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Understanding the Risk of Firearms: Suicide vs. Homicide

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Melissa Mills has 20 years experience as a BSN and specializes in Nurse Case Manager, Professor, Freelance Writer.

11 Followers; 123 Articles; 26,589 Profile Views; 286 Posts

What are your thoughts on the firearm statistics?

Gun violence is a hot topic these days. Turn on the TV for any length of time, and you will hear stories of firearm homicide. But, did you know that firearm suicide is more common in the U.S? Learn about the statistics of this public health issue and if nurses have a role in the firearms debate.

Understanding the Risk of Firearms: Suicide vs. Homicide
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If you watch the news or TV shows, you might be led to believe that there is a high risk of firearm homicide. Researchers from Northeastern University, University of Washington, and Harvard University conducted a study into the perceptions of gun violence and the leading cause of death in the United States. They found that the presence of a firearm in a home increases the risk for suicide, which is more common than firearm homicide.

So, what's behind our misconception about gun violence and how do you educate the community about the real dangers?

Looking at the Numbers

According to the Brady Campaign, the oldest organization in the gun violence prevention movement, 96 people die every day in the United States from gun violence. Of these 96, 34 are murdered, and 59 die from suicide. That means nearly twice as many people die from firearm suicide compared to firearm homicide. There are also 246 people shot daily who survive - 183 are injured in an attack, 49 are shot unintentionally, 4 are shot in a legal intervention, and 11 survive a suicide attempt.

A 2014 study published in the Annals of Internal Medicine reported that access to firearms in the home increases your risk of violent death by suicide, homicide, or unintentional injury. There was a direct correlation to the risk of suicide among people who had access to firearms compared to those without access. The study also reported that the US has one of the highest rates of access to firearms in the world.

Could impulsivity and the ease of access to a gun place some people at a higher risk of committing suicide or homicide? The study suggests that it's possible. Yet, there are no hard data to support the claim. States with the highest rates of firearms, also have a higher percentage of firearm violence compared to non-firearm violence.

Is it a Public Health Issue?

According to the American Public Health Association (APHA), gun violence is an issue that is deeply rooted in our culture and must be addressed through a public health approach. Violence research should be conducted to ensure that guns don't fall into the wrong hands. APHA also believes that access to mental health services must be expanded to those who need it most to decrease the number of suicides by firearms.

Do Nurses Have a Role In the Firearms Debate?

Every day nurses in Emergency Rooms across the country come face-to-face with the gun violence issue. They might deal with victims of homicide, suicide, and unintentional shootings.

Nurses who work in schools have become far too familiar with the issue over the past few years. The National Association of School Nurses released a Position Brief in which they state that school shootings in the US are an urgent public health crisis. The NASN advocates for safe school environments for all children and recognizes the emotional and physical effects that gun violence has on our students. This doesn't account for nurses in the ICU, rehabilitation units, and many other settings that might care for gunshot victims.

Unfortunately, healthcare workers can fall victim to gun violence, too. Recent research has highlighted the prevalence of suicide among nurses. And, gun violence in hospitals and other healthcare facilities seems to happen at an alarming rate. In fact, just a few weeks ago, a young doctor was killed in the parking lot of Mercy Hospital in Chicago at the hands of her former fiancee.

What Can You Do To Help?

Gun violence is a hot political debate these days. No matter which side of the aisle you stand on, as a nurse there are a few things you can do to help keep patients safe:

  1. Educate patients about the risks inherent in having a gun in their home. It's particularly important to speak to parents of young children about safe storage of all firearms.
  2. Connect patients with mental health concerns to services as quickly as possible. Many patients have mental health needs that if left unattended can quickly lead to violence towards themselves or others.
  3. Participate in violence prevention and intervention programs at your hospital or facility. None of us want to discuss or consider that a shooting could happen at our workplace, but unfortunately, the risk is real.
  4. Write to your elected officials to make your viewpoints on the issues known.
  5. Advocate for more research to be done to increase our understanding of homicide, suicide, and those who commit both.

What are your thoughts on the firearm statistics? Do you feel that nurses have a place in the firearm debate? Let us know your thoughts in the comments below.

