Megan Brooks

April 10, 2014

Physicians have a right and responsibility to discuss gun violence with their patients, according to a new position paper from the American College of Physicians (ACP).

"Patients have long trusted their physicians to advise them on issues that affect their health," ACP president Molly Cooke, MD, FACP, said in a statement. "Physicians can play a critical role in educating the public on the risks of firearm ownership and the need for firearm safety through their encounters with their patients."

The position paper was released today at the Internal Medicine 2014 in Orlando, Florida, and was published simultaneously in the Annals of Internal Medicine.

To inform its policy position, the ACP Health and Public Policy Committee reviewed available data on the impact of access to firearms, mental health, state and federal firearms laws, and efforts to reduce firearms violence. The policy outlines 9 strategies to address the societal, healthcare, and regulatory barriers to reducing firearm-related violence, injuries, and deaths in the United States.

ACP Supports Universal Background Checks

The ACP recommends that firearm safety be approached as a public health issue so that policy decisions are based on scientific evidence.

"As such, ACP strongly supports universal criminal background checks to keep guns out of the hands of felons, persons with mental illnesses that put them at greater risk of harming themselves or others, people with substance use disorders, and others who current regulations prohibit from owning guns," according to an ACP statement.

"The United States has the highest firearm-related mortality rate among industrialized nations," Dr. Cooke said during a media briefing. "ACP believes that a comprehensive, multifaceted approach is necessary to reduce this epidemic of gun violence and that physicians play a vital role."

Other Recommendations

ACP supports appropriate regulation on the purchase of legal firearms to reduce firearm-related injuries and deaths, acknowledging that any such regulation must be consistent with the Supreme Court ruling establishing that individual ownership of firearms is a constitutional right under the Second Amendment of the Bill of Rights.
ACP recommends that guns be subject to consumer product regulations regarding access, safety, and design. In addition, the College supports law-enforcement measures to aid in the identification of weapons used in crimes.
ACP believes that firearm owners should adhere to best practices to reduce the risk for accidental or intentional injuries or deaths from firearms.
ACP cautions against broadly including those with mental illness in a category of dangerous individuals. ACP recommends that every effort be made to reduce the risk for suicide and violence through the prevention and treatment of the subset of individuals with mental illness who are at risk of harming themselves or others. ACP believes that diagnosis, access to care and treatment, and appropriate follow-up are essential.
ACP believes there is enough evidence to enact legislation banning the sale and manufacture for civilian use of firearms that have features designed to increase their rapid killing capacity (often called "assault" or semiautomatic weapons) and of large capacity ammunition, and retaining the current ban on automatic weapons for civilian use.
ACP supports efforts to improve and modify firearms to make them as safe as possible, including the incorporation of built-in safety devices.
ACP believes that more research needs to be funded on firearm violence and on intervention and prevention strategies to reduce injuries caused by firearms. Access to data should not be restricted.


A Public Health Threat

There is "very broad support" among internists for the ACP position on gun violence, Robert Doherty, BA, senior vice president for government affairs and public policy at ACP, said during a press briefing.

Of a nationally representative sample of 573 internists surveyed by ACP, 85% said they believe that firearm injury is a public health issue and 71% believe that it is a bigger problem today than it was a decade ago.

In addition, 66% of respondents said they believe that stricter gun control legislation would help reduce the risk for gun-related injuries or deaths. Roughly two-thirds believe that physicians should have the right to counsel patients on preventing deaths and injuries from firearms, yet 58% reported never asking whether patients have guns in their homes.

The survey was published today in the Annals of Internal Medicine.

"We concluded that firearm violence is not just a criminal justice issue, but also a public health threat that requires the nation's immediate attention," Thomas Tape, MD, FACP, chair of ACP Health and Public Policy Committee, said in a statement.

"As an organization representing physicians who have first-hand experience with the devastating impact of firearm-related violence, ACP has a responsibility to participate in efforts to mitigate needless tragedies," he added.

Ann Intern Med. Published online April 10, 2014. Position paper, Survey


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