POINT OF VIEW

was required and a few women declined the option. I t is important to evaluate acceptability to patients; this should be undertaken before establishing any wholesale policy to notify all women routinely of their results. Nevertheless, there seems to be merit in further exploring the mailing of cenical cytology results to women.

Acknowledgments The support of the Epidemiology Unit of the Queensland Department of Health is gratefully acknowledged. We also thank Michelle Horstmann

and Heather Castles for their invaluable assistance, and the anonymous reviewer for the Journal who provided constructive criticism.

References 1. McCormick JS. Cervical smears: a questionable practice?

h n c e f 1989; 2: 207-9. 2. Qiayle S. Pursue Pap results. Ausf I h W d l y 1990; 27 April:

17. 3. Rang EH, Tod EDM. Problems of cervical cancer screening

programmes. J R Coll Crti f'rnct 1988; 38: 267-9, 4. Wright RG, Car SC, Shield PW. Abnormal rrrvical cytologs

in Queensland. Aust NZJObstet C+narcof 1991; 31: 191-2.

POINT OF VIEW

Cars, boats, dogs . . . W h y not guns? The case for national gun registration in Australia

Following any highly publicised gun massacre, no bookmaker will quote odds on the gun lobby's rapid calls for the establishment of an 'unfit-to-own-guns' register of violent and disturbed people. Such a pro- posal is the sole focus of a current New South Wales (NSW) Cabinet Office discussion paper,' the responses to which are being considered by the NSW Firearms Consultative Committee.

Unfit-to-own regsters have a ring of common- sense as being analogous to those operated by road authorities for dangerous drivers - m a n e seriously defends the right of violent or disturbed people to own guns, so to oppose such registers is to risk being seen as supporting violence. However, as a strategy for curbing gun violence, such schemes will have lit- tle effect and represent a dangerous and orchesuat- ed diversion from efforts to reform gun laws com- pre hensively.

This scheme aims to disarm the homicidal mani- ac who has obtained a gun licence but not yet pur- chased a gun. For the few cases that fit this mould it would be a useful preventive measure; the scheme would allow people who appear likely to be danger- ous to be reported and, if the reports were judged reasonable, to have their gun licences cancelled. However, the record of gun violence in this country reveals few incidents perpetrated by people who could be clearly identified as dangerous before- hand. Table 1 lists some of the well-known m a s shootings over the past seven years; in over three- quarters the killers showed no formal signs that might have alerted other people to their dangerous proclivities.

Licence cancellation as a solution The discussion paper rightly notes that 'dangerous- ness' is extremely difficult to detect and predict, even for experts. However, even if a dangerous per- son is identified, and happens to hold a gun licence, cancelling the licence does not restrict access to guns, nor reduce the person's capacity for gun vio- lence. Violence is committed with the gun it$elf, not

with the licence. Cancelling a licence simply pre- vents the gun owner from acquiring new guns and has no effect on any guns already in his possession.

The NSW discussion paper appears to assume that 'access' to guns means being able to buy them. But people who already own guns ob\iously continue to have access to them unless the guns themselves- not just the licence-are removed. Curiously, the discussion paper makes no mention of the need to remove guns from people reported as dangerous.

Table 1: Mass shootings in Austmlia, 1987 to 1993, by killers previously known or not known to be dangerous

'Knwn to be Mass shootings with at least three

Dote shot dead donaeraus'

3 Sept 1993

26 Aug 1993

21 Aug 1993 Melbourne

March 1993 Grofton

27 Oa 1992 Terrigal

1 Sept 1992 Melbourne

17 Aug 1991

10 Aug 1990

26 Mar 1990 Brisbane

5 Feb 1988 Broken Hill

8 Dec 1987 Melbourne

10 Oa 1987

9 Sept 1987 Melbourne

June 1987 NT and WA

23 Jan 1987 Svdnev

Sydney

Sydney

Sydney

Sydney

Sydney

Paul Hudson shoots his twin baby daughters and himself

Josip Jancawc shoots his two neighboun and his landlord

Gun seller Paul Taylor, his doughter and customer shot in the gun shop

The Hanging Rock siege and murder spree that preceded it: 6 shot dead

no

no

no

possibly

Yes The Terrigal massacre: 6 shot deod

Ashley Coulston shoots 3 young house- motes

The Strathfield massacre: 7 shot dead, 1 stabbed

The Surry Hills massacre: 5 shot dead

no

no

no

Michael Woods shoots his two small children and himself

Koldas Mayer shoots his wife, two children and himself

The Queen Street massacre: 8 shot dead

John Van Trung Tran shoots a family at Canley Vale: 6 shot dead

Hoddle Street mossacre: 7 shot dead

no

no

Yes

no

no

The Top End killer: 5 shot dead no

Richard Maddrell shoots 4 teenage girls in Pvmble

y e s

AUSTRALIAN JOURNAL OF PUBLIC HEALTH 1995 va. 19 m. 2 21 3

POINT OF VIEW

New South Wales police already have the power to remove guns from people who are not licensed to own them. But because guns are not registered in NSW, the police have no way of knowing if someone even owns a gun. The reporting scheme as proposed would make no difference to this.

