05/29/2014 10:13 am ET Updated Jul 29, 2014

Bullets, Ballots and Bullies

This video of a father who lost his son in the recent California massacre is riveting and heart-wrenching. But since it wasn't our son or daughter -- this time -- we will doubtless well up, and move on. We always do, much to our shame.

But yet another high-profile massacre does invite a question for those favoring the free flow of personal "arms" in our society. Let's consider "X" all the times such arms, in the hands of private citizens, are used to subordinate tyranny, foreign or domestic. And let's be generous and even extend the definition of "X" to all effective use of a gun by a civilian for fully justified self defense. Let's consider "Y" the times readily accessible guns in our culture are used to harm others unjustifiably, or for self-harm, either intentional or inadvertently.

What, exactly, would the ratio of X:Y need to be to justify our current hands-off-my-arms approach? What would the ratio need to be to justify change?

Before turning back to that, we should note that these questions may suggest some others. The first and most obvious is: do we know what these numbers are? To the extent the answer is "yes," the available data indicate that guns are used far more commonly for ill than for good. Gun ownership is associated with a markedly higher rate of gun-related injury to the gun owner and his or her household. But to a large extent the answer is "no," because the same groups that oppose any kind of gun control oppose any funding of research to establish what the real-world effects are of the virtually unhindered flow of guns.

Now back to the question: what would the ratio of X:Y need to be to justify changes to the status quo?

All of the balloting on the issue of gun control indicates that an overwhelming majority of us favor reforms, including at the very least rigorous background checks, and the banning of high-capacity semi-automatic weapons for other than military and paramilitary uses. So, presumably, that same overwhelming majority of us has the impression that the ratio of X:Y is already far too low to justify the status quo.

Those who disagree either think that the ratio of X:Y is high enough to argue for business as usual, or just don't care what the ratio is. For some, the "right to bear arms" is an ideological absolute.

But of course, the right to bear arms never was, and cannot be absolute. None would suggest that the right extends to prison inmates, psychiatric inpatients, or 2 year olds. None would suggest that it extends to all arms. Personal use of nuclear or biological "arms," for instance, is presumably objectionable to all.

But even if we limit ourselves to reasonable interpretations of "absolute," what does it indicate if the ratio of X:Y just doesn't matter? It means that even if private gun ownership often resulted in intentional or unintentional harm of the "good guys," and NEVER resulted in effective self-defense let alone defense against tyranny, it wouldn't matter. It would mean that the ideological absolute would always prevail over the epidemiological data.

Taken to the extreme, this could mean that every argument any of us ever has with anyone would be settled at the point of a gun. At this absurd extreme, X is 0, and Y is all of us, and the ratio of benefit to harm is nonexistent because there is no benefit and the harm is universal.

If there is anyone who would still advocate for unimpeded access to guns for all on the basis of ideology despite such an extreme (and admittedly absurd) epidemiology, there are names for it. The kinder designation is fanaticism. The more useful appellation for beliefs and perceptions completely dissociated from reality is: insanity.

I am not necessarily saying that anyone out there is that crazy, although I wouldn't be shocked to learn some are. What I am saying is that if zero benefit and infinite harm is unacceptable, then we might all agree that there is a line somewhere. And that means we can agree.

A ratio of benefit to harm above the line could justify our current situation. A ratio below the line would argue for change. All we have to do is agree that there must be a line somewhere, and then we might meet on common ground, and engage in the challenging, but manageable job of deciding where exactly to draw the line.

Why don't we do even that? Why don't we take even the modest step of agreeing there must be a line somewhere, and determining which side of it our guns and bullets are on at present?

It clearly has nothing to do with ballots, since a majority favor reforms and the flow of information that would inform them. And it has little to do with extreme ideologues, since they are a trivial influence in a democracy of 300 million people.

It's not the hot but scattered flames of ideology that matter here -- it's the fuel for that fire, and the fan. The fuel, of course, is money, and the fan is BS. The entanglements of the NRA with gun manufacturers and sellers are well publicized. The status quo is making some people very rich. Some small portion of those funds is allocated to bully cowards in government, fuel and fan the flames of fanaticism, and disseminate the propaganda that Constitutional rights are threatened if we can't all have whatever arms we want whenever we want them.

Frankly, there is a name for it when a small group of wealthy people subvert the will of the majority: tyranny.

I feel obligated to point out that those who believe that our one reliable defense against tyranny is high-capacity, semi-automatic weapons in the hands of civilian ideologues seem to be ignoring the possibility that we have high-capacity semi-automatic weapons in the hands of civilian ideologues because of tyranny. I would also suggest that those who see those guns as our best defense must have a very low view of the rest of our Constitution, which was of course brilliantly drafted with checks and balances far more effective than bullets.

As for defense against foreign tyrants, that's the job of our military -- and there is nothing in the history of our nation since it was founded and a standing military established to suggest that they will invite gun-toting civilians along to help. Those wanting arms for this purpose should enlist.

When ideology prevails and epidemiology doesn't matter, it's not because of the ideologues. They have no real influence. It's because of bullies with money.

Money in the hands of few to subvert the will of many is more than bullying; it is tyranny. Who out there is defending the Martinez family, and those who will inevitably follow, from such tyranny?


Dr. David L. Katz has co-authored multiple editions of a leading epidemiology textbook. More importantly, he has 5 children he loves very much- and would like them to live in a safe and rational world.