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Forbes - Healthcare

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How to Prevent Domestic Violence Deaths
Arthur L. Kellermann · 2026-04-30 · via Forbes - Healthcare
Former Virginia Lieutenant Governor Justin Fairfax dies in apparent murder-suicide

VIRGINIA, UNITED STATES - APRIL 16 : An outside view of the home of Cerina Fairfax and former Virginia Lt. Gov. Justin Fairfax in Annandale, Virginia, after both died in an apparent murder-suicide. (Photo by Celal Gunes/Anadolu via Getty Images)

Anadolu via Getty Images

Eight children and three adults were killed and two adults were seriously injured in two high-profile shootings earlier this month. Yet experts in injury and violence prevention were dismayed at how quickly they faded from public consciousness, perhaps because they were deemed family matters.

“We’ve become so numb to these tragedies that we are now even skipping the TV ritual part,” wrote Dr. Megan Ranney, dean of the Yale School of Public Health.

In response to the children’s deaths, Dr. Jeremy Faust, a Boston emergency physician and author of Inside Medicine, observed, “Just because the event wasn’t a series of random killings at a school, a theater, a bar, a church, a synagogue, or some other public place doesn’t mean it's not the largest mass shooting in the U.S. since January 2024. It is.”

They were reacting to police reports that Shamar Elkins of Shreveport, Louisiana, fatally shot eight children aged 3 to 11, including seven of his own, and wounded his wife and another woman, before being killed in an armed confrontation with police. Most accounts described the shootings as the result of a “domestic dispute.”

Days earlier, former Virginia Lt. Gov. Justin Fairfax fatally shot his wife, Cerina, before shooting himself, according to police. County Police Chief Kevin Davis described the apparent murder-suicide as the product of a “domestic dispute surrounding what seems to be a complicated or messy divorce,” according to NBC News.

Rather than dismiss these tragedies as private family matters, we should approach them the way other fields, such as aviation and healthcare, do. They conduct critical incident reviews to learn what went wrong, determine root causes and develop strategies to improve everyone’s safety.

Firearms Amplify The Consequences Of Intimate Partner Violence

Every year, 3 million to 4 million women in the U.S. are abused and 1,500 to 1,600 are killed by their abusers. Gun ownership is a strong risk factor for someone killing their partner, especially men killing women, according to a newly released study.

About 4.5 million women alive today have been threatened by an intimate partner with a gun, according to an analysis by University of Pennsylvania researchers Susan Sorenson and Rebecca Schut. Although gun threats are less likely to cause visible injuries, they are more likely to terrify the victim than other forms of intimate partner violence.

More than 90% of the killers in murder-suicides are men. At least two-thirds of cases follow longstanding intimate partner violence. Children are killed in 16% of incidents, according to a study released this week by the Violence Policy Center.

In about 80% of murder-suicides, the killer is known to authorities or had a documented history of abusive behavior before the incident. The triggering event is often when their victim attempts to leave the relationship. Guns are used in up to 92% of cases, according to the National Institute of Justice.

There are ways to reverse these statistics.

How To Prevent Intimate Partner Violence Tragedies

Stop labeling them “domestic disputes." It’s a misleading term. Trivializing violent, criminal behavior as a private squabble between two equal parties masks the true nature of intimate partner violence, which is characterized by coercive control. ”Dispute" implies mutual blame. This is rarely the case.

Support and protect victims of intimate partner violence and provide mental health services for abusive men. Both are essential. Justin Fairfax long struggled with “undefined emotional and psychological issues,” according to court documents obtained by CNN and The Washington Post. He clearly needed help, but so did Cerina and their teenage children. They didn’t receive it. Elkins reportedly had a prior gun offense on his record and had allegedly threatened to take his family’s lives as well as his own. No action was taken.

Reduce access to guns in violence-prone homes. Keeping guns in the home, particularly if any are kept loaded and readily available, increases a family’s risk of harm. They also endanger children. A June 2025 study in JAMA Pediatrics found that states like Louisiana with the permissive gun laws experienced more than 6,000 excess pediatric firearm deaths from 2011 to 2023. States with strict laws saw stable or declining pediatric gun deaths.

In violence-prone households, the risk of keeping a gun in the home is particularly high. A 2011 compilation of research by the National Institute of Justice determined that “States with less restrictive gun control laws have as much as eight times the rate of murder-suicides as those with the more restrictive gun control laws. Compared to Canada, the United States has three times more familicide; compared to Britain, eight times more; and compared to Australia, 15 times more.”

In an attempt to prevent tragedies, 22 states and the District of Columbia have enacted “extreme risk protection order" laws. Popularly known as “red flag” laws, they enable civil courts to temporarily prohibit individuals at high risk of harming themselves or others from possessing or purchasing firearms.

The effectiveness of “red flag” laws is unclear, in part because they are inconsistently enforced. For example, Virginia’s red flag law (ironically passed on a tie-breaking vote cast by then-Lt. Gov. Fairfax) was not enforced in his case. Louisiana lawmakers have repeatedly rejected efforts to pass a red flag law.

Every year, 3 million to 4 million women in the U.S. are abused and 1,500 to 1,600 are killed by their abusers. The danger assessment instrument helps abused women determine their level of risk of being killed by their intimate partner. It is free and available to the public.

getty

How To Get Help If You’re A Victim Of Intimate Partner Violence

A danger assessment instrument has been used by many law enforcement officers, healthcare professionals and domestic violence advocates for 25 years to help them determine the level of danger an abused woman has of being killed by her intimate partner. Abused women can directly access the website to take the free survey. Those who score “yes” on 10 or more questions should contact their local domestic violence shelter or call the national domestic violence hotline to get help with staying safe.

Family and intimate partner violence affects households across the social and economic spectrum. It can produce serious intergenerational harm. Stigma, financial dependence, fear of retaliation and societal indifference discourage many victims from reporting their abuse. Although perpetrators can appear charming in public, their victims know a harsher reality.

Intimate partner violence should never be treated as a private family matter. It harms victims, causes thousands of deaths annually and produces spillover effects in society. We should treat it as seriously and as decisively as we treat other forms of violent crime.

In three decades of clinical practice in hospital ERs, Forbes healthcare contributor Dr. Arthur Kellermann treated many abused women. He also published impactful public health research on the connection between keeping one or more guns in the home and violent death, including intimate partner homicides and suicides.