Interesting analysis! I think the question that you didn't fully address here is whether the well-being of the aggressor should be given significant weight relative to the victims. My personal opinion is that the well-being of the victims should take full precedence over the aggressors and the correct course of action is to disable the aggressor as quickly as possible (making sure victims are safe) before providing medical assistance to the aggressor.
I didn't get into that because I think that's a community judgment. Each will approach with their own philosophy there, as they ought to. My only interest is making sure they can have those conversations around better outcome data so that they can make their decisions intelligently.
Your paper came up in my research on baseline mortality from stab wounds, and was very helpful. Though one thing that wasn't clear was whether it was capturing 100% of the dead (in that the NTDB's data is predicated on ICD codes, which seem conditional on hospital admittance). To your knowledge, do the DOA-inclusive numbers in table 3 capture those who aren't sent to the hospital with hope of rescue/resuscitation?
My naive sense was that even if someone was clearly dead they'd still be sent to the hospital so that an ME could look them over. But wasn't 100% clear on that (or if MEs used the same codes), and I don't know anyone who works in trauma to ask. So thought you might know offhand.
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Dr. Zeineddin:
Other than the voluntary nature of data contribution you also highlight another [data] limitation in your question. Do all patients with a stab (or [gun shot wound]) present to a hospital or trauma center even if they are clearly dead at the scene? The answer is no. They could present to a hospital that is not a trauma center where they would not be captured in these databases or they could be pronounced at the scene as you were asking.
The laws regarding the ability of EMS personnel to pronounce death at the scene differ by jurisdiction so there is no clear percentage of how many victims are pronounced at the scene and how many are brought in to the hospital and pronounced there. *NTDB should be able to capture the latter but not the former.* Another factor that complicates this issue is that EMS in jurisdictions where they are able to pronounce at the scene by law, might elect to bring the victim in to the hospital due to safety concerns at the scene or as to not escalate the tense situation at the scene by declaring the death of the victim.
----
(As an aside, he also noted that "with the improvement in trauma care, the fatality rate of stab wounds or even gunshot wounds to a single body region have improved significantly over the 14 years studied." So there's that too.)
You're comparing the risk to Bryant (from being shot) to the risk Bryant posed (by stabbing)? Then don't assume that Bryant would have stopped after stabbing one person. There were a bunch of people there. The officer certainly couldn't assume that Bryant would stop at one.
The point is that the officer, should a single shot not have neutralized Ma’Khia or her aggression, could have very quickly proceeded to additional shots as necessary without significant risk of more stabbing.
What is this, like, one bullet per stab or something? If Bryant kept going, what exactly are you saying the officer should have done?
In your scenario, Bryant could have completed a stabbing and still could have been shot multiple times and killed. Then the outcome for Bryant would have been the same, but Bonner would also have been stabbed some number of times.
Point being, you're not just trying to measure trauma risk, you're also trying to evaluate how far Bryant would have gotten if the officer had fired fewer shots. I very much doubt you'll get enough data points to really answer that kind of question, because there are so many variables involved.
Not to mention the fact that Bryant was the aggressor - I don't think risk to Bryant matters the same as risk to Bonner.
The point of a single shot (warning or direct) is that you gain some information at the cost of some risk. The information you gain is “will that shot suffice to stop her”. If it doesn’t and she proceeds to stab attempt #1, I imagine many communities would find it reasonable for the officer to proceed with additional shots to ensure there is no second stab.
And of course the two risks shouldn’t be treated *equally*! But the risk to Bonner of a single stab was roughly 0.5%. 1% at the most. That’s still far less than a tenth of the fatality risk of shooting Bryant even once. Shooting her four times (all in the torso, where they’re trained to target) meant something like a 30-40% fatality risk. Much, much higher.
So trading off 0.5-1% fatality risk to Bonner *might* be justified for a 20-30 point reduction in risk to Bryant. It would depend on the community. But as I was clear about, I’m not being prescriptive here. My point is only that you can have these debates with data in a way that you can’t without data, and thus we should push for the best data we can get.
