Bioethicists have shown little interest in firearm violence and very few to none have written about firearm violence affecting Black individuals and communities in general bioethics literature. Why are Black individuals and communities invisible in bioethics literature on firearm violence? The few Bioethics Today blogs that address firearm violence discuss gun control, physicians’ role in firearm violence and mass shootings, specifically in regard to schools. It is not to say these topics are not important however what is intentionally overlooked and excluded is whom firearm violence disproportionately affects.
Black Americans are disproportionately impacted by firearm violence. They experience 10 times the gun homicides, 18 times the gun assault injuries and nearly three times the fatal shootings by white police officers. All three issues are prevalent in historically disinvested neighborhoods and cities, that are mainly occupied by Black people. Thirty Black Americans succumb to gun assaults and more then 110 survive their injuries each day on average; Black Americans make up 68% of homicide victims. Looking at the statistics it is safe to say there is a critical need for bioethicists to write about the effect firearm violence has on the health of Black neighborhoods and cities, meaning there needs to be a consideration of race, racism and systemic inequities. Is the Black population not deserving of this inclusivity? Does being included in bioethics literature have to earned?
Bioethicists typically focus their research on ethical issues that arise within the medical and clinical sphere, which is a narrow focus. Bioethicists should also think about the moral and ethical dilemmas affecting the health and well-being of residents of color who reside in disinvested, violent, segregated neighborhoods and cities. This would show that bioethicists understand that one’s behavior, choices and lifestyle is not solely based on individual behaviors but also on other factors such as policies that ensure specific communities are not able to access healthy foods, well-resourced schools, and safe neighborhoods that aren’t overly policed. It is important for them to move from bedside issues to societal-level, macro issues such as social determinants of health (SDOH) and structural racism that exacerbates the burden of violence on Black individuals and communities.
In 2018, Dr. Klugman proposed what he called “six simple bioethics responses to the gun violence crisis.” He mentions supporting frontline healthcare workers, crafting letters of support, bioethics think tanks developing projects around gun violence, speaking up against social injustices, and offers suggestions for bioethics professors, which are all great but not enough. If good ethics starts with good facts, then bioethicists need to clearly state the facts about Black people and gun violence, “Black Americans are disproportionately affected by firearm violence.” We know structural injustices are the root causes of firearm violence but the real question for bioethicists is where do they see bioethics role in actively calling for reform or dismantling structural inequalities that are purposely designed for Black Americans to live in hyper-segregated disinvested neighborhoods that further exacerbates firearm violence?.
Four years later, Dr. Klugman wrote another article “Treating Gun Violence as a Public Health Threat: Not Exactly What We Meant” where he mentions how the burden of COVID-19 and firearm violence with an emphasis on mass shootings is placed on individuals rather than the government. Yet again, there is no mention of how the COVID-19 pandemic and firearm violence disproportionately affected and still affects Black communities at an alarming rate. I find it very peculiar to write about topics without any mentioning of those it affects most. It leaves me to question whether there is intentionality behind continuing to make specific populations invisible by masking writings with broad statistics. But Klugman’s blogs are representative of a general blindspot in bioethics.
There is an understanding that firearm violence is a public health issue and public health approaches should be utilized however it should be used in tandem with a racial equity framework. We need more bioethicists to write about the intersection of public health and social justice with an emphasis on firearm violence. If bioethicists are going to write about firearm violence, they need to push those who it affects most to the center. This means writing about bioethics through an intersectional lens. Furthermore, if there is an argument that the burden of firearm violence is being put on individuals to solve, then what are bioethicists doing to advocate for policy change?
Nazsa S. Baker, PhD, MA is a Post-Doctoral Fellow at the New Jersey Gun Violence Research Center at Rutgers University, School of Public Health.