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Celebrating the ACP Centennial: From the Annals ArchiveFirearm-Related Harms

During the 2015 centennial year of the American College of Physicians, publisher of Annals of Internal Medicine, Annals editors will link an article in each issue with an earlier paper from our archives addressing the same disease or clinical question. We hope our readers find this interesting and we welcome comments, especially from physicians who were practicing at the time of publication of the original paper who might offer insight into the impact of the earlier paper on their knowledge or practice. In this issue, Rowhani-Rahbar and colleagues (1) present data on the risk for subsequent gun-related harms for themselves and others in patients discharged from the hospital after a firearm-related injury. In addition, a group of authors representing 8 health professional organizations and the American Bar Association (2) present a call to action on firearms as a public health issue and express their opposition to state and federal mandates that forbid physicians from discussing a patient's ownership of guns. An editorial on firearms also appears in this issue (3). Twenty years ago, the American College of Physicians published a position paper titled Preventing Firearm Violence: A Public Health Imperative (4). The authors argued that physicians were as responsible for the prevention of firearm violence through public health measures as they were for treating victims. Ways to lessen harms were outlined, including safety regulations for ownership, design modifications, elimination of some firearms from purchase by the general public, legislation to restrict access, and higher taxes. A key recommendation was that physicians inform patients about the dangers of keeping firearms and counsel them on how to reduce risk for injury if they choose to keep them. Four letters to the editor were published in response to the position paper. They were sharply critical and included arguments that controversial statements had been made without presenting balancing arguments, that data were incorrect, that the paper did not represent the views of American College of Physicians members, and that firearm safety is a public safety issue rather than a public health issue. Themes and viewpoints in the current call to action and the 1995 position paper are similar. One change from 20 years ago is that our readers can now provide rapid responses to articles online. We welcome such comments on this important, and often divisive, issue.