Category Archives: Media Portrayals of Violence

Watch Your Mouth: The Use of Language in Gun Control Debates

Just a few days after the addition of the Boston Marathon bombing as another wound in an ongoing tale of public violence in the United States, and following the recent defeat in Congress of a proposed expansion of background checks for gun transactions, President Obama is now focusing his efforts on enforcing executive actions requiring state agencies to release mental health records to the FBI. Federal law currently prevents individuals diagnosed with certain mental health issues to purchase firearms; the FBI uses information provided by states in order to enforce this legislation.  Prior to the 2007 shooting at Virginia Tech, states voluntarily provided these records.  However, following the incident, new legislation was passed requiring states to provide the information or face significant cuts to criminal justice funding. Recently, the Obama administration, under executive order, began working to remove other barriers that might prevent states from releasing mental health records to the FBI.

 

Interestingly enough, this tune is quite different than that of only a couple of weeks ago, when, it was reported that Senate lawmakers were working quietly to develop legislation that would bring about comprehensive mental healthcare reform.  The legislation would provide more funding and development in the mental health care sector across the country, increasing the number of health care facilities, providing early intervention training, and increase Medicaid allotments for mental health care.  While lawmakers and mental health care lobbyists initially attempted to quietly distance the mental health legislation from discussions about gun control, recent events have made the connection inevitable.

 

Such a scenario begs larger questions about the language used in media reporting about mental health and violence, especially in the current popular dialogue over gun control reform in the wake of increasingly frequent mass shootings.  If one were to read through the headlines published about the spree killers involved in the shootings in Aurora, Tucson, or Newtown, one would read scores of connections between the acts of violence and allegations of mental illness or instability.  In fact, according to Ronald Honberg, the director for the National Alliance on Mental Illness, none of these individuals have ever been formally diagnosed with a mental health issue, at least not to our knowledge.  Yet, in the wake of these shootings, the discussion about gun control centered directly on issues of mental health, reflecting subconscious societal connections between violence and mental health.

 

However, the truth is that, although many people assume that mental illness commonly precipitates violence, the annual incidence of violent crimes against people with serious mental illnesses is more than four times higher than in the general population (Teplin, et al. 2005).  If we are going to have a national conversation about mental health, then this aspect has to be included in it.  However, the current stigmas present in the media, political discourse, and social conversation short circuit the potential productivity of a mental health conversation by reducing the impact of mental health to acts of violence, a connection that is not backed up by the facts themselves.

 

A public conversation about increasing resources for addressing mental health is essential in our national health climate, especially when approximately 47% of Americans will have a diagnosable disorder within their lifetime (according to the DSM-5).  However, as we pursue this conversation, we must be extremely careful about the ways in which we conflate mental health and violence.  The language we use and the connections we draw matter immensely for our abilities to care for such a significant and valuable population in our society.

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Morals Meets Finance: Doctor-Assisted Suicide

Cartoon following the failure of a Massachusetts ballot measure that would have legalized doctor-assisted suicide, by Dan Wasserman

Cartoon following the failure of a Massachusetts ballot measure that would have legalized doctor-assisted suicide, by Dan Wasserman

Other than marijuana (see last week’s post), my home state of Oregon is known for its Doctor Assisted Suicide.

Currently doctor-assisted suicide in Oregon is dealt with the Death with Dignity Act. In order to qualify for the life-ending medication, the patient must be diagnosed as terminally ill with a prognosis of less than six months to live. It is, of course, completely voluntary on both the patient’s part and the doctor’s part. The Death with Dignity Act does not qualify legally as “suicide.”1

How frequent is this program? The 2012 Oregon Health Authority reported that 115 prescriptions were written last year in Oregon. The median age was 69 years old, and the most frequent diagnosis was cancer.2

Is right for our doctors to aid in ending a life? According to the 2011 Gallup poll, 45% of respondents agreed it was morally acceptable and 48% found it morally unacceptable, making it the most hotly debated topic in the survey.3 The moral debate can go on for ages –some will always view doctor-assisted suicide as cold-hearted justification for taking a life too soon while others will be comforted by the option of choosing death rather than being forced to live in pain.

