COMMENTARY

What's Our Role in Gun Control?

Brandon Cohen

Disclosures

April 16, 2015

In February, a statement from a group of eight medical societies and the American Bar Association, published in Annals of Internal Medicine,[1] called for increased action to combat gun-related deaths in Americans as a public health issue. Among the specific recommendations advocated in the statement were more background checks on prospective gun owners and a greater responsibility on the medical community to identify and report gun owners with potential mental disorders.

A recent Medscape article spurred a lively debate among healthcare professionals on the merits of these recommendations and on the role of medical professionals with respect to preventing gun violence.

Quite a few commenters bristled at the idea of what they view as unnecessary political baggage being loaded onto the medical community. A psychiatrist sounded the alarm with a dire warning: "This leftist political agenda does not belong anywhere near the physician-patient relationship. Are we to become informers for the police state?"

A registered nurse expressed displeasure at the new initiative while highlighting some of the profession's uglier faults:

The medical community should concentrate on medical-related deaths and injuries from malpractice [and also on] surgical and medical errors which far exceed the number of firearm-related injuries.

Another healthcare provider agreed:

I personally like and professionally respect my doctor. His opinions on firearm ownership are his and I respect his right to have them and act according to his conscience. This is not a topic of any conversation I will have with him. It crosses the line between his taking care of my health (mental or physical) and discussions that I should have with my church.

But a family medicine physician responded quickly:

Why should physicians not be allowed to discuss gun safety with parents, like car seats, household poisons and bike helmets? Or do you not believe in preventive medicine?

A nephrologist also showed enthusiasm for increased medical attention to gun violence as a safety issue:

This is exciting news! I am so glad to see the medical society finally acknowledge firearm-related deaths as a serious threat to public safety in the United States. Tens of thousands of lives have been taken as a result of negligence of guns in America. I hope something can truly come of this to make our country a safer place to live in.

A physician assistant disagreed and saw folly in the politicization of medicine:

This is not a role for us to take as providers. The vast majority of gun deaths are related to the illegal use of firearms either by those who are too young to own guns on their own or by felons. The laws on the books don't stop law breakers, and any new laws will only hinder those who obey the law to begin with.

A pharmacist replied, "Most firearm deaths are from suicide, not use by felons. This is a public health issue." An emergency medicine physician was unconvinced and drew a parallel:

Are you going to ban tall buildings with windows and deep bodies of water, because people kill themselves with those, as well? The second amendment ain't going away, comrade.

A family medicine physician then entered the fray with an impassioned condemnation and partial diagnosis of the gun rights movement:

The language of gun rights is the language of addiction: addiction to the power associated with the possession of lethal force. It would not be unreasonable to say that the biggest threats to American health and well-being do not come from terrorist organizations but rather from the National Rifle Association. We do need gun control and we need it now. Possession of assault rifles gives one the sense of invulnerability and that brings with it a brain rush of chemicals that is similar to crack, methamphetamine, and so forth.

A pathologist was also on board with restrictions and regulations on the owners of firearms:

The main factor leading to excessive gunshot morbidity and mortality is the easy availability of guns. The chief manners of death are homicide and suicide, the former but not the latter typically involving criminals. Accidents, the smallest category, involve innocent perpetrators, often children. The changes required for the reduced availability of guns are primarily social. This will necessitate legislation and regulation.

But another healthcare professional saw some room for common ground, arguing that one could support some of the major provisions of the statement in the Annals of Internal Medicine[1] while still supporting the right to bear arms:

There are probably very few pro second amendment people (of which I am one) who don't support criminal and mental health background checks as a requirement for obtaining a gun purchase permit. If a physician diagnoses mental health issues, he or she should be required to report those findings to authorities.

The gun control discussion raised familiar and well-travelled issues for many. And although there were more than a few prominent attacks on any attempt to regulate firearms, more than 90% of respondents to a reader poll conducted subsequent to the release of this medical society statement supported at least some of the provisions of the medical societies' statement.

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