Melissa is a Quality Assurance Nurse, professor, writer, and business owner. She has been a nurse for over 20 years and enjoys combining her nursing knowledge and passion for the written word. You can see more of her work at www.melissamills.net or on her blog at www.lifeafterforty.blog.

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1 Follower; 4 Articles; 593 Posts; 22,125 Profile Views

You can have my guns when you can pry them from my dead cold hands...but try and take them before then and see what happens.

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VivaLasViejas has 20 years experience as a ASN, RN and specializes in LTC, assisted living, med-surg, psych.

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The way I see it is, I did not leave my Second Amendment rights at the door to my psychiatrist's office. I have a gun and a mental illness. That being said, however, I don't have access to that gun and that is by design-my family stores it for me because I don't trust myself with it. I came thisclose to using it on myself four years ago and I feel safer knowing I can't get to it if/when I ever get severely depressed again.

However, the key concept here is that it's MY CHOICE not to have access to firearms. No one forcibly took my 2A rights away, like so many want to do. The problem with society is that it likes to paint certain groups with a broad brush, and members of those groups get the short end of the stick. Always.

I understand that sometimes it's necessary to protect people from themselves. But there is a serious movement afoot to try to alter the Constitution, and I'd hate to see nurses drawn into it just because we are guardians of the public's health. Not all of us believe that gun control is the answer to suicide or homicide. This article doesn't state outright that it is, but the inference is there, which I'm sure is why Kyrshamarks responded the way he did.

Anyway, this should be an interesting thread. Thanks for the article.

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Luckyyou has 9 years experience as a BSN, RN and specializes in ICU.

463 Posts; 16,251 Profile Views

You can have my guns when you can pry them from my dead cold hands...but try and take them before then and see what happens.

Stuff like this makes you sound very stable and normal, especially when we're talking about such controversial partisan positions like "we should make sure guns are stored in places where children can't find them and accidentally kill themselves or others." Lordy.

Anyway, as nurses we also have a role in caring for patients experiencing domestic violence and identifying and assisting patients in these types of relationships. Unfortunately, women in an abusive relationship are -five times- more likely to be killed if their abuser owns a gun (Jacquelyn C. Campbell, et al., Risk Factors for Femicide in Abusive Relationships: Results from a Multisite Case Control Study, 93 Am. J. Pub. Health 1089, 1092 (July 2003). American women are killed by firearms at sixteen times the rate of women in similar countries, including the nearly 2/3 of women killed by firearms in the hands of current or former intimate partners (Erin Grinshteyn and David Hemenway, "Violent Death Rates: The US Compared with Other High-income OECD Countries, 2010," American Journal of Medicine 129, no. 3 (2016): 266-273., http://www.vpc.org/studies/wmmw2013.pdf).

Many of the recent perpetrators of mass shootings have a history of actual abuse or desire to harm women - Elliot Rodger killing six in California after leaving behind a rambling YouTube video about how he planned to punish women for not sleeping with him (and inspiring a depressing number of copycat "incel" acts of violence); Scott Beierle killing two women and wounding four more at a yoga studio in Tallahassee after a history of arrests for groping and harassment and a series of YouTube videos expressing his hatred for women and desire to kill a particular woman who rejected him: Stephen Paddock killing 58 and wounding more than 500(!), noted to be verbally abusive in public to his girlfriend; Devin Patrick Kelley who killed 26 (including eight members of one family) and wounded 20 after a court martial and imprisonment for abusing his wife and child and a domestic dispute with his mother-in-law - look, I can go on, but this is getting depressing.

We can no longer afford to ignore the link between misogyny, domestic abuse, and violence against women.

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bugya90 has 9 years experience as a ASN, BSN, LVN, RN and specializes in Ambulatory Care-Family Medicine.

560 Posts; 8,320 Profile Views

I grew up around firearms and own multiple firearms myself as an adult. I knew growing up not to touch the gun safe or play with any of my parents guns or ammo. I don't remember my parents ever having a specific discussion about it, just something I grew up knowing (guessing it was ingrained early in in my childhood). Today my guns are locked in a safe. It's called responsible gun ownership.

I live in the south in a hunting and farming community. I work in Pedi. I educate all of my parents about gun safes and gun locks when they check yes on "is there a firearm in the home?" question on the intake forms. A vast majority tell me their guns are already locked up, very few say they don't own a gun safe of some sort.

