Chris Kang, MD, FACEP
ACEP and our members have been in mourning due to the recent heartbreaking incidents of firearm violence in our communities. As emergency physicians, we shoulder the honor of being on the front lines and the responsibility of treating the victims of these tragedies. Schools as well as clinics and hospitals, our workplaces, are no longer sacrosanct and increasingly becoming less safe. Each traumatic event reverberates throughout our communities—impacting not only those wounded, but also the witnesses, friends and families, and those who care for the injured. Whether accidental or intentional, individual or larger scale, firearm violence is an increasing threat to our public health.
Over the past week, ACEP has received questions from members about our College’s stance on firearm violence and injury prevention, and political support of candidates related to this issue. As part of our ongoing commitments to transparency and to advance emergency care, we want to reaffirm the College’s position around firearm safety and injury prevention.
Policy Statement: Firearm Safety and Injury Prevention
ACEP believes emergency physicians have a public health responsibility to reduce the prevalence and impact of violence through advocacy, education, legislation, and research initiatives. For decades, ACEP has sought to address the issue of firearm violence in particular by supporting both public and private efforts to fund high-quality firearms injury-related research, as well as by supporting commonsense, evidence-based policy solutions.
ACEP’s policy statement “Firearm Safety and Injury Prevention” was most recently revised in 2019 but traces its origins back to a series of ACEP Council resolutions starting in 1989. The statement was created and has evolved through the advocacy of your section, committee, chapter, Council, and national leaders.
Our policy statement makes it clear that ACEP condemns the current level of intentional and accidental firearm injuries and acknowledges the threat firearms pose to the health and safety of the public. We support dialogue, research, specific legislative and regulatory actions, and collaboration to reduce the threat of injury and promote the safety and health for our patients and fellow physicians. Read the full statement.
Firearm violence: Is this our lane?
Yes. Firearm violence impacts the patients we see every day—accidents, domestic violence, criminal activity, mass shootings and more. When people are injured by firearms, they arrive at our emergency departments and become our patients, our concern. Because ACEP’s mission is to promote the highest quality of emergency care and to be the leading advocate for emergency physicians, their patients, and the public, we talk about firearm violence because it affects our patients, each of us and our teams, and our communities every single day.
ACEP recognizes that proposed solutions to curbing firearm violence in the United States are complex and multifaceted. Discussions can rapidly become divisive; however, as an organization that represents emergency physicians, ACEP is and has historically been strongly in favor of harm reduction. We are pro public health and patient safety. Our policy and positions as developed and passed by the Council of your peers emphasize a range of solutions, including the need for research, universal background checks, responsible ownership, restrictions on modifications to weapons, and supporting public health efforts that address the underlying causes of violence, among others. It also supports a variety of public health and health care efforts such as investigating social determinants and other cultural risk factors on patterns of firearms injury, supporting community or hospital-based early intervention programs, and promoting access to effective counseling and mental health resources for emergency patients and ourselves.
For years, the American College of Surgeons Committee on Trauma were similarly divided. In 2017, they identified areas of agreement from the results of a membership survey and utilized those points of consensus to guide their subsequent research, education, and advocacy efforts.
What about the politics surrounding firearm injury prevention?
ACEP is a staunch and continued advocate for emergency physicians, and stated in our new strategic plan, we are committed to tackling tough issues that affect your career and professional identity.
ACEP represents 40,000 emergency physicians whose views span the political spectrum. Our positions have long supported legislation, regulations, research and policies that promote public health and delivery of better emergency care. Our commitment is to engage in constructive conversations to address critical, often challenging and contentious issues.
Does ACEP give to candidates who are supported by the NRA or have voted down firearm safety legislation?
ACEP’s political action committee, the National Emergency Medicine Political Action Committee (NEMPAC), donates the voluntary contributions of ACEP members to candidates who will work on behalf of the myriad of issues that are important to emergency medicine and patients. Each election cycle, the 17 members of the NEMPAC Board of Trustees evaluate candidates based on guidelines that include:
- Support for ACEP’s legislative agenda and priorities;
- Leadership and committee assignments in Congress; and
- Established relationships with ACEP members across the country.
The NEMPAC Board also consults with ACEP state chapters, ACEP leaders, ACEP 911 Network members and NEMPAC donors when making contribution decisions. Overall, NEMPAC supported candidates exhibit positive views and actions on behalf of emergency medicine and patients. Often NEMPAC is a means to educate candidates on our viewpoints and develop future champions of the specialty and our patients.
NEMPAC doesn’t always agree with all of a candidate’s views or stances on issues. The decision to financially support a candidate for office is not an endorsement of every vote the candidate has or will cast in Congress. This means supporting candidates who also take donations from other groups we don’t necessarily agree with. For example, if ACEP refused to work with politicians who also accepted money from health insurers, other health care professions, trial lawyers, and the NRA, we would lose valuable access to a large majority of Congress.
During the current 2022 election cycle, NEMPAC has donated $1.1 million to candidate campaigns and committees. $51,500 (4.7%) has gone to NRA A+ candidates.
What kind of firearm safety and injury prevention legislation does ACEP support?
[Update, June 24, 2022: ACEP Commends Passage of Firearm Injury Prevention Legislation]
ACEP sent a letter yesterday to Congress supporting specific bipartisan legislation that would reduce firearm injuries and deaths. Under the framework of our “Firearms Safety and Injury Prevention” policy statement, ACEP has supported and continues to support several commonsense and bipartisan bills to reduce firearms injuries and violence that are aligned with the priorities established by our membership. These include, but are not limited to:
- Improving accountability in the National Instant Criminal Background Check System (NICS) to ensure existing laws are carried out as intended, such as the “Fix NICS Act” that was enacted as part of the Consolidated Appropriations Act, 2018 (P.L. 115-141);
- Expanding background checks to cover all firearms purchases and transactions (with certain reasonable exclusions) like Rep. Mike Thompson’s (D-CA) “Bipartisan Background Checks Act of 2021” (H.R. 8) that passed in the House of Representatives in March 2021;
- Representative James Clyburn’s (D-SC) “Enhanced Background Checks Act of 2021” to eliminate the so-called “Charleston Loophole” by extending the timeframe for law enforcement to complete a background check before a firearm may be purchased;
- Assisting states in implementing “Red Flag” laws to provide family members and law enforcement with the ability to remove firearms from individuals who likely pose a risk to themselves or others;
- Banning the manufacture, possession, and sale of “bump stocks” that allow semiautomatic firearms to nearly replicate the firing rate of fully automatic firearms (ACEP also supported the Trump Administration’s 2019 ban on these and similar devices); and,
- Establishing and supporting hospital-based violence intervention programs.
Two of our strengths as a college are our collective voice and ability to respectfully integrate diverse views across the specialty when we work towards a common goal. As we face this and other contentious and valued issues, ACEP is committed to facilitating objective, collaborative, and productive dialogues throughout our membership with the goal of advocating for evidence-based, practical solutions. In this case, although we may hold differing views, we share several commonalities and the same goal: fewer people injured and killed by firearms.
Learn more about our actions and efforts to reduce and prevent firearm injuries by visiting this page.