EVIDENCE

[Recorded by Electronic Apparatus]

Thursday, May 11, 1995

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[English]

The Chair: I'd like to call the meeting to order. We are continuing our examination of Bill C-68, An Act respecting firearms and other weapons.

This morning we have before us the Canadian Medical Association, represented by Dr. Bruno L'Heureux, the president, and Dr. David Walters, the director, Department of Health Care and Promotion. We also have the Canadian Association of Emergency Physicians, represented by Harold Fisher and Dr. Alan Drummond, the past president.

[Translation]

We also welcome the Association québécoise de suicidologie, represented by Mr. Robert Simon. Is there anyone else with you?

[English]

We have the Canadian Association for Suicide Prevention, represented by Dr. Robert Mishara.

It's our custom to hear the opening presentations in the order listed on the notice, so we will first hear from the Canadian Medical Association, then from the Canadian Association of Emergency Physicians, and the Association québécoise de suicidologie. I understand you have submitted briefs. We try to keep our opening presentations to fifteen minutes. If you can read your brief in fifteen minutes, that's fine. If you can't, I would ask you to address the major points. The brief, of course, is distributed to all the members.

I call first on the Canadian Medical Association, either Dr. Bruno L'Heureux, or Dr. Walters. It's your choice.

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Dr. Bruno L'Heureux (President, Canadian Medical Association): Thank you, Mr. Chairman.

Mr. Chair, and members of the committee, the Canadian Medical Association welcomes the opportunity to appear before this committee to share our views regarding Bill C-68, An Act respecting firearms.

[Translation]

As you have mentioned earlier, Mr. Chairman, I am Bruno L'Heureux, the President of the Canadian Medical Association. I am a family doctor working in Laval Québec. Accompanying me today is Dr. David Walter, Director of Health Care and Promotion for the CMA.

[English]

The Canadian Medical Association, the national voice of organized medicine in Canada, is a voluntary professional organization representing the majority of physicians in Canada. Founded in 1867, CMA's mission is to provide leadership for physicians and to promote the highest standards of health and health care for Canadians.

Our brief, which emphasizes public health and safety issues, has been endorsed by the Canadian Psychiatric Association, the Federation of Medical Women of Canada and the College of Family Physicians of Canada.

Traditionally, firearms control has been viewed primarily as a matter of crime, legislation and punishment, rather than one of health and safety. Yet, physicians have been treating the effects of firearms and other forms of violence for centuries, and increasingly health research has focused on guns, gun control, and the problem of violence in society from a health perspective.

[Translation]

The CMA supports legislation and programs that address the issue of violence in Canada and that help reduce the injury and death caused by inappropriate use of firearms, while at the same time reinforces their safe and legitimate use in recreation and law enforcement.

[English]

I know you've heard the statistics before, but they're worth repeating. Firearms are a major source of death and serious injury. In 1991 there were 1,444 firearm deaths in Canada. The overall risk of death from a firearm is estimated to be 2.37 per 10,000 guns possessed.

Of the total firearm deaths in Canada, about 80% are suicides, 15% homicides, and 5% unintentional fatalities resulting from improper use. In 1991, in addition to firearm fatalities, there were over 1,200 hospital admissions for firearm-related injuries, most of them accidental. This figure does not include cases treated in ambulatory care settings such as physicians' offices. The actual total of firearm injuries is undoubtedly far greater.

This burden of injury and death comes with a large price tag. Canada spends an estimated $60 million annually on medical and health care for firearm-related injuries.

This brief is not our first expression of concern over firearms control.

[Translation]

In 1992, the Canadian Medical Association approved the policy which recommended the following measures to address the issue of firearm injury and death.

First, regulation for the purpose of injuring easy access to firearm by people at risk for violent or self destructed behaviour. The CMA recommended that a regulatory policy address acquisition, secure a storage methods and severe penalties for the use of a firearm in the commission of a crime or act of violence, including family violence. The CMA is pleased to see this recommendation addressed in Bill C-68.

[English]

The second recommendation was for education in safe handling of firearms, particularly for first-time users. Again, our association approved the inclusion of education provisions in the proposed legislation.

The third recommendation was for research on the effects of firearms on crime and research on the effects of firearms on health. Our association recommends that firearm misuse be viewed not in isolation, but in the larger context of violence in society.

As I said, CMA has addressed the effects of violence on the health of Canadians several times. Our 1994 publication on aboriginal health, entitled ``Bridging the Gap'', notes that the violent crime rate on reserves is 3.7 times higher than for the country as a whole, and that the majority of aboriginal women have experienced physical family violence.

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In 1992 we presented a brief to the Canadian Panel on Violence Against Women. The CMA was involved with eight other organizations in the Interdisciplinary Project on Domestic Violence, IPDV. Its primary goal was to promote interdisciplinary cooperation in the recognition and management of family violence.

[Translation]

In 1989, the CMA published a statement on the Health Effects of the Nuclear Arms Race, which also discussed not only the possible consequences of nuclear war but the urgent need for society to develop alternatives to violence in resolving conflict.

In 1985, we also published Family Violence: Guidelines for Recognition and Management which made recommendations to physicians on recongnition of signs and symptoms, assessment and treatment, and referral assistance. As you can see, Mr. Chairman, we are very familiar with this issue.

[English]

We recognize that physicians can play a role in reducing the burden or firearm deaths and injuries in Canada. A physician's influence can be felt in the following areas: first, in patient management. The CMA recommends that physicians continue to be alert to warning signs that patients may be at risk of harming themselves or others.

The second area is in medical disclosure. In some cases, the physician may consider that a patient's risk to self or others is immediate enough to warrant reporting that patient to appropriate authorities.

Our firearms control policy recommends that the physician should consider whether the risk of harm posed by a patient outweighs that patient's right to confidentiality. At this point, I must emphasize that any reporting expectations to social, justice or police authorities should be delineated in clear guidelines and procedures for: a) identifying patients at risk for violent or suicidal behaviour; b) reporting patients to authorities; c) responsibilities of agencies receiving information; d) the explicit protection of physicians from medical legal liability for reporting. This is a difficult area that does not lend itself to simple solutions.

The third area is research in the areas of firearms and violence in its early stages. As data collection becomes more sophisticated and an increasing amount of information is made available to Canadian researchers, we may be able to discover more about the effect of firearm availability on crime, injury and death, causes of and remedies for the problem of violence in society, and the health consequences of violence in relation to other health problems. Physicians have been involved extensively in such research in the last few decades and will undoubtedly continue to be so in future.

[Translation]

The fourth area is health education. The physician is a valuable source of patient information on healthy and safe behaviour. Just as physicians can counsel patients to stop smoking or to buckle up, so they can advise present or would-be firearm users of the importance of proper training and storage, and help them to understand the risks of firearms and all forms of violence as a potential health problem for the patient and family.

The fifth area is advocacy. Physicians can promote healthy acitivities in other ways besides one-on-one consultation with patients. In fact, for many years now, the medical profession has lobbied for legislation that promotes healthy and safe behaviour, like the use of seat belts, a legally mandated blood alcohol limit and the bicycle helmet legislation.

[English]

The CMA also recommends that physicians become advocates for broad public awareness of non-violent conflict resolution as part of an effort to reduce violence in society.

We recognize that there is insufficient evidence to show how best to reduce violence and the inappropriate use of firearms in society. It is unlikely that legislation in itself will achieve these ends. However, the potential for increased firearm availability and the dangers that guns present to the health of Canadians lead us to believe that some regulatory measures are necessary.

We feel that specific aspects of the proposed legislation are perhaps more focused on interdiction of crime than on a public health solution to the root problems and violence in society in general.

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The CMA agrees with the intent of the current legislation to ban military weapons for civilian ownership and use; greatly restrict civilian use of hand-guns outside of defined competitions; impose stiffer sentences for firearms crimes; tighten import-export and transfer controls on firearms; and require training and inspection programs for safe use and storage of firearms.

[Translation]

The Canadian Medical Association asks that any plans for control of firearms be carefully developped so that they focus on users and weapons of major concern in an effort to reduce the burden that firearms pose to the health of Canadians.

The Canadian Medical Association recognizes that, as firearms control is a public health issue, so the medical profession can help in promoting responsible firearm use and minimizing violence in Canadian society.

[English]

The CMA recognizes that, as firearms control is a public health issue, the medical profession can help in promoting responsible firearms use and minimizing violence in Canadian society.

[Translation]

Thank you, Mr. Chairman. Dr. Walters and myself will be happy to answer any question from the committee.

[English]

The Chair: Thank you.

Now we have the Canadian Association of Emergency Physicians, and we have their brief. They're represented by Harold Fisher and Dr. Drummond. Either one of you can make the opening comments. I give you the floor.

Dr. Alan J. Drummond (Past President, Canadian Association of Emergency Physicians): On behalf of the Canadian Association of Emergency Physicians, I'd like to thank you, Mr. Chairman and members of the committee, for allowing us to present our brief on the proposed gun control legislation.

Emergency medicine, unlike any other medical branch that has presented before this committee, has hands-on experience in terms of dealing with the trauma and tragedy associated with firearm-related injury in this country. There are approximately 6,000 physicians who practise emergency medicine in this country, seeing, on average, 18 million patients in 1 000 emergency departments.

Dr. Fisher is a full-time emergency physician from Mount Sinai Hospital in urban Toronto, and I'm a part-time emergency physician living in rural Ontario, in Perth. I guess we represent the spectrum of emergency medicine in this country.

I am a gun owner, as are most rural residents. Dr. Fisher has never a fired a water pistol in his life.

As an integral part of Canada's social safety net, emergency physicians have developed a unique perspective on the relationship of medicine and failed social policy, and for decades we've witnessed the problems with unrestrained drivers, with drinking and driving, with domestic violence, and with child abuse. In emergency departments across this land, be they urban Toronto or rural Saskatchewan -

The Chair: Excuse me, Dr. Drummond. You're speaking too quickly for the interpreter to translate your kind words.

Dr. Drummond: I forgot my lithium this morning. I will try to go more slowly.

Emergency physicians nightly witness the tragedy associated with trauma in this country, and, increasingly, Canadian emergency physicians have noted with dismay the damages inflicted by penetrating injury, particularly those associated with firearms. With the improvements in the general level of trauma care achieved in the 1980s and the unfortunate stagnation of emergency medical system development in the 1990s, we feel that our ability to treat gunshot wounds has largely been maximized. In order to reduce the human toll associated with firearm misuse, emergency physicians therefore are beginning to focus their attention on the issue of prevention.

With regard to injury in Canada in general, it may interest you to know that it is the leading cause of death among Canadians between 1 and 44 years of age, and all told, injuries account for more potential years of life lost at age 65 than heart disease, stroke and cancer.

Most deaths from injuries occur well before emergency physicians can intervene. In fact, 50% of injury-related deaths occur at the scene before medical personnel are able to intervene. Deaths from gunshot wounds to the head occur within minutes in upwards of 70% of fatal cases. Prevention, in our mind, therefore takes precedence over treatment.

The mortality statistics do not tell the whole story. For every injury-related death there are 45 hospital admissions and 1,300 visits to emergency departments across this land. One in five Canadians is injured every year and the economic burden is enormous.

Particularly sobering is the realization that most injuries are in fact not accidents and can be predicted and prevented. Therefore emergency physicians urge you to begin changing your conceptualization of this exercise from formulating simple gun control legislation to that of formulating public health and safety legislation.

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With regard specifically to firearm-related injuries in Canada, guns, by their inherent design, are designed to injure. Firearms are a major cause of death and injury in Canada, with more than 35,s000 Canadians having died from firearm injuries since 1970.

The statistics have probably been beaten to death around this particular table, but it still goes without saying that there are probably 1,300 to 1,400 deaths linked to firearms in this country per year, the bulk of which are suicides at 77%, and homicides at 17%. Accidents, perhaps because of educational endeavours, have been significantly lessened.

Particularly sobering is the realization that suicides in particular are the second and third causes of potential years of life lost owing to injury, after motor vehicle accidents. And one-third of these intentional deaths were related to firearms.

In 1990, there were approximately 1,100 suicides in this country, 300 of those in the 15 to 24 age group, making it the third leading cause of death in this age group.

Each year there are at least 1,000 firearm-related admissions to Canadian hospitals. It is uncertain how many gunshot wound victims are treated in emergency departments and discharged. American data suggest five injuries for every one firearm-related death.

The problem seems to be increasing in some centres. Personal communication with Dr. Barry McLellan, head of the trauma unit at Sunnybrook Hospital, suggests that between 1987 and 1993, the experience of the Sunnybrook trauma unit revealed a fourfold increase in admissions for serious gunshot wounds to the head and the trunk, at a time when trauma volume in general increased by only 20%.

The problem with firearm-related injury is not strictly related to urban centres, as a study from Dr. Brian Rowe in Sudbury would suggest. My own personal anecodotal experience suggests the same.

Legal firearms are responsible for the majority of gunshot wounds treated in Canadian emergency departments. In half of the firearm-related suicides the standard .22 calibre rifle or the 12 gauge shotgun are the most common.

In regard to homicides, firearms are implicated in 33% of these deaths, with hunting rifles and shotguns accounting for 61% of these.

Our greatest opportunity for morbidity and mortality reduction associated with firearm-related injuries would appear to be those associated with suicides, followed by homicides and then accidents.

I'm now going to ask Dr. Fisher to touch on the bulk of the major injuries.