My point is that it's not just about stab wound mortality vs. bullet mortality (your focus in this piece). It's also about how often a single bullet stops the threat.
Consider 100 Bryants in a world where police shoot one bullet first and then wait. If one shot is never enough to stop her, then those 100 Bryants still get shot multiple times, and 100 Bonners also get stabbed.
Right. But in no reasonable world would it be 100. Getting shot / shot at would have an effect.
But anyway you’re reinforcing my core point: let’s get lots of good data so we can have informed conversations. This would be a harder thing to measure (ie, at what rate does a single shot arrest a violent attacker), but it’s presumably a thing that could still be quantified to a point. And I’d be all for that happening.
But even if we concede that a drawn gun is the reasonable baseline here, we can still imagine that four bullets to Ma’Khia’s torso was not the only plausible remedy. Either of a warning shot or a single bullet were plausible median options.
--‐-----------------------------
Hi Jeremy,
I think your overall premise of having a more granular, quantified idea of when to use deadly force is a good one. I think there are a few unstated assumptions above that I think are a bit unrealistic and not in line with how guns are treated in terms of deadly force.
The idea of using a gun to fire a warning shot seems like a controversial technique that some LE entities use and some forbid. When I received deadly force training in the military we were explicitly forbidden from using warning shots (outside of some very specific situations). The idea is that you are firing a deadly weapon at an unknown target and this could cause unintentional injury or death.
The second part about firing a single shot vs four shots sounds like it is getting close to that idea of "just shooting them in the legs". In deadly force training any use of a gun is treated as deadly force. Any given bullet could hit an artery or other vital area of the body resulting in death.
There is room for a more nuanced discussion around how police and law enforcement treat guns and deadly force in general, but the deadly force training (or at least the training I received) treats it as a binary decision of either using a gun (deadly force) to kill or not using a gun at all. The idea being that you're either using deadly force or using non deadly force. Any use of a firearm is considered deadly force, so from that standpoint 1 bullet and 4 bullets are the same "deadliness". This training probably results in police officers firing what seem like an inordinate amount of shots to subdue someone.
There is probably more room to discuss whether this binary makes sense for the use of guns and what the consequences of it are. This may result in situations where someone is shot 40+ times by multiple officers due to the binary of "deadly force" vs "non deadly force". Someone shot 1 time by 1 officer is probably at a lower risk of dying, but if an officer has already made a determination that deadly force is warranted, there doesn't seem to be any limit in the amount of force using this binary approach.
As an aside, some weapons can be used for either deadly force or non deadly force. A metal baton for example can be used to strike a person in the hip or leg to administer non deadly force, but if you strike a person in the head with the baton it is considered deadly force. I think the assumption with firearms is that there is a large amount of force and the slightly inaccuracy can change whether it is deadly or not deadly. Even if you aim for the calf, you could still accidentally hit someone's artery in their thigh and administer deadly force, so any use of a gun is assumed to be deadly.
Well the point is that your training was based on a philosophical idea — a value judgment. And communities are allowed to come up with those. Some communities would find the idea of one shot being the same as four shots obscene. Some would think it totally sane. I’m more towards the former, but that’s my cultural bias. Communities and cultures see things different ways, and that’s fine.
Just so with warning shots. The idea of never using them is a philosophical position that’s neither right nor wrong in any objective sense. It’s either what a given community agrees on or it isn’t. Some do disagree.
(The shoot for the leg one feels a bit less subjective to me, in that I’ve heard there is pretty good data to suggest that those shots miss a lot, on top of non-trivial ricochet risk off the ground. But I’ve never looked at the data closely.)
Anyway, my point isn’t to tell communities what they should do with the data. Only to advocate for popularizing good data so that these decisions can be reached in an informed way. Some may still take a far more conservative approach to victim protection, and that is what it is, etc.
