As a physician, I have always been a staunch supporter of public health in its traditional role of fighting pestilential diseases and promoting health by educating the public as to hygiene, sanitation, and preventable diseases, as alluded to in my book, Vandals at the Gates of Medicine; but I deeply resent the workings of that unrecognizable part of public health incarnated in the CDC's National Center for Injury Prevention and Control (NCIPC) with its politicized agenda and proclivity towards result-oriented research based on junk science.
It is crystal clear that the NCIPC has from its inception pursued, despite valid criticism from many quarters, a grossly politicized agenda --- abjectly losing sight of its mission and becoming a powerful arm of the gun control lobby --- to the detriment of traditional public health. This contention is well expressed in the words of Dr. William C. Waters, IV, Eastern Director of Doctors for Integrity in Policy Research (DIPR), who in a letter to Senator Arlen Specter, Chairman of the Subcommittee on Labor, Health, and Human Services and Education of the Senate Appropriations Committee complained:
"We believe that the NCIPC fails to do its job because of unscientific bias...First is the overt political activism of the NCIPC staff and their federally-funded researchers. Second...is that there seems to be a tacit assumption --- perhaps even foundational concept --- among many public health researchers that firearm prohibition/control provides a ready solution to many of society's ills. We believe that this view is expressed in the NCIPC's approach to the problem of violence, since the research performed is fantastically narrow in scope, excludes most of what is known about violence in human societies...and is often performed using abysmally poor methodology...There seems to be a tendency on the part of those defending the NCIPC to simply reiterate figures depicting the problem of firearms violence/injury as justification for the agency's existence."
A Smoking Gun
Concerned about this issue and possible violations of the public trust, several DIPR members communicated with key members of Congress and last winter visited the offices of 8 Senators at the U.S. Capitol, thoroughly briefing their staffs as to this momentous issue. Other concerned DIPR members and physicians, in an effort to inform the public, appeared on local and syndicated radio and television shows, including the Washington, D.C.-based, National Empowerment Television (NET).
Despite considerable barriers, the monolithic wall of censorship of the mainstream media was pierced when Dr. Timothy Wheeler, President of the California-based Doctors for Responsible Gun Ownership, appeared on CBS's "This Morning" vis-à-vis Dr. Jerome Kassirer, a fierce gun control advocate and Editor-in-Chief of The New England Journal of Medicine (NEJM). It was a brief exchange, but it was devastating for Dr. Kassirer who has essentially established that when it comes to "assault" weapons, he supports the "no-data-are-needed policy" of the NEJM, and has asserted that if a little gun control does not work, then, certainly, more gun control is needed: "if we still found them wanting [draconian gun control laws] we would be justified in supporting even more stringent restrictions."(1)
Dr. Kassirer had defended the CDC/NCIPC in a previous, one-sided NEJM editorial; this time, in a one-on-one debate, he was thoroughly unsuccessful, for he was debating publicly a worthy opponent who wielded the invincible weapon of unadulterated truth. It was a decisive victory for honesty in science. Dr. Wheeler showed on camera a major piece of evidence, the Injury Prevention Network Newsletter entitled, "Women, Guns and Domestic Violence," supported in part by a grant from the CDC, and featuring a cover of a menacing handgun firing a bullet that blasts away at the defenseless female symbol.
Within this newsletter, a section entitled "What Advocates Can Do," among other things, exhort purported researchers and CDC public health staffers to: "Put gun control on the agenda of your civic or professional organization. Release a statement to the media or explain in your organization's newsletter why gun control is a woman's (or nurses' or pediatricians'...) issue.
"Ask TV and print media to name the gun manufacturer in every story it runs involving gun violence.
"Make your support for federal, state, and local gun laws known to your representative. This may include: Opposing repeal of the assault weapons ban; maintaining support for the Brady Law; restricting ammunition availability by caliber and quantity; increasing enforcement of federal firearm laws; maintaining restrictions on issuance of concealed weapons permits...[Also]
"Organize a picket at gun manufacturing sites, perhaps with posters showing pictures of victims of gun violence. (Modeled after the Madres de los Desaparecidos in Argentina and Chile; this can evoke a very powerful moral image.)
