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News from the American College of Surgeons

For Immediate Release


Sally Garneski
Dan Hamilton

New Consensus-Based Recommendations to Reduce Firearm Injury, Death, and Disability Released by American College of Surgeons Workgroup

Public safety recommendations developed by trauma surgeons and firearm owners to make firearm ownership safer for all Americans.

CHICAGO (November 14, 2018): Today the American College of Surgeons Committee on Trauma (ACS COT) released its initial set of recommendations from its Firearm Strategy Team (FAST) Workgroup to move a path forward to the development of an effective and durable strategy for reducing firearm injury, death, and disability in the United States. The recommendations are published online as an “article in press” on the Journal of the American College of Surgeons website ahead of print publication.

The article presents 13 recommendations from a workgroup of 22 surgeons (median experience of 28 years caring for trauma patients), 18 of whom are passionate firearm owners themselves representing a broad range of experience with firearm ownership and use. Hunters, sport shooters, self-defense proponents, law enforcement professionals, and surgeons with previous military experience from a geographically representative sample across the country comprised the Workgroup, along with four surgeon leaders from the ACS COT and the ACS Board of Regents.

These recommendations are put forth in an advisory capacity and include, “strategies and tactics to increase firearm safety, reduce the probability of mass shootings, reduce firearm-associated violence, address mental health factors, and encourage federally funded firearm injury research while preserving the right to own and use a firearm.”

“We hope this carefully developed report provides a framework for discussing policy issues related to firearm violence, which has become a public health crisis in the U.S. These injury prevention recommendations may also open up a wider dialog with others who share our similar interest in addressing firearm violence as a public health problem,” said ACS Executive Director David B. Hoyt, MD, FACS.

“Preventable injury, disability, and death from intentional violence related to firearms is unquestionably a major public health problem in the U.S.,” said author Ronald M. Stewart, MD, FACS, Medical Director, ACS Trauma Programs, and professor and chair of surgery at University of Texas (UT) Health Science Center, San Antonio. “We set out to address the issue by employing a broadly inclusive consensus strategy within the Committee on Trauma. We took all viewpoints into account and working within the FAST Workgroup, engaged surgeons who are experienced firearm owners.”

Consensus was reached through a variety of interactions, including multiple surveys among surgeons, internal town hall meetings, focus groups, conference calls, and numerous small group meetings across the country, which led to an ongoing dialog in which “we came to realize that the community of firearm owners are often approached as part of the problem, but less commonly approached as part of the solution,” wrote the article’s authors. The ACS COT and other physician groups have called for a public health approach to the problem, viewing community engagement for interventions as a key step toward a solution that will move the nation toward more responsible ownership and use of firearms.

“We are optimistic these consensus recommendations will resonate at the community level because they were developed by experienced firearm owners. These firearm owners are also expert trauma surgeons who have cared for thousands of patients with firearm injuries throughout their careers,” said coauthor Deborah A. Kuhls, MD, FACS, professor of surgery and chief, section of critical care, division of acute care surgery, University of Nevada Las Vegas (UNLV) School of Medicine.

“To date, these recommendations appear to be the most unique approach to firearms safety in that firearm owners are standing up and taking responsibility and accountability for the privilege of owning a firearm in the U.S.,” said coauthor Gary Timmerman, MD, FACS, professor and chair, department of surgery, Sanford School of Medicine, University of South Dakota, Sioux Falls. “Moreover, as trauma surgeons who have treated firearm violence victims with devastating injuries, we feel we have a legitimate voice in preventing firearm violence.”

“These recommendations reflect practical solutions to minimize death and disability from firearm injury,” said coauthor Eileen M. Bulger, MD, FACS, Chair of the ACS Committee on Trauma and chief of trauma at Harborview Medical Center, Seattle.  “In developing our recommendations, we also considered the value of better enforcement of existing laws and strengthening current statutes and regulations, many of which are viable ways to keep firearms away from people who endanger themselves or others. Both those who support firearm ownership and those who do not need to come together to address this public health crisis, and these recommendations provide a platform to do just that.”

All 22 surgeons in the FAST Workgroup needed to agree on a recommendation before it could be included in the final article. The Workgroup acknowledges that it does not represent the views of all firearm owners, or all surgeons for that matter, but it does put forth that these recommendations “will increase public safety and improve our understanding of firearm injury in the United States.”

Authors and members of the FAST Workgroup are Cynthia L. Talley, MD, FACS; Brendan T. Campbell MD, FACS; Donald H. Jenkins MD, FACS; Stephen L. Barnes MD, FACS; Richard A. Sidwell, MD, FACS; Gary Timmerman, MD, FACS; Ronald I. Gross MD, FACS; Michael Coburn, MD, FACS; Jeffrey Bailey, MD, FACS; Alexander Eastman, MD, FACS; James Ficke, MD, FACS; Eric Kuncir, MD, FACS; Robert Letton, MD, FACS; Brian J. Eastridge, MD, FACS; Amy Liepert, MD, FACS; Alison Wilson, MD, FACS; Danny Robinette, MD, FACS; James Davis, MD, FACS; Christian Shalgian, BA; Holly Michaels, MPH; Mark Weissler, MD, FACS; Deborah A. Kuhls, MD, FACS; Eileen M. Bulger, MD, FACS; and Ronald M. Stewart, MD, FACS.

“FACS” designates that a surgeon is a Fellow of the American College of Surgeons.

Citation: Recommendations from the American College of Surgeons Committee on Trauma’s Firearm Strategy Team (FAST) Workgroup: Chicago Consensus I. Journal of American College of Surgeons. Available at:

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The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 80,000 members and is the largest organization of surgeons in the world. For more information, visit