Unintended Consequences – Introduction: The Emerging Public Health Debate

Handguns inflict a staggering toll on our society. More than one million Americans have died in firearm homicides, suicides, and unintentional shootings since 1962. Handguns were used in more than 670,000 of these fatal shootings.4 On average, if someone gets shot and killed, four out of five times it will be with a handgun. In 1998, for example, handguns were used in 80.7 percent of all firearm homicides.5

There is thus plenty of evidence that handguns cause substantial harm and, perhaps more importantly, that America’s “gun violence” problem is really a handgun violence problem. But do handguns do enough good to offset the risk of this perennial harm? Pro-gun advocates claim that the utility of handguns for self-defense is a sufficient benefit to justify their incontrovertible risks. This report critically examines that claim. 

The key question the public health and safety approach asks of any consumer product is, what are the product’s relative risks and benefits? If a product inflicts more harm than is reasonable compared to the good, the inquiry then is whether the cause of harm is a defect in design or some factor inherent in the nature of the product. If the source of harm is a design defect, like a motor vehicle with a tendency to roll over on curves, it may be possible to correct the design. Some products, however, like highly toxic pesticides, are so inherently dangerous that no amount of design modification can make them reasonably safe. In such cases, the product may either be restricted to specific persons or banned outright. 

What are the results when we apply this analysis to handguns? 


The Risks of Handguns

Even pro-gun experts agree that handguns make violent encounters more likely to result in death or injury. Here, for example, is what pro-gun author Chris Bird wrote in a manual intended for people who wish to carry a concealed handgun: 

Members of the gun-control movement believe that there are far too many guns of all kinds in American society and that these guns are responsible for much of the violence. This is probably true. Guns facilitate violence. A killer can do in a fraction of a second by exerting a few pounds of pressure on a trigger what it might take him ten minutes and a lot of exertion to do with a baseball bat.6

Why Handguns are the Major Cause of Firearms Death and Injury. Handguns play such a prominent role in “facilitating” firearms violence because of two characteristics: they are portable and they can be easily concealed. Gun advocate Duane Thomas sees this as a virtue in his pro-gun book, The Truth About Handguns

The only thing handguns really have going for them as weapons is their small size, with its resultant portability, concealability, and maneuverability. In other words, unlike a bulky rifle or shotgun, a handgun can be therewhen you need it.7

A third factor, the widespread availability of handguns, has also become important in recent decades as handgun production and import have soared over that of rifles and shotguns—the sporting long guns.8

The Public Health and Safety Analysis. Public health and safety experts view the ready availability of the handgun very differently than does Duane Thomas. 

Unlike traditional “gun-control” advocates who focus on criminal use of firearms,e public health and safety experts look at physical causes of death and injury and seek ways to reduce the effects by modifying the physical causes. Thus, when people being hurled out of or through the windshields of cars was demonstrated to be a factor in motor-vehicle deaths and injuries, these experts advocated seatbelts and other restraints as effective means to reduce harm. 

To such experts, the fact that an implement as lethal as a handgun has become ubiquitous and can be concealed and carried around becomes a significant risk factor. It plainly makes it much more likely that a human being will be killed or seriously injured in circumstances where, without the presence of a handgun, only bruised egos or minor injuries would occur. “A lighted match can certainly start a fire, but the potential for serious injury or death is much greater if you toss in a bucket of gasoline,” wrote public health expert Dr. Arthur L. Kellermann. “Likewise, violence can certainly cause harm, but the potential for serious injury or death is increased when a firearm is involved.”9

The public health and safety approach has become a well established and highly effective way to reduce deaths and injuries from virtually every consumer product other than guns, including motor vehicles, toys, and power tools (among thousands of other products). But because the firearms industry is specifically exempted from the federal Consumer Product Safety Act,10 handguns have escaped the sort of close scrutiny to which every other consumer product in America is subject. 

This situation has begun to change somewhat in recent years, however, as the public health community, gun control advocates, and policymakers have come to understand that the same techniques that have reduced deaths and injuries from motor vehicles, pesticides, and flammable clothing can be applied to guns. Ironically, gun experts also frequently compare handguns to other consumer products. “Think of your gun as a power tool,” writes Bill Clede, author of The Practical Pistol Manual.11 Chris Bird writes, “A gun is a tool, but like a car, it can do a lot of damage if not used correctly and treated with respect.”12 And Ed Shultz, then-president of handgun maker Smith & Wesson, told The Wall Street Journal, “I make consumer products.”13

Nevertheless, Congress has failed to enact legislation—such as the Firearms Safety and Consumer Protection Act introduced by Senator Robert Torricelli (D-NJ) and Representative Patrick Kennedy (D-RI)—that would subject firearms to federal consumer product health and safety regulation, just like power tools and cars. 