"Work for campaign finance reform to weaken the gun lobby's political clout.
"Boycott publications that accept advertising from the gun lobby or manufacturers...Launch a program aimed at getting pediatricians [involved]...Get media attention for your events. Encourage your local police department to adopt a policy prohibiting officers from recommending that citizens buy guns for protection, etc., etc."
Remember, these are not just private citizens using their own money and exercising their constitutional rights and civic duties to free speech, but supposedly objective, unbiased researchers using the taxpayers' research money (grants) for their own economic, ideologic, and political purposes --- in this case, promoting the present administration's policy of draconian gun control, aimed at disarming law-abiding citizens using the cover of junk science as the vehicle.
Faced with this ominous threat --- namely, the perversion of science by a government agency run amok --- DIPR worked harder than ever to expose the danger. In our medical school library I found more smoking guns --- e.g., other public health newsletters involved in deeply partisan and political activities. One, Nation's Health, a newsletter by the American Public Health Association (March 1995), defended the partisan activities of the CDC/NCIPC and even listed a "1-800 number" with a special Western Union Hotline that automatically sends a message to Congress in support of "threatened public health programs." The fact is that we found the tentacles of public health using taxpayer's monies not only used for political advocacy, but also flagrantly using the influence bestowed upon them by society, as supposedly honest, unbiased researchers, to legitimize fraudulent research conducted for political reasons.
One of the most helpful law-makers who assisted in the quest for truth was freshman Congressman Bob Barr (R-GA). Expressing his concern for public-funded research, he wrote to fellow Congressman Christopher Shays, Chairman of the Subcommittee on Human Resources of the House Committee on Government Reform and Oversight:
"I write to bring to your attention a matter that goes beyond impropriety, and in my judgment crosses the line to potential illegality. I have written David Satcher, the Director of the Centers for Disease Control (CDC) in Atlanta asking him to investigate whether certain taxpayer funded grant money is being used to advocate opposition or endorsement of federal legislation, and, among other things urges picketing activities.
"I consider these activities, involving federal taxpayer dollars, to be not only questionable but very likely illegal. I find it highly offensive that federally appropriated monies are being used for lobbying and urging civil disobedience and possible illegal activity...I would officially request that your committee investigate this matter."
Congressman Barr also gave an impassioned and intellectually-charged speech against the politicized, result-oriented research conducted by the CDC/NCIPC and in support of the Dickey Amendment on the floor of the House of Representatives last summer.
Our efforts finally bore fruition on March 6, 1996. Three physicians (Drs. Waters, Wheeler, and myself; representing two physician organizations and clearly indicating that the AMA/CDC/NCIPC axis does not represent the views of all physicians, together with noted criminologist Don B. Kates, were given the opportunity to testify before the House Appropriations Subcommittee on Labor, Health and Human Services and Education [in which, incidentally, Congressman Jim Istook Jr. (R-OK) also serves. Representative Istook has taken leadership in this effort and has co-authored the Simpson-Istook Amendment intended to curtail funding to publicly-funded, lobbying organizations].(2)
I will not recapitulate our entire testimony. Suffice to say, we testified about the misrepresentation of data, skewed study populations (selection and extrapolations), inappropriate research models for the subject under study, and arrival to preordained conclusions (result-oriented research) --- all evident in the immensely shoddy "gun control" research conducted by the CDC/NCIPC. The panel was also informed about how the NCIPC researchers breach accepted scientific practice by refusing to release and make available to other researchers their publicly funded, original data for further critical analysis.
