. Pediat 1 (2003)
Mark A. Schuster et al., Firearm Storage Patterns in U.S. Homes with Children, 90 Am. J. Pub. Health 588 (2000)
David A. Brent et al., Firearms and Adolescent Suicide: A Community Case-control study, 147 Am. J. Diseases of Child. 1066 (1993)
Arthur L. Kellermann , Suicide in the Home in Relation to Gun Ownership, 327 New Eng. J. Med. 467 (1992)
Matthew Miller and David Hemenway , Guns and Suicide in the United States, 359 New Eng. J. Med. 989, (2008)
Lisa Hepburn et al., The Effect of Child Access Prevention Laws on Unintentional Child Firearm Fatalities, 1979–2000, 61 J. Trauma 423 (2006)
Daniel W. Webster & Marc Starnes , Reexamining the Association Between Child Access Prevention Gun Laws and Unintentional Firearm Deaths Among Children, 106 Pediat 1466 (2000)
Daniel W. Webster & Marc Starnes , Reexamining the Association Between Child Access Prevention Gun Laws and Unintentional Firearm Deaths Among Children, 106 Pediat 1466 (2000)
Thomas B. Marvell , The Impact of Banning Juvenile Gun Possession, 44 J.L. & Econ. 691 (2001)
Stephen P. Teret & Nancy L. Lewin , Policy and Technology for Safer Guns: An Update, 41 Annals of Emergency Medici 32 (2003)
Stephen P. Teret & Patricia Culross , Product Oriented Approaches to Reducing Youth Gun Violence, 12 Future of Child. 119, (2002)
David C. Grossman et al., Self-inflicted and Unintentional Firearm Injuries Among Children and Adolescents: The Source of the Firearm, 153 Archives of Pediatric & Adolescent Med. 875, (1999)
Philip J. Cook & James A. Leitzel , “Smart” Guns: A Technological Fix for Regulating the Secondary Market, 20 Contemp. Econ. Pol'y 38 (2002)
Jon S. Vernick et al., Unintentional and Undetermined Firearm-related Deaths: A Preventable Death Analysis for Three Safety Devices, 9 Inj. Preven 307 (2003)
Philip J. Cook & James A. Leitzel , “Smart” Guns: A Technological Fix for Regulating the Secondary Market, 20 Contemp. Econ. Pol'y 38 (2002)
Jon S. Vernick & Stephen P. Teret , New Courtroom Strategies Regarding Firearms: Tort Litigation against Firearm Manufacturers and Constitutional Challenges to Gun Laws, 36 Hous. L. Rev. 1713, (1999)
John G. Culhane & Jean M. Eggen , Defining a Proper Role for Public Nuisance Law in Municipal Suits Against Gun Sellers: Beyond Rhetoric and Expedience, 52 S.C. L. Rev. 287, (2001)
Jon S. Vernick et al., Availability of Litigation as a Tool for Firearm Injury Prevention: Comparison of Guns, Vaccines, and Motor Vehicles, 97 Am. J. Pub. Health 1991 (2007)

Reference Type: notes

Jon S. Vernick et al., Role of Litigation in Preventing Product-Related Injuries, 25 Epidemiologic Reviews: Injury Prevention and Contro 90, 92–96 (Stephen B. Thacker & Ellen J. MacKenzie eds. 2003)
Anne Bloom , From Justice to Global Peace: A (Brief) Genealogy of the Class Action Crisis, 39, Loy. L.A. L. Rev. 719 (2006)
Wendy Wagner , When All Else Fails: Regulating Risky Products Through Tort Litigation, 95 Geo. L.J. 693, 714–20 (2007)
Kenneth R. Feinberg , Reporting From the Front Line – One Mediator's Experience With Mass Torts, 31 Loy. L.A. L. Rev. 359 (1998)
Richard A. Posner , A Theory of Negligence, 1 J. Legal Stud. 29, 31 (1972)
John C. Coffee , Jr., Class Wars: The Dilemma of the Mass Tort Class Action, 95 Colum. L. Rev. 1343, 1358–67 (1995)
Laura J. Hines , Obstacles to Determining Punitive Damages in Class Actions, 36 Wake Forest L. Rev. 889, 902–12 (2001)
Nan D. Hunter , “Public-Private” Health Law: Multiple Directions in Public Health, 10 J. Health Care L. & Pol'y 89 89 (2007)
Richard A. Epstein , In Defense of the “Old” Public Health, 69 Brook. L. Rev. 1421, 1428 (2004) (quoting same maxim as having “powerful roots in the American political tradition”)
James A. Tobey , Public Health and the Police Power, 4 N.Y.U. L. Rev. 126 (1927) (suggesting that government is “organized for the express purpose, among others, of conserving the public health”);)
Dan E. Beauchamp , Community: The Neglected Tradition of Public Health, The Hastings Center Report (Dec. 1985), at 30 (“Our root ideas about health and safety policy can be traced to these early state [police power] policies.”)
