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Professor Vars Publishes Article in New England Journal of Medicine

October 1, 2020

A new article in one of the nation’s most prestigious medical journals suggests that doctors and mental health professionals could use voluntary do-not-sell lists for firearms as a new tool in their suicide prevention toolkit.

Professor Fredrick Vars, the Ira Drayton Pruitt, Sr. Professor of Law, developed the proposal, which would allow those at risk of suicide to voluntarily place their name on a registry, prohibiting gun stores from selling them a firearm.

“Clinicians routinely assess their patients’ risk of suicide, yet they are limited in terms of the practical interventions they can use for patients who are not actively suicidal but who fear they may become suicidal,” Vars wrote in The New England Journal of Medicine.

The article, published in the October issue of the journal, explains how Vars’s proposal has been adopted in Virginia and Washington state. Data show that many people would like to restrict their ability to purchase firearms. A survey of 200 patients receiving psychiatric care in Alabama found that 46 percent said they would register for a do-not-sell list if it were available. In a more general survey, 31 percent of Internet users reported they wanted to participate in a gun registry.

Headshot of Fred Vars

Fredrick Vars

“Clinicians routinely assess their patients’ risk of suicide, yet they are limited in terms of the practical interventions they can use for patients who are not actively suicidal but who fear they may become suicidal,” Vars wrote in The New England Journal of Medicine

The article, published in the October issue of the journal, explains how Vars’s proposal has been adopted in Virginia and Washington state. Data show many people would like to restrict their ability to purchase firearms. A survey of 200 patients receiving psychiatric care in Alabama found that 46 percent said they would register for a do-not-sell list if it were available. In a more general survey, 31 percent of Internet users reported they wanted to participate in a gun registry. 

About 50 percent of all suicides involve a firearm, according to the Centers for Disease Control and Prevention. While doctors may involuntarily hospitalize or file a petition for an extreme risk protection order for a patient who is suicidal, Vars’s proposal addresses the matter before a crisis occurs. He developed it based on his own experience with depression and suicidal thoughts.

“If I had had easy access to a firearm at certain points in my life, I may not be here today,” he said.  “My research shows that the voluntary do-not-sell list appeals to many others and could save many lives.”

The problem of suicide requires a number of solutions, and Vars said his idea is no panacea. Do-not-sell lists, for example, may not affect those who already possess firearms and those who transfer guns privately without a background check in some states. It is, however, a creative, promising, and innovative approach to a public health crisis, he said. 

Vars has further developed the voluntary do-not-sell firearm list idea, and other liberty-enhancing gun proposals, with his collaborator, Ian Ayres, a professor at Yale Law School.  Their new book is forthcoming later this month from Harvard University Press: Weapon of Choice, Fighting Gun Violence While Respecting Gun Rights. Quinnipiac Law School is hosting an open symposium about the book on Nov. 13, 2020.


The University of Alabama School of Law strives to remain neutral on issues of public policy. The Law School’s communications team may facilitate interviews or share opinions expressed by faculty, staff, students, or other individuals regarding policy matters. However, those opinions do not necessarily reflect the views of the Law School, the University, or affiliated leadership.