American Academy of Emergency Medicine

The process of recruiting and assigning members to the AAEM Firearms Injury Prevention Task Force, which began last fall, is now complete. The Task Force is comprised of 15 AAEM members, from a wide variety of personal, medical, and geographical backgrounds. All AAEM members who expressed interest in being on the Task Force in response to a previous article in Common Sense or to an e-mail to the general membership were considered candidates for the Task Force. To be appointed to the Task Force, interested members had to agree that firearms violence is a serious public health problem in our country which should be addressed by emergency physicians. Task Force appointees were also required to commit to spending the time necessary to develop a draft of an evidence-based position statement on firearms injury prevention for consideration by the AAEM Board of Directors, and to work with other Task Force members in a professional and objective manner.

Approximately 30 AAEM members initially expressed interest in being on the Task Force. About half of those who initially expressed interest later withdrew, mainly because of other time commitments. A single prospective Task Force member was excluded on the basis that he disagreed that firearms violence is a serious public health problem in our country. While Dr. McNamara and I respect the right of AAEM members to hold the belief that firearms violence is not a serious public health problem, we felt that for the Task Force to effectively move forward, its members needed to start with some common ground. We felt that agreement that firearms injuries and deaths are a serious public health problem which should be addressed by emergency physicians was a reasonable starting point.

The Task Force is presently in the process of gathering data on firearms injuries and firearms injury prevention, and in developing a system for rating quality of evidence. To facilitate data gathering, we have divided the topic of firearms injuries into a number of subtopics. A summary of the initial 23 subtopics was published in the January/February issue of Common Sense. We have since added three more topics to this list, including the importance of socioeconomic factors, classification systems for types of firearms injuries, and systems for rating quality of evidence. The term, "firearms violence" was initially used in defining the subtopics, but the Task Force later agreed to replace this term with "firearms injuries," with the understanding that the Task Force will be studying both accidental and intentional firearms injuries and deaths.

To identify areas of greatest consensus and greatest controversy at the outset of the data gathering process, Task Force members were asked to indicate their levels of agreement or disagreement on the various subtopics. This survey revealed a fairly wide diversity of initial opinions. We shared the results of this survey at the open meeting of the Task Force at the AAEM Scientific Assembly in Orlando on February 24. It was suggested at the meeting that we publish the results of this survey in Common Sense. Unfortunately, space does not allow printing the entire survey. As examples of the diversity of initial opinions among Task Force members, though, 53% of Task Force members agreed with the statement that guns in the home were more likely to kill or injure a household member than to kill or injure an intruder, while 26.7% disagreed with this statement and 20% had no opinion. One third of Task Force members believed that defensive use of firearms by private citizens is an effective means of deterring crime and preventing personal injury, while 40% disagreed and 26.7% had no opinion. Forty percent of Task Force members agreed that restricting firearms ownership is an effective means of reducing firearms violence, while 40% disagreed and 20% had no opinion. I would like to emphasize that this survey was done to assess the initial opinions of Task Force members prior to gathering and analyzing the available data. The results of the survey should not be construed as an indicator of what the Task Force's final conclusions will be. It will be interesting to see how much Task Force members' positions change after studying the data.

We hope to complete the data gathering phase of the project over the next six months. We continue to welcome input from the AAEM general membership with regard to other issues or references we should consider. AAEM members who are not on the Task Force may submit their suggestions directly to a Task Force member or to Eric Lanke at elanke@aaem.org. Mr. Lanke will forward any communications sent to him to the entire Task Force.

I would like to thank the members of the Firearms Injury Prevention Task Force for their commitment to this project. I would also like to thank the AAEM administrative staff for its invaluable support and the AAEM general membership for its continued interest and input. Firearms injury prevention is a difficult and controversial issue. The AAEM Firearms Injury Prevention Task Force is endeavoring to proceed in an open, methodical, and objective manner in addressing this issue. I believe that the end result will be an evidence-based position statement which will be a credit to AAEM and which will serve as an effective blueprint for reducing firearms injuries and deaths in our country.