We pointed out and brought into evidence the inappropriate (and probably illegal) diversion of taxpayers' monies allocated to research being used for dissemination of partisan newsletters. We also disclosed the occurrence of politicized meetings and organizations in which NCIPC staff and funded researchers were (and are) active participants. For example, at the Handgun Epidemic Lowering Plan (HELP) held in Chicago, Illinois in 1993 (and again in 1995), NCIPC researchers and staff were faculty for this "strategy conference" in which "like-minded individuals who represent organizations...[the goal of which is to] use a public health model to work toward changing society's attitude so that it becomes socially unacceptable for private citizens to have guns." Dr. Katherine Christoffel, one of the founders of this conference is well known for her anti-firearms activism and her profoundly revealing statements. For example, she has reached prominence with statements such as:
"...Guns are a virus that must be eradicated. We need to immunize ourselves against them." [And] "...Get rid of the cigarettes, get rid of the secondhand smoke, and you get rid of lung disease. It's the same with guns. Get rid of the guns, get rid of the bullets, and you get rid of deaths."(3)
In the case of Dr. Kellermann, it was reported that during his formal presentation at the (October 17, 1993) HELP conference, in an emotional moment admitted his personal anti-gun bias (a bias that, as we have seen, is evident in the pattern of his research). Although in a letter to the Journal of the Medical Association of Georgia, Kellermann denied making such a statement at that specific meeting, he did not actually repudiate his general anti-gun bias.(4) Dr. Kellermann's elitism (and true appreciation of the value of a gun for self-protection) nevertheless is well encapsulated in the following retort directed at a question by a reporter and quoted in the San Francisco Examiner: "If that were my wife [being attacked], would I want her to have a .38 Special in her hand? 'Yeah,' says Dr. Kellermann."(5)
When the University of Iowa sponsored a conference in 1992 on firearms violence, that confab was also funded in part with CDC/NCIPC funds which had previously been allocated to the study of rural injuries and farm occupational hazards; moreover, the only non-academic faculty member invited was Ms. Sarah Brady of Handgun Control, Inc. (HCI). The conference, subsequently entitled "National Violence Prevention Conference --- Bridging Science and Program" reconvened in 1995, using again, the same type of funding and hosted by the CDC/NCIPC and the University of Iowa Injury Prevention Research Center. In his invocation to the conference, Dr. Mark L. Rosenberg, Director of the NCIPC who served as Chairman of the Executive Planning Committee vaunted, "Violence in America has reached epidemic proportions and presents our nation with a public health challenge as great as we have faced in the past...We believe that violence in our homes and communities is a great public health challenge that our nation can face and overcome as we enter the next millennium."
From the foregoing, it becomes plainly evident how --- oblivious to the lessons of history, the unchanging nature of humanity, the fallibility of man (and his imperfectability), not to mention the accumulating body of legitimate scientific evidence in the sociologic, legal, and criminologic literature --- public health officials like statist bureaucrats, truly but erroneously, believe in the Utopian-socialist notion of the perfectibility of man (novus homo) and the omnipotence of the state (der staat über alles) to accomplish their social objectives --- and demonstrates how pervasive is the arrogance of power in this arm of academia.
Finally, in our testimony we shed much-needed light onto the fact that much of the injury prevention research performed by the CDC/NCIPC (except, ironically, for its politicized, flawed gun [control] research we have discussed is superfluous, already being performed by a myriad of other agencies within the maze of government bureaucracy; this includes the Departments of Transportation (which studies automobile-related injuries), Labor (where Occupational Safety and Health Administration [OSHA] carries out studies on workplace injuries (while terrorizing employers and employees alike), Justice (which studies domestic violence), Education (supervises violence prevention within school systems), Health and Human Services (oversees the National Institutes of Health which conducts research on violence prevention, mental health, drug and alcohol abuse, etc.), not to mention additional divisions, too many to list here within or outside the purview of these labyrinthine departments.
We concluded our testimony with the virtually unanimous opinion that given the complex nature of violence in our society, violence and crime prevention efforts should be addressed by a fortified educational and criminal justice system --- not to mention our churches and synagogues. Violence is not a disease and not treatable or amenable to study with the traditional public health model. Moreover, based on the serious violations in the conduct of [un]scientific research, the numerous transgressions in the pursuit of political agendas (that seek ultimately citizen disarmament), and the overly redundant functions of the NCIPC --- we recommended that the committee eliminate all funding for the NCIPC for the fiscal year of 1997, and thereby realize a savings to taxpayers of nearly $50 million annually --- and most importantly, effecting a major step forward, towards liberating science from the claws of politics.
