Think of it: two learned professions, which in popular lore don’t really like each other (thus, the dismissive jokes each make about the other), agreeing on a public policy response to a pressing national priority? Two professions, often at loggerheads with each other, whether it is on tort reform or facing each other down in court of law, yet finding something they can agree on?
Well, this is precisely what happened this week when the American Bar Association joined with ACP and 7 other health professional organizations in a call to action, published in the Annals of Internal Medicine, on preventing deaths and injuries from firearms. The physician organizations that co-authored the paper—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, representing the vast majority of U.S. physicians, were joined by the American Public Health Association and the American Bar Association to “advocate a series of measures aimed at reducing the health and public health consequences of firearms. The specific recommendations include universal background checks of gun purchasers, elimination of physician ‘gag laws,’ restricting the manufacture and sale of military-style assault weapons and large-capacity magazines for civilian use, and research to support strategies for reducing firearm-related injuries and deaths.”
This paper is, to my knowledge, the first interdisciplinary agreement among the largest and most influential specialty organizations representing the medical profession, the legal profession, and the public health community to take on one of the most vexing problems facing this country: that each year “more than 32,000 persons die as a result of firearm-related violence, suicides, and accidents in the United States; this rate is by far the highest among industrialized countries.”
Each organization approached the issue from a position of credibility on the aspects of firearms policies for which they had the most standing: physicians and public health advocates on the impact of firearms on the individual health of patients and on population health, the lawyers on the Constitutional issues involved. The ABA confirmed that the policy recommendations proposed in the paper are well within the right to bear arms as established by the Second Amendment:
“These recommendations do not come solely from a group of health organizations without expertise in constitutional law but have been developed in collaboration with colleagues from the ABA, which has confirmed that these recommendations are constitutionally sound. For 50 years, the ABA has acknowledged the tragic consequences of firearm-related injury and death in our society and expressed strong support for meaningful reforms to the nation's gun laws, as well as for other measures designed to reduce gun violence that do not fall under Second Amendment scrutiny. Because the courts have repeatedly held that the Second Amendment is consistent with a wide variety of laws to reduce gun-related deaths and injuries in our nation (yet confusion exists among the public about whether the Second Amendment is an obstacle to sensible laws), 1 mission of the ABA has been to educate its members, as well as the public at large, about the true meaning and application of the Second Amendment. . . No ruling of the Supreme Court (or any other court, for that matter) calls into question any of the specific proposals that we recommend.”
The origins of the ABA joining with ACP and the other health professional associations go back to a year ago, when the ABA first informed ACP of its interest in the working with the College on firearms policy, following the publication in Annals of ACP’s own paper on reducing deaths and injuries from firearms, written on behalf of the College’s Health and Public Policy Committee, chaired by Dr. Thomas Tape. At the ABA’s invitation, Dr. Tape presented at an educational seminar for lawyers at the ABA’s annual conference in August 2014 on 'Combatting Gun Violence, A Role for Lawyers and the Bar.' Renee Butkus, ACP’s Director of Health Policy and co-author (with me) of the ACP’s 2014 position statement, participated in the Fall of 2014 in the founding meeting of the Prosecutors Against Gun Violence, prosecutors from 23 jurisdictions who “formed to combat gun violence by sharing information on programs that work and copying effective state laws,” reported USA Today.
Both the ACP and the ABA decided that it would be even more effective to broaden the effort to include other major physician membership organizations and public health advocates—leading to the joint statement published on Tuesday. The plan now is to seek endorsements of the paper by an even broader universe of physician, public health, health services researchers, and consumer and public advocacy groups over the next several months.
I think the combined credibility of doctors and public health professionals on the health impact of firearms, and the lawyers on the constitutional issues, will give this new effort more credibility than any one organization, or any one profession, could bring to the firearms debate on their own.
It will need it, given the pervasive influence the gun lobby has over public policy in the United States. In an editorial accompanying the joint paper, Drs. Darren Taichman, Executive Deputy Editor, and Christine Laine, Editor in Chief of the Annals of Internal Medicine, argue that it will take the engagement of the 500,000 plus members of the health professional organizations that signed the statement to make the difference:
“What if the more than one half million health care professional members of these organizations contacted their federal and state government representatives to tell them that they believe firearm-related injury is a public health crisis that we need to fix? We just did. It took less than 1 minute to find contact information for our state government legislators (we searched “e-mail my PA legislator”). You may contact your Congressional representatives at www.house.gov/representatives/find or www.senate.gov/general/contact_information/senators_cfm.cfm. We provide a copy of the letter we sent (Supplement), and you can modify it or write your own to convey your thoughts on the public health threat of firearms.
"We, as health care professionals, are trusted, expected, and paid to prevent harm to our patients and discover solutions to public health problems. Have we done our jobs? Can we? The answers are no and maybe: No, we have not sufficiently reduced the firearm-related harms our patients suffer, but maybe we can, if we demand the resources and freedom to do so.”
Today’s questions: What do you think of the joint paper by ACP, the seven other health professional organizations, and the ABA? Do you agree with Drs. Taichman and Dr. Laine that physicians have not “sufficiently reduced the firearm-related harms our patients suffer, but maybe we can, if we demand the resources and freedom to do so?" What are you willing to do?