|Jorge Fernandez, MD||University of California, San Diego, Department of Emergency Medicine, San Diego, California|
|Taylor Nichols, MD||University of California, San Diego, Department of Emergency Medicine, San Diego, California|
|Zahir Basrai, MD||University of California, San Diego, Department of Emergency Medicine, San Diego, California|
|Randall Young, MD||University of California, San Diego, Department of Emergency Medicine, San Diego, California|
|Michael Gertz, MD||University of California, San Diego, Department of Emergency Medicine, San Diego, California|
|Marc Futernick, MD||University of California, San Diego, Department of Emergency Medicine, San Diego, California|
|Andrew Fenton, MD||University of California, San Diego, Department of Emergency Medicine, San Diego, California|
Firearm-related deaths and injuries are a serious public health problem in California and the United States. The rate of firearm-related deaths is many times higher in the US than other democratic, industrialized nations, yet many of the deaths and injuries are preventable. The California American College of Emergency Physicians Firearm Injury Prevention Policy was approved and adopted in 2013 as an evidence-based, apolitical statement to promote harm reduction. It recognizes and frames firearm injuries as a public health epidemic requiring allocation of robust resources, including increased governmental funding of high-quality research and the development of a national database system. The policy further calls for relevant legislation to be informed by best evidence and expert consensus, and advocates for legislation regarding the following: mandatory universal background checks; mandatory reporting of firearm loss/theft; restrictions against law-enforcement or military-style assault weapons and high capacity magazines; child-protective safety and storage systems; and prohibitions for high-risk individuals. It also strongly defends the right of physicians to screen and counsel patients about firearm-related risk factors and safety. Based upon best-available evidenced, the policy was recently updated to include extreme risk protection orders, which are also known as gun violence restraining orders.
California ACEP Firearm Injury Prevention Policy
It is the position of the California Chapter of the American College of Emergency Physicians that:
Emergency Medicine is well positioned, as a profession and specialty, to appreciate the multifaceted ramifications of firearm injuries in our society. Firearm violence is a public health epidemic that can only be effectively cured by deploying necessary and appropriate resources.
California ACEP deplores attempts to politicize or silence physicians and science on firearm violence. We recommend robust funding (federal and otherwise) of research on firearm injury and evidence-based prevention as well as its impact on public health and safety. It is our hope and belief that such research will guide better future legislation and lead to well-informed public policy.
Legislative measures and policies to curb or reduce firearm violence should be informed by evidence-based consensus. We advocate for continued research and implementation of programs focused on the safe storage of legitimate firearms, development of childproof or personalized guns, prevention of both interpersonal and self-directed violence by firearms, including the prevention of gang-related and domestic violence.
We support mandatory, comprehensive, and universal background checks for the purchase of firearms. Background checks should be required for essentially all firearm transfers, including at gun shows and auctions and from private sellers. Prohibited straw purchases of firearms should be recognized as serious crimes and be treated as such, and all secondhand gun sales and firearm transfers should be regulated. We support continued efforts to improve the quality of the data on which background checks are performed, such that all prohibited persons can be detected.
We support requiring that all firearm owners of record be required to report the theft or loss of their firearm within a timely period of becoming aware of such a loss.
We recommend legislation banning civilian purchase or access to assault weapons, large-capacity ammunition magazines, and any munitions specifically designed for the use by military and law enforcement agencies.
We encourage all healthcare providers, including emergency physicians, to screen and counsel patients with diagnosed mental illnesses or believed to be at risk of harming themselves or others for their potential access to firearms, and to refer such patients to appropriate mental health services in a timely manner. Policies and procedures for this process need to be validated and standardized.
We recommend the creation of a national database and surveillance system to track firearm-related injury and mortality, including mandatory reporting of firearm injuries and fatalities by all hospitals and healthcare centers.
We support restraining orders that allow for the removal of a firearm to provide a rapid, focused response when risk for imminent firearm violence, including suicide and homicide, is high. We support restraining orders that rely on actions by judicial officers and include due process protections and provide for immediate firearm recovery and include a prohibition on possession and purchase of firearms and ammunition. We support allowing petitions for such orders to be submitted by family members, law enforcement officers, physicians, and other mental health professionals including school counselors.
We recommend prohibiting firearm purchases by individuals in high-risk categories that include but are not limited to habitual criminals, drug traffickers, persons with mental illness who are suicidal or high risk, those with violent misdemeanors, persons with multiple convictions for alcohol-related offenses, those with a history of domestic violence, juveniles convicted of violent crimes, and violators of parole and restraining orders.
We believe in the protection of healthcare providers’ rights to educate patients regarding firearm safety. We encourage all healthcare providers, including emergency physicians, to counsel patients about firearm safety when appropriate including discussing with parents safe storage of firearms in homes with children.
Full text available through open access at http://escholarship.org/uc/uciem_westjem
Address for Correspondence: Jorge Fernandez, MD, UC San Diego Health, 200 W. Arbor Drive, MC8676, San Diego, CA 92103. Email: firstname.lastname@example.org. 3 / 2021; 22:266 – 269
Submission history: Revision received November 17, 2020; Accepted November 17, 2020
Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.
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