Public Safety Committee on March 10th, 2023

[Dr. Najma Ahmed]

We would be pleased to table the evidence—

[Raquel Dancho, Conservative, Kildonan—St. Paul, MB]

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Dancho.

Thank you to the witness.

We'll go now to Ms. Damoff.

Please go ahead for five minutes.

[Pam Damoff, Liberal, Oakville North—Burlington, ON]

Thank you.

Thank you to all of our witnesses for being here today.

Dr. Kortbeek, I listened to a podcast you did where you talked about the “burden of injury” from firearms and said that the burden of injury is why you became involved in this issue. Could you maybe talk about that a bit?

[Dr. John B. Kortbeek]

Yes, certainly. As I said, we were experiencing an increase in injury admissions in Alberta and were able to substantiate that we're now admitting about 100 patients a year for gunshot wounds, in addition to homicide and suicide. The national figures for homicide and suicide are approximately 200 and 600 for firearms.

In Alberta, the admission data often doesn't get presented. We did have a national database for injury admissions that was within CIHI—the national trauma registry—but it was discontinued due to funding approximately 10 years ago. Having a national repository that captures all of the injury admission data for firearms would actually be very useful to inform policy.

Nevertheless, we've seen an increase in admissions. The prairie provinces have the highest number of admissions per capita in Canada. Based on the data I've seen from B.C. and Alberta, annual admissions in Canada probably exceed 500. There's a significant—

[Pam Damoff, Liberal, Oakville North—Burlington, ON]

Are all those admissions—

Oh, I'm sorry, Doctor.

[Dr. John B. Kortbeek]

There's a significant burden of injury from firearms.

Multiple mass shooting events fortunately are uncommon. They still attract media attention and grab the public's attention, as was seen with the 2019 shooting of three people in northern B.C., which resulted in daily frontline headline news and the largest manhunt in recent Canadian history.

They occur about once a year. The majority of them have been associated with either handguns or semi-automatic weapons with large-capacity magazines, the latter resulting in a greater number of casualties per incident.

[Pam Damoff, Liberal, Oakville North—Burlington, ON]

Thank you very much.

Dr. Ahmed, do you support the government's proposed red flag laws?

[Dr. Najma Ahmed]

Thanks for the question.

Our organization supports well-written and properly implemented red flag laws, as they have been shown to decrease the number and severity of public mass shootings, as well as having an effect of decreasing suicides. Our organization does support the proposed red and yellow flag laws.

[Pam Damoff, Liberal, Oakville North—Burlington, ON]

Thank you.

To go back to you just quickly, Dr. Kortbeek, have you conducted any academic research on the topic of firearm injuries?

[Dr. John B. Kortbeek]

Only with respect to treatment and not with respect to surveillance, apart from the presentation at city-wide critical care rounds and the publication of the interview podcast with the Canadian Journal of Surgery, Cold Steel.

[Pam Damoff, Liberal, Oakville North—Burlington, ON]

Okay.

Dr. Ahmed, we had Dr. Langmann here, who testified that his research says that access to firearms does not result in an increase in suicides and that stricter gun control measures do not lead to reductions in homicides. Do you agree with his work? Are you familiar with it? I wonder if you could elaborate on that a bit.

[Dr. Najma Ahmed]

Thank you. That's a great question, Ms. Damoff.

I'll hand it over to Dr. Dare, who is prepared to answer.

[Dr. Anna Dare]

Thank you.

As with any field of study, there are varied opinions and perspectives on the data. There are some lone wolves in this area of research, no question, but the consensus within the scientific community internationally is that comprehensive firearm laws save lives.

Within the context of Canada's measuring the impact of gun laws, one of the challenges we do have is that we don't disaggregate data, and it makes it very difficult to study this problem. We should also be very wary of drawing any sweeping conclusion. That said, there have been some Canadian papers looking at major gun control changes in the late 1970s and in 1995 that are considered to be methodologically sound and do show reductions in homicides and suicides.

I would note and caution this committee and the references it draws to a couple of the Canadian studies that have come before the committee most recently. They ask very important and relevant questions, but there are major flaws in the design, analysis and reporting of the results. We will be submitting a more thorough statistical assessment based on input from independent academics and biostatisticians across North America, including in leading universities such as Johns Hopkins, Harvard and Toronto, to both the journal and this committee.

The method used in 2023 and the 2020 paper looking at Canadian legislation by a sole author, called difference-in-differences, cannot be applied to a single population exposed to the same legislation. It chooses the incorrect control group and it is highly selective in which laws it chooses to include and how it divides time periods up.

I would also like to acknowledge that not all peer review is created equal and not all journals are created equal. PLOS One, where these studies have been published, does not rank in the top 5,000 scientific peer-reviewed journals currently. I do publish on firearm mortality surveillance around the world, and my work has been published in The Lancet Public Health, which is the world's leading public health journal.

[Pam Damoff, Liberal, Oakville North—Burlington, ON]

Thank you very much.

[Dr. Najma Ahmed]

Ms. Damoff, if I could add one comment, I've read that paper and Dr. Dare's done an excellent analysis of it as well, but I would urge anyone to read that paper and particularly the discussion in which the author himself documents and acknowledges the many, many limitations of that study.

