“Reporting the news, not creating it”
Editors’ Note: We have received many passionate letters and articles in response to our articles on firearms safety. We have opted to publish a selection of these unsolicited letters here, as they reflect the opinions we’ve received. These opinions do not represent official positions of ACEP, nor are they representative of all opinions on this topic.
We read with interest the recent pro/con debate in ACEP Now (July 2016) about gun control. This debate followed reporting of advocacy for the restoration of federal funding for gun violence research in June by ACEP President Jay Kaplan, MD, and by the American Medical Association (AMA) (ACEP Now, June 2016). The July article purported to debate the merits of political advocacy for gun control by our profession. However, it confused legal advocacy with science advocacy, and so it perpetuates the misconception that public health and the science of firearm injury prevention are in opposition to the US Constitution.
Science informs law. Americans’ enjoyment of individual rights and civic security has been repeatedly refined and improved by the application of scientific evidence to legal reasoning. The science of firearm injury prevention intends to diminish firearm-related health risks and, therefore, to improve the rights and securities afforded to all Americans. Portraying firearm injury prevention as being in opposition to Constitutional law expresses a fear of science and the knowledge it may provide. ur profession has long been a standard bearer in injury prevention science. Under the leadership of emergency physicians and other injury prevention specialists, the United States has improved the health outcomes of many nonfatal and fatal injuries, ranging from motor vehicle crashes and drownings to unintentional medication overdoses. These health improvements were achieved without changing the availability of cars, pools, or prescription medications. We have simply made these consumer items, and the behaviors of individuals who use them, safer. We can do the same for firearms, which are by far the most lethal mechanism of injury and which cause the same number of deaths in the United States each year as cars.
FIREARM PREVENTION IN CLINICAL PRACTICE
The science of firearm injury prevention also has immediate application to our clinical practice. It’s relevant to every emergency physician who has evaluated the danger of a depressed, angry, agitated, delusional, or intoxicated patient or who has treated a patient at elevated risk of firearm-related victimization or injury/death. According to a recent survey of a sample of emergency physicians participating in the Emergency Medicine Practice Research Network (EM-PRN), the majority of us ask “often” or “almost always” about firearm access for patients with suicidal ideation, with fewer regularly asking about firearm access for patients suffering from psychosis, domestic violence, assault injury, or substance use. More than 90 percent of respondents said that knowledge of firearm access would change their risk assessment and disposition for suicide, and more than two-thirds said that it would change their risk assessment and disposition for victims of domestic violence or patients with acute psychosis (see Figures 1 and 2).