British Medical Journal's clever plan to increase violent crime

BMJ 2005;330:1221-1222 (28 May), doi:10.1136/bmj.330.7502.1221
http://bmj.bmjjournals.com/cgi/content/full/330/7502/1221

Reducing knife crime: We need to ban the sale of long pointed kitchen knives

"Britain in the grip of knives terror—third of murder victims are now stabbed to death." Daily Express,, 31 January 2005
"Stabbing rampage kills one, injures five—a large kitchen knife was found." Independent, 24 December 2004

Violent crime in the United Kingdom is increasing; figures from London show a 17.9% increase from 2003 to 2004,1 and one easily accessible weapon used in many incidents is the kitchen knife. Unfortunately, no data seem to have been collected to indicate how often kitchen knives are used in stabbings, but our own experience and that of police officers and pathologists we have spoken to indicates that they are used in at least half of all cases. UK government statistics show that 24% of 16 year old boys report carrying knives or other weapons and 19% admitting attacking someone with the intent to harm.2 Although other weapons—such as baseball bats, screwdrivers, and chains—are also carried, by far the most common weapons are knives.3 In the United Kingdom in the first two weeks of 2005 alone, 15 murders were attributed to stabbings and 16 other non-fatal attacks.4

To tackle this increasing problem, various measures are being considered by the government, particularly targeting the adolescent age group. These include raising the minimum age for purchasing a knife from 16 to 18 years and allowing head teachers the power to search pupils for knives.5 However, not all crimes are committed with newly purchased knives, and every household and home economics department in schools contains a plethora of readily available weapons. The modern stainless steel kitchen knife has a high quality blade that makes it unnecessary to look further for another lethal weapon.

Most domestic kitchen knives are based on two designs, the dagger variety with a pointed tip—for example, vegetable knife or carving knife—and the blunt round nose variety—for example, bread knife. When using a knife to harm, a blunt nosed knife is unlikely to cause serious injury, as penetrating clothing and skin is difficult with it. Similarly an assault with a knife with a short blade such as a craft knife may cause a dramatic superficial wound but is unlikely to reach deep structures and cause death. A dagger type knife, however, can penetrate deeply. Once resistance from clothing and skin is overcome, little extra force is required to injure vital organs, increasing the chance of a fatality (likened to cutting into a ripe melon).6

As knives are so readily available, does a culinary reason exist for so many domestic knives to be of the dagger variety, or are we just sticking to tradition? Knives as we recognise them were made first from copper and bronze between 3000 and 700 bc, and some are very similar in design to those used today. Personal eating knives were first used in Britain in the 14th century and became commonplace during the 1800s when manufacturing processes improved.7

Knives were used to spear meat, lifting it from plate to mouth, so pointed tips were vital for this function. Also, with repeated sharpening of a flat blade, a pointed tip inevitably develops. However, now domestic knives do not need sharpening, and numerous other kitchen utensils can be used to spear food. The current practice of eating with forks and blunt ended table knives was introduced in the 18th century to reduce the injuries resulting from arguments in public eating houses. In 1669, King Louis XIV of France noted the association between pointed domestic knives and violence and passed a law demanding that the tips of all table and street knives be ground smooth.8 Today many households have a block of kitchen knives of which several will be of the long pointed variety.

Perhaps the pointed kitchen knife has a culinary purpose that we have failed to appreciate? We contacted 10 chefs in the UK who are well known from their media activities and chefs working in the kitchens of five leading London restaurants. Some commented that a point is useful in the fine preparation of some meat and vegetables, but that this could be done with a short pointed knife (less than 5 cm in length). None gave a reason why the long pointed knife was essential. Domestic knife manufacturers (Harrison-Fisher Knife Company, England, personal communication, 2005) admit that their designs are based on traditional shapes and could give no functional reason why long pointed knives are needed. The average life of a kitchen knife is estimated to be about 10 years.

Many assaults are impulsive, often triggered by alcohol or misuse of other drugs, and the long pointed kitchen knife is an easily available potentially lethal weapon particularly in the domestic setting. Government action to ban the sale of such knives would drastically reduce their availability over the course of a few years. In addition, such legislation would make it harder to justify carrying such knives and prosecution easier.

The Home Office is looking for ways to reduce knife crime. We suggest that banning the sale of long pointed knives is a sensible and practical measure that would have this effect.

Emma Hern, specialist registrar in emergency medicine, Will Glazebrook, specialist registrar in emergency medicine Mike Beckett, consultant in emergency medicine