Dr. Harold Fisher (Spokesperson, Canadian Association of Emergency Physicians): Thank you Dr. Drummond. Thank you, Mr. Chairman and members of the committee, for the opportunity to present some of the information from the Canadian Association of Emergency Physicians.

I have a couple of comments beforehand. I have taken a course in the safe use of water pistols, and I will medicate Dr. Drummond if he so requests.

I'll present more of the data, some of which you may have undoubtedly heard. There are an estimated 3,500 suicides per year. In 1989 there were 3,600. For every completed suicide, approximately eight people attempt. It's the leading cause of death in men aged 30 to 40, and that's closely followed by AIDS and motor vehicle accidents. It causes more deaths than AIDS.

Suicide is the second leading cause of death among Canadian adolescents. As you've heard, there are approximately 1,100 to 1,200 firearm-related suicides in Canada per year. That represents about 80% of firearm-related deaths. So 80% of deaths are due to suicide. One-third of all successful suicides are due to firearms. Therefore, firearms have the highest rate of success of any method.

In an article in The New England Journal of Medicine there is a suggestion that there is a fivefold increase in risk of suicide in a home where guns are kept. A similar study compared the incidence of suicide in two similar areas, the Seattle area and the Vancouver, British Columbia area. Amongst those aged 15 to 24 the rate of suicide was higher in the Seattle area. This increase was accounted for almost entirely by a high ratio of suicide by handguns. In other words, there was no compensation in other methods.

As I mentioned, suicides by firearm have the highest lethality. If you can call it success, 92% of people who attempt are successful. The data seem to indicate that the number of firearms and access to firearms are related to an increased risk of homicides, suicides, and so-called accidents, particularly when there is unsafe storage and the gun is stored loaded. In other words, these are largely impulsive acts and are related to the access to the firearm.

I'll just touch very briefly on homicides. Between 1978 and 1987 shooting was the leading cause of homicidal deaths in Canada. Usually the victim knows the assailant. As you've heard, this is usually a domestic dispute or a dispute where the assailant knows the victim.

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With respect to spousal and common-law homicides in Canada from 1985 to 1989, approximately 40% involve firearms. Of those, 84% of the victims were women. In another article in The New England Journal of Medicine there was a conclusion that keeping guns in the home was a strong and independent risk factor with a threefold increased risk of homicide, usually by an acquaintance or a family member.

Again, I would like to mention there is a positive correlation in the medical literature between rates of household firearm ownership - and this is particularly non-military firearms - and the national rates of homicide and suicide when different countries are compared with respect to gun ownership.

With respect to accidents, there have been 2,500 so-called accidental deaths since 1970. You've heard from Dr. Drummond that most of these are preventable. About one-third of these occur in children aged 5 to 19.

The issue of cost is somewhat problematic. However, there have been recent efforts to try to estimate the cost to Canadians. The costs are either direct or indirect. You've heard that the direct costs are approximately $60 million per year in Canada, probably about $70 million if you include other public services.

Canadian estimates for hospitalization for firearm-related injuries range anywhere from $15,000 to $30,000 per person injured. In the United States, there is an estimate that the annual direct and indirect costs exceed $25 billion, although this does not include pain and suffering costs and various other measures.

Extrapolating this to Canada, you would get a figure of $1.75 billion per year, which is probably the health care budget of a small maritime province. In 1990 there were data from Ted Miller on Canadian injuries. His estimate, if you include pain and suffering costs and loss of productivity, comes to $6.5 billion annually in Canada.

As Dr. Drummond mentioned, in terms of injury prevention there has been an improvement in the delivery of trauma care. We've basically plateaued in our ability to save lives due to advances in trauma care. We're now turning our efforts toward primary prevention of these injuries.

There are a number of different public health approaches. One includes the so-called three E's: education, enforcement and engineering. You can read the details of these three in the brief. Engineering basically relates to modifying any hazardous or dangerous product so that there is no effort or compliance necessary on the part of the user to increase safety in a product. With respect to firearms, we can think of things such as safety locks disabling them for children, loading indicators, and decreased lethality of ammunition.

Another approach would be to view the injuries as having a number of components, all of which are necessary to cause injury. The agent is the firearm, the host is the victim, the vehicle is the ammunition, the vector is the perpetrator, and the environment would be the social and physical environment. We can try to target all of these.

It seems that education is a fairly slow process of unsure efficacy. Legislation and automatic protection through modification of the product and the environment may perhaps be more efficacious.

We know that in injury control, the most effective investment, money-wise, is in prevention. We can look to airbags and seatbelts in cars and taking dangerous toys off the market.

I'll briefly touch on the trend since 1978. We know that firearm legislation has been effective in decreasing the burden of death and injury since that legislation was instituted. There's been a decrease in so-called accidental deaths, although 24% still occur in children. There's been a decrease in the total number of suicides and the percentage caused by firearms, although this is still a significant problem. There have been small decreases in the total number of homicides and overall deaths in the 15 to 24 age group. Now we have an opportunity to accelerate those trends by instituting new legislation that will effect long-lasting public health benefits.

I turn back to Dr. Drummond.

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Dr. Drummond: The Canadian Association of Emergency Physicians believes that Bill C-68 will make a significant contribution in lessening the morbidity and mortality associated with firearm-related injury. By legislating possession permits and full registration, gun owners will necessarily be made more accountable for their weapons. Safe storage will reduce accessibility, which will be of great importance in reducing both suicides and homicides in the home. By further restricting availability of hand-guns, prohibited weapons and ammunition access, the bullets will be eliminated and the environment substantially altered, modifying the risk for firearm-related injury.

How can this bill be strengthened? It can be strengthened by not allowing it to be weakened. Every year thousands of Canadians are either killed or injured. Can we wait five, six, seven years to have full implementation?

Secondly, there should be provisions made for the introduction of a medical reporting system for those at substantial risk for firearm-related injury - the untreated schizophrenic, the untreated manic-depressive, those victims of alcohol abuse or domestic violence.

We feel there should be emphasis on the development of a national firearms registry so that we know what guns are being used for what purposes so we can effect a more appropriate research base for the further study of gun-related violence.

There should be a concerted effort made to develop and institute educational programs on violence and conflict resolution in school-aged children in Canada.

We'd like to thank you very much. We have a window of opportunity here to do something quite positive for the country and we'd welcome any questions that you may have.

The Chair: Thank you very much.

[Translation]

And now I would ask Mr. Robert Simon, from the Association québécoise de suicidologie, to now take the floor, followed by Mr. Mishara. Mr. Simon.

Mr. Robert Simon (Representative, Director, Centre de prévention du suicide du Saguenay-Lac St-Jean): Thank you, Mr. Chairman. Ladies and gentlemen, members of the committee, I am pleased to be here this morning representing the Association québécoise de suicidologie.

I'd like the members of the committee to use the French version of the document because this morning we will be introducing completely new data prepared expressely for the members of this committee to inform them about some totally new things that have not yet been made public.

The Association québécoise de suicidologie (AQS) brings together suicide prevention centres from all over Quebec. These suicide prevention centres who are members of the AQS are made up of volunteers and professionals who, together, try to decrease our high rate of suicide.

The AQS also brings together individuals and organizations interested in preventing suicide. We believe it is necessary to act together with all interested parties, schools, justice and also our MPs, and that's why we're here this morning.

We also strongly believe - the document we're presenting this morning bears witness to that - that firearms have an influence on the suicide phenomenon both in Quebec and probably elsewhere in Canada.

Personally, I'm the General Director of a suicide prevention centre, the one for the Saguenay-Lac St-Jean area, that is member of the AQS and I have been working in this field since 1986.

Suicide by firearm in Canada: In 1992, there were 3,709 suicides committed in Canada. One thousand forty-six people used a firearm, which accounts for over one quarter of all deaths due to suicide. As for deaths due to firearms, which includes both suicides and homicides, of course, as well as accidental deaths, there are, 1,354 cases.

So we could consider that, in fact, suicide counts for 77% of deaths due to firearms. If you look at Quebec as a whole, from 1990 to 1992, we had 3,559 suicides, of which 936 involved the use of firearms, which also represents 26% of all deaths involving firearms. I don't think you have the French document available yet. Do you have the tables in the French document? I'd like the members of the committee to...

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The Chair: We're in the process of distributing the document. It's being photocopied right now, but it will be distributed.

Mr. Simon: If we look at suicide in Quebec - or in all regions - you can see that in Quebec, suicide by firearm varies from one region to another. That means that from one region to another, the proportion of people committing suicide with a firearm is not the same.

In the Gaspé, for example, 48.9% of people who committed suicide between 1990 and 1992 used a firearm. In the north of Quebec, the rate is 47.4%. So 47.4%, or one of every two people committing suicide, used a firearm.

In Abitibi-Témiscamingue, the rate is 44.8%; in other words, almost half the people committing suicide used a firearm. In the Montreal and Laval region, the north shore of Montreal, the proportion drops to 17.5% and 13.7% for Montreal. That means that in heavily urbanized area like Montreal, the proportion of people committing suicide with a firearm is far lower.

Now let's look at the kind of firearm used to commit suicide. In Quebec, between 1990 and 1992 - this data is from the Quebec Coroner's Office - long arms were used in 83.7% of all cases. So, in eight cases out of ten, people use long guns which are probably intended for hunting. Hand guns were involved in 12.9% of those cases.

The AQS, that I represent, wondered if there was a link between firearms in circulation and the ratio of suicide by firearm, thus the total number of suicides.

There is no trustworthy data on the number of homes where firearms are available - this situation should be remedied when Bill C-68 on firearms control comes into force - so we don't know how many homes have firearms. So we used the data from the ministère de l'Environnement et de la Faune du Québec who gives out hunting certificates.

That certificate gives the right to then obtain a hunting license. Of course, we have to be prudent in using these data because they provide an indicator on the popularity of hunting as a sport, not on the presence of firearms.

Certificate holders may not even have any firearms in their possession anymore. They may own more than one firearm and have only one certificate. This gives no indication either on how those firearms are stored. And, of course, you can also own a firearm and not have a hunter's certificate.

Despite all those reservations, the AQS thinks it's reasonable to believe that the more certificates you have, for a given region, the more hunters you have and thus, the more firearms also.

So we tried to see whether there was any relation between the proportion of hunter's certificates and the number of suicides involving firearms. Of course, if we saw there was a link between the number of suicides involving firearms and the number of certificates, we'd also have to see whether there's a link between the number of suicides involving firearms and the number of suicides in general.

If firearms are not available, maybe another means could be used. I don't think we have the graph I was talking about yet. So the association ran a check to see if that link did exist in a given region.

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We've put the regions of Quebec in order, from the region where you have the lowest number of hunter's certificates to the region where you have the most. And what do we get? As the proportion of hunter's certificates goes up, the rate of suicide by firearms also goes up.

So, at the bottom of the ladder, we have the municipalities of Montreal, Laval and the Montérégie. The Montérégie, to give you an idea, is Montreal's south shore. The Greater Montreal area is where you have the fewest firearms and the fewest hunter's certificates delivered in Quebec. Curiously, that's also where the suicide rate involving firearms is the lowest.

If you look at the regions where the proportion of hunter's certificates is high, you get Quebec's north, the Gaspé, the north shore and Abitibi-Témiscamingue. Curiously, once again, those are the regions of Quebec where the number of suicides involving firearms is at its highest. So there is a link between firearms ownership and existence, which leads to believe that there's an increase in the number of suicides involving firearms in those homes where they are available.

Now we should turn to a second verification. We should check to see if there is a link between the number of suicides involving firearms and suicide in general. I hope you'll be getting the graph soon. It's very eloquent. As the curve of suicides involving firearms increases, the number of suicides in general also increases. So we must come to the conclusion that there is a link between the number of suicides involving firearms and the number of suicides in general.

So, contrary to what some maintain, there is no substitution of means when firearms are not available. Perhaps some people do attempt suicide using less lethal methods. Maybe they try to commit suicide, but death is not the consequent result. It has to be realized that any candidate for suicide has ambivalent feelings.

[English]

I will say a few words in English despite the fact that my English is not very good.

Suicidal persons are ambivalent. Until the last moment nobody wants to commit suicide. Nobody wants to live with the pain they have. They have a problem; they don't want to live the way they live, but they don't want to die. Then when they confront a lot of problems, sometimes they will be impulsive. They will make a decision to commit suicide. If you remember only one thing of my presentation, you must remember that suicidal persons don't want to die, but they want to stop the pain they have. They are ambivalent until the last moment. They don't want to really die.

Young adolescents are especially impulsive, and if they can obtain a means rapidly, they will very quickly commit suicide. Some adults are very impulsive too, especially when they are using drugs or alcohol.

The coroner's inquest has made the following computations. If the person or persons who committed suicide were using somebody else's firearms and had this firearm been well stored, probably the suicide could have been avoided. Suicidal persons are ambivalent, and the length of time they take to find the means they will use is time that works for the prevention of suicide.

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[Translation]

So the harder it is to actually do it, the longer it takes to find the way of doing it, the more the crisis has a chance of waning and the more opportunity people will have to find help. Eighty per cent of people who commit suicide are sending out a message. Why are they sending out a message? It's because they don't feel like dying. They want to find help. Otherwise, why would they be sending messages to those around them in 80% of all cases?

When individuals use other means, it's sometimes possible to interrupt the process. It frequently happens, in Quebec just as in the rest of Canada, that individuals phone suicide prevention centres after ingesting medication. That's clear evidence of the ambivalence factor. There have been cases where an individual have jumped off a bridge only to then swim to shore. You also have cases of people swallowing medication then going to the hospital, people unhanging themselves, but with a firearm...