[The Chair, Liberal, Ron McKinnon]

Thank you very much.

We have to go now to our next panellist.

Ms. Michaud, you have five minutes.

[Kristina Michaud, Bloc, Avignon—La Mitis—Matane—Matapédia, QC]

Thank you, Mr. Chair.

I thank the witnesses for being here today. We are very grateful to them.

I have a question for the representatives from Doctors for Protection from Guns. As you said, you have witnessed gun violence first-hand. Quite frankly, you see some rather traumatizing things. You are not necessarily obligated to advocate for better gun control, but you do and you are here. I thank you for that.

In a letter from last December, you spoke about disinformation and the tactics the gun lobby was using to claim that certain guns would be included in or excluded from the legislation and amendments. Upon closer examination, we see that this information is not true. Most of the guns that were described on social media as firearms that the government wanted to ban would not be affected. The posts were referring to a similar model or there was some other issue.

Certain tactics have even been used against you, Ms. Ahmed. I learned that, in 2019, you had close to 70 complaints filed against you by members of the Canadian Coalition of Firearms Rights.

I would like you to tell us about that experience.

Do you think that this kind of tactic hinders the debate that we are having and interferes with the passage of legislation for better gun control?

[Dr. Najma Ahmed]

Thank you for the question.

Yes, you correctly point out that when we first started this work, I was personally targeted by members of the Canadian Coalition for Firearm Rights. Seventy of their members, people I had never met or treated as a physician, made complaints to the regulatory body in Ontario, the College of Physicians and Surgeons of Ontario, alleging that my work in this area, my advocacy in this area, was somehow unprofessional and that my licence to practice medicine should be revoked. After a review of those complaints, the college concluded that those complaints were an abusive process and frivolous, and dismissed each and every one of them out of hand.

To answer the second part of your question, I would like to say I believe these tactics are specifically used to intimidate, harass and quieten the other side. I would say that the majority of physicians and the majority of Canadians are in favour of evidence-informed firearm policy, but there's a very loud, vociferous and constant drumbeat from the other side, the intent of which is simply to harass and intimidate those of us who would come forward with a voice of science and advocate on behalf of the communities and patients that we serve.

I would also note that a key function and role of physicians in society is that of advocate. This has been true if you look at smoking legislation, seat belt legislation, asbestos or safe water. All of those public health advances have in many cases been spearheaded and in all cases supported by physicians who have seen the results of poor legislation at the coalface, which is in our emergency departments, operating rooms and hospitals.

[Kristina Michaud, Bloc, Avignon—La Mitis—Matane—Matapédia, QC]

Thank you.

I am sorry that happened to you.

At this stage of the game, what do you expect from the government and the members of this committee when it comes to the passage of Bill C‑21. I know that the government is reworking some amendments and may come back to us with amendments on military-style assault weapons. As it has been said many times, this was not an accurate way of describing the weapons in question. There are some good things and some not so good things. The process could be improved.

At this stage of the game, what do you expect from the government and the opposition members?

[Dr. Najma Ahmed]

Thank you.

I'll start and perhaps I'll ask Dr. Dare to jump in.

I will be brief. I think it's exceptionally important, as we consider amendments G-4 and G-46, that a clear definition is put forth, one that does not allow copycat models to come forth in the future. I think it's very important that we address the proliferation of handguns and that we continue to use the science to inform public policy in this matter.

Dr. Dare.

[Dr. Anna Dare]

Thank you.

I would echo those comments, and I think it is helpful to consider the international context as well in which much of this legislation has gone before. Internationally, legislation really seeks to target two common features when it comes to assault weapons: prohibiting semi-automatic rifles and shotguns, and restricting magazine capacity. Those two things must go together.

The technical details of how those are realized are specific to each country context. However, it's very important to retain the core intent in mind to reflect on what is known and the evidence, to be aware of what are high-quality studies and what are not high-quality studies in support of that, and to acknowledge that many countries do grant narrow and detailed exemptions in specific areas. That may be an important way forward, particularly for some of our more unique communities.

[The Chair, Liberal, Ron McKinnon]

I'm sorry to have to cut you off there. Thank you.

Mr. MacGregor, please go ahead for five minutes.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Thank you, Chair.

I'd like to thank all of our witnesses, some of whom are reappearing, for helping to guide our committee through this study.

Mr. Savikataaq, I'd like to direct my questions to you. I want to thank you for your opening statement, for making an appearance and for also giving a very important perspective—the indigenous perspective—on what these proposed amendments would mean for communities like yours.

When Bill C-21 was first introduced, on the day it was introduced, the minister made mention of the fact that amendments would also be added to the bill. When they were brought in, and we did spend a lot of time on them, there was quite a visceral reaction from many indigenous communities.

I just want to know, before those amendments were brought in, were any communities within your jurisdiction ever consulted by the Government of Canada on these amendments and what they would mean for communities like yours?

[Joe Savikataaq]

Thank you for that.

That's a negative. No, we were not consulted on anything, on how we would have been affected or impacted. There was absolutely no consultation or information flowing to us in the whole territory of Nunavut here at our level.