So instead of telling you my opinion, I turn instead to the economics of doctor-assisted suicide. As we all know, end of life care can be expensive. So economically speaking, such measures could ultimately decrease the costs of terminal illness in cases where the patient will not recover and does not want to be sustained. According to an estimate from Emanuel and Battin, legalizing physician-assisted suicide could save as much as $627 million annually in the United States.

It is precisely because of its cost effectiveness that causes some to worry. The New York State Task Force on Life and the Law explains that “patients may be pressured to consent… when their care is expensive or burdensome to others.”  Even if not explicitly pressured by others, they may feel guilty about continuing their life for financial reasons.

Furthermore, those in the health care sector might be a source of pressure. Emanuel and Battin calculate, for example, that a large managed care plan could save around $3.3 million a year from doctor-assisted suicide. More than just care plans, hospitals also stand to save money from such a program.4

How should we deal with these competing economic factors? A bioethics and law expert Maxwell J. Mehlman, J.D., urges us to think about how a financial motivation would affect the situation. Suppose a patient is poor and seeks to participate –should we stop him or her from participating? Are we forcing them to die? But then, does denying the option of doctor-assisted suicide improve their condition in any way?5

Many questions can be asked about doctor assisted suicide, and they should be if we wish to develop comprehensive health-care for the terminally ill.

Links:

1.http://public.health.oregon.gov/providerpartnerresources/evaluationresearch/deathwithdignityact/pages/faqs.aspx

2.http://public.health.oregon.gov/providerpartnerresources/evaluationresearch/deathwithdignityact/pages/faqs.aspx

3.http://www.gallup.com/poll/147842/doctor-assisted-suicide-moral-issue-dividing-americans.aspx

4.http://www.nejm.org/doi/full/10.1056/NEJM199807163390306

5.http://www.thedoctorwillseeyounow.com/content/bioethics/art1976.html?getPage=4

Example Post: On Oscar Grant

Three (pink) Protestors at Oscar Grant Rally have signs taped to their backs that say "Don't Shoot"

I watched the verdict last night. Not on any TV news station because NONE of the major networks had any coverage of the rage and pain of the people in Oakland and LA last night. Tweeting with folks across time zones and continents, we tried to hold Oscar Grant’s memory.

As my Twitter Timeline filled with anguish, police positions, disbelief, it also became populated by folks who seemed to have a similar level of rage (or excitement) for LeBron’s decision to Join the Miami Heat.

I have to say that sports are not my thing and I already don’t hold professional athletes in much esteem but the reality that folks were more or even equally incenced by LeBron’s decision was beyond what I could process in an evening. An ESPN hour long interview, The Decision, sponsored by Bing “the decision engine” (gag), was all that major networks wanted to talk about. The contradictions of this country are astounding. LeBron’s lust for victory is more compelling than the realities of our criminal (in)justice system. Did I mention that NO major TV news network covered the trial  last night (I have a deep and abiding hatred for CNN; we have history)?

Riot Police in full gear; helmets, shields, bullet proof vests, etc.

I suppose I was also surprised by folks tweeting as though it was just another day in America, like this grave injustice didn’t occur, like this kind of thing happens all the time… oh wait. It does. And the fact that it does makes people more likely to check out than check in. More likely to say ‘F*ck it I want the new Nike’s’ than to question the system that sells you rubber and cloth with an 1000% mark up. As Summer M. asked “can we blame a cat for being nihilistic? if he screams “f[*]ck bitches, get money”? what decent alternative do we have to offer? our tweets?”

I don’t know that I have an answer…

Side Note: Johannes Meshserle does not sound like the name of a good ol’ American boy born and raised by parents born and raised in the US of A. Though I have no evidence of this my hunch is that the Meshserle clan don’t have an extended history in this country. Seems like an immigrant white boy, or a white boy that’s the son of immigrants, makes for a better first time “involuntary manslaughter” police perp than someone whose colonial and prison industrial complex roots are deeper. That and multiple “caught on tape” videos of Meshserle’s deed that can’t be erased from public memory…