In short, a protracted war has been waged by concerned citizens over the perversion of science in gun (control) research conducted by the AMA/CDC/NCIPC establishment and promulgated by the medical journals. This battle, whose clarion call was made by the NRA years ago, reached high intensity through the Spring and Summer of 1996. Although we were not able to close the doors of the NCIPC, and that remains our goal, our fight culminated in a significant defeat for the gun-prohibitionists in the House of Representatives. This past July, the House voted to shift $2.6 million away from the NCIPC and earmarked the funds for other health research projects. The redirected funding was the amount formerly allocated by the NCIPC to their discredited "gun (control) research."
In a "Dear Colleague" letter sent to all members of the House, Rep. Jay Dickey (R-AR), who sponsored the Amendment, revealed what the NCIPC director said about their political agenda: "What we have to do is find a socially acceptable form of gun control." And, in a letter to Senator Arlen Specter (R-PA), several senators who support the effort to curtail NCIPC's anti-gun activities also noted that NCIPC Director Dr. Mark Rosenberg has stated that he "envisions a long-term campaign, similar to tobacco use and auto safety, to convince Americans that guns are, first and foremost, a public health menace."(6)
Although, the re-direction of $2.6 million away from the NCIPC's gun control research is a modest and overdue effort to deprive the anti-gun lobby of a taxpayer-subsidized propaganda organ and a first step towards attempting to restore the integrity of public health research, it also sends the greater symbolic message: that citizens, including many scientists and physicians, are not going to sit idly by and allow the perversion of science and medical research for political ends. For the reasons enumerated and discussed here, the appropriate and obvious long term course of action should be to eliminate all funding for the NCIPC, prohibit the CDC from conducting "research" in this area, and save the taxpayers nearly $50 million annually --- and most importantly, effecting a major step towards restoring credibility and integrity to public health, returning it to its former traditional role of stamping out infectious diseases and epidemics, and de-politicizing medical research.
Whether this victory is fleeting and evanescent or definitive and long-lasting is yet to be seen. Already this year the AMA has directed its lobbyists to "strongly advocate" that funding for gun (control) research be restored to the CDC/NCIPC.(7)
I urge everyone to remain informed and vigilant on this issue. As Andrew Jackson once said, "The brave man inattentive to his duty, is worth little more to his country, than the coward who deserts her in the hour of danger."
1. Kassirer JP. Guns in the household. NEJM 1993;329(15):1117-1118.
2. Waters WC, IV, Faria MA, Jr., Wheeler TW, Kates DB. Testimony before the Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, House Committee on Appropriations. March 6, 1996. Hearing Volume, Part 7:935-970.
3. Christoffel KK. Quoted in Somerville J. Gun control as immunization. AMNews, January 3, 1994, p.9.
4. Kellermann A. Letter to the editor. J Med Assoc Ga 1994;83(5):254-255.
5. Kellermann A. Quoted in the San Francisco Examiner, April 3, 1994.
6. Rosenberg M. Quoted originally in The Rolling Stone 1993. Cited by Kates DB, Schaffer HE, Waters WC, IV, How the CDC succumbed to the gun epidemic. Reason, April 1997, pp.25-29.
7. Kent C. AMA wants CDC gun research funds back. AMNews 1997;40(1):8.
Dr. Faria is a consultant neurosurgeon, Adjunct Professor of Medical History (1993-1996) at Mercer University School of Medicine, and author of Vandals at the Gates of Medicine (Macon, Georgia, Hacienda Publishing, Inc., 1995) and Medical Warrior: Fighting Corporate Socialized Medicine (Macon, Georgia, Hacienda Publishing, Inc., 1997). He serves as Editor-in-Chief of the Medical Sentinel, the official journal of the Association of American Physicians and Surgeons (AAPS). This article is based on his speech given at the 53rd Annual AAPS meeting held in La Jolla, California, October 10-12, 1996.
Originally published in the Medical Sentinel 1997;2(3):83-86. Copyright ©1997Association of American Physicians and Surgeons (AAPS).