Lately, there seem to have been so many public mass shootings that the most recent one could be the cover story on every single issue of this magazine. We obviously can’t do that. What’s more, the stories are all roughly the same. The terrorist uses a weapon of war to kill and injure dozens, and emergency departments are put to the test. Heroes are lauded for their acts, which should never have been necessary in the first place. Could there be anything more nauseating than the fact that we have become collectively “bored” by these events? The news cycles are getting shorter because, frankly, we’ve grown accustomed to mass shootings.
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ACEP Now: Vol 38 – No 09 – September 2019When these catastrophes occur, though, it must spur some action. Inaction is the embodiment of cowardice and is not who we are. It seems unfathomable that, as of last fall, there was any doubt as to whether firearm safety was “in our lane” as emergency physicians. We know it is. ACEP’s long-standing policy on “Firearm Safety and Injury Prevention,” was last revised in 2013 and embodies many sensible measures. The policy, printed below, takes a “yes, and” approach, rather than a “no, but” one.
Below is a summary of some of ACEP’s statements, and our ongoing efforts in this arena. Some revisions and additions are being made as I write this. Know about them and get involved.
—Jeremy Samuel Faust, MD, MS, MA,
Medical Editor in Chief of ACEP Now
Our Policy
ACEP abhors the current level of intentional and accidental firearm injuries and finds that it poses a threat to the health and safety of the public.
ACEP supports legislative, regulatory, and public health efforts that:
- Encourage the change of societal norms that glorify a culture of violence to one of social civility
- Investigate the effect of socioeconomic and other cultural risk factors on firearm injury and provide public and private funding for firearm safety and injury prevention research
- Create a confidential national firearm injury research registry while encouraging states to establish a uniform approach to tracking and recording firearm related injuries
- Promote access to effective, affordable, and sustainable mental health services
- Protect the duty of physicians and encourage health care provider discussions with patients on firearm safety
- Promote the development of technology that increases firearm safety
- Support universal background checks for firearm transactions
- Require the enforcement of existing laws and support new legislation that prevents high-risk and prohibited individuals from obtaining firearms by any means
- Restrict the sale and ownership of weapons, munitions, and large-capacity magazines that are designed for military or law enforcement use
Update on ACEP Firearm SAFETY Initiatives
In response to the mass shootings in July, ACEP President Vidor Friedman, MD, FACEP, provided the ACEP membership with an update on ACEP’s firearm safety initiatives, including:
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3 Responses to “ACEP Now Responds to Mass Shootings”
September 22, 2019
Mike Simpson, MDWhenever we hear about the gun statistics, they are inevitably followed by a call for restrictions on magazine capacity and on semi-automatic “Assault rifles”. The fact of the matter is, these types of weapons only represent around 2% of those murdered by firearms and an exceedingly low percentage of the “gun deaths” number that is always thrown out (People prefer to commit suicide with handguns for obvious reasons). Shotguns represent a statistically equivalent number and yet lawmakers, including the former Vice President of the United States, seem to think that it is perfectly acceptable for anyone to own a shotgun. The other 96% of firearm murders are perpetrated with handguns and yet, we almost never hear any proposals to limit handguns. Why is that?
I will answer that question with a question: What is the purpose of the second amendment? Is it about hunting? No. Sport shooting? No. Personal protection against crime? Also no. Even though I am an advocate of all of those things, especially the last one, that isn’t the purpose of the second amendment. The founding fathers did not say “Protection of individual life and property being necessary”. Indeed, they seemed less concerned with personal protection than with that of the “Free state”, and rightly so. The bottom line is that the second amendment exists to protect the “Free state” from tyranny. Could that be accomplished with pistols and shotguns? Unlikely.
Let’s back up for a moment and break down the amendment word by word.
“A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.”-The Second Amendment of the United States Constitution.
There is a great deal of contention around the words “Well regulated militia”. Those who wish to assign a very restrictive meaning to the second amendment maintain that “Well regulated” means supervised and restricted. This cannot be the intent, as the amendment doesn’t list any “regulation” measures i.e. licensing, registration, etc. Because it does not stipulate or further explain/define the term, it stands to reason that “Well regulated” had a common meaning in the vernacular of the time. It did.
Doctor Robert Cottrol has done exhaustive study on this subject, and has determined that the term “Well regulated” is a reference to proficiency in the use of the tools of warfare. Today, we would have said “A proficient militia” or “A militia possessing adequate marksmanship skills”. Let me reiterate and expound upon this point: if the framers intended the word “regulated’ as a restriction, why would they point out its necessity and then fail to suggest a method of ensuring it? If their intent was to outline restrictions, then the amendment would have read something like this: “A well regulated Militia, being necessary to the security of a free State, all militia members shall be required to conduct supervised training every other fortnight, and muskets shall remain secured in the armory when not used for official duties”. But that isn’t what they said. (Side note, you notice the word “musket” never appears in the amendment, nor does the word “hunting”).
What about the word “Militia”? Second amendment opponents argue that the military and the militia are one and the same. Nothing could be further from the truth. At that time, a standing army of career soldiers was a tool of the government, while the militia was derived from the civilian populace as the defense force “Of, by, and for the people!”, typically made up of all able bodied men between the ages of 17 and 45. When called upon to protect the people and their lands, the militia would not have time to train, nor would they be able to walk on foot to a central mobilization point. For these reasons, and more, they would be required to keep the tools of warfare at home and have ample ammunition to maintain proficiency (Be “Well regulated”). In simplest terms, the military is an extension of government, and a projection foreign policy, while the militia is an extension of the citizenry, and safeguards the welfare of the people.