So if firearms were made less readily accessible, you might not eliminate all suicides involving firearms, but maybe those of impulsive individuals or teenagers or even people you may know. The AQS supports the principle of universal firearms registration.

Moreover, the AQS urges the Department of Justice to take all means necessary to make the regulations on firearms storage more broadly known and to show vigilance in its implementation. So universal registration, Bill C-68, should be seen as a preventative. Thanks to that legislation, the department will be able to inform people of the danger firearms represent. The Canadian population to whom firearms are available should be made aware that they are dangerous objects and not ordinary tools.

During a coroner Anne-Marie David's inquest in Quebec, what came out was that in many cases of teenage suicide the young people had found the firearm that they used to commit suicide in a closet, exactly where I would have put my tennis racquet and tennis balls, right beside. On the other hand, it's not a tennis racquet and some Wilson tennis balls. It's a firearm with the necessary and appropriate ammunition right beside it. These teenagers knew how to use the firearm in question, just as my own son knows how to use my tennis racquet. So we have to send out a message to the Canadian population to the effect that a firearm isn't a toy or a tennis racquet and that the government of Canada considers a firearm to be something that's dangerous for adults and their children.

Once we finally know who owns firearms in this country, we'll be able to tell them how to store them. Unfortunately, the storage regulations are as yet unknown. You can drown our television stations and the newspapers and advertising, but to get people to know the storage regulations, you have to aim directly at the target and that's those men and women who own firearms.

The Chair: Thank you, Mr. Simon.

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[English]

Now we have Dr. Mishara from the Canadian Association for Suicide Prevention.

I understand you wanted to make some remarks to the committee as well.

Professor Brian L. Mishara (Past President, Canadian Association for Suicide Prevention, Professor of Psychology, Université du Québec à Montréal): I would like to complement the presentation by Robert Simon with some information concerning firearms and suicide in Canada in general.

The Canadian Association for Suicide Prevention, L'Association canadienne pour la prévention du suicide, is a non-profit, national organization comprised of organizations, professionals and individuals from all walks of life with a common goal: the promotion of treatment, education and research on the prevention and reduction of suicidal behaviour in Canada.

The Canadian Association for Suicide Prevention does not support any moral beliefs as to whether suicide is right or wrong. However, on the basis of research studies and clinical experience, we recognize that suicides are often preventable tragedies. One means of prevention, which is well documented in research studies, is the reduction of the availability and lethality of means of suicide.

During the period 1990-1992, 36% of the suicides in males were by means of firearms and 9% of suicides in females. Although the number of deaths by firearms has decreased from ten years earlier, firearms still comprise the largest category of suicide methods for Canadian men and a significant, although smaller category, for women.

Only a minority - about 3% - were handguns. Most suicide deaths involve long guns, shotguns and rifles and other types of guns, for example combat weapons, such as semi-automatic or automatic long guns. As other people have mentioned, firearms are the most common method of suicide in Canada. Thus, the Canadian Association for Suicide Prevention is concerned about gun control and the possibility that legislation will have a positive effect of decreasing tragic suicidal deaths by firearms.

Research studies and clinical experiences by professionals in suicide prevention centres across Canada indicate that in many cases suicides by firearms appear to be committed impulsively and without careful premeditation. Although a large proportion of Canadians think of killing themselves at some time in their lives, these thoughts are infrequently transformed into actions, sometimes impulsively after a particularly distressing life event, such as an academic or relational set-back or conflict.

Young Canadian males are particularly vulnerable to impulsive suicide after stressful life events. In these circumstances, access to an instantly lethal method, such as a firearm, means that there is no enforced period of waiting or planning during which a distressed person might have a chance to get over what might be a temporary crisis situation. If the lethal method is not immediately accessible, the additional time required to find an alternative method often results in a decreased risk of suicide.

Furthermore, research suggests that individuals who intend upon ending their lives by a particular means, such as using firearms, do not necessarily find another means of suicide when their chosen method is not available.

Several research studies have found that males are more likely to die by suicide if there is a loaded gun in the home. Several studies in the United States have shown first that adolescent suicide victims who do not have apparent psychiatric disorders were more likely to have a loaded gun in the home than suicide victims with psychiatric disorders. In another study, they found that those who died by suicide attempt were more likely to have a gun in their home and use this method when compared with suicide attempters who survived.

Guns were twice as likely to be found in the homes of suicide victims who died by their attempts than those who survived. Even guns stored locked or separate from ammunition were associated with a higher risk of suicide.

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In a large American study involving interviews with relatives of 328 suicides committed by guns in Tennessee and the State of Washington, they conducted a detailed investigation in which they matched an equal number of people who did not commit suicide. They determined, within a 95% confidence interval, that having access to a firearm in the home increases the risk of suicide. The risk of suicide was five times higher in homes with guns than in homes without guns.

These carefully conducted studies strongly support the conclusion that the availability of firearms in the home increases the risk of suicide, particularly among males.

Although it is proven that when people feel desperate and think of killing themselves, having a firearm available in the home increases the risk of death by suicide, a determined suicidal person may seek alternative means when the method of choice is unavailable.

However, research results indicate that a significant number may be deterred from proceeding further. There are several examples in which the reduction of access to a particular lethal method resulted in a reduction in suicide rates - a reduction that did not appear to be compensated for by an increase in suicide using other methods.

For example, in Britain, suicide rates fell in the 1960s when more lethal domestic gas from coal was replaced by natural gas with a much lower carbon monoxide content. This was a common suicide method in Britain for the elderly. Suicide rates for the elderly who used this method fell sharply, and the decrease persisted even though rates for other age groups who used other methods continued to rise.

Similarly, suicides committed by jumping in front of moving trains in metropolitan transit systems were significantly reduced in Singapore metro when barriers, introduced to save energy in air conditioning, were installed.

Seiden, who studied people who tried to jump off the Golden Gate Bridge in San Francisco, found that those who were denied access to this means of death generally did not kill themselves by another method.

Many Canadians, particularly young males, have the fantasy of shooting themselves in order to die quickly by suicide. One may ask if limiting the immediate availability of guns through gun control legislation may really decrease tragic deaths by suicide without having a parallel increase in alternative methods.

Research has shown that during the eight years after the introduction in Canada of Bill C-51, the total suicide rate and the firearm suicide rate showed a decreasing trend when compared with the eight years before the introduction of Bill C-51. Similarly, studies showed that before the introduction of Bill C-51, from 1965 to 1977, both firearm and total suicide rates increased in nine of the Canadian provinces, but after the bill - between 1979 and 1989 - all ten provinces had either stable or decreasing total and firearm suicide rates. In no province did non-firearm suicide rates increase after passing Bill C-51.

Comparisons between cities on the west coast of the United States and Canadian cities, which have more restrictive gun control, have shown that there is a correlation between stricter gun controls and lower suicide rates. American states, which have stricter gun controls, have lower suicide rates than states that do not.

The research to date strongly supports the view that suicide impulses are not generally transferred or displaced to different methods of suicide when there is less availability of firearms. Moreover, previous Canadian legislation, Bill C-51, appears to have decreased the number of deaths by suicide in Canada. We therefore conclude that any further legislation that decreases the availability of firearms in homes will most probably save many lives.

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Furthermore, any legislation that results in a delay in obtaining firearms, for example by requiring a permit application and waiting period, is likely to result in a decrease in the number of tragic deaths by suicide in Canada each year.

Although a suicidal person can always find another method if firearms are not immediately available, a significant number of suicidal deaths by firearms occur during a transient crisis situation where impulsive actions at that moment result in death by suicide.

In these common situations, if a firearm is not on hand or immediately available, there is a strong likelihood that another method will not be immediately chosen and by the time the individual may be able to obtain a firearm, the crisis will have diminished, thus averting a tragic premature death.

Over 1,000 Canadians kill themselves by firearms each year. Legislation that will result in a decrease in the number of Canadian homes in which firearms are available and that limits or delays, even for a short period of time, access to firearms will most likely result in the saving of hundreds of lives each year.

The Canadian Association for Suicide Prevention respectfully asks that this be taken into consideration when considering legislation to further control firearms in Canada.

The Chair: Thank you.

We will now proceed to our rounds of questioning. According to the rules, we start with three ten-minute rounds, one round for each of the three political parties of ten minutes each. Then we will have five-minute rounds of questioning, alternating between the government and the opposition members.

I recommend the members, in putting their questions, direct them at one of the individuals or one of the groups, since we have a large number of witnesses before us this morning. I would suggest in the limited time you have that you direct your questions to one or another of the witnesses.

[Translation]

We will begin with Mrs. Venne, for ten minutes.

Mrs. Venne (Saint-Hubert): Thank you, Mr. Chairman. Good morning, gentlemen.

My question is for the Canadian Medical Association. On page 9 of your brief, you point out that the CMA is unconvinced that registration will be effective in reducing suicides and homicides.

However, the Fédération des médecins omnipraticiens du Québec, one of your member organizations, which represents some 6,400 members, has given its unconditional support to Bill C-68, including registration of firearms. How can you explain this?

Dr. L'Heureux: Mr. Chairman, first of all, I must point out that the Canadian Medical Association comprises 12 divisions, one for each of the ten provinces and two territories, and it includes some 45,000 doctors. Obviously, each division can take whatever position it considers appropriate for its jurisdiction.

In representing doctors across Canada, the Canadian Medical Association must take into account a variety of use, and it must also assess the objectives being pursued.

I will ask Dr. Walters to answer the technical part of your question concerning registration. I will try and explain how the FMOQ's position differs from that of the CMA.

Mrs. Venne: In choosing our witnesses, we were unanimous in favouring pan-Canadian associations since they also represent provincial and territorial associations. That seems to have been a great mistake in this case, since you do not reflect the views of the Fédération des médecins omnipraticiens du Québec on this legislation.

Dr. L'Heureux: I must point out that it is perfectly in order for the FMOQ, of which I am a member, to have taken the position it did take. At the national level, we have looked into the long-term effects. Dr. Walters will comment more specifically on this issue.

[English]

The Chair: Dr. Walters, please.

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Dr. David Walters (Director, Department of Health Care and Promotion, Canadian Medical Association): I think this addresses a very important technical question area, and I think you've heard in the presentations today that people are saying that probably there will be a good effect from the legislation as posed.

I think it is important, and I think it's a role of some of the expert groups, to ask important questions to make sure that things are as effective as possible.

As you've heard - and we all agree and we all use these statistics - the risk increases in those households where there are guns. Where there are guns that are perhaps sloppily stored or loaded, etc., the risk increases. We agree with that totally.

With a registration system, are you really taking guns out of circulation and, therefore, are you reducing that availability of guns? You have seven million guns. What will happen on January 1, 1996? Some of those guns will be accompanied by yet another piece of paper or a computer listing, correct? But there will still be that many guns.

The guns that are being restricted we totally agree with. In other words, the handguns are being reduced, the military weapons are being reduced. That's what we've said here; that reduction in guns will reduce risk, it will make them less available. To have an additional piece of paper, i.e., a possession certificate, all we want to point out is that this may not address the level of despondency, the level of despair, the level of the severe health problem, if you will, that somebody who is contemplating suicide has.

That's where our colleagues, who are experts in this in terms of suicide prevention, know that you have to have a complete network of workers, you have to have a 1-800 number, you have to be intensively working throughout the community. It is these health programs that will probably have a major effect on suicide as opposed to a police and legislative program, by and large, which is not directed, per se, at the problem of suicide directly.

[Translation]

Mrs. Venne: Forgive me for interrupting, but I think that you have abundantly answered my question on the difference of views between the Canadian Medical Association and the Fédération des médecins omnipraticiens du Québec. As my time is very limited, I would like to move on to another question.

Before I ask my second question, I would like to say that, on page 9 of your brief, you seem to agree with the proposed legislation which is intended to: «Ban military weapons for civilian ownership and use.»

I would like to point out that there is a mistake here. The legislation will not ban civilian ownership of military weapons. Those individuals who already own such weapons will have the benefit of the grandfathering clause, and the legislation will even allow for transfers of weapons within a particular group. So, people will not be prohibited from owning military weapons. I just wanted to point out that you are in error in making that statement in your brief.

My next question deals with what your colleagues from the Canadian Association of Emergency Physicians say on page 9 of their brief. They say that, by enacting legislation to make registration mandatory, government will make gun owners more accountable for their weapons.

I wonder if you could outline the Canadian Medical Association's position on this, and I wonder as well how you would respond to that statement which was made by your colleagues.

Dr. L'Heureux: Just as is the case within Canadian society as a whole, there are a variety of views among members of the CMA. I have the greatest respect for the views of emergency physicians. I think that they have a very specific view of the practice of medecine, and in making such a statement, they are without a doubt expressing their opinion as experts in that field.

We, on the other hand, represent doctors working in a variety of fields, be it psychiatry, radiology, etc... Obviously, our position must be a more general one.

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There is no doubt whatsoever in our minds that additional gun control measures will indeed have an impact. However, we, at the CMA, are suggesting that no one knows what that impact will be in the long run, so we are simply flagging that as a concern. We are not telling you to not go ahead. What we are saying is: Don't go thinking that the legislation will solve the problem by itself. This is only one element among a myriad of others which will surely improve the situation for Canadian society as a whole.

