Intended for healthcare professionals

Observations Yankee Doodling

Yet another US massacre with a semi-automatic rifle

BMJ 2018; 360 doi: (Published 02 March 2018) Cite this as: BMJ 2018;360:k1024
  1. Douglas Kamerow, senior scholar, Robert Graham Center for policy studies in primary care, professor of family medicine at Georgetown University, and associate editor, The BMJ
  1. dkamerow{at}

Can outraged Florida students move us to action this time?

My wife and I were on a small ship in a remote part of Patagonia when the news reached us: another US school shooting, this one on Valentine’s Day. Seventeen students and teachers were killed in Florida by a disaffected 19 year old with a semi-automatic rifle. We followed the reaction from afar. Shock and sadness from the community and the nation, grieving parents and teachers, stories of unimaginable pain and heroism. Calls for new laws and restrictions, with proposals ranging from disarming those with mental illness to arming all teachers to protect themselves and their students.

Sadly, this is now a familiar drill in the US.1 We are outraged, the story dominates the news for a few days, nothing really happens, and then we go back to our usual activities. Until the next time.

But maybe there is something different about this most recent mass shooting. Amazingly, the story is still in the headlines as I write this, two weeks after the event. The students continue to protest and testify. The (conservative, Republican) governor of Florida has proposed a series of measures to restrict access to assault weapons and keep schools safer. President Donald Trump has held several “listening sessions,” is meeting with Congress, and has signalled support for tighter gun control and stronger background checks.

Realistically, though, prospects for meaningful action at a national level remain slim. This is, after all, a nation with almost as many guns as people: around 300 million. A country with a fearsome lobbying presence—the National Rifle Association—against all things involving gun control. So far there seems to be no congressional leadership for any new legislation that would restrict gun sales, increase scrutiny of purchasers, or provide protection for school children. Hope does not lie with Congress.

But maybe, just maybe, hope can be found in the states, or at least some of them. Not waiting for Congress to act, some states have jumped to action. Unsurprisingly, “blue” (liberal) states have been most active. The Washington state legislature is considering a bill that would raise the minimum age to buy a semi-automatic rifle to 21, tighten background checks on gun purchasers, and create a reporting programme for troubled students. The Illinois legislature is voting on bills that would require gun dealers to be licensed and would let judges bar gun ownership for individuals if recommended by family members or law enforcement. As mentioned, Florida is considering raising the semi-automatic rifle purchasing age to 21, instituting a waiting period after purchase, as well as new measures designed to stop people with mental health problems and violent people from buying guns.2

Some states, mainly red (conservative), are going in the other direction, however. Believe it or not, since the Florida shooting, bills loosening gun restrictions have advanced in Indiana. Kansas is considering lowering the age at which people can carry hidden, loaded guns to 18. And Texas, the last frontier, has taken the bold step of ordering safety information be distributed to all schools in the state.2

There is debate about whether any regulations short of a ban on semi-automatic rifles and other military style weapons, as in Australia, and buy back programmes for assault weapons would help at all, but some new laws, even at the state level, might be effective.3 It seems that the teenager, now charged with 17 counts of premeditated murder for the Florida shooting, was on the radar of several law enforcement agencies, so more focus and funding on tracking such threats might help stop similar tragedies in the future.

But we still have millions of semi-automatic rifles in private hands. There is a limit to what more research, tighter gun controls, background checks, and safety information can achieve. Until the US bans semi-automatic weapons these tragic shootings will continue.1


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