Lessons from a Tragic Death

This month is the twentieth anniversary of the Dunblane school shooting in Scotland where 16 students and a teacher were killed. The even led to the banning of private ownership of guns in the U.K. Last week, our friend and colleague died of a gunshot to her head, courtesy of her husband, David in San Antonio. Casey Ross (known to her friends as Casey Mitchell Drawert) was a successful and intelligent anesthesiologist who dedicated her life saving lives. Even with her education, independent means, and experience helping others, she was a victim of abuse going back at least 3 months. When she moved to leave him and changed the locks is when his violent temper turned for the worse. He broke into the house and shot her. Then he shot himself.

They had only been married for a little over a year and she had kept her abuse to herself. Like my many victims, she had seemingly disappeared from her social circles, a common tactic with abusers who are jealous and want to control their victims. Only in the last week did she let others know of what was going on and that she was leaving him.

Sadly, 4,000 women each year die as result of domestic violence and 75% of those deaths happened when they were trying to leave their abusers. The Violence Policy Center estimates there are up to 1,500 murder-suicides each year and 93% of those involve a firearm.

As far as we know, David had no history of mental illness or violent behavior. Even if he did, it is only since February 2016 that a Presidential Executive Order took effect that permits doctors to share information regarding their patient’s mental status with the FBI gun background check system. Previously, HIPAA rules meant the physician would be violating confidentiality to do so.

As a clinical ethicist for the last 15 years and a physician for the last ten, we have seen more than our share of human tragedy. We also disagree with each other on gun policy, but where we both agree is that smart policy would create rigorous background checks. A poll released this year in MD Magazine found that over 90% of physicians (many of whom own guns) believe there need to be stricter controls, especially through better background checks.

Entering a name into a database alone may not be enough for a background check. After all, David’s name would not have come up. Perhaps personal references, proof of completing a safety training course, and even consent of other adults in the home would be simple requirements that might have put prevented this tragedy.

Under the federal Domestic Violence Offender Gun Ban, a person convicted of a violent domestic crime cannot purchase a weapon. This rule is currently being challenged in Voisine v. United States before the U.S. Supreme Court. Anyone suspected of being a violent offender or abuser should be under a purchase quarantine until the facts are known. Let’s create a way that those silent victims of abuse can anonymously input the name of an abuser and that person is added to the do-not-buy list for a limited period, say 3 months. And let’s allow the abuser to renew that listing after the expiration period.

Naysayers may claim that the problem wasn’t that David had a gun, but that Casey did not. Whether that would have made a difference can never be known, but what cannot be denied is that David should not have been permitted a gun because of his threats and actions of harming others. The philosopher John Stuart Mill believed in a minimalist government, but the one condition under which he believed the government should intervene is when a person poses a potential threat to others. Certainly an abusive spouse qualifies.

This tragedy cannot be undone, but perhaps stronger rules and better enforcement may have helped. Perhaps better funding of domestic violence programs can remove the stigma that victims often feel and allow even a strong, independent physician to reach out for help. Like in Scotland, sometimes it only takes one case to move a nation. Since the laws were changed in the U.K., there has not been another school shooting. Casey’s life could not be saved, but perhaps the lives of countless others can be.

Craig Klugman is a professor of bioethics and chair of the department of health Sciences at DePaul University. He is blog editor at bioethics.net and a Public Voices Fellow.

Joseph Reses is an anesthesiologist in Chicago, IL.

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