As an ACEP member, I share what many other members desire from membership: ACEP should make my life easier by seeking legislation and policies that make me work less hard, preserve our practice environment, and enhance our ability to care for our patients. That’s what people want. We did not join ACEP for broad-based, political advocacy. Thus, when ACEP gets involved in issues not specific to the practice of emergency medicine, such as the separating of families at the border, climate change, or the firearms issue, ACEP runs the risk of alienating a good number of members. In other words, emotionally charged issues, which are polarizing, can and often do become divisive, creating a “no win” situation for ACEP.
The firearms issue may, in some cases, be less about patient safety than about furthering a political agenda. If it were solely about patient safety, then we would look to the multitude of peer-reviewed articles and data analyses outside the medical literature that prove that gun control efforts are not effective in reducing crime and injury.
If we examine the issue of research, testimony by John R. Lott, Jr., president of the Crime Prevention Research Center, before the House Committee on Appropriations on March 7, 2019, clarified several important issues:
- The Dickey Amendment has been misinterpreted. It does not prevent (and has not prevented) firearm research. It merely states that the Centers for Disease Control and Prevention cannot advocate for gun control.
- After 1996, firearms research fell as a percentage of all research. However, this is artifactual because there was an increase in new journals and published articles, creating a larger denominator. Accounting for this, firearm research remained relatively constant from previous years.
- This has not been widely publicized, but there were three federal funding amendments for firearms research in 1996, 2003, and 2012.
- By 2013, the number of firearms articles rose to 121, to 196 in 2014, and to 344 in 2015.
- The share of federally funded research before 2000 was 2.9 percent, but after 2000 it was 3.3 percent. The share of research that mentioned any funding source before 2000 was 8.5 percent and 18.2 percent after 2000.
- In 2015–2018, the total federal funds for firearms research was $43.2 million, a 465 percent increase from 2011–2014, which resulted in 83 projects.
- One cannot apply the “medical method” of studying disease to studying firearm-related issues. (Incidentally, referring to firearm violence as an “epidemic” is erroneous and misleading because “epidemic” refers to a widespread occurrence of an infectious disease, not an action.)
- There is an abundance of firearm literature outside medicine in the economics and criminal justice literature that is peer-reviewed and scientifically sound, but is often ignored by those in medicine. These links direct to the Crime Prevention Research Center (https://crimeresearch.org/cprc-research/ and https://crimeresearch.org/data/) and a policy analysis from the Cato Institute. They are a good starting point for a review from “the other side.”
The directive followed by the ACEP task force when creating the existing firearms policy in 2013 was not to “legislate” or contradict existing laws. Thus, if we examine legislative issues, ACEP recently advocated for H.R. 8 (requiring a background check for every firearms sale). Unfortunately, the support for that bill may not effect the desired change, because it still does not prevent criminals from obtaining firearms.
Interestingly, California recently decided that a ban on high capacity magazines (more than 10 rounds) is unconstitutional. Should ACEP’s current firearms policy be updated to delete the referral to “high capacity magazines” in the last bullet?
I would prefer ACEP concentrate its efforts on the many challenges before us to make our lives easier, such as protecting patient’s rights, advocating for access to emergency care, preserving the interests of emergency physicians, ensuring fair reimbursement, etc. We need to stay out of divisive politics and issues.
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8 Responses to “Opinion: ACEP Should Avoid the Firearms Debate”
May 19, 2019
David McClellanVery well said Dr Coppola. I especially commend your comments about research differing from advocacy and ACEP risking alienating a sizable portion of its membership with the way this is being done. Giving $20K to a markedly biased organization with an advocacy agenda of my dues dollars smacks of big union politics. Stick with the mission, ACEP!
May 20, 2019
Clifford CloonanI have been an ACEP member since 1988. I have never been a member of the AMA because that organization has been politicized for many, many years. If ACEP goes in the same direction as the AMA I will leave ACEP – I almost did this year. Gun control is a political, not a medical issue.
Clifford Cloonan
May 26, 2019
Cody WardYes! Well written. ACEP should stay away from taking a political stance on anything not specific to the practice of medicine.
May 26, 2019
Mike HaleyI couldn’t agree more !!!!
ACEP should concentrate on practice issues!!!!
When you go Political Agenda you alienate 40-50% of your members! Your friends may be all of one party but you have confirmational bias!!!
Michael Haley MD FACEP
Member since 1984
May 28, 2019
BrentWhere are your citations for this “multitude of peer-reviewed articles and data analyses outside the medical literature that prove that gun control efforts are not effective in reducing crime and injury”? I’m not very familiar with this literature but thought country-level data suggested otherwise?
May 29, 2019
W. Kan, MDFinally, prioritizing factual analysis over political advocacy. Thank you, Dr.Coppola.
May 30, 2019
Gregory LewisYou are saying that ACEP should not express an opinion on a public health issue? Because there is a political overlay on that issue? Should we take the same approach to vaccination, helmet use, seatbelts etc… In reality, the exact opposite approach should be taken. We should take the politics out of what should be simply a public health policy debate.
Then you refer people to a blatantly political site for information? The Crime Prevention Research Center was founded in 2013 by John Lott, author of the book “More Guns, Less Crime.” It has a very clear agenda and is very politically motivated. Do a quick search for John Lott and you will find that he regularly distorts data and research to support his agenda. He is also very likely funded by the gun industry.
June 1, 2019
Randy CordleI applaud Dr. Coppola for having the courage write this article in these politically charged times where the facts rarely get in the way of nonsensical opinion and policy. He is absolutely correct on each point. I have already left one similar organization over this issue where their political agenda meant more to them than the data. ACEP, a trade organization, should focus on supporting the practice of Emergency Medicine and improving the conditions under which it’s members work. I will leave it at that for brevity.