I am a firm believer in the 2nd amendment, however I am also for smart gun control. A big step would be enforcing the laws and restrictions that are already in place before trying to add mountains more of legislation. I am in the camp of try to pry the gun from hands, however there is a very long road before we as a country get to that point.

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1,739 Posts; 17,966 Profile Views

You can have my guns when you can pry them from my dead cold hands...but try and take them before then and see what happens.

Oh yeah- like Charlton Heston, the actor. That was awesomely dramatic when he said that.

But are you saying that if any of your guns become illegal to own, you will get into a firefight with a law enforcement officer carrying out his sworn duties?

Or do you just like that quote?

Just curious.

BTW- gun owner here. Loaded and accessible 357 in my house as I write.

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OldDude specializes in Pediatrics.

7 Followers; 1 Article; 4,783 Posts; 30,653 Profile Views

The way I see it is, I did not leave my Second Amendment rights at the door to my psychiatrist's office. I have a gun and a mental illness. That being said, however, I don't have access to that gun and that is by design-my family stores it for me because I don't trust myself with it. I came thisclose to using it on myself four years ago and I feel safer knowing I can't get to it if/when I ever get severely depressed again.

However, the key concept here is that it's MY CHOICE not to have access to firearms. No one forcibly took my 2A rights away, like so many want to do. The problem with society is that it likes to paint certain groups with a broad brush, and members of those groups get the short end of the stick. Always.

I understand that sometimes it's necessary to protect people from themselves. But there is a serious movement afoot to try to alter the Constitution, and I'd hate to see nurses drawn into it just because we are guardians of the public's health. Not all of us believe that gun control is the answer to suicide or homicide. This article doesn't state outright that it is, but the inference is there, which I'm sure is why Kyrshamarks responded the way he did.

Anyway, this should be an interesting thread. Thanks for the article.

This is quite insightful and, I believe, "spot on." Thank you for a worthy contribution.

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OldDude specializes in Pediatrics.

7 Followers; 1 Article; 4,783 Posts; 30,653 Profile Views

You can have my guns when you can pry them from my dead cold hands...but try and take them before then and see what happens.

Stuff like this makes you sound very stable and normal, especially when we're talking about such controversial partisan positions like "we should make sure guns are stored in places where children can't find them and accidentally kill themselves or others." Lordy...

I have been called a simpleton more than once but I can't understand the relevance of your response to the quote from Kyrshamarks.

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macawake has 10 years experience.

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Educate patients about the risks inherent in having a gun in their home. It's particularly important to speak to parents of young children about safe storage of all firearms.

Connect patients with mental health concerns to services as quickly as possible. Many patients have mental health needs that if left unattended can quickly lead to violence towards themselves or others.

Participate in violence prevention and intervention programs at your hospital or facility. None of us want to discuss or consider that a shooting could happen at our workplace, but unfortunately, the risk is real.

Write to your elected officials to make your viewpoints on the issues known.

Advocate for more research to be done to increase our understanding of homicide, suicide, and those who commit both.

You can have my guns when you can pry them from my dead cold hands...but try and take them before then and see what happens.

How is your response to OP's post supposed to be interpreted? Does it mean that you feel that any education on gun safety is a waste of time and energy and that public health concerns are of no interest to you? I don't see how OP's suggestions mean that you have to relinquish your Second Amendment rights.

Before becoming a nurse I spent about a decade working armed. I viewed my gun as a helpful tool for the job I had to do, just as my radio and handcuffs etc. I was not more in love with one or the other object and even though I really enjoyed the many hours spent on the range, I don't miss carrying a gun every day and I certainly don't need a gun in my home.

As a European I really don't understand why so many Americans seem so infatuated with their firearms and the right to carry one whenever/wherever. I'm done wasting my breath attempting to convince y'all that there are ways to reduce the numbers of homicides committed on a daily basis... I will just take this opportunity to congratulate your country on your formidable capacity and willingness to sacrifice the lives of school children on the altar of your personal freedom. It's truly remarkable. One has to wonder if you'll ever reach your breaking point.

I know I'm being blunt, but really the habitual thoughts and prayers offered up every time some more kids have been slaughtered, are useless. They don't protect a single child. They don't save a single life.

