Public Release: 

Annals of Internal Medicine tip sheet for Feb. 23, 2015

American College of Physicians

1. Eight health professional organizations and the American Bar Association call for policies to reduce gun injuries and deaths in the U.S.

Leaders from the American College of Physicians (ACP), seven other national health professional organizations, and the American Bar Association call for policies to help mitigate the rate of firearm injuries and deaths in the United States. Key principles and consensus-based recommendations are outlined in the paper, Firearm-Related Injury and Death in the United States: A Call to Action from 8 Health Professional Organizations and the American Bar Association, published in Annals of Internal Medicine.

Approximately 300,000,000 guns are privately owned in the United States - more than in any other nation in the world - and research shows that access to firearms increases a person's likelihood of death by suicide or homicide. The organizations support a public health approach to reducing firearm injuries and fatalities, similar to approaches used to reduce tobacco use, motor vehicle fatalities (seat belts), and unintentional poisoning.

The physicians organizations (ACP, American Academy of Family Physicians, American Academy of Pediatrics, American College of Emergency Physicians, American Congress of Obstetricians and Gynecologists, American College of Surgeons, and American Psychiatric Association) are joined in support by the American Public Health Association and the American Bar Association, which is committed to helping lawyers and the public understand that the Second Amendment does not stand as an impediment to reasonable measures to limit firearm violence.

"Along with our colleagues in law and public health, those of us who represent the nation's physicians realize that there are significant political and philosophical differences about firearm ownership and regulation in the United States," said ACP Executive Vice President and CEO Dr. Steven E. Weinberger. "However, we strongly support a multifaceted public health approach and will not be dissuaded from advocating for the improved health of our patients and families."

The paper offers the following recommendations for reducing firearm-related injuries and death. The recommendations reflect the organizations' policies and integrate the multidisciplinary perspectives of medical, public health, and legal professionals.

  • Support criminal background checks for all firearm purchases, including sales by gun dealers, sales at gun shows, and private sales from one person to another.
  • Oppose state and federal mandates that interfere with physician free speech and the patient-physician relationship, including physician "gag laws" that forbid physicians to discuss a patient's gun ownership.
  • Oppose the sale or ownership of "assault weapons" and large capacity magazines for private citizens.
  • Advocate research into the causes and consequences of firearm violence and unintentional injuries so that evidence-based policies may be developed.

The American Bar Association notes in the paper that these recommendations "are constitutionally sound." The health professional societies made two additional recommendations:

  • Support improved access to mental health care, with caution against broadly including all persons with any mental or substance use disorder in a category of persons prohibited from purchasing firearms.
  • Oppose blanket reporting laws that require physicians to report patients with mental or substance use disorders, as these laws may stigmatize the patients and inhibit them from seeking treatment.

This paper is accompanied by an editorial by Darren B. Taichman, MD, PhD, Executive Deputy Editor of Annals of Internal Medicine.

Note: For a PDF of the recommendations or to interview Dr. Weinberger or Dr. Taichman from the American College of Physicians, please contact Angela Collom.


2. Hospitalized victims of gun violence more likely to become repeat victims or perpetrators themselves

Being hospitalized for a firearm-related injury is associated with a heightened risk of subsequent violent victimization or crime perpetration, according to an article published in Annals of Internal Medicine. There are 40 times as many nonfatal firearm-related crimes as there are firearm-related deaths, and 23 percent of victims of such crimes sustain an injury. Information on the risk of subsequent violent victimization or crime perpetration following hospitalization for a firearm-related injury is lacking, but is needed to inform future interventions among this group of patients. Using a retrospective cohort study design, researchers identified all gun trauma patients hospitalized during 2006-2007 in Washington State and compared their risk of subsequent violent injury, death, or crime perpetration to the rates among a random sample of patients with a noninjury-related hospitalization and the general population of the state. They found that patients with a hospitalization due to firearm violence were at a significantly greater risk for subsequent firearm-related hospitalization, firearm-related death, or violence-related arrest in comparison with noninjury patients. In addition, prior criminality had a stronger association with subsequent firearm or violence-related arrest than did prior mental illness diagnosis.

Note: For a PDF, please contact Megan Hanks. To interview the lead author, please contact Catherine Shen at cshen489@uw.edu.

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