What is missing from this is the public health perspective in preventing these tragedies. In particular, it sure would have been nice for our emergency physician national organization to take a stand against the sale of automatic and semiautomatic weapons used in these mass shootings. ACEP has policies and statements advocating against texting while walking and against laws requiring mandatory reporting of certain injured patients in the ED to law enforcement to improve the health and safety of the public. Responding to and taking care of mass shooting victims is clearly important. More important to all of those whose loved ones have been murdered during these tragedies would have been the prevention in the first place. The fact that there is no such prevention statement listed in this ACEP correspondence seems odd and unfortunately suspicious for political motivation.

—C.J.S.
(from ACEPNow.com)

This is a shame that ACEP is even trying to have a debate on this issue. As emergency physicians who treat victims of gun violence, it’s pretty clear our position should be that we should be doing everything we can to ensure fewer gun deaths. The ecological data from other countries and from studies in the United States is clear, in spite of what Dr. Coppola is suggesting—where there are fewer firearms, there are fewer firearm deaths. If ACEP wants to consider his position that we should become an even more armed society, it only has to remember we are already far and away the most armed first-world country in the world and have more gun violence and gun deaths than any other such country. Coincidence? I think not.

–Paul
(from ACEPNow.com)

Thanks to ACEP Now for acknowledging that there are two sides to this issue. But let me correct an error that has been endlessly perpetuated by those who wish to even further restrict firearm civil rights.

Congress did not prohibit firearm research at the CDC. I know. I was one of three medical doctors who testified before the House Appropriations Committee in March 1996. We showed the committee hard evidence of the CDC leadership’s overt gun control advocacy. It was that anti-civil rights advocacy that Congress quite reasonably prohibited, not firearm research.

The events of that era are documented in my three-part historical series, “The History of Public Health Gun Control,” at Doctors for Responsible Gun Ownership’s website, drgo.us.

—Timothy Wheeler, MD
Director, Doctors for Responsible
Gun Ownership, California
(from ACEPNow.com)

In ACEP Now’s July 15 gun control debate, you asked whether ACEP and, by implication, any other medical organization should become involved in questions regarding the Second Amendment to the Constitution. We should, without a doubt.

As an emergency medicine physician, sworn law enforcement officer, retired Navy Medical Corps captain, and firearm trainer with multiple certifications from the National Rifle Association and the Massad Ayoob Group, I am extraordinarily qualified to comment on this subject.

As physicians, we bear extraordinary privileges and responsibilities not only because of what we do but also because we are Americans. All American physicians (and we are the American College of Emergency Physicians) should stand behind all of the amendments to the Constitution, especially the Second Amendment, without which none of the others are enforceable. The first 10 amendments to the Constitution are called the Bill of Rights. Those amendments are actually a Bill of Restraints on the federal government. History teaches us that without them we would not have had the Constitution and likely not a country. Now we are engaged in a great civil discussion regarding the nature and culture of our country. On one side are those who believe that it is the province of the federal government to control and provide for all actions and resources within our society. Those on the other side of the discussion maintain that although there are some constraints upon individual and group actions, progress has been made more by individuals, and freeing the people to make progress yields more liberty. It is ludicrous that some are trying to prohibit citizens from owning the very firearms that our police use to protect us—pistols and rifles with a modern design. Yet we know that the police are rarely on the scene when desperately needed. Therefore, since it is natural instinct for all animals, including Homo sapiens, to defend themselves and their young, it seems only fitting that the people have access to the same firearms that we expect our police to use to defend and protect us. Statistics can be twisted, but I have yet to find a study that produces significant evidence of crime going up as firearm ownership and use have increased in the United States. We also find studies that show that in countries that have recently restricted firearms, rates of violence have not trended up. The exception is the United Kingdom, specifically Britain, where criminal violence has increased dramatically since civilians were disarmed.

The states of California, New Jersey, Illinois, and Maryland have seen significant increases in criminal misuse of all weapons, including firearms. It must be clear to anyone paying attention that those states have the strictest firearms laws in this country. Why would anyone expect more draconian gun control laws to somehow work?

The first 10 amendments to the Constitution are called the Bill of Rights. Those amendments are actually a Bill of Restraints on the federal government. History teaches us that without them we would not have had the Constitution and likely not a country.

While the total number of firearms and the population of the United States have increased dramatically, both the rates and absolute numbers of firearm deaths have decreased. Poorly done and often discredited studies such as the 1993 Kellerman study are still referenced by those who wish to decrease our freedoms.

Supporters of still more gun control laws often point to innovations in motor vehicle safety reducing auto fatalities as a model for mandating similar safety modifications to firearms. This comparison is false on several levels. First, better trauma care has reduced fatalities and mitigated injuries from both motor vehicles and firearms. Decreasing gasoline prices encourage drivers to log more miles, thus increasing the probability of collisions.
But the auto-to-firearm comparison really falls apart when one ponders the obvious—auto deaths are almost all accidental, but firearm deaths are almost all intentional. Expecting a safety device to stop a killer is ridiculous.

About two-thirds of firearms deaths are suicides. Countries with strict firearms restrictions have higher rates of suicide than we do. Mentally ill persons who choose to commit suicide can always find a way. Police and criminologists have data that small populations of chronically violent offenders are responsible for most wrongful homicides. A firearm is simply a tool and not the cause of the criminality.

Death is inevitable. None of us will leave this world alive. But reducing the already declining number of avoidable deaths in America will not be accomplished by passing even more gun prohibition laws. We should renew our allegiance to the Constitutional principles that made America great instead of looking for even more ways to limit the freedom of good Americans.

—Robert A. Margulies, MD, MPH, FACEP
Richland, Washington