Dr. Kaplan’s statement in response to the Orlando mass shooting and the related ACEP Task Force recommendations are inane and are an embarrassment to me as a longstanding member of the American College of Emergency Physicians.

Almost 50 years ago, after the assassinations of Senator Robert F. Kennedy and Reverend Martin Luther King in 1968, Senator Thomas Dodd of Connecticut issued the following statement:

“Pious condolences will no longer suffice … Quarter measures and half measures will no longer suffice … The time has now come that we must enact stringent gun control legislation comparable to the legislation in force in virtually every civilized country in the world.”

It is long past time that we should heed Senator Dodd’s words and enact gun control legislation similar to regulations already in place in every other high-income democratic country of the world—countries in which mass shootings are rare or nonexistent and in which overall rates of firearm-related deaths and injuries are far lower than in the U.S. Such legislation includes stringent regulation of, if not complete bans on, civilian ownership of handguns and rapid-fire semiautomatic rifles. In 1998, ACEP endorsed the Eastern Association of the Surgery of Trauma position paper on violence in America, which called for this very kind of gun control regulations.

It is regrettable that over the past two decades ACEP has retreated from its prior position of advocating stringent gun control regulations and that following the worst mass shooting in U.S. history, the best that ACEP can offer is “pious condolences” and recommendations such as gathering more data on “wounding patterns and causes of death for victims of mass violence.”

It is regrettable that over the past two decades ACEP has retreated from its prior position of advocating stringent gun control regulations and that following the worst mass shooting in U.S. history, the best that ACEP can offer is “pious condolences” and recommendations such as gathering more data on “wounding patterns and causes of death for victims of mass violence.”

Mass shootings are preventable, as are most of the more than 90 firearm-related deaths that occur every day in the U.S. and the many other non-fatal gunshot wounds. I would like to invite fellow ACEP members to join me in becoming charter members of a new organization, Americans Against Gun Violence (aagunv.org), that will work toward definitive measures to stop what a former ACEP president, Dr. Jack Allison, referred to in 1992 as the “shameful epidemic” of gun violence that afflicts our country.

—Bill Durston, MD

Dr. Kaplan Responds

Dr. Durston,

In response to your allegation that my reaction to the Orlando mass shooting was inane and is an embarrassment to you, I must respond. The statement to which you refer was written and released immediately after the shooting. It was meant to express my prayers for those who were hurt and killed as well as what ACEP was doing in an attempt to have our communities be better prepared in the future.

If you saw any of my public statements in multiple news organizations that followed those initial words, some of which were video-recorded, you would see that I also called gun-related violence a public health catastrophe and shared my personal sentiment that much more must be done by our federal legislators. I even traveled to Washington, D.C., on June 17, catching a 5:40 a.m. flight after working a clinical shift until 11:30 p.m. the night before in order to speak to a group of 40 legislative aides gathered by House Minority Whip Steny Hoyer to talk about what we should do together to stem this plethora of mass-casualty incidents. A video captured after that talk is available on ACEP.org.

At times, I have had to indicate that I have personal sentiments (which I elucidated) that differ from a significant number of ACEP members. While you criticize me for not doing enough, I have been condemned by some ACEP members for calling firearm-related violence a public health crisis and for saying too much. Please remember that I must represent all of our members. We have had vigorous debates at our Council meeting about ACEP’s position on this issue, and I expect that we will have many more. A change in our “Firearm Safety and Injury Prevention” clinical policy has come before the Board, and a workgroup is being put together to ensure appropriate revisions. I will certainly share your name with Becky Parker, MD, FACEP, who will be assuming the ACEP presidency in mid-October and will be watching over those deliberations.

If you saw any of my public statements in multiple news organizations that followed those initial words, some of which were video-recorded, you would see that I called gun-related violence a public health catastrophe and shared my personal sentiment that much more must be done by our federal legislators. —Jay Kaplan, MD, FACEP, president of ACEP

I have reiterated ACEP’s 2013 policy, which includes the following:

Promoting firearm safety and injury prevention research;

• Creating a confidential national firearm injury research registry while encouraging states to establish a uniform approach to tracking;
• Recording firearm-related injuries;
• Promoting access to effective, affordable, and sustainable mental health services;
• Protecting the duty of physicians and encouraging health care provider discussions with patients on firearm safety;
• Promoting the development of technology that increases firearm safety;
• Supporting universal background checks for firearm transactions;
• Requiring the enforcement of existing laws and supporting new legislation that prevents high-risk and prohibited individuals from obtaining firearms by any means; and
• Restricting the sale and ownership of weapons, munitions, and large-capacity magazines that are designed for military or law enforcement use.

I take your comments very seriously. You would not know that my own family has been affected by gun violence. One of my nieces, who lives in Springfield, Oregon, was in her high school cafeteria when she was shot by a student gunman in 1998. She survived, but she still carries the bullet in her pelvis as well as the post-traumatic effects of that experience; her best friend was shot in the head and died.

I understand that you are president of the new organization, Americans Against Gun Violence. I wish you well in your efforts. ACEP has stood publically against gun violence. Our policy promotes some of the measures that you support. We will continue to advocate for stronger laws to protect the public and decrease the penetrating trauma that we unfortunately see so often in our emergency departments.

Jay Kaplan, MD, FACEP, is president of ACEP.