Firearm-related injuries, deaths in Charleston and beyond

A reflection on recent tragedies leads to embracement of initiatives meant to stem the tide of gun violence.

The murder of 9 congregants at the Mother Emanuel AME Church in Charleston, S.C., earlier this year was a painful, gut-wrenching reminder that firearm-related injuries and deaths remain an enormous national problem. On a sunny, sultry, early summer evening, a misguided young man who harbored “nihilistic” notions about others took precious lives with a semi-automatic weapon he should not have had access to and which there is no reasonable sporting reason to possess.

More recently, on Oct. 1, at least 10 people were killed and others wounded by a gunman at Umpqua Community College in Roseburg, Ore., and in late August, a disgruntled and troubled former television journalist took the lives of 2 former coworkers on live television. This and other mass shootings have become all-too-common occurrences. Whether at Sandy Hook Elementary School in Connecticut, a movie theater in suburban Denver, or a Sikh temple in suburban Milwaukee, they share similar circumstances in that firearms were used to take innocent lives by individuals who should not have had access to such weapons due to their criminal background and/or preexisting documented psychiatric diagnoses.

In the wake of these events, many are left wondering what can be done to decrease their likelihood. I did not say to eliminate them, as clearly that would be virtually impossible, knowing what physicians do about human behavior and frailty and their many manifestations. I could not be prouder of the American College of Physicians as it has staked out a series of positions that are respectful of the cherished Second Amendment's right to bear arms but are designed to minimize such injury and death from happening so regularly.

Last spring, ACP joined with the American Bar Association and 7 other leading medical professional organizations, the American College of Surgeons, the American Academy of Family Physicians, the American College of Emergency Physicians, the American Congress of Obstetricians and Gynecologists, the American Psychiatric Association, the American Academy of Pediatrics, and the American Public Health Association, to issue a highly regarded and timely policy paper in Annals of Internal Medicine. Titled “Firearm-related injury and death in the United States: a call to action from 8 health professional associations and the American Bar Association,” the paper cogently stresses the fact that firearm-related injuries and deaths are major public health problems. They are more deadly to many communities than HIV/AIDS, motor vehicle fatalities, and other public health threats that are more often recognized as such.

Specifically, the measures advanced by these organizations, which represent more than 1 million physicians, include robust universal background checks, restrictions on assault/military-style weapons and high- capacity bullet magazines, expanded mental health care programs to address “at-risk” individuals, sensible reporting laws, and elimination of “gag laws” that prohibit physicians from discussing gun safety issues during clinical encounters. Additionally, the organizations noted an absence of research on firearm-related injuries and deaths and called for funding of research that addresses the public health and injury-prevention aspects of firearms and firearms policies.

To be clear, absolutely none of what we have proposed interferes with the right to bear arms. It does, however, make it much more difficult for individuals to get easy access to weapons, which may go a long way toward significantly reducing such horrific events from occurring.

I embrace these initiatives not only as President of the College but also as an African-American physician who is very concerned about the spike in gun-related deaths in communities of color in many of our nation's inner cities. Guns are simply too easy to obtain, particularly by those who should not be able to do so. To date, 50 major medical professional and other advocacy groups have embraced and formally support our call for commonsense measures to reduce firearm violence in America.

With regard to “gag rules” implemented in Florida that prevent physicians from asking their patients such simple questions as “Do you own a firearm?” and “Is it safely secured out of the reach of children or those suffering from mental illness?”, we have joined with the American Medical Association and 4 other professional medical associations and with concerned physicians in Florida to file an amicus brief arguing that such restrictions not only clearly violate physicians' First Amendment right to counsel our patients but also interfere with the all-important doctor-patient relationship. As the “conscience of American medicine,” ACP is leading this important effort because it is consistent with our principles and our mission.

Dec. 4 will mark the 6-month anniversary of the deaths of the “Emanuel 9,” as they are so lovingly known now. I will be honored to be present that day in Charleston to mark the occasion and to confer with leaders of many concerned medical and professional organizations to discuss how we can build on our important work to address firearm-related injuries and deaths as the public health problems they so glaringly are. In his eulogy for the pastor of Mother Emanuel AME Church, Rev. Clementa Pinckney, 1 of the Emanuel 9, President Obama spoke movingly of having the grace to promote change. Let us seek to honor all victims of firearm injury and violence, no matter the locale, by embracing the commonsense measures that will make us truly a better, healthier, and safer nation.