The decades-old battle over the role medical professionals should play in reducing gun violence erupted onto social media in the past week after the National Rifle Association admonished doctors to “stay in their lane” rather than share thoughts about gun safety. Members of the medical profession took to Twitter with a viral — and often graphic — campaign detailing the damage guns do to the human body, and the frequent efforts doctors must take to save the lives of those who have been shot, under the hashtag #Thisisourlane.
Now, a work group from the American College of Surgeons has chimed in with the release Wednesday of a new set of gun-safety recommendations that aims to bridge the political divide. The recommendations, which include robust background checks, enhanced gun-safety training, mandatory reporting requirements for people considered a threat to themselves or others, and the use of innovative technologies to prevent accidental firearms discharge, are striking not so much for their content as their authorship.
Eighteen of the 22 surgeon-authors are passionate firearms owners, including hunters, self-defense proponents and doctors with previous military experience.
The paper is “a brilliant application of well-established social science,” said Jeremy Faust, an emergency physician at Brigham and Women’s Hospital in Boston and instructor at Harvard Medical School. Faust was not involved in creating the report. “People tend to change or moderate their position on a closely held belief when the prevailing argument comes from a trusted insider.”
The American College of Surgeons’ Firearm Strategy Team represents two key kinds of insiders, Faust said: “As surgeons, they know firsthand the havoc that guns can impart. As gun owners, they understand the issues that non-gun owners might not fully appreciate.”
The group’s recommendations come at a time when the long-standing divides over firearms have become increasingly polarized amid a steady torrent of deadly mass shootings in places many had long deemed safe: at school, in church, in synagogue, at a concert. The nation has suffered through a succession of mass shootings this year, most recently the Oct. 27 killing of 11 in a Pittsburgh synagogue and the Nov. 7 carnage in a country music bar that left 12 dead in Thousand Oaks, Calif.
Many medical professionals believe gun violence should be addressed in the same way as car or food safety, but the NRA has long argued for blocking research of guns as a public health issue. The gun-safety and sporting group evolved into a powerful pro-firearms lobby and encouraged Congress to pass the Dickey Amendment in 1996, effectively cutting funding for gun violence research at the Centers for Disease Control and Prevention.
The NRA did not immediately respond to a request for comment after the report was released at noon on Wednesday.
Two weeks ago, on Oct. 30, the American College of Physicians published a position paper recommending “a public health approach” to firearms-related violence and saying that the medical profession has a “special responsibility” to speak out. The NRA retaliated, first with an editorial and then with a Nov. 7 tweet, mocking “self-important” doctors who dared enter the debate.
Doctors, nurses and other members of the medical community responded, posting gruesome photographs of blood-drenched operating room floors and accounts of maimed bodies and shattered psyches related to the aftermath of gun violence.
“This is entirely in my lane,” said Gary Timmerman, a trauma surgeon and gun owner from Sioux Falls S.D., who helped compile the recommendations. “Those trauma victims come to us.”
James Ficke, a Johns Hopkins surgeon who served for 30 years in the Army and described himself as a life member of the NRA, expressed concern that the #thisisourlane campaign could backfire by alienating responsible gun owners and making the debate even more divisive.
“We acknowledge that we have different ‘lanes,’ but we absolutely need to interchange and align,” said Ficke, who was an author of the new report.
The authors emphasize the importance of “preserving the right to own and use a firearm” and embracing the viewpoints of gun owners.
“It’s the way we would deal with bicycle safety,” said Ronald M. Stewart, a trauma surgeon in San Antonio and a leading author of the paper. A public health approach to bicycle safety would engage with bicycle riders, he explained, because they have expertise on bicycles, understand the practicalities of riding them and also are at risk.
The team’s recommendations, which arose out of the collective horror following the shooting of 20 children and six adults at Sandy Hook Elementary School in 2012 and have been honed by the work group during the past eight months, are strikingly similar to those put out two weeks ago by the ACP, Stewart said.
The difference, he said, was the consensus-building process that led to them, which included a town hall of 250 doctors with wide-ranging views.
“It was one of the most civil, collegial events I have ever experienced,” Stewart said. “We realized at that time that we can build bridges, we can work together.”
The process has impressed violence-prevention experts.
“If we take politics out of this public health issue, we can achieve consensus,” said Megan Ranney, an emergency physician in Rhode Island and chief research officer for the American Foundation for Firearm Injury Reduction in Medicine.
Even though discussions leading to the recommendations became testy at times, Timmerman said, as scientists who believe in evidence-based medicine all of the surgeons involved agreed on the fundamental importance of research.
“We are not afraid to let the truth speak for itself,” Timmerman said.