Mrs. Venne: Thank you. Can I give the floor over to my colleague?

The Chair: You have only one minute.

Mr. de Savoye (Portneuf): Then I will pass and come back later.

[English]

The Chair: Mr. Hill, you may start.

Mr. Hill (Macleod): My name is Grant Hill. I'm a physician from Alberta. I've practised for 25 years in a suburban location. I have dealt with an emergency urban setting. I worked for a year in emergency in a large urban centre. I've dealt with suicide all my life. I'm speaking now with my colleagues, my friends, my chums, my buddies. I'd like to do it in that way.

Dr. L'Heureux, I'd like to direct my initial comments to you. I'd like to say how proud I am of the Canadian Medical Association for presenting what I consider to be an accurate view of what Bill C-68 will do.

You have agreed with five things Bill C-68 will address. You have gone on to say the CMA is unconvinced that registration will have an effect on health issues. However, throughout the debate the justice minister has said specifically that he has the support of the Canadian Medical Association on Bill C-68. This statement here is directly refuting that comment. How would he have the idea that he had the unqualified support of my association when you come here before this committee and say no?

Dr. L'Heureux: I'm not really aware, Mr. Chairman, of the comments made by the justice minister. However, as I said, we support the objectives. That's the same answer I gave to your predecessor. We are not confident that registration per se will solve all our problems. It's another measure that will be added and should probably have an impact, but we can't say it will without any doubt.

Mr. Hill: If I could be very specific now, the heart of these new proposals is the registration of firearms. The justice minister has said that very plainly. Without the registration of all firearms, his proposals do not change much at all. Many of the things your other colleagues are speaking about - accessibility, storage and what not - are currently legislated.

If my association does not agree with registration of firearms and is, in your words, unconvinced that this registration will be effective, how would the justice minister be able to state, as he said to me personally, in the House that he has the support of the Canadian Medical Association for Bill C-68? Is the justice minister mistaken? How would he have that information? How could he say that?

The Chair: Of course you can answer, but we're going to have the minister back before us in a few days and it seems to me that he is in more of a position to answer that question. We have your brief now. We know what your position is. You may answer the question if you wish.

Dr. L'Heureux: That's exactly what I was going to say, Mr. Chairman. Our position is clearly defined here in our brief. You should ask the minister why he states that he has the support of the CMA, how he interpreted that.

Mr. Hill: Let me try a different direction. Have you given the minister any documentation that would allow him to say that the CMA supports him on Bill C-68?

Dr. L'Heureux: Mr. Chairman, the only documentation we have provided is the brief we are giving you today.

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Mr. Hill: All right. The answer is no. There is no documentation that has gone to the justice minister to say to him that the CMA supports Bill C-68.

Dr. L'Heureux: As far as I know, the only document we have is this one.

Mr. Hill: This fits very well with what I've been seeing reported in the medical literature. The CMA's position, the policy summary, is very clear and supports storage, education, and real, sound public health measures. These are the only things that have been presented to the justice minister. Is there nothing else?

Dr. L'Heureux: As far as I know, Mr. Chairman, the only document we have is this policy and that brief.

Mr. Hill: Should I ask the other CMA representative? Does he know of anything else that could have gone to the minister?

Dr. Walters: No. I agree with what Dr. L'Heureux has said. As stated in the brief here, this is the position of the CMA.

Mr. Hill: We have a secretary of the CMA here. Could he make a comment? Has there been anything else?

Maybe I'm going beyond my purview.

The Chair: I think, Dr. Hill, that the president and Dr. Walters would know. I don't know if we're going to try to have contradictory positions between the secretary and the president. I think we have to rely on the president.

Mr. Hill: You can understand my concern -

The Chair: Yes.

Mr. Hill: - because a lot of us have heard these statements made.

The Chair: I must say I haven't, but you make a good point, and we'll have Mr. Rock before us and put the question to him.

Mr. Hill: I'm sure you know that question will be put to him before he comes back here. This is a fairly significant issue.

The Chair: That's fine. That's your right.

Mr. Hill: All right. If I could go towards the other issues.... Is there another document there we should be made aware of?

Dr. L'Heureux: Mr. Chairman, if you would permit me, we issued a news release on February 15, before the legislation, and we said that doctors support the objectives of firearm legislation. As I said before, we support the objectives of controlling firearms. We did not state in that document that we were or were not supporting the registration. The exact phrase was:

While we recognize that there is a place for the legitimate use of firearms in hunting and collecting, we intend to review the legislation to ensure that it addresses the problem of violence in society and helps to reduce the morbidity and mortality caused by inappropriate firearm use. We view this as an important public health issue. It is a sobering experience that brings the issue into sharp focus, and any reasonable measure to address this problem effectively must be considered.

That's what we said at the time.

The Chair: Would you mind if the clerk had a copy of that to distribute to members of the committee? That may be the basis of what the minister believes, since the press release says you support the objectives and it doesn't go into the details as you do today.

Dr. L'Heureux: Exactly. It was issued the day after the minister introduced the firearms legislation.

The Chair: That might be the reason for his statement. Dr. Hill, you may continue.

Mr. Hill: You have very broad membership across Canada. In reaching a consensus on an issue like this, how does the consultation process work?

Dr. L'Heureux: That position was taken by the board of directors, which consists of approximately 28 persons from different parts of the country. We act almost the same as the House of Commons, but on a smaller scale.

Mr. Hill: So would you bring from the various parts of the country purviews that were specific to those parts of the country?

Dr. L'Heureux: Yes, sir.

Mr. Hill: And it would not be made by simply urban-oriented individuals, nor by an elite. This would come more from what I would call the ground up.

Dr. L'Heureux: It's from the grassroots, Mr. Chairman. We have members who come from the Northwest Territories, the Yukon, Nova Scotia, Prince Edward Island, Newfoundland, Quebec, and Ontario. All the provinces and territories have their own representatives. Even if you look at the Ontario delegation, it's not only doctors from around Toronto. We have doctors from other places.

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Mr. Hill: The document that was prepared here would have been prepared by staff after those consultations had taken place?

Dr. L'Heureux: It was prepared by staff and by the committee on health promotion, submitted to the board of directors, corrected, resubmitted, and duly voted on at the last board meeting, which happened to be a week or two ago.

Mr. Hill: All right. There would be disagreement in the committee? There would be discussion? The majority will of this report then would be reflected by my association, by Canadian doctors as a whole, as an umbrella group?

Dr. L'Heureux: Exactly. In fact, there was dissension as there is always. As I said earlier, it's like the Canadian society. There are doctors who did not agree with that, but overall, the vast majority said yes it's a noble objective and we should support that kind of legislation.

Mr. Hill: I will end then by saying how proud I am of my own association for a grassroots consultation, for a consultation that does follow principles that I think are really appropriate for a group that represents so many individuals. Thank you.

Mrs. Barnes (London West): Before I start with my time, during the presentations I saw people skipping some of the paragraphs, Mr. Chair. I'd like to ask that all of the full presentations, including the appendices, be read into the record.

The Chair: Does the committee agree? All right.

Mrs. Barnes: I really appreciate your testimony here before us. It's always appropriate that whenever we're getting into hard-core data and research that the reservations be put out there. It's funny, I believe that the more professional and the more data, people tend to disclose the reservations more readily as opposed to coming forward with their opinions.

We get a lot of opinions in the testimony before this committee, some of which are very right and some can be very wrong. It's our job here to try to sift through this and come up with a balance that will satisfy the needs of Canadians in this time and place, Canadians from across the country, not just from one region of the country.

You were invited here today because of your expertise, and your expertise obviously is on suicide and the health area and the data that you have collected with respect to death by firearms, not only with suicide but with homicide and by accident. I think you are in an excellent position to assess this risk and this need within our country and I appreciate that.

There are a number of questions here. First of all, as I read your brief, it says here:

The CMA agrees with the intent of the current legislation.

Then it lists...so you are on record here as agreeing with the intent of the current legislation. What you have stated here is linking, in a sentence, your reservation with respect to registration and suicide. That's the only reservation that I see here. Is that correct.

Dr. L'Heureux: Yes.

Mrs. Barnes: I just want to clarify a point for the record and for my own mind on this issue. One of the things that you say you agree with in the intent of the current legislation is your point number 4: ``to tighten import-export and transfer controls''.

Would you agree that it is conceivable, or maybe outside of your area of expertise but more in the area of the expertise of the RCMP and the police who have presented before this committee, that this is where the registration would be most useful within the legislation?

Dr. L'Heureux: I think you pointed out that our expertise relies on our care and not on means of enforcing the law. That's your job from our point of view.

Mrs. Barnes: So that would be a fair analysis, that what you were directing your mind to were the health care issues of this bill?

Dr. L'Heureux: Yes.

Mrs. Barnes: Would you say that even though you know the enforcement aspects of the bill, you are agreeable to those aspects of the bill?

Dr. L'Heureux: Yes.

Mrs. Barnes: Could you therefore agree that registration may be more important with respect to enforcement aspects of the bill than the health care aspects, in your opinion?

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Dr. L'Heureux: Probably.

Mrs. Barnes: ``Probably'' doesn't help me too much.

The Chair: You can give whatever answer you want though.

Mrs. Barnes: I don't want to push this point. I want it clarified.

Dr. Walters: I'd just like to say that this whole registration bill in detail has a lot of aspects to it. As you know, it's a long piece of legislation if you've gone through it line by line.

Mrs. Barnes: Yes, I have.

Dr. Walters: Certainly, this would seem to allow police and the judicial system to intervene more and to have more information, etc. How that works...again, we wouldn't really have tried to figure out, or pretend to have the expertise, on how well it is going to work, i.e., the police system of registration.

It was our feeling when we looked at this that the health data is complex enough and there are enough unanswered questions in the health areas for us to become really sure of what we're saying about suicides or homicides or even accident prevention, which of course we're all very interested in. I think all we're saying is we want to be sure that any program directed in this area is being thought through carefully as to how effective it's going to be as a health program. That's really what we're looking for; we're looking for a health gain here. We want to be very sure that health gain has been thought through, probably by the health experts as well as the police and judicial experts.

Certainly, you've heard from Dr. Chapdelaine and the public health people before, and you have to look at that potential. Is it really addressed by the registration, or are we really addressing this as a crime problem, from a police perspective?

Mrs. Barnes: Thank you very much for that clarification.

It has been suggested a couple of times, and I think it's an area of confusion in the country, that firearms accidents, deaths, suicides - the firearms issue is an urban issue; it's an urban problem. In the country there are more firearms, it's safer, and everybody knows how to use their firearm; it's a tool of the trade.

Maybe I would request the emergency physicians to address that for me.

Dr. Drummond: First of all, in regard to gun registration, if I may comment quickly, I think what we feel here is that there should be an environmental change. I know darned well I have two guns in my home and they're not particularly well looked after, but if all of a sudden I think the police are going to come and make me a criminal overnight, then I'm going to start locking them up and making sure my ammunition is stored appropriately. I'll make that admission and I hope the RCMP aren't waiting for me outside.

The second thing is that I happened to spend two wonderful years in the special service force in Camp Petawawa. I know ``special service force'' are dirty words on Parliament Hill, but nevertheless it was an interesting two years. It was a controlled, violence-oriented society, if you would, but guns were very well respected and very well controlled. As a result, I never saw a gun-related injury in Camp Petawawa during my two years in service. I saw a lot of broken ankles and a lot of bad backs, cases of runny noses and one grenade fragment. But I never saw a gunshot wound.

During my time in hospitals in urban Montreal and Vancouver, I occasionally saw gunshot wounds related to crime. I've seen about 12 gunshot wounds in my life. During my 12 years in Perth, just south of here - I moved to Mayberry thinking this was a great place to raise my kids and it would be a quiet, sleepy little town where nothing ever happened, and I've seen the entire gamut of gunshot wounds. The fact of the matter is in Canadian rural life we all have guns. We have them for a variety of reasons. You can't get your car or your plumbing fixed in Perth in November because everybody is hunting.

I have guns in my home largely for varmint control. Squirrels get in my home and upset my wife, racoons ravage my garbage - I know these are terrible admissions, but it's the awful truth.

Mrs. Barnes: I appreciate the testimony.

Dr. Drummond: I know it's a crime in Canada to shoot Canadian beavers, but the fact of the matter is they eat a lot of trees and I've taken a couple of shots at those, but I usually miss.

The fact of the matter is what we've heard from the suicide prevention groups is that access to firearms is a major determinant for suicide. You can take pills; I'll save you. As has happened to me recently, you can walk in front of a transport tractor-trailer and I'll save you. If you put a gun in your mouth, I can't. So remove that access to guns and you reduce the risk of suicide.

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If you look at the homicide situation in rural Canada, often it is a domestic violence situation that has gotten out of hand. There has been an impulsive act. Again, reducing the access to firearms, which every rural home has, reduces that risk.

So how does registration work? I've got a 12 gauge shotgun and I've got a .22 rifle. They're not registered. All of a sudden I have to take possession of these things from a very legal perspective. The question is, have I used my gun in the last three years? No. Do I need my gun? Maybe not. There are other ways of doing things. I then have to question the need for the old family firearm, and in many cases I suspect the firearm would then be given up. Dad brought it home from the war, we've never fired it, why do we need it?

I think it gives a sense of responsibility for firearms and forces people to take responsibility for their gun, to safely store ammunition, and it may reduce or impair the impulsive aspect of suicide and homicide.