The way I see it is, I did not leave my Second Amendment rights at the door to my psychiatrist's office. I have a gun and a mental illness. That being said, however, I don't have access to that gun and that is by design-my family stores it for me because I don't trust myself with it. I came this close to using it on myself four years ago and I feel safer knowing I can't get to it if/when I ever get severely depressed again.

However, the key concept here is that it's MY CHOICE not to have access to firearms. No one forcibly took my 2A rights away, like so many want to do.

First of all, I'm am genuinely very happy that you didn't, four years ago. Of course I don't know you other than as a poster here on AN but Viva, please know that I like and appreciate your contributions here

I read your post in this thread and I thought about it. I guess my response is that if all people, and that means people both with and without any psychiatric illnesses, always made their decisions with such maturity, intelligence and self-awareness/insight, we could dispense with laws and law enforcement altogether. But that's not the world we live in. So how make the world as safe as possible for the largest amount of people possible?

Guns in America: Attitudes and Experiences of Americans | Pew Research Center

I find it pretty sad that 2/3 of gunowners cite protection as a major reason for owning a gun. That suggests a rather widespread perception of insecurity and a feeling of living under threat.

Why is that and are there any other possible remedies than arming oneself?

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cec0007 has 1 years experience.

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This is a lengthy post, but gun violence (and gun control) are such currently hot topics that I want to give a perspective of a staunch Second Amendment supporter. I'm also a little old lady who is a retired elementary school teacher (second career) and who literally cannot step on a bug. I'm certainly no Rambo.

This post veers from strictly gun violence into the closely related topic of gun control, so I apologize for that to those who don't want to go there.

Now...

This was an insightful and good article, and one that makes some often overlooked points. Suicide greatly inflates the "gun violence" figures. Law enforcement situations, re both officers and criminals, are also usually included in the figures on gun violence. And if the gang-related homicides in just a few major urban areas were separated from the rest of the homicide statistics, there would be a big difference. Not that those homicides aren't just as important, because they are, but including them gives the impression that mainstream Americans are at far greater risk of firearm homicide than is actually the case. Yes, there is some risk (there is some risk of an auto accident or even an airplane crashing onto you), but statistics on any topic can be misleading.

Some other points not addressed are the fact that gun ownership both actively and passively also prevents crimes of violence. The media doesn't often report on these, or if it does, only in passing and on only a local level. As an example, just yesterday I read of a female homeowner in South Carolina who shot an escaped prisoner who had forced himself into her home. Undoubtedly she would have been a victim of violence had she not had a gun with which to defend herself. (She was still a victim, but it could have turned out much, much worse.) While not something we hear of everyday, it happens more frequently than some might think or want to acknowledge, and the "prevention" factor should be included in any discussion of gun violence or gun control. (Criminals ignore laws and will always be able to obtain guns one way or another. Not so for the average citizen, however.)

In another incident that I saw today but with a more tragic outcome, a woman in New Jersey was stabbed to death in her yard by her ex-boyfriend. This lady had obtained a restraining order against this person and had applied for a permit to have a gun inside her home. When she was stabbed to death, she was still waiting on the permit, which was overdue. However, the situation in New Jersey, with its very strict gun control laws, is actually even worse. Had she been granted the permit, its restrictiveness would still have resulted in her murder, as it would have remained illegal for her to have the gun in her possession outside of her home. (Unless she was willing to break the law and keep the gun in her possession outside her home, which considering the fact that she was still waiting on the permit before obtaining a firearm, she most likely would not have done.) She was killed just outside her home. I'm willing to speculate that her killer counted on the fact that she would be unarmed. These laws need to change, but try to convince some groups of that. On a lot of levels, this was a needless murder, and one in which overly strict gun control played a part. It's not assured she could have successfully defended herself, but she would have had at least a fighting chance, and would have probably lived in somewhat less fear before the incident. My heart goes out to this lady, whom I'm sure felt absolutely helpless. She had checked on the status of her permit again just the week before her death.

As for passively preventing violence, I'm convinced that one reason non-drug and non-gang related home invasions are very low in some locations is because of widespread gun ownership. I live in a southern state, and almost every family I know has at least one firearm in the home, and probably has had for several generations. This is widely known and accepted, and most people seem to understand that breaking into an obviously occupied home here is a good way to likely get shot, so home invasions are uncommon.

