OP-ED: "Transforming Initiatives," the Second Amendment, and Public Health: Reframing the Gun Control Debate

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But Jesus didn’t just say no to violence. He taught His followers how to find creative alternatives that could bring deliverance from violence. He taught what Glen Stassen has called “transforming initiatives,” such as going the second mile with the Roman soldier’s pack, turning the other cheek as an unexpected response to being struck, and taking the first step to make peace by finding one’s adversary and beginning the conversation (Matt. 5:23-24, 39, 41).[1]

In the wake of the Sandy Hook massacre and other recent mass shootings, the issue of gun control has shifted in and out of the focus of public policy discussion in America. Calls for stricter gun control regulations have increased across a diverse swath of social, religious, and economic demographics. Intriguingly, the response of many evangelical Christians has been characterized by at least one pastor as a “deafening silence.”[2] According to a January 2013 Public Religion Research Institute report, only 38% of white evangelical Protestants favor stricter gun controls, compared to 60% of Americans in general.[3] But data from Christians is far from homogeneous. American Catholics, for instance, have been particularly vocal in favor of ending America’s love affair with guns,[4] and both minority and white mainline Protestants likewise part ways with their white evangelical brethren. Indeed, support for stricter gun control increased dramatically (from already relatively high levels) among several of these groups—as it did among Americans in general—between the 2012 PRRI survey and the 2013 iteration following Sandy Hook. Among white evangelicals, on the other hand, support for stricter gun controls increased merely 3% over this same period.

Why are American Christians so divided on this particular question when they seem to agree on pro-life issues, like abortion? I am not convinced that I have an answer, but I would like to reframe the question on gun control and, as a physician, attempt to shed some light on this debate within the context of public health. Healthcare professionals in the Christian-Hippocratic tradition may have opinions in the context of their professional responsibilities that conflict with their private stances. The questions are multifaceted and will not permit simple answers. Even the best options available to us may not completely solve the problem either. Nonetheless, by considering what several Christian commitments mean, we can at least begin to evaluate the extent to which our opinions reflect them. To this end, we will look at three topics I take to be interrelated: First, how does the contemporary evangelical pro-life stance (one concentrated on abortion, but with a tendency to marginalize other issues like gun violence) contrast with the example of the early Church? Second, does a biblical frame for the question of gun control arrive at a different conclusion than a Second Amendment approach? Finally, for healthcare professionals specifically, what does empirical public health data add to the discussion? Through consideration of these questions, we will see that frequently-cited concerns which motivate some Christians to oppose tighter gun controls (such as dedication to the Second Amendment or, in the case of healthcare professionals, to the confidentiality of patients) are not the only relevant commitments we have about this issue, either as Christians or as healthcare professionals. From the birth of the church, Christians were comprehensively committed to the biblically-established special value and dignity of human life, taught and modeled by Jesus; and healthcare professionals recognize that when it comes to public health issues, protecting human life sometimes has to take priority over other values, such as patient privacy.

A Pro-Life Witness Then and Now

Catholics and evangelicals generally agree in their self-identification as strongly pro-life. Both groups have, for instance, persistently and vocally opposed abortion. So, why the striking difference in the attitudes of their respective adherents toward an issue such as gun control? One contributing factor may be the marked tendency of the Catholic Church to view the sanctity of human life as a holistic commitment, rather than thinking about it primarily in terms of a few discrete points of controversy. From this perspective, gun control is part of a broad class of issues—a class which also includes abortion, euthanasia, and capital punishment—regarding which a concern for the value of human life generates commitments which should in most cases be considered overriding or decisive. In this respect, concern for the value of human life does not exert determinative influence only in select cases; it should be considered a guiding commitment wherever it is relevant.

Even in its infancy, the early church exemplified this perspective as well, viewing human life as sacred. In opposition to prevailing cultural norms, the earliest Christians uniformly condemned abortion, infanticide, suicide, killing during war, and slaughter as a consequence of gladiatorial contests.[5] Life, for them, was sacred in all its manifestations, and challenges to that principle merited opposition. From a healthcare perspective specifically, Gary Ferngren has documented that early Christian physicians practiced a pro-life ethic similarly—that is, comprehensively.[6] Attention to only one aspect of a pro-life witness was not the example of the early church. This consideration alone does not give us a clear perspective regarding gun control policies, of course, but it does highlight the fact that doing justice to our Christian dedication to the sanctity of human life at least suggests consideration that ethical efforts to protect lives at risk of gun violence is consistent with a Christian worldview. Our faith commits us to comprehensive, all-inclusive concern for human life. So, if we are to oppose measures that could potentially protect human life, we will have to be ready to affirm that we have other commitments that appear to be taking precedent.

