1 AMNESTY INTERNATIONAL: IN THE LINE OF FIRE AMNESTY INTERNATIONAL: TABLE OF CONTENTS Executive Summary .......................................................................................................................................................8 Key recommendations .................................................................................................................................................18 Acknowledgements .....................................................................................................................................................20 Glossary of abbreviations and a note on terminology .....................................................................................................21 Methodology ...............................................................................................................................................................23 Chapter 1: Firearm Violence: A Human Rights Framework ............................................................................................24 1.1 The right to life .................................................................................................................................... 25 1.2 The right to security of person ................................................................................................................ 25 1.3 The rights to life and to security of person and firearm violence by private actors and in the community ........ 26 1.4 A system of regulation based on international guidelines .......................................................................... 27 1.5 Gender-based firearm violence ............................................................................................................... 28 1.6 Suicide and accidental death ................................................................................................................. 29 1.7 Firearm violence and economic, social and cultural rights ......................................................................... 30 1.7.1 Firearm violence and the right to health ............................................................................................ 31 1.7.2 Firearm violence and the right to education ....................................................................................... 31 1.8 Firearm manufacturers, distributors and dealers ...................................................................................... 32 Chapter 2: Firearms in Domestic Law and Politics .........................................................................................................34 2.1 The Second Amendment ....................................................................................................................... 34 2.2 The impact of lobbyists on firearm legislation ......................................................................................... 36 2.2.1 The National Rifle Association ......................................................................................................... 36 2.2.2 The Gun Violence Prevention Lobby .................................................................................................. 38 Chapter 3: Failure to protect: The gun violence crisis in the USA ...................................................................................41 3.1 Urban gun violence ............................................................................................................................... 43 3.1.1 The disparate impact of gun violence on communities of color ............................................................ 43 3.1.2 Unsolved homicides and community mistrust .................................................................................... 48 3.1.3 Easy access to firearms ................................................................................................................... 48 3.1.4 Gangs and gun violence ................................................................................................................... 49 3.1.5 Community-based intervention strategies ......................................................................................... 57 3.1.6 Failure to address race-based policing .............................................................................................. 60 3.1.7 Incarceration: rates and consequences .............................................................................................. 61 3.2 Children .............................................................................................................................................. 62 3.2.1 Preventable, unintentional deaths and suicides of children ................................................................. 63 3.2.2 Children as the victims of criminal firearm violence ............................................................................ 67 3.2.3 Children who commit firearm violence .............................................................................................. 70 3.2.3 Gun violence in schools ................................................................................................................... 71 3.2.4 Age limits and access to guns .......................................................................................................... 74 3.2.5 Gun violence among children: An under-researched public health issue ............................................... 76 3.3 Domestic violence and firearms .............................................................................................................. 76 3.3.1 The “boyfriend loophole” ................................................................................................................. 78 3.3.2 The “misdemeanor stalking” loophole ............................................................................................... 79 3.3.3 Domestic Violence Protection Orders and firearms possession ............................................................. 80 3.3.4 Prohibited possessors and the surrender of firearms ........................................................................... 82 3.3.5 Inadequate reporting of prohibited individuals to the National Instant Criminal Background Check System............................................................................................................... 83 3.3.6 The “gun show” loophole and private sellers ...................................................................................... 85 3.4 Access to firearms for individuals who may present a risk of harm to themselves or others ........................... 86 3.4.1 Mandatory waiting periods ............................................................................................................... 87 3.4.2 Restrictions on health care providers ................................................................................................ 87 3.4.3 Mechanisms to temporarily remove access to firearms for individuals at risk of harming themselves or others ................................................................................................. 88 3.5 Firearms and Tribal Nations ................................................................................................................... 89 3.5.1 Tribal firearm laws ......................................................................................................................... 89 Recommendations ...................................................................................................................................... 90 Chapter 4: Gunshot survivors .......................................................................................................................................93 4.1 Gunshot injury: the devastating human cost ........................................................................................... 93 4.2 International standards: health and human rights .................................................................................... 94 4.3 Emergency trauma care ......................................................................................................................... 95 4.4 The long recovery .................................................................................................................................. 97 4.5 Retained bullets .................................................................................................................................. 99 4.6 Spinal cord injury ................................................................................................................................. 99 4.7 Lack of accessible housing and inappropriate institutionalization ............................................................ 101 4.8 Financial burden of gun injuries: The cost of carnage ............................................................................. 102 4.9 Post-Traumatic Stress Disorder ............................................................................................................. 103 Recommendations .................................................................................................................................... 105 Chapter 5: Failure to prevent: Inadequate gun laws and policy ....................................................................................106 5.1 Background checks ...........................................................................................................................