Mrs. Barnes: In the one minute I have left, I'm going to read in here... It was astounding to me - this is your brief actually, the Canadian Association of Emergency Physicians - that the risk of death from a firearm discharge in Canada is almost equal to the risk of death from a motor vehicle crash, 2.37 deaths per 10,000 firearms possessed versus 2.4 deaths per 10,000 registered motor vehicles in 1990. I just couldn't believe that. I thought car accidents, firearm deaths...just expand on that.

Dr. Drummond: There's not very much to expand on. The fact is that the numbers are there. In fact, even for the Reform Party members, its world-wide data... New Zealand has the same rate of death per number of civil firearms registered. Data are data, and data can be used whatever you want to use them. Nevertheless these data suggest that it's a significant problem.

[Translation]

Mr. de Savoye: Thank you, Mr. Chairman.

Mr. Simon, I was quite impressed by the numbers and graphs you provided.

It's clear there's a direct cause and effect correlation between the presence of firearms and the suicide rate in a given area. I think it's the first time that this committee has been given data showing it this clearly. I think we should all be grateful to you.

On page 11 of your brief, you had a certain number of recommendations that flow over on page 12. You have seven recommendations in all. Each one of these is interesting on its own: disseminate information, constant vigilance of authorities in enforcing regulations, making firearms inaccessible to teenagers and so forth.

None of those recommendations are part of the bill. Now, for my first question: Do you think those recommendations should be made part of the bill as distinct clauses?

Mr. Simon: No, Mr. Chairman, not necessarily.

In fact, we put those recommendations there because we thought it was important to make the members aware of those questions and also because we think Bill C-68 should finally be a tool to lead us even further. It provides leverage to help us go even further in the area of suicide prevention.

So, in effect, I think that as soon as we have legislation like that, we'll be able to do more to make people who own firearms more aware of things and finally to get them to store them according to very stringent rules.

Mr. de Savoye: Well, that does confirm what I thought your intention was - which is to help and encourage those who have to enforce the law to go even further to make it known and to make sure that the initial objectives are really attained.

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How does universal registration help us meet the objectives of your recommendations any more than the present system?

Mr. Simon: Okay.

According to our information, a lot of firearm owners, in extreme cases, don't even know where their firearms are stored anymore.

We think by making people more responsible and getting the message across that these are dangerous tools, there's a chance those weapons might be stored properly.

There are people who haven't used their firearms in a very long time and who don't need them any more. We think that thanks to Bill C-68, those people will reconsider why they had to own a firearm in the past. They might get rid of them and finally make our society one where the risk of suicide and homicide will be reduced.

I was here during yesterday's hearings when the Alberta Minister of Justice asked for evidence that Bill C-68 will decrease homicides and criminality.

Basically, I don't think that you, Members of Parliament, should consider Bill C-68 as one whose sole objective is to prevent criminality; you should also see it as a bill whose objective is to prevent suicide.

Mr. de Savoye: Actually, you're right. The bill should also, and maybe first and foremost, be seen as leading to better health and a decrease in violence and even crime like armed robbery and others.

So you think that registration will support and help attain the initial objectives set by the Minister of Justice, Mr. Allan Rock, at the very beginning?

Mr. Simon: Absolutely. I think the association I represent would not have supported universal registration of firearms if, in all Canadian homes, firearms were properly stored.

Mr. de Savoye: I understand your reasoning and I'm convinced that all my colleagues do too.

However, we know that the CMA doesn't show the same conviction you do. We have here, this morning, an ideal opportunity to have light thrown on the situation by parties with two different views.

So I'd ask the CMA to explain where the divergence is in their point of view, not concerning the objectives because I understand you're in agreement with them, but with regards to universal registration, and why your point of view is different from your colleagues', Mr. Simon?

I'm all ears, members of the CMA.

[English]

Dr. Walters: I guess we're subject to your plan, Mr. Allmand. I think what we're trying to do is maybe tease out in detail what would be the most effective route here.

As has been pointed out, we think the training and inspection programs and demands for safe use and storage are critical and can be improved. The compliance with that can be improved.

In preparing our background, I was struck by information from public health advocates in this field who think this is a very important problem. I've also been listening to the point of view of people who've been around guns, have been collectors and recreational users, etc. I have no particular bias. I have no guns and our kids have no guns. I'm not a hunter, etc.

But returning to the health problem, when we think of most of the deaths here - I don't know if you've consulted with Health Canada on this and made this a health program. From reading it, I suspect not.

If we were to address the health problem head on, I'm hearing from one side of the argument that even if we have our arms stored away and they're way up on the top shelf and the ammunition is somewhere else, it really takes just a minute or so to put this together. For someone who's in a despondent state, whether it's impulsive or not, this is still going to be available.

As we understand the legislation, you are not taking those guns away. I heard this morning, for clarification, that you are not even taking away the military assault weapons. You're prohibiting them prospectively, but not retrospectively. Is that correct? So there is still going to be that availability.

.1110

That's where I think we're trying to tease out what are the most effective things, that even though you still have all of those guns available... Although our colleagues may be correct, we don't know how many people will surrender their guns because we've thrown paperwork at it, we're going to have fees, etc. That may in fact happen, but we still suspect there's going to be a lot of guns out there.

To really be effective in intervening at that time I think is a much more complex problem than saying yes, you're now going to have a card in your wallet. I don't know how influential that's going to be. In the case where you have 100 guns, you're going to have 100 pieces of paper, as I read this information. That could be a deterrent; in fact, I would think some of the gun owners would get quite depressed about that.

Nevertheless, I think in saying whether all of that is going to be effective, we're just asking the question to make sure that if you're designing this thing, that you design something that works rather than something that isn't a huge, expensive computer with paperwork that doesn't address the health issue. I think that is the essence of what we're saying.

Dr. Drummond: Is it possible for me to make a comment?

The Chair: Yes. Just before you do that I'll go to Dr. Gallaway for a clarification.

I don't know, Dr. Walters, if you're aware of the provisions in the bill that deal with licences for possession. In order to get a licence for possession, mental health considerations are considered, and you also have to have two signatures of people in your community who will sign your application, as is now the case with the firearms acquisition certificate. But it will be broadened to all possessors. A person who applies who has a problem with schizophrenia or depression or whatever, as was mentioned, could be denied the possession certificate. Maybe they wouldn't be able to get two individuals in the community of Perth or wherever to sign because people know this person has a history of instability.

So when you combine the licensing procedures with the registration, it doesn't mean that everybody will have a possession certificate. It's a screening process whereby if you don't get the possession certificate you cannot have any guns registered to your name. I don't know if you understood that. You seem to believe that there would be no difference in the new system of proposed possession and registration, that everybody who has guns now would continue to have them nonetheless. Was that your understanding?

Dr. Walters: If you're asking me directly, I think it is a little confusing. If you're saying that not everybody will have a possession certificate -

The Chair: Exactly. They could be turned down for many reasons.

Dr. Walters: I see, you're just referring to those who are turned down?

The Chair: Yes.

Dr. Walters: I understand.

The Chair: So if a person has a history of instability -

Dr. Walters: Yes. I understood that if you could specify certain parameters there that were a risk, i.e., a serious mental health problem...

The Chair: It is in the bill.

Dr. Walters: That's right. But I'm not sure how many of those people are coming forward anyway.

The Chair: Dr. Drummond wanted to answer Mr. de Savoye's question.

Dr. Drummond: If I may comment briefly, everybody's having trouble with this whole issue of registration as it relates to... I'm not going to talk about criminality, but preventive aspects of health. It seems to me it's going to be a two-step process and you can decide which one should go. Ultimately, I think we're going to have to come to a medical reporting system of those individuals at risk. Not infrequently in emergency departments or in family practice offices in this country, as doctors here will attest, people will often come in and say that they are either contemplating suicide or there's a domestic violence situation, or somebody really crazy comes in and says they want to shoot all lawyers -

The Chair: That's understandable.

Dr. Drummond: In fact, maybe desirable.

Some hon. members: Oh, oh!

The Chair: I want to make it clear for those who read this record that you and I, Dr. Drummond, were laughing and we had our tongues in our cheeks as we said that.

Dr. Drummond: Absolutely. It's just a joke.

But I think the problem is when somebody comes in and they're frankly suicidal, there's an easy mechanism. They're committed on a mental health act and off they go to be looked at by the psychiatrist for x number of days. The trouble comes when it's not such a direct threat and it's just sort of rambling and you just don't know whether they're serious or not.

.1115

It's very nice, from an emergency room perspective, to say, gee, you know your domestic violence situation is getting out of hand, is there a gun in the house? While you get your problems resolved through conflict resolution, let's get the guns out of the house before there is escalation and a tragic event. While you're ruminating about suicide and dropping all kinds of hints to the medical profession, let's get the guns out of the home.

We need to develop a medical reporting system. In rural Canada there tend to be extended families and you can say to Aunt Mary, get his guns out of the house, and it's basically done. That doesn't always exist in urban Canada. It might be nice to have a system where, similar to drivers' and pilots' licences, those who are at risk have their licences removed pending resolution of their medical problem.

In order for that to be effective, you have to have universal registration. I'd raise that point. The medical reporting is not part of this bill, although it may be part of subsequent bills. Do you have the registration in place and then move to medical reporting, which is important for full implementation? Or do you bring in medical reporting and then registration? Reporting without registration is not going to be effective.

The Chair: There were others who wanted to answer this question, before I go to Mr. Gallaway.

Mr. Simon, you wanted to answer.

[Translation]

Mr. Simon: I only wanted to indicate to the Committee members that before reaching a conclusion with regards to the universal registration of firearms, the Association québécoise de suicidologie reviewed the literature referred to in the French document; you may have a look at it. In fact, these are mainly English-language publications. Therefore, there shouldn't be any problem. There are among others a 1993 publication by the Canadian Medical Association as well as The New England Journal of Medicine and most publications originate from the medical world.

What we find surprising in all these articles - and it is well demonstrated - , is that there is a decrease in the number of suicides among all age groups and sometimes more specifically among young people when the firearm legislation is more severe.

Thank you, Mr. Chairman.

The Chair: Dr. L'Heureux.

Dr. L'Heureux: I would just like to make a brief comment, Mr. Chairman, for Mr. Savoye's information. For all practical purposes, both positions are not incompatible. You are being told that the registration is part of the process and that, on its own, it might not have the intended result.

However, you have been presented with other somewhat important measures aimed at ensuring safety with regards to firearms. These people are the real experts; they work with people who commit suicide or who come to the emergency department. As I was telling you at the beginning, we should speak on behalf of a much larger group of people.

[English]

Dr. Fisher: I'd like to just make one more comment to elaborate on some of these similar issues and some of the issues my colleague Dr. Drummond addressed.

First, I'd like to address something Mr. Allmand mentioned with regard to screening. There is an issue that in fact screening may have to be even more detailed than it has been. As physicians, we know there are people with disorders such as personality disorders and other psychiatric disorders who can mask their disabilities very well. It may not become apparent unless they present themselves to a physician.

One recommendation we have made is that perhaps physicians should be references or be involved somehow in the screening process for firearms acquisition permits.

Moving on to the registration issue, I'd just like to elaborate slightly. You've heard that there are approximately 1,400 firearm deaths per year in Canada and many more firearm injuries. We, as the Canadian Association of Emergency Physicians, are not willing to continue to have Canada as the laboratory and Canadians as the subjects in this possible research project about whether or not registration will reduce the significant burden of deaths and injuries. It's costing 1,400 lives and up to $6.5 billion a year.

We have medical evidence, much of which has been presented by the suicidologists and many others, showing that decreasing the availability of firearms and increasing the restrictions are clearly associated with a decreased rate of homicide and suicide. We know there are data that probably up to half the firearms in homes have not been used in the past year or two. You've heard a personal anecdote about the truth of that.

This allows people to re-evaluate their need if they are required to have a permit. We know this doesn't just apply to handguns and assault rifles. The most common agents of death are the .22 calibre rifles and 12 gauge shotguns. If you re-evaluate your need, they are less available for the impulsive acts we've heard about from the suicidologists. We know that in domestic disputes these are impulsive acts.

.1120

The availability of firearms, if they are not stored safely and if they are perhaps issued inappropriately, will result in higher rates of domestic deaths. We know and we've heard anecdotally, again, that if we legislate these things, then there will probably be an increased compliance with the safe storage provisions.

Dr. Drummond has mentioned that, from our point of view and particularly from a research point of view, we need a national database for tracking the kinds of firearms used, the physical and social environment, the demographics, how we can prevent this in the future and the kind of research we can do. We need a system, such as registration, on a national level to collect this kind of data.

I drive a car and I'm a law-abiding, licensed car driver. I'm quite willing to abide by those laws and pay my registration fee. I think that law-abiding, responsible gun owners - and the Canadian Association of Emergency Physicians feel that law-abiding, responsible gun owners - are not really asked to do anything particularly onerous by licensing their firearms in the greater interest of the health and safety of all Canadians.

Last, I would just like to mention that we also know that the registration of firearms will probably help track the illegal movement of firearms. We know that a great deal of firearms are stolen every year. We know that illegal firearms are most commonly used for suicide and homicide and perhaps even criminal activity, although that's not our field.

In summary, we do strongly recommend that registration should be part of the package. That's the point of view of the Canadian Association of Emergency Physicians.

The Chair: I appreciate the answers that were given, all to Mr. de Savoye's questions.

We have limited time, so I would ask the witnesses, in answering, to.... I don't want to admit there are other people who have specific questions.

