Massachusetts Medical Society: Testimony On House 4121 An Act Relative to the Reduction of Gun Violence

Testimony On House 4121 An Act Relative to the Reduction of Gun Violence

Before the Committee on Public Safety and Homeland Security

As the Committee on Public Safety and Homeland Security considers the legislation before you today, relative to firearms and gun control, the MMS would like to bring the following facts and Society policies to the members’ attention.
In 2013, Massachusetts Medical Society (MMS) then President Richard V. Aghababian, MD, issued a "Call to Action" regarding acts of violence. That Call instilled urgency in physicians and the Society to take action to facilitate the safety of patients, children, and communities through a renewed focus on gun control, mental health, and education.
The Call to Action included supporting legislative reforms that limit access to assault weapons and large clips of ammunition, and advocating for meaningful changes in mental health care. Physicians should be increasingly sensitive to early identification of those individuals who may be prone to outbreaks of violence. 
A working group was convened at the MMS and the members devised a set of overarching principles:

  • Reduce the number of deaths, disabilities, and injuries attributable to guns
  • Make gun ownership safer
  • Promote education relative to guns, ammunition, and violence prevention for physicians and other health professionals as well as for the public
  • Encourage research to understand the risk factors related to gun violence and deaths
  • Support policies that strengthen the mental health system, including early identification and treatment of people with mental health problems, achieve parity, increase the mental health workforce, and reduce stigma associated with mental health issues and treatment.

The Second Amendment of the U.S. Constitution states that “[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.” Indeed, many physicians and patients appreciate gun ownership and use and do so responsibly. In a Pew Research Center survey conducted February 13–18, 2013, 37% of adults reported having a gun in their household: 24% say they personally own a gun, and 13% say the gun or guns in their home are owned by someone else.
We are all too familiar with the many tragedies involving multiple shootings in communities across the United States. We all know the names of the communities that have become forever associated with such events.  We must also address the ongoing individual tragedies around us. There are more than 85 deaths attributable to guns each day, with more than 300,000,000 guns in the US. For every person who dies from a gunshot wound, two others are wounded.  Guns increase the probability of death in domestic violence incidences and increase the likelihood of fatalities by those who intend to injure others or who attempt suicide. . Guns leave children and young people at special risk and disproportionately affect communities of color.
Most violence in the United States — 96% — is not committed by people with mental illness, and most people with mental illness are not violent. Therefore, it seems that targeting the small number of people with mental illness who are violent or at risk for violence will have negligible effects on the rates of gun violence in this country. However, research also shows that individuals with serious mental illness, especially those not receiving adequate services, pose a far greater risk of harming themselves than others. We do have concerns that language in the bill requiring individual physician certification that individuals with substance abuse or mental health histories are cured before they may seek a gun license is inconsistent with the current clinical terminology and view of substance abuse and mental health disorders. 
Intentional death (suicide) by firearms for the year ending 2010 included 19,392 people, of which 16,962 were men, according to the CDC. According to an analysis of multiple studies completed by Matthew Miller and David Hemenway, the probability of suicide increases in homes where guns are kept loaded and/or unlocked. To that end, we support language in the bill advocating for the use of resources by the Board of Medicine in developing educational resources for physicians interested in learning about suicide prevention.
The Brady Handgun Violence Prevention Act of 1993 requires licensed gun dealers to perform background checks. Background checks are not required for private gun sales (though it is a crime to knowingly sell a gun to someone with a criminal record). To ensure privacy, Section 103(i) of the Act prevents the Federal government from keeping the names submitted for background checks, or using this information to create any sort of registry of gun owners.
In comparison with thirteen European and Asian countries, the US is the only country that does not have a national licensing system or storage regulations.

To address the above referenced statistics and considerations, the following policy was passed by the Society at its 2012 annual meeting:

  1. That the MMS be guided by the principles of reducing the number of deaths, disabilities, and injuries attributable to guns; making gun ownership safer; promoting education relative to guns, ammunition, and violence prevention, for physicians and other health professionals as well as for the public; encouraging research to understand the risk factors related to gun violence and deaths.
  2. That the MMS encourage health care providers to review gun safety as a routine component of preventive care.
  3. That the MMS promote and support state legislative efforts to make licensing and background checks mandatory for all sales of firearms regardless of the seller.
  4. That the MMS strongly advocate that the AMA support federal efforts to promote legislation to make licensing and background checks mandatory for all sales of firearms regardless of seller.
  5. That the MMS reaffirms its advocacy for the right of physicians to discuss gun safety and the ownership and storage of guns within the duty and privacy of obtaining a medical history.
  6. That the MMS offer education to physicians and other health care providers concerning instituting a gun safety discussion. 
  7. That the MMS initiate a campaign within the framework of the Society’s existing publications and communications, on behalf of the public’s health, to diminish the menace of gun violence in America and beyond.

On behalf of our 24,000 physician members, the MMS thanks you for your consideration of our policy and testimony on this very important public safety matter.

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