Example A This shortcoming was tragically illustrated by the events leading up to the 1992 Terrigal massacre. In Table 1, this case is marked as one where danger- ousness was detected in advance: Malcolm Baker had been violent to his de facto wife, who had obtained an apprehended violence order against him two weeks before. His shooter’s licence was can- celled-as it would be under the proposed reporting scheme. In addition, the police searched his house for guns (a procedure which is required under the domestic violence law). While they found and con- fiscated several guns, they could not know he had at least one more which they did not find. This was the gun he used to kill his de facto wife, her eight- months-pregnant sister, and four other people.

In this case the authorities had formal and clear- cut warning of dangerousness; yet that did not pre- vent a bloodbath ensuing, because the police had no record of the guns owned by Malcolm Baker. The proposed reporting scheme suffers from the same fundamental flaw.

Exampb B The circumstances which led to the Terrigal mas sacre are by no means unique. The Coalition for Gun Control knows of at least one more family mas- sacre waiting to happen. It involves a man in rural NSW who occasionally bashes his wife and has threatened that he might shoot members of her fam- ily if they cross him. Despite the urgings of her rela- tives, she will not complain to the police, because she is afraid this could provoke him to further-and fatalviolence. The relatives had gone to the police, but their concerns were dismissed because they had not been threatened directly to their faces.

Under the proposed reporting scheme, the rela- tives’ concerns would lead to an investigation which might result in the husband’s gun licence being can- celled. However, it is the fact that he has guns in his possession which creates a high degree of danger and distress for this family. Only the removal of his guns will make the household safer. As with the case of Malcolm Baker, the absence of firearms registra- tion will make this impossible for police to achieve with any degree of certainty.

Access to guns owned by others Many people commit violence with guns they do not own, but which are easily accessible to them. The classic case is the suicidal teenager whose father is a licensed and law-abiding gun owner. The father is licensed but not dangerous; the teenager may be obviously dangerous but is not licensed, and is there- fore not considered to have access to guns. A report- ing scheme which links dangerousness with licences will do nothing to prevent such teenagers from killing themselves or others.

Example C One example which has come to the attention of the Coalition for Gun Control is that of a teenage girl with suicidal tendencies who is being seen by a psy- chiatrist. There are guns in her home, owned by other members of her family. She has expressed the wish to shoot herself with one of these guns. The proposed reporting scheme will do nothing to pre- vent her death because she does not own the guns, so she has no licence to cancel. The people who own the guns are licensed, but they themselves have shown no signs of dangerousness.

Example D Another example arose in Adelaide in 1993 when a lsyear-old, armed with a gun owned by his father, created a siege in his high school, wounding one stu- dent and terrorising the entire school. In NSW, even if this boy showed signs of depression or anger beforehand, a reporting scheme would be useless because he would not be the licensed owner. Yet he obviously had access to a gun.

The presence of guns as the risk factor for violence Research has shown that the presence of guns in a house increases the risk of both suicide and homi- cide by a family member or intimate acquaintance in that This research is directly relevant to Australia, where between 1990 and 1992,80 per cent of the average annual 620 gun deaths were suicides.‘ The overwhelming majority of gun homicides are by family members, friends or acquaintances.

It is the accessibility of guns themselves, not the holding of a licence by any particular member of the household, that creates the danger. The only way the proposed reporting scheme can make an impact on gun violence is if the police are able to ascertain whether the dangerous person has access to guns. They need a mechanism that links not only names with licences, but with individual guns and the addresses where they are kept, in other words, firearms registration. As with car registrations, this must be linked nationally and involve all states to enable the tracking of guns across borders. For example, if police in Victoria (which has gun regis tration) apprehend a man bashing his family and that man is a former resident of NSW who has pur- chased unregistered guns in NSW, the Victorian police will have no way of knowing that the man owns these guns.

Suicide Registration could prevent gun suicides by licensed owners who come to the attention of police under the reporting scheme. Police would be able not only to cancel the licence, but also locate and remove the guns from the reach of the dangerous person. Gun registration could also prevent suicide by those who do not own guns but live in households where there are guns.

Take as an example the young girl in Example C above. Under the proposed reporting scheme, her psychiatrist would report to the police a belief she is suicidal and has access to a gun. The police could search the gun register not only for her name

21 4 AUSTRALIAN JOURNAL OF PUBLIC HEALTH 1995 va. 19 NO. 2

POINT OF VIEW

(which would not appear), but also her address. The guns owned by other members of her family would appear on the register.

