7 steps to reduce gun violence

Comprehensive background checks on all gun purchases, better access to mental health care, and allowing doctors to counsel patients about firearm safety are among the steps that could reduce gun-related injuries and deaths, according to the heads of seven  physician and public health organizations.

In an article published August 7 in Annals of Internal Medicine, the authors noted that the U.S. experienced nearly 40,000 firearm-related deaths in 2017, a 20-year high and far more than any other high-income country.

While not referencing them directly, the article appeared shortly after the mass shootings in El Paso, Texas, and Dayton, Ohio, in which at least 31 people were killed. And while such incidents account for only a small proportion of all gun deaths each year, they “create a sense of vulnerability for everyone, that nowhere…is safe from becoming the venue of a mass shooting,” the authors say.

“We are living in a world where gun violence is becoming increasingly common, and as physicians, we have a responsibility to address this public health crisis and to keep our patients safe and healthy,” Robert McLean, MD, FACP, president of the American College of Physicians and one of the article’s authors, said in a written statement.

The policy recommendations outlined in the article include:

• Requiring comprehensive criminal background checks for all firearm purchases, including those by gun dealers, at gun shows, and transfers between individuals,

• More funding for the Centers for Disease Control and Prevention to research the causes and consequences of firearm-related injuries and deaths and develop strategies to reduce them,

• Prohibiting gun sales to people who have been found guilty of crimes of violence against a family member or intimate partner, including dating partners,

• Support for laws that penalize firearm owners who negligently store firearms under circumstances where children could or do gain access to them,

• Improved screening, access to and treatment for mental health disorders, since such disorders “play a critical role in reducing risk for self-harm and interpersonal violence,”

• Passage of “Extreme Risk Protection Order” laws, which allow families and law enforcement officers to petition a judge to temporarily remove firearms from people thought to be at imminent risk for using guns to harm themselves or others,

• Opposing state and federal mandates that forbid doctors from discussing a patient’s firearm ownership, since “providing anticipatory guidance on preventing injuries is something physicians do every day, and it is no different for firearms than for other injury prevention topics,” and

• Instituting special scrutiny and regulation for high-capacity magazines and firearms with features designed to increase their rapidity and extend their killing capacity

“The medical profession has an obligation to advocate for changes to reduce the burden of firearm-related injuries on our patients, their families, our communities, our colleagues and our society,” the authors write.

In addition to the ACP’s McLean, authors of the letter include Patrice Harris, MD, president of the American Medical Association; John Cullen, MD, president of the American Academy of Family Physicians; Kyle E. Yasuda, MD president of the American Academy of Pediatrics; Bruce J. Schwartz, MD, president of the American Psychiatric Association; and Georges C. Benjamin, MD, executive director of the American Public Health Association.