As for school and movie theater mass shootings, it is my belief that one contributing factor is that many of these places have signs clearly stating there are no guns there, in other words, they are "gun free zones." Strangely enough, most murderers aren't worried about obeying the signs or laws! To me they might as well be "sitting duck zone" signs. Of course, another and larger contributing factor is the lack of an adequate mental health care system. I don't pretend to have a solution for that. But many of these killers gave clear danger signals before these tragedies happened, and the signals were ignored by those systems that could have taken action but did not. This seems to have been especially true in the Broward County school shooting.

"Guns (knives, cars, baseball bats, rocks) don't kill people; people kill people."

I am an older female who lives alone. Despite tragedies that may involve the use of guns, the Constitution grants me the right to own firearms, and I do. Whether I could or would use them to defend myself, their use would be much more effective than hitting my attacker with my purse. Yes, I'm a Second Amendment supporter. I also like being able to own a vehicle and a cell phone, despite many, many highway deaths, some of which are due to texting. Although I'm a very infrequent drinker, I like being able to own a bottle of wine or have a margarita if I choose, despite many DUI and other alcohol related deaths and violence, including lots of domestic violence. And owning cars and cell phones aren't even Constitutional rights.

When reading about gun violence, it's important to remember and consider the above factors. To those who are against gun ownership by law-abiding citizens, I'd ask that you not punish me, nor those like me, for the crimes of other people, which is exactly what overly restrictive gun control laws do. I believe that murder is already against the law in every state. More gun control laws aren't the solution, and gun owners like me aren't the problem.

Sorry for the soapbox rant, but I'm concerned about the inappropriate responses/"solutions" to the recent school shootings, and I'm disturbed today about the lady in New Jersey.

Edited by cec0007

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OldDude specializes in Pediatrics.

7 Followers; 1 Article; 4,783 Posts; 30,653 Profile Views

This is a lengthy post, but gun violence (and gun control) are such currently hot topics that I want to give a perspective of a staunch Second Amendment supporter. I'm also a little old lady who is a retired elementary school teacher (second career) and who literally cannot step on a bug. I'm certainly no Rambo.

This post veers from strictly gun violence into the closely related topic of gun control, so I apologize for that to those who don't want to go there.

Now...

This was an insightful and good article, and one that makes some often overlooked points. Suicide greatly inflates the "gun violence" figures. Law enforcement situations, re both officers and criminals, are also usually included in the figures on gun violence. And if the gang-related homicides in just a few major urban areas were separated from the rest of the homicide statistics, there would be a big difference. Not that those homicides aren't just as important, because they are, but including them gives the impression that mainstream Americans are at far greater risk of firearm homicide than is actually the case. Yes, there is some risk (there is some risk of an auto accident or even an airplane crashing onto you), but statistics on any topic can be misleading.

Some other points not addressed are the fact that gun ownership both actively and passively also prevents crimes of violence. The media doesn't often report on these, or if it does, only in passing and on only a local level. As an example, just yesterday I read of a female homeowner in South Carolina who shot an escaped prisoner who had forced himself into her home. Undoubtedly she would have been a victim of violence had she not had a gun with which to defend herself. (She was still a victim, but it could have turned out much, much worse.) While not something we hear of everyday, it happens more frequently than some might think or want to acknowledge, and the "prevention" factor should be included in any discussion of gun violence or gun control. (Criminals ignore laws and will always be able to obtain guns one way or another. Not so for the average citizen, however.)

In another incident that I saw today but with a more tragic outcome, a woman in New Jersey was stabbed to death in her yard by her ex-boyfriend. This lady had obtained a restraining order against this person and had applied for a permit to have a gun inside her home. When she was stabbed to death, she was still waiting on the permit, which was overdue. However, the situation in New Jersey, with its very strict gun control laws, is actually even worse. Had she been granted the permit, its restrictiveness would still have resulted in her murder, as it would have remained illegal for her to have the gun in her possession outside of her home. (Unless she was willing to break the law and keep the gun in her possession outside her home, which considering the fact that she was still waiting on the permit before obtaining a firearm, she most likely would not have done.) She was killed just outside her home. I'm willing to speculate that her killer counted on the fact that she would be unarmed. These laws need to change, but try to convince some groups of that. On a lot of levels, this was a needless murder, and one in which overly strict gun control played a part. It's not assured she could have successfully defended herself, but she would have had at least a fighting chance, and would have probably lived in somewhat less fear before the incident. My heart goes out to this lady, whom I'm sure felt absolutely helpless. She had checked on the status of her permit again just the week before her death.