The Second Amendment and Biblical Revelation

So, what kinds of commitment do evangelicals who oppose stricter gun control typically cite in favor of that position? Shortly after the Sandy Hook shootings, blogger Matthew Paul Turner aptly pointed out an attitude commonly expressed by evangelicals in this connection:

Far too many evangelical churches promote the freedom to bear arms like it’s mentioned in the Beatitudes. … Supporting the Second Amendment is one thing, rallying for the freedom to purchase and own assault rifles is quite another. … Many of us in the evangelical communities treat the Second Amendment like it’s one of the Ten Commandments. And there’s simply no theological rhyme or reason for our love affair for guns.[7]

Could it be that the desire to justify the status quo of gun ownership in America is based on commitment to principles such as the Second Amendment more so than a careful consideration of Scripture?

Jesus was consistent in his opposition to violence, particularly within the context of the Kingdom of God he was establishing on earth. He not only refrained from violence himself and instructed his disciples to do the same, teaching them even in the context of Simon Peter’s attempt to protect his life that “all who take the sword will perish by the sword” (Matt. 26:52), but also called his followers to seek out “transforming initiatives”—as the quote at the beginning of this piece calls them—as an additional step to counteract violence with active peacemaking. He reminds us that those who rely on the “sword” will die by it. If we acknowledge that strengthening gun control in some form or fashion (which need not include loss of freedom to own guns responsibly, but certainly would preclude relatively unfettered access to firearms) is likely to contribute in some degree to combatting violence and thus protecting life, should it not be tried and supported by those who espouse the way of Jesus? If commitment to a particular interpretation of the Second Amendment conflicts with our Christian commitment to resist violence actively, as modeled by Jesus and the early church, because of the overriding commitment to the value of human life, do we not have reason to give priority to the latter?

Gun Violence as a Public Health Issue?

Further light might be shed on our commitments relevant to gun control if we think about gun violence not just as a problem, but as a public health issue. Guns kill more than 30,000 Americans annually. More persons are killed in the U.S. each year through gun violence than are killed in Iraq or Afghanistan. So, framing gun violence as a public health issue—a health concern that affects and thus must take into account the well-being of a whole population—is not difficult. But do we have any compelling empirical evidence to suggest that addressing it through public policy which includes tighter gun controls could make a difference significant enough to justify individual trade-offs that might be involved?

On April 28, 1996, in Port Arthur, Australia,[8] 35 people were killed by a lone gunman with an “assault weapon.” John Howard, Australia’s Prime Minister at the time, vowed to change gun laws in an effort to prevent similar future tragedies. He was successful. Within a legal framework, Howard and his fellow Australians passed a ban on civilian ownership of semiautomatic long guns (e.g., rifles) and pump action shotguns. They also instituted a market price gun buy-back program, financed by a small, one-off income tax levy on all workers. As a result, Australians have smelted more than 1 million firearms, or one-third of the national civilian arsenal. A similar program in the U.S. would involve an estimated 40 million guns. Purchase of firearms requires demonstrating a genuine reason for firearm possession, which can include motivations like hunting for sport or (in the case of farmers) animal control, but excludes motivations like general “self-defense.” Prohibition of mail or internet gun sales was enacted, as was a requirement that all firearms be registered. Background checks and significant waiting periods were made standard and mandatory for all gun purchases.

The subsequent developments in Australia have been striking. The rate of homicides decreased 7.5% per year after the new policies took effect, totaling as much as a 59% reduction by some accounts. Suicide by firearms decreased from 3.4 to 1.3/100,000 persons per year, a reduction of almost 65%. There were 13 gun massacres in Australia in 1996; there have been none since the new laws took effect. The U.S. population is 13.7 times larger than Australia’s, but currently suffers 134 times the number of total firearm deaths.

So, there is reason to think, on the basis of empirical evidence regarding Australia’s experience, that gun control can help ameliorate—though not completely solve—the public health crisis represented by rampant gun violence. But even in the context of healthcare specifically, there exist commitments which may seem to pull away from stricter gun control. As a result, some healthcare professionals have indeed argued against proposed gun law changes in America.[9] For instance, some individuals and groups view reporting of mental health records to the national gun background check database as a potential breach of medical confidentiality.