Interesting analysis! I think the question that you didn't fully address here is whether the well-being of the aggressor should be given significant weight relative to the victims. My personal opinion is that the well-being of the victims should take full precedence over the aggressors and the correct course of action is to disable the aggressor as quickly as possible (making sure victims are safe) before providing medical assistance to the aggressor.
I didn't get into that because I think that's a community judgment. Each will approach with their own philosophy there, as they ought to. My only interest is making sure they can have those conversations around better outcome data so that they can make their decisions intelligently.
Excerpts from my emails with Dr. Zeineddin.
----
Me:
Your paper came up in my research on baseline mortality from stab wounds, and was very helpful. Though one thing that wasn't clear was whether it was capturing 100% of the dead (in that the NTDB's data is predicated on ICD codes, which seem conditional on hospital admittance). To your knowledge, do the DOA-inclusive numbers in table 3 capture those who aren't sent to the hospital with hope of rescue/resuscitation?
My naive sense was that even if someone was clearly dead they'd still be sent to the hospital so that an ME could look them over. But wasn't 100% clear on that (or if MEs used the same codes), and I don't know anyone who works in trauma to ask. So thought you might know offhand.
----
Dr. Zeineddin:
Other than the voluntary nature of data contribution you also highlight another [data] limitation in your question. Do all patients with a stab (or [gun shot wound]) present to a hospital or trauma center even if they are clearly dead at the scene? The answer is no. They could present to a hospital that is not a trauma center where they would not be captured in these databases or they could be pronounced at the scene as you were asking.
The laws regarding the ability of EMS personnel to pronounce death at the scene differ by jurisdiction so there is no clear percentage of how many victims are pronounced at the scene and how many are brought in to the hospital and pronounced there. *NTDB should be able to capture the latter but not the former.* Another factor that complicates this issue is that EMS in jurisdictions where they are able to pronounce at the scene by law, might elect to bring the victim in to the hospital due to safety concerns at the scene or as to not escalate the tense situation at the scene by declaring the death of the victim.
----
(As an aside, he also noted that "with the improvement in trauma care, the fatality rate of stab wounds or even gunshot wounds to a single body region have improved significantly over the 14 years studied." So there's that too.)
You're comparing the risk to Bryant (from being shot) to the risk Bryant posed (by stabbing)? Then don't assume that Bryant would have stopped after stabbing one person. There were a bunch of people there. The officer certainly couldn't assume that Bryant would stop at one.
The point is that the officer, should a single shot not have neutralized Ma’Khia or her aggression, could have very quickly proceeded to additional shots as necessary without significant risk of more stabbing.
Shoot once
if stab but no slump/drop > shoot again
if stab but slump/drop > stop
if no stab > stop
What is this, like, one bullet per stab or something? If Bryant kept going, what exactly are you saying the officer should have done?
In your scenario, Bryant could have completed a stabbing and still could have been shot multiple times and killed. Then the outcome for Bryant would have been the same, but Bonner would also have been stabbed some number of times.
Point being, you're not just trying to measure trauma risk, you're also trying to evaluate how far Bryant would have gotten if the officer had fired fewer shots. I very much doubt you'll get enough data points to really answer that kind of question, because there are so many variables involved.
Not to mention the fact that Bryant was the aggressor - I don't think risk to Bryant matters the same as risk to Bonner.
I don’t think I’m being unclear here.
The point of a single shot (warning or direct) is that you gain some information at the cost of some risk. The information you gain is “will that shot suffice to stop her”. If it doesn’t and she proceeds to stab attempt #1, I imagine many communities would find it reasonable for the officer to proceed with additional shots to ensure there is no second stab.
And of course the two risks shouldn’t be treated *equally*! But the risk to Bonner of a single stab was roughly 0.5%. 1% at the most. That’s still far less than a tenth of the fatality risk of shooting Bryant even once. Shooting her four times (all in the torso, where they’re trained to target) meant something like a 30-40% fatality risk. Much, much higher.
