If It Saves One Life

By Timothy Wheeler, M.D. | July 7, 2008 | 8:02 PM EDT

Guardians of public health have identified a new deadly threat to Americans--doctors and hospitals. In a dramatic press release, the prestigious Institute of Medicine recently announced "stunningly high rates of medical errors" resulting in death, disability, and unnecessary suffering. The Institute puts the annual death toll at the hands of doctors and hospitals as high as 98,000.

Aside from a halfhearted amen from the American Medical Association, response from medical leaders has been less than rousing. Curiously, no leaders of organized medicine have called for a ban on medical education or bars on hospital doors.

Of course they haven't. That would be too extreme a response.

But if you substituted "guns" for "medical errors," the high priests of public health would be raising their familiar hue and cry for more gun control. Following the logic of gun-control activists, we should lock all the hospital doors and send doctors looking for other jobs. Such drastic action would be justified, the controllers often say, "if it saves only one life."

By comparison, the death toll from gun accidents is insignificant. Fatal gun accidents across the nation have dropped to just over 1,000 annually, a tiny fraction of the Institute of Medicine's tally of the carnage wrought by doctors and hospitals. Even if we throw in gun homicides and suicides with the accidents, the total of firearm deaths is outnumbered by the total dead from medical treatments gone bad.

Why do medical experts rail at the ever-decreasing rate of accidental gun deaths, but remain silent about the far greater death toll from medical accidents?

It's no secret that deaths occur from medical mistakes. The 1991 Harvard Medical Practice Study yielded an even higher iatrogenic death count. Extrapolating from hospital deaths in New York State, researchers found that as many as 180,000 Americans die each year from medical mistakes. That is about the same, the study's principal author wrote, as "three jumbo jet crashes every two days."

Should we accept these accident rates as inevitable? Of course not. But neither should we allow the fact of human imperfection to be used to manipulate our feelings.

Reality insists that we view accident rates in their context. Doctors and hospitals save far more lives than they lose in accidents. It is now settled that firearms used responsibly save many more lives in self-defense than they take by crime or accidents. These realities show the phoniness of the "just one life" plea. Anyone who coyly mouths these three words as justification for new gun-control laws is practicing emotional flimflammery.

People make mistakes. But gun accidents have been on the wane for over 30 years. If the decline continues, they will soon number less than 1,000 per year. This encouraging trend is likely bolstered by the gun safety education provided by private firearm owner groups. The public service of these groups goes largely uncredited.

Doctors and hospital employees make mistakes. But despite public suspicions of cover-ups, we doctors regularly hold formal meetings to look into medical accidents, striving always to learn from them. This self-scrutiny is done increasingly under the probing eyes of plaintiff's lawyers and a throng of government agents, including sworn law enforcement officers.

So how can health-care professionals further lessen medical errors? We could adopt proven methods of error reduction from other high-risk industries, such as the airlines. Error analysis and system design are established methods for identifying and reducing accidents. Now that medicine is a high-volume service industry, such macro-scale quality control seems not only practical but also promising.

And how can health-care professionals advance their stated goal of reducing gun injuries? We could adopt time-tested methods of injury reduction from firearm-safety authorities. Countless state and local gun clubs are eager to work with community leaders to teach gun safety. For over a century, the National Rifle Association has taught firearm safety. The National Safety Council and several state governments have lauded the NRA for its Eddie Eagle gun-safety education program for children. The NRA commands great resources and an extensive community outreach for gun-safety instruction.

Instead of pushing gun control under the guise of gun safety as they now do, medical organizations could actually work with the true firearm experts. Then we could believe doctors' claims of concern for the safety of gun owners.

The question is not whether we should fear gun-owning citizens or scalpel-wielding doctors. Common sense tells us that we have nothing to fear from either. We can be confident that health-care workers are generally capable people of good will, and that law-abiding gun owners are, too.

Rather, we should fear the demagogues in white coats who try to manipulate our emotions with factoids and false statistics.

Timothy Wheeler, MD, is director of Doctors for Responsible Gun Ownership, a project of the Claremont Institute.