Individuals representing some of the nation’s preeminent medical organizations have called for “reasonable, evidence-based solutions” to reduce injury and death related to firearms, according to a special article published in the Annals of Internal Medicine.1
These organizations include the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American College of Surgeons, American Medical Association, American Psychiatric Association, and American Public Health Association.
“Our organizations support a multifaceted public health approach to prevention of firearm injury and death similar to approaches that have successfully reduced the ill effects of tobacco use, motor vehicle accidents, and unintentional poisoning,” the authors wrote.1
The group’s recommendations focused on 8 areas to reduce firearm-related injury and death in the United States. First, background checks should be required for all firearm purchases, regardless of where or how the firearm is purchased. This requirement should apply to sales by gun dealers or at gun shows, private sales, and transfers between individuals. In addition, the authors urged the need for adequate research funding to better understand the causes and effects of both intentional and unintentional firearm-related injury. On a similar note, the authors pointed out that current federal laws prohibiting domestic abusers from accessing firearms do not apply to “dating partners,” despite nearly half of intimate partner violence cases involving current dating partners. This is a loophole in the background check system they say must be closed.1
Furthermore, safe storage of firearms can prevent individuals who are at greater risk for accidental or intentional injury from accessing said firearms (eg, children/adolescents, individuals with dementia, people with substance use disorders, and the small subset of individuals with serious mental illnesses that are associated with greater risk of self-harm or harming others). The authors cited a 2018 study2 that found an estimated 4.6 million children in the United States live in homes with at least 1 loaded and unlocked firearm. According to an earlier report, a large number of unintentional firearm fatalities occurred in states where owners were more likely to store their firearms loaded, with the greatest risk in homes with firearms stored both loaded and unlocked.3 Therefore, the authors support “child access prevention laws” that hold firearm owners accountable when they negligently store firearms.
The authors also support improved access to mental health care but caution against prohibiting all individuals with a mental health or substance use disorder from owning firearms. Those who receive treatment from healthcare professionals are less likely to commit acts of violence, whether against themselves or others.
In addition, the authors oppose any state or federal mandates that interfere with physicians’ right to free speech and the patient-physician relationship (aka, “gag laws”), including any discussions about a patient’s firearm ownership. “Providing anticipatory guidance on preventing injuries is something physicians do every day, and it is no different for firearms than for other injury prevention topics,” they wrote. “Our organizations are working on programs and strategies that engage firearm owners in devising scientifically sound and culturally competent patient counseling that clinicians can apply broadly.”
The authors emphasized the importance of a common-sense approach to reducing casualties in mass shootings, such as addressing high-capacity magazines and “firearms with features designed to increase their rapid and extended killing capacity.” These weapons should be subjected to more specific scrutiny and regulation, the writers noted. They welcomed partnership and engagement with responsible firearm owners to strategize on how to best approach these issues.
“As with other public health crises, firearm-related injury and death are preventable,” the authors concluded. “The medical profession has an obligation to advocate for changes to reduce the burden of firearm-related injuries and death on our patients, their families, our communities, our colleagues, and our society.”
1. McLean RM, Harris P, Cullen J, et al. Firearm-related injury and death in the United States: a call to action from the nation’s leading physician and public health organizations [published online August 7, 2019]. Ann Intern Med. doi:10.7326/M19-2441
2. Azrael D, Cohen J, Salhi C, Miller M. Firearm storage in gun-owning households with children: results of a 2015 national survey. J Urban Health. 2018;95(3):295-304.
3. Miller M, Azrael D, Hemenway D, Vriniotis M. Firearm storage practices and rates of unintentional firearm deaths in the United States. Accid Anal Prev. 2005;37(4):661-667.