Before we go to Mr. Gallaway, I just want to refer you to clause 5 of the bill, which is on page 5. It says that in granting the licence to an applicant, the firearms officer has to consider whether the person:

(b) has been treated for a mental illness, whether in a hospital, mental institute, psychiatric clinic or otherwise and whether or not the person was confined to such a hospital, institute or clinic, that was associated with violence or threatened or attempted violence on the part of the person against any person;

I don't want you to respond now, but that's part of the screening process.

Mr. Gallaway (Sarnia - Lambton): I would like to address my questions to Dr. Walters.

Certain jurisdictions in this country have reporting procedures for doctors. For example, in Ontario, if a physician suspects that child abuse is taking place, there's a statutory requirement for that to be reported to certain authorities.

In certain jurisdictions, a physician, under the highway traffic act of that province, may have to report to the registrar that an individual who is in possession of a valid driver's licence is no longer capable of driving for certain medical reasons. Blindness is one that would come to mind. I shouldn't say blindness, but reduced or impaired vision.

Speaking on behalf of your association, would you then have a problem reporting an individual to authorities who was, at one time, a legal, law-abiding gun owner, but who, for whatever reason of a medical nature, should not have a gun? Would you have a problem doing that?

Dr. Walters: I think I'd like to refer you to page 7 of the brief. This, again, is a fairly complicated area. We think a lot can be done in terms of clear guidelines and procedures in this area.

For instance, the CMA wrote the guideline book for the drivers examination, which you may be interested to know. We circulate it to all new members, etc. It has been the standard guideline for assessing drivers' health.

When you get to blindness, again, there's an example. There are a number of guidelines and sub-guidelines for legal blindness. It gets a little complicated and requires a detailed examination.

For instance, if you're going to turn down a truck driver in terms of his ability to earn a living on the basis of visual criteria, you have to be very specific.

.1125

You can be fairly specific with some of those medical conditions, such as are eyes working or not. But now you take that to the example you brought up, the area of mental health. Are there very clear guidelines at the present time to say whether that person should perhaps drive or own a gun or do whatever? We do not have those guidelines at the present time. We have consulted with the Canadian Psychiatric Association because we see the work possibility here. They have endorsed our brief.

We indicated those points you will have to have. You will have to delineate clear guidelines and procedures for identifying patients at risk for violence or suicidal behaviour. Is it a legal or a voluntary requirement to report these patients to the authorities? All of those questions have to be sorted out, as for the driver's licence.

What are the responsibilities of the agencies that receive this confidential information? What happens then? Is this the police? Is this the judicial system? Who gets this information and what do they do with it? They may not operate under the same levels of confidentiality as the medical system does.

Then, what about explicit protection of physicians from liability if they do have to report this? We've covered that in the brief and have thought about this in a fair amount of detail. Rather than giving a simplistic answer, again, there would be a lot of work to do here. If you think of this for 55,000 physicians, some of whom are emergency physicians, some who are psychiatrists.... Some are the family physicians who may be put in the onerous position of doing this assessment and examination for all the patients in their practices in rural areas where there are a lot of guns. You really have to think about this before we get into it.

That's the long answer. Sorry.

Mr. Gallaway: Dr. Drummond, I just want to draw a comparison. I believe you made reference to The New England Journal of Medicine. One of the great problems in this whole exercise we've been going through is that a number of witnesses have appeared before us and referred to experts as being biased.

Recently we had a group represented by a medical doctor from Ontario who was their spokesperson, and in his brief he said, ``The anti-gun editor of The New England Medical Journal, Jerome Kassirer, publishes these biased, result-oriented studies in an otherwise reputable medical magazine''. Do you agree with him?

Dr. Drummond: I don't know the editor of The New England Journal of Medicine, but I suspect he's an honourable fellow. Most reputable journals are, in fact, peer-reviewed. It's not the opinion of one individual but of an editorial board. There was ample opportunity for questionable studies to be refuted in subsequent literature. In fact, that was not done. I guess I do disagree.

Mr. Gallaway: The other thing that this Dr. Sobrian stated when he was here is that suicides are not impulsive acts. Would you care to comment on that?

Dr. Drummond: Yes. That's nonsense.

Mr. Gallaway: Thank you.

The Chair: Mr. Mishara, did you want to comment?

Prof. Mishara: The thought of suicide is very common. Most Canadians think of killing themselves at some time. Very few actually attempt suicide. People who do kill themselves have certainly thought about it over a long period of time. Very few who have thought about it actually pass to committing an act of suicide.

All the research we know to date indicates that the presence of a lethal, available method increases the risk. People commit suicide when it's really bad. There are studies of people who tried to jump off the Golden Gate bridge and were stopped. The next day they were out on the street again, and 24 hours later they did not head for another bridge or go buy a gun. The delay - any delay in access - during a particularly stressful and difficult period has the effect of reducing the number of suicides.

So the important question is will this legislation delay access for a number of Canadians to lethal means? If the answer to that question is yes, then we can predict, on the basis of virtually all known studies, that there will be a decreased number of suicides. If this legislation decreases the number of homes in which there are guns available, on the basis of all research to date I would predict that we would save lives. If this legislation ensures that more firearms are correctly stored, then this will also save lives, because not only the owner, who has the key, is the potential victim but perhaps his adolescent son, who may not have the key and may not have access.

.1130

What is the value of the life of a Canadian when compared to the inconvenience and cost of any proposed measure? That's something I leave to your wisdom.

Mr. Hill: I'd like to direct my comments to my emergency colleagues. Much of your brief has reflected upon suicide, as have our other colleagues. Just so that we can set suicide into a frame of reference, we're talking about one-third of suicides in Canada. We sometimes lose sight of the fact that firearms suicides are one-third. So when we talk about firearms, this is a very serious and significant portion of suicides but by no means the major one.

Most of your suggestions have reflected upon safe storage, the gun and ammunition being separate, the difficulty of somebody having access to the weapon, screening individuals so that if you have risk this screening will flag that risk, and education for firearm safety. Those things are all currently present in the legislation we have.

As you know, that legislation is new legislation. It has not had time to go through the process. There is still a significant number of individuals who have not got a new FAC, if they had one.

The difficulty with the new legislation is that registration of every individual using a firearm is not required. Since the new legislation has all the things in it that you have suggested - and, Dr. Drummond, you suggested there should be registration as a means of reducing accessibility - would you think that licensing versus registration of every firearm would be as effective?

The Chair: Dr. Drummond, with respect, in the present legislation while the firearms acquisition certificate is a screening process, it only applies to those who acquire arms from the time of the FAC. In the bill, the process for the FAC is applied to all possessors, so -

Mr. Hill: I was going to get to that.

The Chair: I thought you left the impression that the whole screening process is now in place. It isn't in place. It's only in place for new acquisitions, whereas the bill will apply it to all possessors.

Dr. Fisher: With respect to that question, when you raise the point that we don't currently have a comprehensive screening program, to that extent registration will affect the accessibility.

I mentioned earlier that we believe the registration process continues to have the owner re-evaluate their need for the firearm and therefore may reduce accessibility if firearms are no longer needed in that home. You did mention that firearms accounted for 30% of suicides, but in fact, to keep that in perspective, that is the most common method still and it does account for 80% of firearm deaths.

We also mentioned that one of the objectives we have is to have a comprehensive database so we can continue to track this problem in a scientific way and therefore decrease deaths for which the primary source is suicide. So to that extent we still -

.1135

Mr. Hill: You really haven't answered my question. Do you think licensing of every individual who wants to have a firearm in Canada would be a reasonable step rather than registration of every firearm?

Dr. Drummond: Dr. Hill, in fact Dr. Fisher probably just did answer your question in a sense, from the point of view of what you're saying as a physician and scientist, which is show us the hard data, show us the science. It's very difficult, as you know, to get hard data from a Canadian perspective.

What the CMA is doing by hedging their bets on their comment with regard to registration is saying we need more science. In order to have more science, you need to have registration to know which firearms are where and doing what. That's the first thing.

In your question and in your summary of our association's recommendation, you also omitted to mention the concept of medical reporting. I will refer to my original comments with regard to the linkage of reporting of those individuals at risk who present to Canadian emergency departments and the need to have knowledge of whether or not there are firearms in the home.

Mr. Hill: You know of course that is not in Bill C-68 as it is not in the legislation.

Dr. Drummond: Exactly, but I know as a young parent you have to walk before you can run. There's no point in having a medical reporting system in place until you know who has what guns in which home.

Mr. Hill: All right. We disagree on that.

Dr. Drummond: I guess we agree to disagree.

Mr. Hill: In your document on 3.110, you noted accurately that the majority of firearm injuries in Canada are caused by legal firearms. Then the majority of firearm injuries would not be changed by registration unless the registration, as you hope, will reduce substantially the number of firearms there are. Fair comment?

Dr. Fisher: Not necessarily; just to the extent that they're used more responsibly, to the extent that they're stored more responsibly, to the extent that they're less available to impulsive people who are prone to kill themselves or kill another in their family. To that extent, it's our opinion that when we have reviewed the data currently available that in fact that does help.

Mr. Hill: Could I go to international statistics on suicide, the specific statistics. Because it's easy to do a small analysis, if you look at the country-wide analysis we find that...and the two countries I'd like to compare are Finland, which has very restrictive firearms legislation, and Switzerland, which does not. Switzerland has very lax legislation and in fact encourages people to use firearms. These are the two countries that have the highest suicide per 100 000 in the world. Because they are so dramatically different in the way they handle firearms, and so similar - the numbers are exactly the same; they have 25 suicides per 100 000 with firearms. How would you explain that divergence?

Dr. Drummond: I wouldn't. I've never been to Finland either, and even if I lived in Finland I'd be awfully depressed. The fact of the matter is we just need to look at the domestic situation, and I've alluded already to a very tightly regulated segment of Canadian society where firearms are very tightly regulated and yet you don't see the same level of firearms-related violence as you do in Canadian society at large.

Mr. Hill: I just gave you refuting evidence.

Dr. Fisher: One other comment then on that evidence. From the information we've seen - and my colleagues who deal with suicide may have more information on this - in fact when you compare international trends as a whole, decreased availability does correlate with decreased homicide and suicide. In this example, if it exists - and I haven't evaluated their data in detail, and if that's their data, that is an aberration from all international data.

[Translation]

The Chair: Mr. Simon.

Mr. Simon: You're quite right, an important study was conducted by Killias, and this study was in fact published in the Canadian Medical Association Journal in 1993. It is entitled International Correlation between Gun Ownership and Rates of Homicides and Suicides in Switzerland; this study compares data from several countries. We mention it on page 18 of the bibliography of the French brief we have submitted.

In the light of the various international studies that were conducted, this paper shows, through a comparison study of various countries, that strict arms control has an impact on suicide attempts. In the end, the stricker the control, the less we see suicides by firearms and suicides in general. They come to the same conclusion as we do.

.1140

[English]

The Chair: Before I call on Ms Torsney, because Dr. Hill put it on the record, I have recently been in contact with the Swiss government. I have in my hands a document from the embassy of Switzerland. Because they were concerned in Switzerland with the abuse of firearms, they have a new law that will go into force at the beginning of 1996 to put a much stricter control on guns in Switzerland. I'm willing to distribute this to all committee members if they wish.

Mr. Ramsay (Crowfoot): I'd like a copy of that.

Ms Torsney (Burlington): First of all, I've been very particularly interested in the experts on trauma, emergency and suicide, especially with regard to your comments on safe storage and the choice to keep a gun.

I've certainly heard from a lot of my constituents that they do have guns they bought for their sons when they were fifteen and interested in hunting. Ten years later they're not even sure if the guns work and if they're interested in them. This legislation will force them to make a decision about keeping those guns. Perhaps it will have some impact on the rest of their children's lives.

I've also been interested to hear that you really care about the one-third of our young people who commit suicide who choose to use guns and that you are trying to work those numbers down more significantly. I think those lives are certainly very valuable. It concerns me greatly that it's particularly young men who are going through a difficult time in their lives who choose to use guns because they're available. Those young people could become very productive members of our community.

I wanted to ask both groups how you come to your decision-making process. I'm interested in knowing if you consulted particularly within your organizations on the aspects of domestic violence and on women's issues within the organizations.

I imagine the CMA has certainly done some work on trying to reduce domestic violence. What input would that committee or that group have had into this final position you've made? I also want to know from the CMA, after you've listened to the experts on suicide and emergency, if somehow you're not a little more sold on the concept of registration. Please clarify if you are in fact against registration, or if you're not completely sold, which is a different position from being completely against it. I've left a number of questions on the table and hopefully they'll get answered.

The Chair: Who will speak first?

Ms Torsney: Dr. Drummond can speak first.

Dr. Drummond: Thank you for your question. In fact, I'll let Dr. Fisher answer the first part of that question.

Dr. Fisher: I'm sorry, you'll have to repeat the first part, because I'm now confused.

The Chair: Maybe we should go on to the second part.

Dr. Drummond: With regard to how it came to be, you may be interested to know that the impetus for this arose in 1991, when Dr. Ron Stewart returned from a life in the United States to become a Liberal politician in rural Nova Scotia. Dr. Stewart was an emergency physician. In fact, he was one of the world's honoured founders of emergency medicine and had lots to do with development of emergency medical systems in the United States. He brought some of that expertise back to Canada.

There were several members of our physicians' association who were trained in emergency medicine, because emergency medicine in the United States preceded emergency medicine in Canada as a recognized specialty by about ten years.

