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Gun violence is an epidemic and “we solve epidemics with medicine, not politics”

Brian Owens | St. Stephen, N.B. | December 11, 2018

Physicians are becoming more involved in preventing gun violence, being familiar with the trauma it produces.

Canadian doctors have joined their American colleagues in declaring that the medical profession has a duty to address firearms safety. The topic has received much attention of late after an update to a position paper by the American College of Physicians (ACP) caused an online dispute between physicians and the US gun-rights lobby group, the National Rifle Association (NRA).

“Someone should tell self-important anti-gun doctors to stay in their lane,” the NRA tweeted after Annals of Internal Medicine published the ACP’s position paper on preventing firearm deaths and several related research articles.

American doctors immediately responded with tweets and opinion articles of their own, declaring their right to engage in the gun control debate. “Physicians take care of people who are experiencing the impact of gun violence. We see first hand the consequences,” says Dr. Ana Maria López, president of the ACP. “And like with any other public health issue, we think about what can be done.”

Canadian doctors are showing support for American physicians and for the medical profession’s place in developing policies on gun safety. “Just because there is a political border, that doesn’t mean we shouldn’t be concerned with other citizens of the world,” says Dr. Natalie Yanchar, past-president of the Trauma Association of Canada. “It’s almost a humanitarian crisis, and from a global perspective, our voice needs to be heard.”

Canada should also be engaged in shaping its own response to gun violence, even if the problem is not as severe as across the border, noted Dr. Katherine Austin. “In Canada, we tend to compare ourselves to the US, but that’s like saying I’m shorter than Lebron James. I might still be pretty tall,” says Austin, a pediatric and adolescent medicine specialist who helped craft the Canadian Paediatric Society’s firearms policy. “We definitely have a lower rate of mortality than the US, but if you compare us with similar countries like the UK, Australia or New Zealand, we have a much higher rate.”

Canada has the fifth-highest rate of gun deaths in the world among populous high-income countries. Between 2008 and 2012, more young men aged 18–24 died from firearms than from cancer, falls, drowning and fires combined. “It’s important not to pat ourselves on the back just because we’re not as bad as the US,” says Austin.

Doctors on both sides of the border advocate for treating gun violence as a public health issue and promoting evidence-based interventions to reduce firearms deaths and injuries. “Gun violence is an epidemic just like any other,” says Dr. Megan Ranney, chief research officer at AFFIRM, a US group dedicated to supporting research on gun violence. “We solve epidemics with medicine, not politics.”

Doctors stress that they are not advocating for an end to gun ownership. Instead, they compare the issue to the HIV epidemic or car crashes, where the solutions were not abstinence or banning cars, but rather safe sex and seatbelts. “This is no more about gun control than car safety is about car control,” says Ranney.

For example, the Canadian Paediatric Society recommends that pediatricians ask parents about the presence of firearms in the home and provide information on potential risks and the importance of safe storage. The ACP’s position paper includes support for measures such as limiting access to firearms for people with a history of domestic violence, strengthening background checks, and creating mandatory gun safety education programs. “These are common sense things from a public health perspective to limit firearms injuries,” says Lopez.

But doctors need to have data to back up their positions, which can be difficult in the US, where an amendment to a spending bill has restricted the Centers for Disease Control from funding research on gun deaths and injuries since 1996. That amendment was weakened earlier this year, but it is not yet clear if the agency will begin supporting this type of research. AFFIRM is raising money from private sources to fund the necessary work. In spring 2019, it will launch a US$2.5-million international call for proposals for research on how to stop shooters before they shoot. The group wants to support projects in areas like predictive medicine and social analytics to find innovative solutions to the gun violence epidemic.

“If we can decrease cigarette smoking, HIV, and car accidents, we can do something for gun violence,” says Ranney.

Photo credit: Isaac74/iStock


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