Remember, the United States had just come out of a conflict where the people’s militia had triumphed over the army of the legal government. The founding fathers recognized that the people would always need a means to fight back against an unjust ruler who commanded an army.
Even Former Supreme Court Justice John Paul Stevens, one of the harshest and most high-profile critics of the second amendment, openly admitted that the true purpose of the amendment was unmistakable when he said in an editorial in March of 2018: “Concern that a national standing army might pose a threat to the security of the separate states led to the adoption of that amendment”. Most alarming is the title of his editorial: “Repeal the Second Amendment”. Personally, I find it chilling that a former Supreme Court Justice would recognize the true spirit of the Second Amendment’s anti-tyrannical roots and call for it to be repealed in the same breath. I am thankful that Justice Stevens no longer sits on the high court.
This brings me to an argument I hear quite often: “It isn’t like a bunch of rednecks with AR’s are going to be able to stand up to the might of the U.S. military! I’d like to see how the NRA does against a drone strike or a MOAB!”. This is a ridiculous argument. And, as a former Special Forces Operator who possesses the equivalent of a master’s degree in Unconventional Warfare, I can assure you this concept could not be further from the truth.
First of all, if that assumption were true, Iraq and Afghanistan would have been over in a matter of weeks. In the aftermath, we would have rolled convoys through the smoking ruble and ground the ashes of their bones into dust while the world looked on in awe and revulsion. Annihilation and victory are not one and the same. Even in the Vietnam conflict, where our forces had much less restrictive rules of engagement, a guerilla army utilizing mostly small arms proved to be a formidable opponent.
History is rife with examples of guerilla forces winning battles and even entire wars against highly trained and better equipped standing armies. The Maccabees, The Berbers, The Scots, The Sikhs, The American Revolution, The Philippines, The Zulu, The Boer, The Czech and French resistance in WWII, The Mujahidin, and the list goes on.
Another aspect that people don’t understand is the difficulty that a theoretically tyrannical US government would have getting American troops to engage American citizens. At the drop of civilian blood, there would be desertion from the active ranks, and huge segments of the civilian population quickly deciding which side they were on. What would unfold is a bloody civil war in which the government could never regain the trust of the American people, and that a guerrilla force would could turn every small victory into a propaganda windfall.
Now, before some idiot tries to read something that isn’t there into the previous paragraphs: I do NOT support any militia group that advocates for armed insurrection! I am a patriot, and I support our duly elected government. These fringe organizations members who try to act like some kind of modern freedom fighter make me sick. My words are NOT meant to embolden anyone who thinks that armed revolution is warranted. IT IS NOT!
All I am saying, is that should a tyrannical government ever eye the reins of power in this country, a population possessing small arms capable of tipping the scales of warfare will prove to be quite a deterrent. And, should that tyrannical government seize power anyway, an armed populace would be a formidable foe.
In short, if you like the other freedoms we enjoy, then you must recognize that the freedom to bear arms is the only thing that can guarantee them, regardless of who walks the halls of government.
In the previous blog, I broke down the gun crime numbers and compared them to other means of death. Those numbers make for good talking points, but they ignore the real numbers: the cost of not having the second amendment.
Firearm murders in 2017: 15,611
Compared to:
Nazi persecution (total deaths): 17,000,000
Soviet rule under Stalin: 20,000,000
Communist China: 35,326,000
Cambodia under Pol Pot: 1,871,000
The Armenian Genocide: 1,500,000
The list goes on and on. Those numbers represent the potential price of NOT having the right to own weapons that put the citizenry on a level playing field with those who would seek to persecute them.
Does that make it easier for a parent who lost a child to gun violence? Of course not. I feel deep pain for every innocent life that is loss. But, in detaching oneself from the emotional aspect, and looking at it through the lens of logic, it is obvious that the right of the people, and of the person, to keep and bear arms cannot be infringed. The alternative is far too costly.
And, to circle back on the point I made at the beginning, if people really cared about the “gun deaths” number they throw around, they would target handguns, not the “Scary assault rifles”. To be honest, you could almost make a logical argument that the founding fathers never intended people to own handguns, since the militia certainly wouldn’t need them. But, you will never hear them make that argument, because they want your AR more than they want your Glock. Although, truth be told, they want them both.
September 22, 2019
William Gluckman, DO. MBA, FACEPRestrict the sale and ownership of weapons, munitions, and large-capacity magazines that are designed for military or law enforcement use is NOT something ACEP should be advocating for. As a long time member and Fellow of the college, and a tactical physician, this is simply a ridiculous comment. ACEP should focus on evaluating the problem and looking at objective data with solutions that will truly make an impact. This only serves to dilute our 2nd amendment rights with no justification on a benefit. Stay in your lane.
October 9, 2019
Chuck SheppardBefore you try and restrict the rights of law abiding gun owners (who arguably prevent more death and injuries than mass shooters cause),there should be some evidence that the restrictions would have prevented the Mass shootings. There is no evidence for example that “universal background checks’ (however one defines that) would have prevented a single event unless you count the Texas shooting where IF the Air Force had reported him he would not have been eligible to buy. On the other hand if the neighbor across the street had been unable to buy the AR he used the carnage would have been so much worse. No doctor would propose subjecting the entire population to a treatment with known bad side effects in order to “prevent” something without some evidence the treatment would work. So far all the empiric evidence points the other way. The other problem is in areas where guns are less readily available we are seeing fire as a weapon (see the Japanese attack) or vehicles etc. Also keep in mind that Columbine was supposed to be an explosion with thousands of casualties and only when the bombs failed did it become a shooting.