Firearm violence is a public health crisis and physicians are telling a federal appeals court to let stand a law that one Maryland county has enacted to ensure gun buyers are informed about potentially lifesaving information on suicide prevention, conflict resolution and secure firearm storage.
After an Anne Arundel County, Maryland, task force discovered that 63% of firearm-related deaths in the county between 2014 and 2018 were suicides, lawmakers enacted an ordinance that requires gun shop owners give customers literature the county health department created in an effort to prevent tragedies.
Four gun retailers and a nonprofit organization challenged the law, claiming that it’s unlawful compelled speech under the U.S. Constitution’s First Amendment. The U.S. District Court for the District of Maryland said there was no violation. Gun retailers now are asking the 4th U.S. District Court of Appeals to reverse that decision.
The Litigation Center of the American Medical Association and State Medical Societies—along with MedChi, The Maryland State Medical Society, the American Academy of Pediatrics and several state chapters of physician specialty organizations—filed an amicus brief asking the appellate court to uphold the lower-court decision to protect Maryland’s most vulnerable citizens’ health.
“Amici share the strong conviction, informed by their health care work and research, that the county and other state and local governments must be able to respond to the untenable levels of firearm violence, including suicide and violence against others, by requiring the distribution to firearm purchasers of potentially life-saving information,” says the brief in the case, Maryland Shall Issue Inc, et al. v. Anne Arundel County, Maryland.
The AMA and four other health-professional organizations also filed an amicus brief in the U.S. Supreme Court in the case of United States v. Rahimi. The brief asserts that upholding firearm prohibitions on domestic violence abusers who are the subject of restraining orders is a necessary and constitutional protection that saves the lives of family members and others.
Find out more about the cases in which the AMA Litigation Center is providing assistance and learn about the Litigation Center’s case-selection criteria.
Ordinance is constitutional
The public health pamphlet being challenged explains there is “no single cause” of suicide and that “some people are more at risk for suicide than others” with the risk varying on health, environmental and historical factors. One factor, it says, is “access to lethal means, including firearms.” It explains how to identify suicide warning signs and provides resources, including how to securely store firearms.
The information in the pamphlet is similar to other information governments at all levels require for people to assess risks and make decisions that affect their health. For example, alcoholic beverage containers must warn that consuming alcohol impairs one’s ability to drive a car or operate machinery. The federal government requires that fireworks, poisonous chemicals and drugs carry warning labels. New York City requires disclosure if foods have added sugars or high sodium.
If the court finds this ordinance violates the First Amendment, it would “threaten these and other product warnings and health-related disclosure laws that are vital to informed decision-making,” the AMA and others tell the court.
Information saves lives
The brief shares firsthand accounts from nearly a dozen physicians who have witnessed the deaths, grief and suffering that firearm violence leads to, along with the lifelong physical, psychological, social and economic consequences for firearm-violence survivors.
Among the many statistics the brief shares with the court:
- About 50,000 Americans were killed with firearms in 2021. More than half of those citizens used a firearm to take their own life.
- Firearms-related deaths are the most common type of death among the nation’s children, and about one-third of them are suicides.
- When firearms are used in suicides, 90% of people die. By comparison, people attempting suicide by toxic ingestion die just 3% of the time.
- Among suicide-attempt survivors, 95% do not try again.
Katherine Hoops, MD, MPH, is an attending physician in the Johns Hopkins Medicine pediatric intensive care unit and a firearm owner. She provides safety information about firearms and works with families to reduce risks.
Over 60% of patients who got an information pamphlet about secure storage said that they would be more likely to store their firearms safely, according to Dr. Hoops’ research, published in the journal Clinical Pediatrics. That’s important because studies show that 71% of firearm owners do not store all of their firearms locked and unloaded. In addition, in 75% of the cases in which a child attempts suicide with a firearm, the gun was in the child’s home or that of a friend or relative.
“Dr. Hoops believes the county’s ordinance will save lives by helping her patients and their families make informed decisions about how to store firearms securely,” says the brief from the AMA and others. “This information is vital to the health and safety of children.”