As for passively preventing violence, I'm convinced that one reason non-drug and non-gang related home invasions are very low in some locations is because of widespread gun ownership. I live in a southern state, and almost every family I know has at least one firearm in the home, and probably has had for several generations. This is widely known and accepted, and most people seem to understand that breaking into an obviously occupied home here is a good way to likely get shot, so home invasions are uncommon.

As for school and movie theater mass shootings, it is my belief that one contributing factor is that many of these places have signs clearly stating there are no guns there, in other words, they are "gun free zones." Strangely enough, most murderers aren't worried about obeying the signs or laws! To me they might as well be "sitting duck zone" signs. Of course, another and larger contributing factor is the lack of an adequate mental health care system. I don't pretend to have a solution for that. But many of these killers gave clear danger signals before these tragedies happened, and the signals were ignored by those systems that could have taken action but did not. This seems to have been especially true in the Broward County school shooting.

"Guns (knives, cars, baseball bats, rocks) don't kill people; people kill people."

I am an older female who lives alone. Despite tragedies that may involve the use of guns, the Constitution grants me the right to own firearms, and I do. Whether I could or would use them to defend myself, their use would be much more effective than hitting my attacker with my purse. Yes, I'm a Second Amendment supporter. I also like being able to own a vehicle and a cell phone, despite many, many highway deaths, some of which are due to texting. Although I'm a very infrequent drinker, I like being able to own a bottle of wine or have a margarita if I choose, despite many DUI and other alcohol related deaths and violence, including lots of domestic violence. And owning cars and cell phones aren't even Constitutional rights.

When reading about gun violence, it's important to remember and consider the above factors. To those who are against gun ownership by law-abiding citizens, I'd ask that you not punish me, nor those like me, for the crimes of other people, which is exactly what overly restrictive gun control laws do. I believe that murder is already against the law in every state. More gun control laws aren't the solution, and gun owners like me aren't the problem.

Sorry for the soapbox rant, but I'm concerned about the inappropriate responses/"solutions" to the recent school shootings, and I'm disturbed today about the lady in New Jersey.

Well done!! Well done!!:up:

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pixierose has 3 years experience as a BSN, RN and specializes in Neuro-ICU, psych, ED.

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As a European I really don't understand why so many Americans seem so infatuated with their firearms and the right to carry one whenever/wherever. I'm done wasting my breath attempting to convince y'all that there are ways to reduce the numbers of homicides committed on a daily basis... I will just take this opportunity to congratulate your country on your formidable capacity and willingness to sacrifice the lives of school children on the altar of your personal freedom. It's truly remarkable. One has to wonder if you'll ever reach your breaking point.

I know I'm being blunt, but really the habitual thoughts and prayers offered up every time some more kids have been slaughtered, are useless. They don't protect a single child. They don't save a single life.

"Sacrifice the lives of school children on the alter of your personal freedom" - well put, and spot on. My father in law is a gun owner who has the whole "it's my right and you can pry my guns from my cold, dead hands" mantra going on. How many school shootings do we need to have? How many mass shootings do we need to have?

My impression was that the 2nd amendment was put in place back in the days when military militia marching into homes was a concern ... in 1791. To protect the rights of the states to maintain and arm those militias.

Didn't know such federal tyranny was such a problem nowadays.

The 2nd amendment was never intended to make it a right to carry any weapon whatsoever for any purpose whatsoever. Personal possession was never the main focus. With that in mind, an unlimited individual right to bear any kind and/or number of weapons can not, and should not, be interpreted from the context of the 2nd amendment.

America's gun culture is seriously so far out of whack that people, including my father in law, need to take a serious step back. There is a balance somewhere. Why does anyone need a device that allows bullets to be fired at 400 rounds/minute? Guns can protect. Guns also destroy.

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