They all brought back the same concerns. They've come back to Canada because Canada's a better place to live. They sensed that guns were a major problem in the United States and they did not want Canada to become a northern version of the life they had experienced in the emergency departments of Denver, Chicago and New York.

There was correspondence to our association suggesting that we become involved in injury prevention, particularly firearm-related injury. You must understand, emergency medicine is a relatively young specialty. It's only twelve years old. It took us ten years to get our act together with regard to training standards and education, and so on and so forth. For us, injury prevention has been a relatively new endeavour.

Nevertheless, with a response to several cries for assistance, if you will, from emergency physicians, both rural and urban, we elected to endorse the broad goals of the Coalition for Gun Control in 1993.

.1145

With regard to the development of this particular position, it is our feeling that in large measure the medical literature speaks for itself. This is the experience of physicians from around the world, which all points to the same things. It has been endorsed by our board and is presented to you now.

Dr. L'Heureux: Mr. Chairman, I want to answer two aspects. The first one is that we did consult the gender issue committee, which is addressing all the things that could happen to women in our society.

The other answer to your question is that we have expressed the opinion of the CMA. We are not here today to necessarily change your minds or that kind of thing. What we did, as I said before, is we went through a due process that arrived with the conclusion we have presented today.

[Translation]

The Canadian Medical Association is not a static organization; it is obvious that, as this notion of domestic violence and firearms acquisition progresses, the Association will be re-examining its position. However, for the moment, you understand that these are opinions which, as I was saying before, are not irreconcilable.

The only thing we warned you against was registration itself, the fact that having an additional piece of paper in your pockets may not be the only solution. Our colleagues told us that, for them, if there is registration and a reduction in the number of available firearms follows, it would have an effect.

The Chair: Mr. Simon!

Mr. Simon: The Board of Directors of our association is made up of members who head suicide prevention centres throughout the province of Quebec, including obviously and mostly outlying areas, rural or semi-rural. It is as a result of our thoughts on firearms suicide over the last year that we are filing this brief.

The Chair: Mr. de Savoye, you have five minutes.

Mr. de Savoye: Thank you, Mr. Chairman. I would like to bring certain matters to the attention of Mr. Simon and Mr. Drummond, in order to get their reactions. Mr. Walters was deploring the fact that the bill didn't take into account medical concerns. Moreover, Mr. Drummond, you suggested the advent of what you termed a «medical reporting system». However, I say that the advent of such a system, in the same way as the implementation of all the AQS' recommendations, can be carried out separately from Bill C-68, which does not provide for anything anyway concerning these matters.

Mr. Simon also stated before that the registration of firearms' owners would allow the government to send information directly to the firearm owner and that this would have a greater impact than T.V. advertisements aimed at the public at large.

I would also like you to think about two other elements: the campaign against drunk driving was aimed at the general public, not only car drivers; secondly, the spouse of a firearm's owner who is suffering from psychological troubles must be aware of the preventive measures available to her and she will not be able to do so if the owner is the only one who has been informed.

Mr. Simon, the correlation that you have shown us indicates that the suicide rate in an area is directly related to the presence of firearms in that area. But I would say that firearms registration will not reduce the presence of firearms in an area and quite likely will not therefore reduce the suicide rate.

I'd like you to react to those statements and tell me your viewpoints, starting with Mr. Drummond and then Mr. Simon.

.1150

[English]

Dr. Drummond: Thank you for your comment. Again, I think inevitably there will be the development of a medical reporting system. The reason we're all here today is there have been some fairly high publicity situations where there's been inappropriate use of a firearm by a person who otherwise, in retrospect, would have been at risk and could have been clearly identified as being at risk of firearm misuse.

Again, a medical reporting system without adequate registration or inadequate knowledge of who owns the gun and where the gun is kept will not work.

Second, as pointed out by Dr. Fisher, what we're also looking for here is hard data and science. The hard data and science cannot be in existence without hard registration data. So if we're going to have a national firearms registry - which is not part of the bill but I think ultimately should be - we're going to have to have science.

Your comments with regard to education are well taken. I think to isolate registration as being the saviour of the misuse of firearms in this country is probably inappropriate. There will have to be broad educational endeavours with regard to domestic violence, conflict resolution.

[Translation]

Mr. Simon: True, considering campaigns aimed at the general public, such as the one against drunk driving, I don't know if the government is ready to start up that kind of campaign concerning firearms; I'd be surprised if it was. And I think that there are more car owners in a country than firearms owners and that the type of publicity you want depends on the people targeted.

In our opinion, universal registration will in effect include people who aren't hunters; you have to understand that there are many more firearms than hunters presently in Canada. So there are people who will go and sort out their hardware, their artillery, who will check, basically, to see which firearms they use; we think that universal registration of firearms will in effect lead people who don't use those firearms any more to get rid of them; therefore, there would be a reduction.

Obviously, Bill C-68, if there is no other emphasis on storage, would end up being, in my opinion, insufficient. But it gives up the possibility to go further. All the studies show that, when you strengthen firearms legislation, there is a decrease in firearms suicide rates and, as a result, of suicide rates in general. Add to that the people who will get rid of their firearms; I think that yes, there will a decrease in the number of suicides in Canada, thanks to Bill C-68.

[English]

Mr. Bodnar (Saskatoon - Dundurn): It's a pleasure having heard the information you have given to us today and your concerns for the bottom line, the concerns for human life and how to help preserve it for people in stressful situations.

It's such a good contrast to some of the other information we've heard. In particular, one that comes to mind is where a person was concerned about gun legislation affecting the population of animals, that we will be overrun by deer, bear and wolves. It's nice to hear people concerned about human life rather than about the populations of wolves and bear.

With respect to the CMA, I really don't have questions so much as a comment. Reference has been made by Dr. Hill with respect to the one comment you had about not being convinced about registration. I realize in your brief that the CMA agrees with the intent of our legislation...where you indicate that with the intent of the legislation to tighten import-export and transfer controls and also to require training and inspection programs for safe use and storage.

I simply wish to remind you that such an endorsement is very much appreciated, but such an endorsement is hollow unless we have the tools to work and put that into effect. The tool for controlling transfers, for inspection and safe use is registration. Without registration, transfer controls are impossible, and without registration, inspection would be virtually haphazard. I simply indicate that to you, and I would ask you to revisit that particular clause in your brief.

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Other than that, I really don't have any questions.

The Chair: Is there any comment in response?

[Translation]

Dr. L'Heureux: The only comment I want to make is that, as we stated initially, our expertise is in health care in Canada and not in the means to be used to strengthen legislation. I think that is the work of the people who represent us in Ottawa and that we will let you do that part of the work.

[English]

Mr. Hill: I'd like to direct my comments to Mr. Simon, if I could.

You made an impassioned plea, and a plea that I really appreciate, about the suicide patient who is ambivalent, who has not made up his mind to commit suicide. That's 100% true. But you went on to say that most guns used to commit suicide are owned by another. I'd like you to connect the fact that the gun is owned by another with registration. How would registration help when it's obvious that the suicidal patient is picking up someone else's gun?

[Translation]

Mr. Simon: Once the government, our civil authorities, knows who owns firearms, I think that's an element which leads firearms owners to act more carefully concerning their firearm and that it leads them to comply with the legislation in force concerning those firearms. So, if I had a firearm and if I knew that the government knew that I had a firearm and that the said firearm was not stored properly, I would be afraid of it eventually coming back to haunt me. Therefore I would make sure that it was properly stored.

Presently, we don't know who is a firearm owner; therefore, they can easily store their firearms the same way as my tennis racket, in the back of their closet without locking it. I think that registration will have a coercive effect on firearms owners.

[English]

Mr. Hill: You do know, and I'm sure you know, that Canadians must store their weapons safely, that the legislation is there. The gun must be locked. The ammunition must be in a different locale. There must be a trigger lock. The bolt in a rifle must be removed. Since those things are currently in the legislation, how will more legislation make people more responsible? This must be complied with. You would have to have 100% compliance. Could you explain to me how registration would change the mind-set of those who today do not store their weapons safely?

[Translation]

Mr. Simon: Listen, some legislation leads us to do certain things, things that you don't do when it's possible to remain anonymous. Presently, firearms owners are anonymous. We don't know who has one. How can you be afraid of controls if nobody knows who has firearms. Once this is known, once the government knows of the existence of our firearm, that we own it, I think that it will be the owners' interest to comply with the act.

And I'd like to reiterate that if firearms were correctly stored, we could avoid 30% of suicides.

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I guess that fathers and mothers who own firearms in Canada would store them if the department could tell them that these firearms represent indeed a more serious threat to their safety than many other household items and that they would then make sure to store them properly.

[English]

Mr. Hill: Finally, because cost is a factor in many things we do, and you must look at suicide in the overall perspective, if you had to choose between spending money on more suicide prevention mechanisms, like advertising and programs that involved 1-800 telephone numbers that were more available in the rural areas, would you spend that money on preventive means for suicide overall, or would you spend it on registration of firearms? You have to make that choice.

[Translation]

The Chair: The Minister has said that the owner of a firearm must pay for the interim system.

Mr. Simon: I will answer to Mr. Hill that currently, a good number of organizations work at suicide prevention across Canada. The lines you mentioned already exist. They exist in Quebec, everywhere across Canada, and even maybe in your region. Some services are already in place. Suicide prevention is not achieved only through firearm control. That control is just another element of prevention. At the beginning of my presentation, I talked about concerted action, saying that we could all join forces in preventing suicide. I manage an organization which operates emergency telephone lines, deals with suicide prevention in the Saguenay-Lac-St-Jean region. You have to raise awareness, you have to be trained with professionals who meet young people in schools, who meet groups at risk; a lot has already been done for suicide prevention, Dr. Hill. What we ask is for you to contribute to suicide prevention by adopting a legislation that will make access to firearms more difficult.

[English]

The Chair: I understand that Dr. Drummond and Mr. Mishara want to answer the question too. I would ask one from each organization to answer.

Mr. Hill: I'd love to come back to that, if I could, Mr. Chair.

The Chair: Sure, you can in a further round. You have no more time now. There'll be time to come back.

Dr. Fisher: I want to address the issue of cost that was mentioned. First of all, there are data that this might perhaps be a $6.5 billion problem per year in Canada. It would seem a cost that is borne by the responsible owners is not excessively onerous for a $6.5 billion problem.

On the issue of education, we know there's a plateau, a limit, that education and prevention programs will reach. After that, there are other public health measures that are probably necessary.

When you also focus on the domestic abuse and homicide situation, physicians and probably most of the public are aware that this is usually an escalating problem. It happens over time. There are a number of episodes of abuse over a very long period of time before a spouse may in fact try to kill the other spouse or another family member.

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With the mandatory reporting system, if the firearm was registered and a physician became aware of an escalating situation in a domestic context, it would seem he would have the tool to remove the lethal weapon from that escalating situation. To that extent, registration is the necessary tool.

Prof. Mishara: As a researcher, I can say this is not a controversial issue. Virtually all the studies have indicated that any efforts to further control access to firearms have resulted in a significant decrease in deaths by suicide.

One study in Toronto that initially found there was a compensatory increase in hangings was re-analysed using better methodology, and it concluded that control of firearms resulted in a decrease in suicides.

I don't think we have that convincing a research base in many areas, in terms of suicide prevention up until this point. Registration will have an effect only if there are fewer homes in Canada that have firearms after this legislation is passed. But it will also have an effect for another reason, even if it doesn't affect the number of homes that have firearms.

That is, any step that results in some form of delay in obtaining a firearm is likely to decrease suicides. For people who are in great distress and ready to kill themselves, anything that drags out the time a little bit longer before they procure the method - going and getting signatures from someone else, filling out a form, having to go somewhere - is likely, based on everything we know in the research, to result in the saving of lives.

The Chair: As chair, I have a few questions. I also have the names of Mr. Wappel and Mr. Lee, and we still have time to get to those.

Several witnesses who've come before this committee have trivialized the suggestion that stricter control of guns might reduce suicide. They've generally said, well, you make a stricter control on guns and they'll kill themselves with pills or they'll hang themselves and so on. This morning you've dealt with the question. You say the research indicates they don't usually go to another means.

I want to go to another matter as well. Is it not correct that the success rate of suicide with a gun is much higher than it is with other methods like pills, hanging, and carbon monoxide. I'd like Dr. Drummond and Mr. Simon to comment on that. Dr. Drummond, I think you mentioned very quickly how you might be able to save people from some of these other methods. Have you any hard information? Let's say people tried to commit suicide with pills, or in a garage with a car running, or by hanging.

Dr. Drummond: Yes, they try with all of those and more. The lethality of firearm-related suicide attempts is 92%. With intentional exposure to carbon monoxide, it's 78%. With hanging it's 78%, and it's 67% for drowning. Is it approximately 30% with an overdose of drugs?

Dr. Fisher: I think it's about 23%.

Dr. Drummond: It's 23% with a drug overdose.

[Translation]

The Chair: Mr. Simon, do you have more or less the same information?

Mr. Simon: Yes. It would seem that the highest rate of lethality is that of firearms. One must think that if access to this means of suicide is more difficult, we have chances of finding a solution in the meantime. It is clearly stated: time is one of the essence in suicide prevention. Therefore, if it takes longer to get a hold of a firearm, all the better!

Moreover, we know that attempted suicide by people using another means, have a lower success rate. People will try to commit suicide using other means, but the success rate will be much lower. Therefore, we will save lives.

