Gun Violence Research and the Profession of Trauma Surgery

Abstract

The effects of violence are clearly a central component of any trauma surgeon's job.The role trauma surgeons should play in its prevention and advocacy, however, is not clearly defined.In this article, we discuss the statistics and lack of research on gun violence and survey some of the moral frameworks that define a trauma surgeon's professional responsibilities in violence prevention at a practice and a policy level. The Context: Some Basic Facts on Gun Violence and Gun Violence Research in the USGun violence is responsible for approximately 35 000 deaths per year in the US-roughly equivalent to 96 gun-related deaths per day [1].Mass shootings account for less than 1 percent of all gun-related deaths in the US [2].Most gun-related deaths in the US are from suicide or homicide (65 percent and 35 percent, respectively) [3,4], with 70 percent of homicides being gun-related [5] and states with more guns having more homicides [6].A person's odds of dying from gun injuries increase at least twofold just by living in a house with a gun [7][8][9].A systematic review and meta-analysis found that access to a gun increases the odds of suicide threefold [8].Gun violence in the US far exceeds that of any other developed nation [10].Homicides by gun violence in the US number approximately 29.7 per 1 million annually; the next closest developed nation is Switzerland, with 7.7 per 1 million annually [11].In addition to gun-related deaths, an estimated 81 114 Americans were injured, but not killed, by guns annually between 2011 and 2015 [1].There are now more guns in the US than there are people [12].Simply having this information has important implications, and perhaps moral relevance, for trauma surgeons who practice in an environment where gun violence is a key pathology and a primary clinical concern.A public health approach to gun violence has provided some insight into ways to prevent injury and death from firearms.Studies have provided epidemiological data on gun violence, including the prevalence of gun ownership and its correlation with gun violence-specifically, homicide victimization and suicide-that have important implications for public health interventions and policies that could effectively decrease the burden of gun violence [6][7][8][9][13][14][15][16].But, as we discuss below, this approach has been limited by underfunding.All this poses an ethical

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