“Enough is enough”: AMA takes more steps to prevent gun violence

The AMA House of Delegates declared firearm violence a public health crisis at the 2016 Annual Meeting, which convened in the aftermath of the mass shooting at the Pulse nightclub in Orlando where 49 people were killed.

The 2022 AMA Annual Meeting was preceded by mass shootings at a school in Uvalde, Texas, and a grocery store in Buffalo, New York, and delegates adopted new policy to support regulating homemade weapons known as “ghost guns,” research warning labels on ammunition packages, and considering the mental health of schoolchildren as they engage in active-shooter drills.

Physicians themselves have not been spared. Stephanie Husen, DO, and Preston Philips, MD, were shot and killed at their offices in Tulsa, Oklahoma, and John Cheng, MD, was killed while attending church in Orange County, California. 

“This cannot be our new normal,” said AMA Immediate Past President Gerald E. Harmon, MD, in special remarks delivered at this meeting’s opening session. “Gun violence is out of control. Enough is enough. 

“Ignoring the problem will only lead to more bloodshed—to more senseless deaths and grieving families,” added Dr. Harmon, a family physician in South Carolina. 

A sense of optimism followed the next day when word came from Washington of a possible compromise breaking the congressional deadlock on gun legislation had been developed in the U.S. Senate. 

“Today’s bipartisan blueprint to address gun violence is a breakthrough that shows compromise is possible, common ground can be reached, and that Congress can take commonsense steps to keep deadly weapons out of the hands of people who are a significant danger to themselves or others,” Dr. Harmon said in a statement. “This agreement will save lives.”

Homemade weapons known as “ghost guns” because they are assembled from parts that lack serial numbers are difficult to trace and are becoming more commonly used in criminal activity. But they are not regulated under existing gun laws, says a resolution from the New York delegation. 

Delegates adopted policy to support “state and federal legislation and regulation that would subject homemade firearms, including ghost guns, to the same laws and regulations and licensing requirements as traditional regulated firearms.” 

“America’s physicians treat gun violence victims every single day, and we see it for the public health crisis that it is,” said AMA Trustee Thomas J. Madejski, MD, a geriatrician in New York. “We see the urgency of the moment, and we call on Congress to meet the moment.  

“The AMA has exhaustive policy to address the public health crisis of gun violence,” Dr. Madejski added. “These policies—and laws—need to be constantly updated to address the pernicious ingenuity of gun manufacturers.”

The AMA supports warning labels on packaging for foods containing fructose corn syrup, energy drinks, indoor tanning equipment, and nicotine and tobacco products, according to a resolution from the AMA Medical Student Section.  

Now it also has policy supporting the same for firearm ammunition packaging, as delegates directed the AMA to support “research on the effectiveness of warning labels on packaging for firearm ammunition.”  

At minimum, this includes:

• Text-based statistics or graphic picture-based warning labels related to the risks, harms and mortality associated with firearm ownership and use. 
• Explicit recommendations that ammunition be stored securely and separately from firearms.   

“Evidence suggests that graphic warning labels on tobacco packaging reduced tobacco use,” said Dr. Madejski. “With the frightening frequency of mass shootings, this approach on ammunition might save lives as part of a comprehensive approach to firearm dangers,”

Delegates also noted that mental health needs of children need to be taken into account as schools take measures meant to make them safer. 

With school shootings continuing at a troubling pace, some schools prepare faculty and children to respond. While well-intentioned, there are concerns that the style of drill may have unintended harmful effects on children’s mental health.  

To address these concerns, the AMA adopted policy encouraging that active-shooter and live-crisis drills be conducted in a trauma-informed way that takes children’s physical and mental wellness into account. Such drills should avoid creating additional traumatic experiences, and schools should provide support for students who may be adversely affected. 

Delegates directed the AMA to advocate research on the impact of live-crisis drills on children, including the goals, efficacy and potential unintended consequences of crisis-preparedness activities. 

“It’s important that these drills and exercises are conducted in an evidence-based way and that we understand the potential consequences for the mental health and well-being of children,” Dr. Harmon said in an AMA statement. 

Over the past two decades, the AMA has developed numerous policy recommendations to reduce firearm trauma, injury and death. These include: 

• A waiting period for firearm availability.
• Background checks for all firearm purchasers.
• Firearm safety and research and enhancing access to mental health care.
• Gun safety education and regulation of interstate traffic of guns.
• Distribution of firearm safety materials in the clinical setting.
• Limit and control the possession and storage of weapons on school property.
• Firearm safety counseling with patients.
• Trigger locks and gun cabinets to improve firearm safety.
• Data on firearm deaths and injuries.
• Prevention of unintentional shooting deaths among children.
• Ban on handguns and automatic repeating weapons.
• Prevention of firearm accidents in children.
• Waiting period before gun purchase.
• Restriction of assault weapons.
• Mandated penalties for crimes committed with firearms.
• Public health policy approach for preventing violence in America.

Read about the other highlights from the 2022 AMA Annual Meeting.