Paul Starr , The Social Transformation of American Medicine 189–90 (1982)
Elizabeth Fee , The Origins and Development of Public Health in the United States, reprinted in Gostin, supra note 1, at 27, 28 (from Oxford Textbook of Public Health, vol. 1 (3d ed. 1997))
Wendy E. Parmet , Health Care and the Constitution: Public Health and the Role of the State in the Framing Era, 20 Hastings Const. L.Q. 267, 290 (1993)
Scott Burris , The Indivisibility of Public Health: Population-Level Measures in Politics of Market Individualism, 87 Am. J. of Pub. Health 1607, 1608 (1997)
Joseph M. Boyle , Jr., The Concept of Health and the Right to Health Care, 3 Soc. Though 5, 5 (Summer 1977)
Ynonne Denier , On Personal Responsibility and the Human Right to Health Care, 14 Cambridge Q. of Healthcare Ethics, 224, 224 (2005)
Michael Walzer , Security and Welfare, reprinted in Gostin, supra note 1, at 69, 75 (from spheres of justice: a defense of pluralism and equality (1983))
Jonathan Oberlander , Who Pays? Who Benefits? Distributional Issues in Health Care, 60 Law & Contemp. Probs.245, 252 (2006)
Garrett Hardin , The Tragedy of the Commons, 162 Science 1243–8 (1968)
Kevin M. Malone & Alan R. Hinman , Vaccination Mandates: The Public Health Imperative and Individual Rights, in Law in Public Health Practice 262–63 (Richard A. Goodman et al. eds., 2003) (describing Hardin's essay)
John Locke , The Second Treatise of Government 8–10 ( J.W. Gough ed., 3d ed. reprint, Basil Blackwell, 1976) (1690)
Thomas Hobbes , Man and Citizen 112 ( Bernard Gert ed., Charles T. Wood et al. trans., Hackett Publishing Co. 1991) (1651)
James R. Davis & Ross C. Brownson , A Policy for Clean Indoor Air in Missouri: History and Lessons Learned, 13 St. Louis U. Pub. L. Rev. 749 (1994)
Jean C. O'Connor et al., Preemption of Local Smoke-Free Air Ordinances: The Implications of Judicial Opinions for Meeting National Health Objectives, 36 J.L. Med. & Ethics 403, 403 (2008)
Linda Geller Dubinsky , The Minnesota Mandatory Seat Belt Law: No Right to be Reckless? 10 Hamline L. Rev. 229, 229 (1987)
Anthony P. Polito , Constitutional Law: Seatbelt Laws and the Right to Privacy, 10 Harv. J.L. & Pub. Pol'y 752, 757 (1987)
Kenneth M. Royalty , Motorcycle Helmets and the Constitutionality of Self-Protective Legislation, 30 Ohio St. L.J. 355, (1969)
Jeffery Thomas , Freedom to be Foolish? L.B. 496: The Mandatory Seatbelt Law, 19 Creighton L. Rev. 743, 743 (1986)
Marc Galanter , Real World Torts: An Antidote to Anecdote, 55 Md. L. Rev. 1093, 1095–97 (1996)
Charles Silver , Medical Malpractice Litigation and Tort Reform: It's the Incentives, Stupid, 59 Vand. L. Rev. 1085, 1086 (2006)
Stephen D. Sugarman , Assumption of the Risk, 31 Val. U. L. Rev. 833 (1997)
Wendy E. Parmet & Richard A. Daynard , The New Public Health Litigation, 21 Annual Rev. Public Health 437, 449 (2000)
Marc Franklin , Vermont Requires Rescue: A Comment, 25 Stan. L. Rev. 51, (1972)
Nancy Levit , The Kindness of Strangers: Interdisciplinary Foundations of a Duty to Act, 40 Washburn L.J. 463, 466–67 (2001)
Philip Cole , The Moral Bases for Public Health Interventions, Epidemiology, vol. 6, no. 1, Jan. 1995, at 78, 80
Dan Markel , How Should Punitive Damages Work? 157 U. Pa. L. Rev. 1383, 1390–92 (2009)
Richard A. Nagareda , Punitive Damage Class Action and the Baseline of Torts, 36 Wake Forest L. Rev. 943, 949 (2001)
Mark Galanter & David Luban , Poetic Justice: Punitive Damages and Legal Pluralism, 42 Am. U. L. Rev. 1393, 1437–38 (1993)
Edward L. Rubin , Reconceptualizing the Runcible Remedies of Common Law, 1998 Wisc. L. Rev. 131, 138
George P. Fletcher , Fairness and Utility in Tort Theory, 85 Harv. L. Rev. 537, 542 (1972)
Kenneth J Arrow et al., Is there a Role for Benefit-Cost Analysis in Environmental, Health, and Safety Regulation?, Science, vol. 272, April 12, 1996, at 221, 221
Cass Sunstein , Health-Health Tradeoffs, 63 U. Chi. L. Rev. 1533 (1996)
Saul Levmore , Probabilistic Recoveries, Restitution, and Recurring Wrongs, 19 J. Legal Stud. 691, (1990)
Uwe Reinhardt , Can Efficiency in Health Care Be Left to the Market? 26 J. Health Pol., Policy & Law 967, 970 (2001)
Eric A. Posner & Cass R. Sunstein , Dollars and Death, 72 U. Chi. L. Rev. 537, 554–57 (2005)
William E. Nelson , Teaching Torts: The Moral Perversity of the Hand Calculus, 45 St. Louis L.J. 759, 7690–61 (2001)
Rand Rosenblatt et al., Law and the American Health Care System 862–63 (1997) (describing Helling as “[t]he most famous (and largely unique) recent health law case purporting to overrule a professional standard” by relying on The T.J. Hooper, 60 F.2d 737, (2d Cir. 1932))
Peter D. Jacobson & Matthew L. Kanna , Cost-Effectiveness Analysis in the Courts: Recent Trends and Future Prospects, 26 J. Health Pol. Pol'y & L. 291, 303 (2001)
Jerry J. Phillips , The Unreasonably Unsafe Product and Strict Liability, 72 Tenn. L. Rev. 833, 838 (2005)