June 1992

The gun and the sanctity of human life; or The bullet as pathogen

Arch Surg. 1992;127(6):659-664. doi:10.1001/archsurg.1992.01420060025004

Thoughtful clinicians and researchers are constantly on the alert for pathogens, whatever their nature, acting on the premise that identification of harmful environmental agents will lead to the introduction of measures to eliminate or control them.

In this presentation I discuss the bullet as a pathogen in our "peace-time" American society, a designation often considered a tragic joke by those of us who function professionally in metropolitan coroners' or medical examiners' offices, where we deal with violent death daily and, all too frequently, several times daily. I shall also mention briefly the epidemiology of gunshot incidents inasmuch as epidemiology may point to etiology.

Fatal and nonfatal gunshot incidents, whether they be attempted or successful homicides and suicides, accidents, or of undetermined origin, have multifaceted causations involving more than the presence of a potentially deadly firearm; but all too often a gun escalates the degree of violence to irreversible lethality. ("Wife,

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