Commitment to the value of patient confidentiality in healthcare runs deep, and for good reason. But confidentiality in the physician-patient relationship is a relative, not an absolute, good. Though the Hippocratic Oath prescribes protection of “secrets” that “should not be published abroad,” both the healthcare professions and applicable U.S. law have acknowledged that not all privileged information belongs to that category in all circumstances. That was the basis of the precedent-setting Tarasoff decision of 1976, in which the Supreme Court ruled that mental health professionals have a “duty to protect” individuals they believe on the basis of otherwise confidential information to be threatened by their patients. In the hierarchy of “goods,” saving a life outranks confidentiality, and I have argued elsewhere that the relative good of confidentiality should be overridden (even at the risk of imprisonment) to protect life.[10] Informed by such considerations, a number of physician-led appeals (not emanating from any religious perspective) for gun control reform resembling Australia’s initiatives and President Obama’s proposals have appeared in recent medical literature.[11] Here, again, commitment to the value of human life emerges as a consideration highly—indeed, decisively—relevant to evaluation of gun control options.

It is time for evangelical Christians to break their “deafening silence” about gun violence in America. There certainly exist commitments, such as those to Second Amendment freedom to bear arms or (for healthcare professionals specifically) to patient confidentiality, which can be interpreted in such a way as to foster opposition to stricter gun controls. But a powerful and deep-running commitment to the value of human life filtered through the concerns of public health might cause us to think about the issue differently. A holistic regard for human life just might find its applicability to the issue at hand by recognition of gun violence as a public health issue.


[1] David P. Gushee, The Sacredness of Human Life: Why an Ancient Biblical Vision Is Key to the World’s Future (Grand Rapids: Eerdmans, 2013): 87.

[2] Nigel Tomes, “U.S. Gun Control: Evangelical’s Deafening Silence,” Church in Toronto (blog), December 20, 2012, http://churchintoronto.blogspot.com/2012/12/us-gun-control-evangelicals-deafening.html (accessed June 21, 2013).

[3] Public Religion Research Institute, “Significant Increase in Support for Stricter Gun Control Laws, “Pro-Life” Identity Linked to Opposition to Gun Control Among Evangelicals, Not Catholics,” January 23, 2013, http://publicreligion.org/research/2013/01/january-2013-tracking-poll/ (accessed June 21, 2013).

[4] Laurie Goodstein, “In Fight over Life, a New Call by Catholics,” New York Times, January 25, 2013, http://www.nytimes.com/2013/01/26/us/politics/catholics-raise-issue-of-guns-amid-call-to-end-abortion.html?smid=pl-share (accessed June 21, 2013).

[5] Gushee, The Sacredness of Human Life, 122-129.

[6] Gary Ferngren, Medicine and Health Care in Early Christianity (Baltimore: Johns Hopkins University Press, 2009), 100-101. 107.

[7] Matthew Paul Turner, “4 Questions Every Evangelical Christian Should Consider (in Light of the Newtown Shooting),” Matthew Paul Turner (blog), January 8, 2013, http://matthewpaulturner.com/2013/01/08/2013184-questions-every-evangelical-christian-should-consider-in-light-of-the-newtown-shooting/ (accessed March 17, 2014).

[8] The following information regarding gun policies in Australia is taken from: Simon Chapman and Philip Alpers, “Gun-Related Deaths: How Australia Stepped off ‘The American Path,’” Annals of Internal Medicine 158, no. 10 (May 21, 2013): 770-771.

[9] Joe Palazzolo, “Medical Groups Push Back at Gun-Law Change,” The Wall Street Journal June 12, 2013, http://online.wsj.com/article/SB10001424127887324049504578541662498741022.html (accessed June 21, 2013). See also, Joe Palazzolo, “On Guns and Mental Health: Feds Issue New Regulations,” The Wall Street Journal January 3, 2014, http://blogs.wsj.com/law/2014/01/03/on-guns-and-mental-health-feds-issue-new-regulations/ (accessed March 17, 2014).

[10] G. W. Rutecki, “Please Don’t Say Anything: Partner Notification and the Physician-Patient Relationship,” American Medical Association Journal of Ethics: Virtual Mentor 5, no. 11, (November, 2003): http://virtualmentor.ama-assn.org/2003/11/ccas2-0311.html.

[11] Dariush Mozaffarian, David Hemenway, and David S. Ludwig, “Curbing Gun Violence: Lessons from Public Health Successes,” Journal of the American Medical Association 309, no. 6 (February 13, 2013): 551-552; Katherine L. Record and Lawrence O. Gostin, “A Systematic Plan for Firearms Law Reform,” Journal of the American Medical Association 309, no. 12 (March 27, 2013): 1231-1232; Megan L. Ranney, et al., “A Call to Action: Firearms, Public Health, and Emergency Medicine,” Annals of Emergency Medicine 61, no. 6 (June 2013): 700-702.