So trading off 0.5-1% fatality risk to Bonner *might* be justified for a 20-30 point reduction in risk to Bryant. It would depend on the community. But as I was clear about, I’m not being prescriptive here. My point is only that you can have these debates with data in a way that you can’t without data, and thus we should push for the best data we can get.
My point is that it's not just about stab wound mortality vs. bullet mortality (your focus in this piece). It's also about how often a single bullet stops the threat.
Consider 100 Bryants in a world where police shoot one bullet first and then wait. If one shot is never enough to stop her, then those 100 Bryants still get shot multiple times, and 100 Bonners also get stabbed.
Right. But in no reasonable world would it be 100. Getting shot / shot at would have an effect.
But anyway you’re reinforcing my core point: let’s get lots of good data so we can have informed conversations. This would be a harder thing to measure (ie, at what rate does a single shot arrest a violent attacker), but it’s presumably a thing that could still be quantified to a point. And I’d be all for that happening.
But even if we concede that a drawn gun is the reasonable baseline here, we can still imagine that four bullets to Ma’Khia’s torso was not the only plausible remedy. Either of a warning shot or a single bullet were plausible median options.
--‐-----------------------------
Hi Jeremy,
I think your overall premise of having a more granular, quantified idea of when to use deadly force is a good one. I think there are a few unstated assumptions above that I think are a bit unrealistic and not in line with how guns are treated in terms of deadly force.
The idea of using a gun to fire a warning shot seems like a controversial technique that some LE entities use and some forbid. When I received deadly force training in the military we were explicitly forbidden from using warning shots (outside of some very specific situations). The idea is that you are firing a deadly weapon at an unknown target and this could cause unintentional injury or death.
The second part about firing a single shot vs four shots sounds like it is getting close to that idea of "just shooting them in the legs". In deadly force training any use of a gun is treated as deadly force. Any given bullet could hit an artery or other vital area of the body resulting in death.
There is room for a more nuanced discussion around how police and law enforcement treat guns and deadly force in general, but the deadly force training (or at least the training I received) treats it as a binary decision of either using a gun (deadly force) to kill or not using a gun at all. The idea being that you're either using deadly force or using non deadly force. Any use of a firearm is considered deadly force, so from that standpoint 1 bullet and 4 bullets are the same "deadliness". This training probably results in police officers firing what seem like an inordinate amount of shots to subdue someone.
There is probably more room to discuss whether this binary makes sense for the use of guns and what the consequences of it are. This may result in situations where someone is shot 40+ times by multiple officers due to the binary of "deadly force" vs "non deadly force". Someone shot 1 time by 1 officer is probably at a lower risk of dying, but if an officer has already made a determination that deadly force is warranted, there doesn't seem to be any limit in the amount of force using this binary approach.
As an aside, some weapons can be used for either deadly force or non deadly force. A metal baton for example can be used to strike a person in the hip or leg to administer non deadly force, but if you strike a person in the head with the baton it is considered deadly force. I think the assumption with firearms is that there is a large amount of force and the slightly inaccuracy can change whether it is deadly or not deadly. Even if you aim for the calf, you could still accidentally hit someone's artery in their thigh and administer deadly force, so any use of a gun is assumed to be deadly.
Well the point is that your training was based on a philosophical idea — a value judgment. And communities are allowed to come up with those. Some communities would find the idea of one shot being the same as four shots obscene. Some would think it totally sane. I’m more towards the former, but that’s my cultural bias. Communities and cultures see things different ways, and that’s fine.
Just so with warning shots. The idea of never using them is a philosophical position that’s neither right nor wrong in any objective sense. It’s either what a given community agrees on or it isn’t. Some do disagree.
(The shoot for the leg one feels a bit less subjective to me, in that I’ve heard there is pretty good data to suggest that those shots miss a lot, on top of non-trivial ricochet risk off the ground. But I’ve never looked at the data closely.)
Anyway, my point isn’t to tell communities what they should do with the data. Only to advocate for popularizing good data so that these decisions can be reached in an informed way. Some may still take a far more conservative approach to victim protection, and that is what it is, etc.