If guns were removed from households, some intent on suicide would then use other means, although evidence from the United States, Japan and Switzerland about the fall in the national suicide rates when town gas was detoxified, suggests that when accessible means of suicide are removed, many do not pursue or succeed with other means of end- ing their

Support for regtstration Registration of all firearms is required in five juris- dictions in Australia-but not in NSW, Queensland or Tasmania. It is a major element in the Australian Police Ministers Council’s agenda for national uni- form gun laws. It is supported by the National Committee on Violence, the National Committee on Violence Against Women, medical and public health bodies, the NSW Police Association and all other police unions in Australia and New Zealand.

The NSW government has persistently opposed registration at the Australian Police Ministers‘ Council. This opposition is based in part on the fact that the Parliamentary Joint Select Committee, established after the Strathfield massacre, did not recommend registration of all guns. New South Wales already has a coordinated scheme of licensing and registration for pistols; the discussion paper itself acknowledges the importance of this system as part of the procedure when a licence renewal is refused. As a result of strict regulation, pistols account for the tiny minority of gun deaths in Australia: over 90 per cent of gun deaths involve rifles and shotguns.

If the aim of firearm regulation is to prevent gun violence, then the guns which do most of the killing should be regulated to the same degree as those which kill only a few people each year.

New South Wales also has a successful scheme of regulation for motor vehicles, involving licensing, registration and a voluntary reporting system for people who should not be allowed to drive. The dis cussion paper points to the existence of this system as justification for the proposed new reporting sys- tem for gun owners:

As a reporting scheme operates in respect of driver’s licences, there are good grounds for establishing a reporting scheme in respect of firearms licences (p. 3) . I

Precisely the same statement can be made about reg- istration: as a nationally linked registration scheme operates in respect of all motor vehicles, boats and even for dogs at local government level, there are good grounds for establishing a national registration scheme in respect of firearms.

The discussion paper also accepts the objections raised by various psychiatrists and mental health groups to the proposed reporting system-that it will discriminate against the mentally ill and perhaps be stigmatising. The paper says that these concerns are overridden by the interests of public safety:

[These objections] must be conceded.. . Howevrr, if i t is like- ly that this procedure will prevent violent crinies, then i t should be implemented (p. 15).’

Again, the same statement applies to registration.

A browse through gun lovers’ magazines in any newsagent reveals the vehemence of the gun lobby’s objections to gun registration. Repeatedly, letter writers and columnists in these magazines show their preocccupations with the potential for malicious false reporting of threats by disgruntled ex-wives and girlfriends, with Dad’s Army fantasies about defend- ing Australia from invading forces, and with con- spiracies about socialist plots to disarm the popula- tion so that a totalitarian regime can be established.

These self-serving and hysterical analyses never include a further concern close to the hearts of many in.the gun lobby. Lack of national registration of guns allows a tax avoidance cash market in guns to flourish through gun collectors’ fairs and word-of- mouth. Registration would severely inhibit this trade as well as secure the public health gains outlined above.

The gun lobby also argues that many people intent on violence or otherwise concerned to not appear on any register will not register their guns. In this they are certainly correct. The same argument of course also applies to car registration. The fact that a small proportion of car owners deliberately drive unregistered or falsely registered cars is never used as an argument for abandoning the registra- tion system at large. It is plainly recognised that vehi- cle registration will have many public and adminis- trative benefits. As the gun lobby would put it, ‘no law or registration system is going to prevent the determined criminal or suicide getting hold of a gun’. This ignores the fact that most domestic shoot- ings and suicides will involve people who were not premeditating gun violence when they would have been required to register their guns. In essence, the gun lobby’s argument here follows the logic of ‘if you can’t fix all of the problem, don’t attempt to fix any of it’. Such thinking has no place in public health.

Rebecca Peters Coalition for Gun Control, Sydney

Simon Chapman Department of Public Health and Community Medicine

University of Sydney

References 1.

2.

3.

4.

5.

6.

7.

Cabinet Offce and NSW Police Service. Discussion paper; mental illness andfiream misuse. NSW Ministry for Police and Emergency Services, 1994. Kellermann AL, Rivara FP, Rushforth NB. Banton JG, et al. Gun ownership as a risk factor for homicide in the home. N EnglJ Med 1999; 329: 1084-91. Kellermann AL, Rivara FP, Somes G, Reay DT, et al. Suicide in the home in relation to gun ownership. NEnglJMcd 1992;

National Injury Surveillance Unit. Aust h j u v Rru Bull 1994; 8. Lester D. The rffects of detoxification of domestic gas on suicide in the United States. AtnJ Public Health 1990; 80: 80-1. Lester D, Abe K. The effect of restricting accrss to lethal methods for suicide: a study of suicide by domestic gas in Japan. A& PJychiafr Sand 1989; 80: 150-2. Lester D. The effect of the detoxification of domestic gas in Swiv.rrland on the suicide rate. Ada Psyrhintr Scand 1990; 82: 38.3-4.

327: 467-72.

AUSTRALIAN JOURNAL OF PUBLIC HEALTH 1995 v a . 19 NO. 2 21 5