Legislative Strategies to Reduce the Toll of Firearm Injuries in America

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To the Editor:
I applaud the commentary “Stopping the bleeding is not enough” by Masiakos and Warshaw,1 and agree that parallel advocacy and legislative solutions should be crafted to partner with the educational outreach of the Stop the Bleed campaign. There is good reason for optimism that these goals can be achieved, as in November of 2016 California voters overwhelmingly supported a firearm safety ballot measure (Proposition 63) by a nearly 2 to 1 margin.2 After a year marked by a series of mass shootings, California Lieutenant Governor Gavin Newsom introduced Proposition 63 to reduce firearm violence by toughening California's already strict gun control laws. The legislation fulfills several goals of the 2013 revision of the American College of Surgeons (ACS) Statement on Firearm Injuries,3 and strengthens existing California restrictions by (i) outlawing the possession of ammunition magazines that hold more than 10 rounds, (ii) requiring licensure and a background check before the purchase of ammunition, (iii) mandating the reporting of lost or stolen guns, and (iv) expanding disarmament beyond those with dangerous mental illness to those with a history of felony convictions. The core elements of the initiative could signal the beginning of a new national debate on mandatory relinquishment and ammunition background checks, and serve as the basis for model legislation to be introduced across the nation. Another source of encouragement is the consensus revealed in a national poll4 of ACS Committee on Trauma (COT) members presented at a Town Hall of the Clinical Congress in Washington DC in October of 2016. Over 92% of COT members support advocacy efforts to (i) improve mental health screening and treatment to reduce suicides and gun violence, (ii) implement evidence-based injury prevention programs, (iii) prosecute convicted felons who attempt to purchase a firearm, (iv) increase penalties for illegal firearm sales, and (v) prevent those with mental health illness from purchasing firearms. From a public policy perspective, a window of opportunity now exists to utilize the Stop the Bleed campaign as the starting point of a conversation with our elected officials of the need to strengthen our nation's trauma systems, while simultaneously advocating behind the unity of the ACS COT consensus for the introduction of companion legislation to reduce the epidemic of death and disability associated with firearm violence in America.
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