The NRA's extremist agenda endangers us all

Following the controversy of #ThisIsOurLane, ACP's Senior Vice President for Governmental Affairs and Public Policy takes on the National Rifle Association's leadership, which he says advocates for extreme policies that endanger lives.


I usually like to stick to the issues when writing about public policy, without characterizing the motives and actions of other organizations, whether they agree with the College or not. When it comes to the National Rifle Association, though, I'll make an exception, because the NRA's extremist, pro-gun, anti-health agenda endangers us all. One simply can't understand gun policy in the United States without acknowledging and understanding the NRA's role in shaping it, pushing policies that contribute to thousands of deaths and injuries each year.

It wasn't always so. “For much of the 20th century, the NRA had lobbied and co-authored legislation that was similar to the modern legislative measures the association now characterizes as unconstitutional,” wrote historian Arica L. Coleman in Time magazine in July 2016. “But by the 1970s the NRA came to view attempts to enact gun-control laws as threats to the Second Amendment … Today's NRA could be summed up with words uttered by the Black Panther Party 40 years earlier: “the gun is the only thing that will free us—gain us our liberation.” The NRA today pushes radical policies to block and roll back just about any effort to restrict guns. It pushes a narrative of exaggerated threats that can only be repelled by armed citizens, never mind the evidence that more guns are associated with more deaths and injuries from guns.

In case you think my characterizing the NRA's agenda as “radical” and “extremist” is unfair or too harsh, consider a few points.

The NRA opposes reauthorization of the Violence Against Women Act (VAWA), which funds proven programs to protect women from harm at the hands of others, because it makes it harder for domestic violence offenders to obtain guns. It would do this by closing loopholes in the current federal instant background check system.

Currently, persons with misdemeanor convictions for domestic violence against a member of their household are prohibited from buying guns. However, those with convictions for domestic violence against a person outside their household (such as persons they've dated) are exempted. Also, under current law, persons with permanent restraining orders are prohibited from buying guns, but those with temporary restraining orders are not. VAWA would close both of these loopholes, as recommended by ACP in its recently updated policy paper on reducing injuries and deaths from firearms. (This is the same ACP policy paper that launched “This Is Our Lane,” the physician movement against gun violence, when the NRA attacked ACP, and Annals of Internal Medicine, which published the paper, telling doctors to “stay in their lane.”) Fortunately, the House of Representatives voted on April 4 to reauthorize VAWA, on a vote of 263-158. However, the NRA will do everything possible to block it in the Republican-controlled Senate.

The NRA opposes expanding the federal background check system to include sales of guns at gun shows or through the internet, resulting in sales of guns to persons who otherwise would be prohibited because they have felony convictions, have been involuntarily hospitalized for a mental health condition that makes them a danger to themselves or others, or are otherwise prohibited under current law. Universal background checks are supported by nine out of 10 Americans, including an overwhelming majority of gun owners, yet the NRA opposes them.

The NRA advocates for “concealed-carry reciprocity,” which would require states to allow persons from any other state to carry a concealed firearm, preempting a state's right to determine its own conditions for granting concealed-carry permits. It also advocates for “constitutional carry” laws, which would repeal any and all state restrictions on carrying concealed weapons. This would effectively result in virtually no restrictions on concealed carry, anywhere.

The NRA opposes banning future sales of military-grade assault rifles and high-capacity magazines, the weapons of choice for mass shooters. For the NRA, it appears there is no type of firearm or ammunition that can be banned, no matter the harm it can inflict, even when there is no reasonable self-defense or recreational need for civilians to own such weapons.

The NRA opposes extreme risk protection, otherwise known as red-flag laws. Such laws would allow family members or the police to seek an order from a judge, usually within three days, to remove guns temporarily from people determined to be at imminent risk of using their firearms to harm themselves or others, with due process to have their firearms returned to them if they are no longer a risk.

The NRA opposes laws to require guns and ammunition to be stored safely and securely, and separately from each other, to reduce the risk of injuries and deaths when children, or other unauthorized persons, get hold of unsecured and loaded guns.

Extreme and radical? How else to characterize an effort to make it easier for domestic violence offenders to buy and possess guns, to allow felons and other restricted persons to buy guns at gun shows or on the internet, to eliminate all concealed-carry restrictions (and to force all states to accept their elimination), to make it impossible to remove guns from persons at imminent risk of harming themselves or others, to oppose requirements for safe storage of firearms and ammunition, and to allow sales of military-style assault weapons? How else?

To be clear, when I call out the NRA for promoting a radical and extreme advocacy agenda, this does not mean I believe that most of its members, or most gun owners, are radical or extreme. Polls show that most gun owners support the policies cited above that the NRA opposes. Yet as long as the NRA's leadership advocates for extreme policies that endanger the lives of the rest of us, ACP will continue to speak up in support of common-sense policies to reduce injuries and deaths from firearms, because protecting patients from harm is very much in physicians' lane.