[English]

The Chair: To complete this, I presume the emergency physicians in Canada are, from time to time, treating people who've attempted to commit suicide. They've been taken to the hospital. They've been found with an overdose of pills, or they've been found unsuccessfully trying to hang themselves, and you try to save them. Maybe you try to save them with gunshot wounds too. You've given us the rates of success.

Mr. de Savoye, do you have a comment?

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Prof. Mishara: May I just add one piece of data that we didn't put in our memoir? One out of ten people still survive attempting suicide with a firearm. There's one study, I know, from England, that determined that of those who shoot themselves and afterwards do not die immediately, or become unconscious, almost 50% were able to get to a phone and call for help - meaning that they wanted help and would like to have changed their minds. A certain percentage of those people died later on despite the help that was received. It didn't get there in time or whatever. But the fact that someone even uses a dramatic method, like shooting themselves, does not mean that they do not want to be saved, and if they are saved, that they do not want to go on living.

[Translation]

Mr. de Savoye: This morning, we have had very interesting presentations. It is certainly one of the most productive sessions in terms of information and I thank you. However, I noted a while ago that we have talked a lot about suicide.

It may be because we have experts on the subject. The firearms problem is not limited to suicide in the health area. It also has to do with injuries and domestic violence, among other things.

I would like the Canadian Medical Association, and also Mr. Drummond and Mr. Simon, to tell me whether, in those other areas, there is also a correlation between the presence of firearms in a region and the level of injuries and domestic violence. In other words, is what we have been saying on suicide equally true in other areas having to do with health? Please.

Dr. L'Heureux: Mr. Chair, the availability of firearms in a region is linked to an increase in suicide rates, homicide rates and non-intentional injury rates. You are right to link availability of firearms to domestic violence. It is something that we have been able to verify. The more firearms, the more dramatic are the consequences of domestic violence.

[English]

Dr. Drummond: It's still the same response.

[Translation]

Mr. de Savoye: Thank you Mr. Drummond. Mr. Simon.

Mr. Simon: Yes, we have mostly studied suicide prevention and suicide by firearm, but I know of other scientific research which show that, in fact, there could be a link between availability of firearms and homicides.

Mr. de Savoye: Mr. Mishara, I think that in your brief, you had some numbers on this.

Prof. Mishara: We don't have any numbers on other types of violence in our brief, but from what I've read on that subject, there is clearly a link that is demonstrated in the literature.

Dr. L'Heureux: Dr. Walters could give you some other data.

The Chair: Dr. Walters.

[English]

Dr. Walters: This is information that you already have from the Canadian Centre for Justice Statistics, which has a very good document on spousal homicide. I think we would be remiss if we didn't recognize in spousal homicide that domestic violence is the precursor and spousal discord is the precursor to this. It is very important to consider. This is interesting stuff, and in analysing this for a health program there are certainly some very definite risk factors that one would want to be aware of.

The aftermath of a separation, a break-up of a marriage, is obviously a very threatening and a very difficult time for everybody. Men are extremely upset in this, although perhaps they don't show this as emotionally as women sometimes. The result is that they perhaps brood, cover this up, and then there is the consideration of violence, whether it be against themselves or, very often, against the spouse.

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We have some excellent risk factors here. It's far greater in common-law than in registered marriages. Teenage wives incur the greatest risks of being killed by husbands. These are things that the astute medical practitioner or other health care practitioner, be it a psychologist, suicidologist, social worker, etc., should be aware of. That information, I think, is critical in considering the domestic threat, particularly to women, who incur the greatest proportion of being homicide victims.

[Translation]

Dr. L'Heureux: Mr. Chairman, there are now 40% of women killed by firearms.

The Chair: Mr. De Savoye.

Mr. De Savoye: I would like an additional piece of information, if one of you has it: Regarding those 40%, do you know what the situation is region by region, in terms of the availability of firearms per thousand inhabitants in a given area?

Dr. L'Heureux: I can't give you a precise answer, but that information is in that same document from Statistics Canada, which says that the number of spouses killed varies from region to region. If we link this with what Mr. Simon was saying earlier, we realize that the percentage of spouses killed is higher in the areas where there are more firearms.

[English]

Mr. Wappel (Scarborough West): I too have found this morning's testimony very interesting and very helpful. I'd like to really concentrate simply on suicide, and I address my questions to the Canadian Association for Suicide Prevention.

How many suicides were there in Canada in 1991?

Prof. Mishara: I don't have these statistics memorized.

Mr. Hill: There were 1,119.

[Translation]

Mr. Simon: In 1992, there were 3,709 suicides in Canada. As far as I know, this is the most recent data available.

[English]

Mr. Wappel: Great. We'll concentrate on the most recent data. Out of those 3,709, how many committed suicide using a firearm?

[Translation]

Mr. Simon: One thousand and forty six. More than a quarter.

[English]

Mr. Wappel: Is this across Canada?

Mr. Simon: Yes.

Mr. Wappel: Do you have any figures, let's say, for 1972, from 20 years ago?

Dr. L'Heureux: In 1972 there were a total of 505 homicidal deaths, 203 by firearm, which constitutes 40.2%. For suicide it was 2,657. Of these, 935 were by firearm for a percentage of 35.2%.

Mr. Wappel: I'm sorry, I lost those figures.

Dr. L'Heureux: Suicide was 2,657, of which 935 were by firearm, which constitutes 35.2%. That's from 1972. You asked for 1991?

Mr. Wappel: I'm just looking for a comparison; 1992 is fine. I don't know how you calculate this rate. Is it per 1,000 or per 100,000? Would they be similar in 1972 and 1992? For example, would the 2,657 suicides in 1972 represent approximately the same rate per 100,000 as in 1992, of 3,709?

Prof. Mishara: The suicide rate is presently lower in Canada.

Mr. Wappel: All right. Can you tell me what the rate per 1,000 or 100,000 was, whatever the calculation is that you use, for those two years?

Prof. Mishara: I have different years, so maybe someone who has those years could respond.

In Canada, both sexes - for which years?

Mr. Wappel: For 1972.

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Prof. Mishara: In 1972, the overall rate was 11.9.

Mr. Wappel: Per how many?

Prof. Mishara: It was per 100,000. Actually, the overall rate is higher in 1992. It's 13. During that time, it's gone up, it's gone down. It varies little from year to year.

Mr. Wappel: I'm trying to find out if there were more suicides per 100,000 people in 1992 than there were in 1972.

Mr. Simon: That's right.

Mr. Wappel: Yet, suicide by firearm has gone down by 10% in the span of twenty years as far as the totals are concerned.

Prof. Mishara: Yes.

Mr. Wappel: And in that twenty-year span there has been an increase in the controls exercised upon firearms.

Prof. Mishara: The studies of the rates in the eight years before Bill C-51 and after indicated a decrease, but when one considers this you have to look at the age groups and the sexes that use firearms.

Firearms are a method preferred by men, men who are in certain high-risk groups, aged 30 to 40, and who are adolescents and young adults. Suicide has gone up among men, and among the elderly in Canada, who constitute one of the highest risk groups. Elderly people in Canada don't usually use firearms as often as other males do. If we look at females for the same period, the suicide rate went down. You're right.

When one does a study like this, one looks at different age groups and the people who are at risk of using those particular factors. The research studies that compared before and after legislation found significant increasing trends before the legislation and either stable or decreasing trends after. Also, a rate of one per 100,000 is not a dramatic change over a period of twenty years.

Mr. Wappel: In your brief, you indicate that only in a minority - 3% - of successful, complete suicides were handguns employed, if one can use that term successful.

Prof. Mishara: We use the word ``completed''.

Mr. Wappel: Only 3% of completed suicides are by handgun. Have you done any studies to try to indicate why that is?

Prof. Mishara: People have speculated. There are no research studies on it. We can't ask the people why they used a long gun or a handgun after they've died by suicide. Those people who have reported on it suggest that the small number of suicides by handgun in Canada, in comparison with the United States, is due to the lesser availability of handguns in Canada.

Mr. Wappel: Thank you.

Dr. Walters: I'd like to reinforce that last comment. I think the availability of handguns is clearly much higher in the United States. Therefore, a much greater risk is presented. They are used in homicides and suicides.

Clearly, I think the effective part of the bill will prohibit many classes of handguns. This will have a big effect. I think that's what this statistic reinforces. We are less prone to using handguns. We traditionally have the long guns here for hunting, and that's where most of the problem is. If we get into the wide distribution of handguns and easy access, then we're importing a problem we don't need. Perhaps we can argue for this legislation in the United States. That would save a lot of lives.

The Chair: Dr. Hill, you have five minutes.

Mr. Hill: I'd like to refer to the overall suicide statistics that were just mentioned. The overall suicide statistics have climbed since 1972. There are some tiny dips in the process. They've climbed from about 12 per 100,000 to the current 14 per 100,000. The proportion of firearm-related suicides is virtually unchanged. If anything, proportionally it has climbed. We won't have an argument about that. My data here refute what you just said.

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If I could now address all my colleagues in a general sense to each one of your groups...I do want to try to address you as a group. The discussion we've had here as colleagues is whether or not firearm registration will be effective, both in terms of saving lives as well as cost-effectiveness. My own association brought up the issue of whether or not it is cost-effective.

Many of the things you've said in your presentations are currently present. Safe storage, reducing access...all those things are currently present in legislation. I would like to have each one of you comment. This is why I wanted to have an expression from you to exactly what I'm saying.

The chairman says this will all be borne by the firearm owners. That's good in theory, but in other jurisdictions where firearm registration was undertaken it became very expensive.

There are three reasons this has failed. They are expense, difficulty with compliance - we need 100% compliance to have all the things you hope come to pass - and no impact whatsoever on criminal use. Criminals will not register.

I'm asking you directly: would you, individually, spend the money that it will cost for gun registration as opposed to spending the same significant amount of dollars on other aspects of preventive medicine? I'd like each one of you to say either you'd spend it on registration or spend it otherwise - just registration or other preventive medicine. I don't want a long harangue on this because I'll never get through.

Dr. Fisher: I'm not sure if that choice exists right now. I believe that....

Mr. Hill: I'm sure of that.

Dr. Fisher: As far as I'm aware, I don't think that choice exists. However, in a theoretical world, with the numbers we've been presented, I think the potential $6.5 billion cost does justify the cost of registration.

Mr. Hill: Would you register?

Dr. Drummond: Yes, I'd register.

Dr. L'Heureux: I won't change what we've said before.

Mr. Hill: Wouldn't you register?

Dr. L'Heureux: No, no. That's not what we said.

Mr. Hill: Then I would like the answer. Would you register or would you put the funds in another area?

Dr. L'Heureux: I mean that's a positive bait. You can't put registration on one side versus preventive medicine on the other. It's probably one means of preventive medicine.

Mr. Hill: Can't you answer that?

Dr. L'Heureux: I can't answer it.

[Translation]

The Chair: Mr. Simon.

Mr. Simon: I don't think we really have a choice. As I said earlier, we already use our material, human and financial resources to prevent suicide. It is now up to the Department of Justice to act and to make access to firearms more difficult. Thank you.

[English]

Prof. Mishara: I cannot put a price on the saving of several hundred Canadian lives per year. I don't think that's a reasonable thing to ask someone to do.

Mr. Hill: Really, I did not ask you that. I did not.

We talk about saving lives. Saving lives does not impact only on this part of medical health prevention. There are many other lives to save. I was trying to ask if this is the most cost-effective way to spend our preventive health dollars. Would you spend it on gun registration or would you spend it on other suicide prevention mechanisms?

Please don't think I'm saying to cast off people who commit suicide.

Prof. Mishara: The only way I can answer that question is to try it and then determine how efficient it is, and also try other methods and see how efficient they are in saving lives.

The Chair: Dr. Hill, you've quoted some statistics that seem to be different. Would you mind telling us the source?

Mr. Hill: I'd be delighted to provide these to the committee. The source is ``Gun Control Is Not Crime Control'', by Gary Mauser, in the Fraser Forum.

The Chair: Okay.

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Ms Torsney: Could I ask for one point of clarification?

The Chair: Yes, but make it brief.

Ms Torsney: Did Dr. L'Heureux say that gun registration was one means of preventive health medicine? I wasn't sure of exactly what you said.

[Translation]

Dr. L'Heureux: My problem, Mr. Chairman, is that I am being asked for a black or white answer. But Dr. Hill knows, probably better than anyone else here, that there often are gray areas in medicine.

I keep referring you to our brief, where we say that registration per se might not have the expected results. We must take other measures. But we never say anywhere in that brief that it won't be efficient. What we are saying is that we are not convinced it is the only means, or the most useful means, but it is one means amongst others.

[English]

The Chair: Before we adjourn, I want to bring three things to the attention of the committee. First, I want to thank the witnesses for this very useful perspective on this legislation. It's been very helpful and I thank you all.

Second, I want to alert the committee to the fact that tomorrow morning we're not having witnesses who will present briefs. We will have officials and technical experts and so on. I'm recommending that you please prepare your questions of a technical nature in advance, so that tomorrow we make the best use of those witnesses and the best use of the time.

Finally, I want to tell you this information from the television people. As you know, they've been televising these sessions all week. They will be rebroadcast throughout the weekend. On Saturday it'll be from 7:30 a.m. until midnight and on Sunday from 7:30 a.m. to 7:30 p.m.

The meeting is adjourned until 3:30 this afternoon.