Julie Rosenbaum

Matthew Ellman

By MATTHEW S. ELLMAN, MD and JULIE R. ROSENBAUM, MD

What if firearm deaths could be reduced by
visits to the doctor? More than 35,000 Americans are killed annually by
gunfire, about 60% of which are from suicide. The remaining deaths are mostly
from accidental injury or homicide. Mass shootings represent only a tiny
fraction of that number. 

There’s a lot physicians can do to reduce
these numbers. Typically, medical organizations such as the AMA recommend
counseling patients on firearm safety.  But there is another way to use
medical expertise to help reduce harm from firearms: physicians should evaluate
patients interested in purchasing firearms. The idea would be to reduce the
number of guns that get into the hands of people who might be a danger to
themselves or others due to medical or psychiatric conditions.   This
proposal has precedents: physicians currently perform comparable standardized
evaluations for licensing when personal or public safety may be at risk, for
example, for commercial truck drivers, airplane pilots, and adults planning to
adopt a child.  Similar to these models, a subset of physicians would be
certified to conduct standardized evaluations as a prerequisite for gun
ownership. 

As a primary care physicians with decades
of practice experience, we have seen the ravages of gun violence in our
patients too many times. A 50-year-old man shot in the spinal cord 30 years ago
who is paraplegic and wheelchair-dependent. A 42-year-old woman who sends her
teenage son to school every day by Uber because another son was shot to death
walking in their neighborhood. A teacher from Sandy Hook who struggles to cope
with post-traumatic stress disorder.  

Physicians can contribute their expertise toward determining objective medical impairments impacting safe gun ownership. These include undiagnosed or unstable psychiatric conditions such as suicidal or homicidal states, memory or cognitive impairments, or problems such as very poor vision, all of which may render an individual incapable of safely storing and firing a

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