Putative Benefits From Handguns

We quoted gun advocate Chris Bird acknowledging that guns increase violence. He also wrote, however, that “it is also true that guns prevent violence.”14 And gun expert Massad Ayoob dismisses advice against buying a handgun for self-defense as “bullshit, all bullshit. Guns are the only weapons that put a physically small or weak person at parity with a powerful, very possibly armed, criminal.”15

No one questions that it is possible to kill or disable another human being with a handgun. But the public health questions remain: is it true that the handgun is an effective tool for self-defense in a real way, as opposed to a merely theoretical or rhetorical way?f And, if it is true only in a limited number of cases, does the possibility that handguns may prevent some violence outweigh the risks of the greater non-defensive violence they certainly cause? 

The modern gun industry was built on the premise that handguns are good for self-defense. Until late in the last century, handguns were a small part of the American firearms mix. In 1946 handguns accounted for only eight percent of all firearms available for sale.16 But this product mix began to change in the mid-1960s as the gun industry, faced with declining rifle and shotgun demand, heavily marketed handguns for self-defense. Today, handguns regularly account for at least half of the firearms that come onto the market from domestic manufacture and importation combined,17 and—in some years—more. Whatever else handguns have done to America, they have been a lifeline to keep the gun industry alive. 

The Embarrassing Subtext—Handguns Don’t Make One Safer. The many pro-gun experts quoted in this report make the pro forma argument in their works that the person who owns a handgun is safer because he is able to defend himself against others who are bigger, meaner, more violent, or criminal in intent. However, the substance of their own work undercuts this premise to an amazing degree. The words of these experts demonstrate authoritatively and convincingly that handguns are so difficult to shoot accurately, and the stresses of actual mortal fear so great, that only a tiny minority of handgun owners possess the requisite skill and judgment to effectively use their guns for self-defense in legally appropriate circumstances without needlessly endangering the lives of innocent people. 

Expert Bird, for example, points out quite candidly that handguns are crude, difficult-to-master tools, ill-suited for self-defense: 

Like many things in life, a handgun is a compromise. It is the least-effective firearm for self defense. Except at very close quarters—at arm’s length—shotguns and rifles are much more effective in stopping a drug-hyped robber or rapist intent on making you pay for his lack of social skills. A handgun is the hardest firearm to shoot accurately, and, even when you hit what you are shooting at, your target doesn’t vaporize in a red mist like on television.18

This is a staggering admission that raises on its face the question of misleading advertising by the handgun industry. No handgun manufacturer includes in its advertising or instructional materials the candid statement that a handgun is the “least-effective firearm for self-defense.” Expert Ayoob writes this critique: 

The uninitiated tend to make two kinds of mistakes with firearms: they either use guns when they shouldn’t, or do not use them properly in the rare circumstances when they should.19

Like Ayoob, expert Bill Clede undercuts the need for handguns by noting how rarely they are needed for self-defense: 

Many police officers reach the end of their careers without ever drawing—much less firing—a gun in the line of duty. The odds against your ever needing to use your gun are even greater.20

Assuming a real self-defense need and a theoretical utility of handguns to meet that need, does the typical handgun owner have the requisite skill and judgment to effectively use his handgun without unreasonably endangering the lives of other innocent parties? Here is how Ayoob, one of the most prominent and vociferous writers in the pro-gun panoply, summed the matter up: 

Too many people believe they can shoot suspected criminals when, in fact, they may have no right to do so. Too many people are incapable of using their guns in a combat situation with sufficient expertise to either prevent an armed criminal from taking innocent lives, or to be sure of not hitting bystanders with their own stray bullets. Both knowledge and ability should be pre-requisites for the privilege of carrying a gun in public. It is my personal opinion that every applicant for a carry permit should pass a written examination on self-defense and lethal force laws, and a close-range qualification run over a combat pistol shooting course.21

No state requires such demanding qualification as a condition to owning or carrying concealed a handgun. 

We examine these points in more detail throughout this report. But this preliminary examination of expert pro-gun opinion makes clear that the real world is far different from the glossy advertising of the gun industry and the glib propaganda of the National Rifle Association. 

In the real world, gun owners lack minimal skills and don’t know when they can legally, much less morally, shoot another human being. In the real world, criminals shoot back. And in the real world, innocent people—gun owners and bystanders alike—pay the price with their lives


e) Most gun violence is not criminal in its inception. Suicides, for example, are the majority of gun deaths every year. Even most homicides occur between people who know each other, such as spontaneous killings by previously “law-abiding” angry spouses. Adding unintentional shootings to these suicides and acquaintance shootings leaves a decided minority of shootings that originate as part of a criminal act. However effective gun control measures aimed at criminal violence may be, they have little impact on the vast amount of non-criminal gun violence.

f) Some pro-gun advocates have made greatly inflated claims about the number of so-called “defensive gun uses” each year. Although refuting these claims in detail is beyond the scope of this report, there is a substantial body of academic analysis critically questioning or entirely refuting these claims. See Otis Dudley Duncan, “Gun Use Surveys: In Numbers We Trust?” The Criminologist 25 (January/February 2000): 1-7, for a summary of the key issues and sources cited in Appendix B.


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