The APA PAC is not alone in undermining its organization’s public position on firearm safety reform. By all measures investigated, almost all of the 25 medical organization PACs evaluated by Schuur and colleagues demonstrated a similar pattern of donations. This includes the American Medical Association (AMA; $574,500 to $420,500), the American College of Surgeons (ACS; $257,500 to $185,500), and the American College of Emergency Physicians (ACEP; $716,900 to $344,500).
In 2016 alone, health organization PACs donated about $5.5 million to NRA A-rated candidates as opposed to $4 million to candidates with any other rating. Schuur and colleagues concluded that their findings demonstrate a donation pattern on the part of 20 out of 25 PACs that “appears to be inconsistent with and a barrier to effective public health advocacy for firearm safety.”
In a related study, Neufeld and colleagues6 compared 2018 donations to individual politicians from physician organization PACs and the National Rifle Association Victory Fund (NRA PVF), focusing on seven organizations with published firearm injury prevention policies, including the APA, the AMA, the ACS, and the ACEP. Of the 141 members of Congress who received donations from both physician organization PACs and the NRA PVF (political victory fund), the NRA PVF rated 139 candidates as having greater than 90% NRA approval rating; 70.2% of the candidates received more funds from the medical organization PACs than from the NRA PVF, despite their votes against policies endorsed by the physician organizations themselves.
Overall, combined physician organization PACS donated about $1.5 million to NRA backed candidates; the NRA PVG contributed a total of about $420,000 to these members of Congress. The authors concluded that donations make an impact on NRA-backed members of Congress and to align with their organization’s public health policies regarding firearms “Organizations wishing to make firearm violence and injury prevention a priority must consider redistributing political donations.”
Notably, Steven Sharfstein, MD, a past President of the APA, found similar donation patterns by the AMA’s PAC in 1994 and concluded that this practice belied the AMA positions on these important public health issues.7 Medical organization PACs also contribute to politicians who support firearm reform legislation. Donating to politicians on both sides of any issue is business as usual in Washington. However, as pointed out in the article, this does not explain why any PAC, including the APA PAC, would give significantly more money to representatives who disagree with their organizations’ official positions than to those who support them.
Nevertheless, political business as usual regarding gun violence is no longer acceptable, particularly for medical organizations. The APA PAC’s pattern of political contributions in direct opposition to the APA’s stated positions on firearm reform undermines our professional credibility. More importantly, the APA PAC is supporting a deadly status quo. The fact that politicians’ obstructionist stance invariably includes reflexively blaming gun violence on individuals with mental illness makes the APA PAC’s complicity in supporting these A-rated politicians over others particularly egregious. And, every day, another 110 people die from gun violence.
Dr Gold is Clinical Professor of Psychiatry, Georgetown University, Washington, DC.
1. American Psychiatric Association: Position Statement on Firearm Access, Acts of Violence and the Relationship to Mental Illness and Mental Health Services.
2. Weinberger SE, Hoyt DB, Lawrence HC, et al. Firearm related injury and death in the United States: a call to action from 8 health professional organizations and the American Bar Association. Ann Intern Med. 2015: 162:513-516.
3. Bulger EM, Kuhls DA, Campbell BT, et al. Proceedings from the Medical Summit on Firearm Injury Prevention: A Public Health Approach to Reduce Death and Disability in the US. J Am Coll Surg. 2019.
4. DeBonis M, Guskin E. Americans of both parties overwhelmingly support “red flag” laws, expanded background checks for gun buyers. Washington Post. September 9, 2019.
5. Schuur JD, Decker H, Baker O. Association of physician organization affiliated political action committee contributions with US House of Representative and Senate candidates’ stances on firearm regulation. JAMA Network Open. 2019;2:e187831.
6. Neufeld MY, Sanchez SE, Siegel M. Firearm policy: physician organizations’ role in political action committee funds, 2018. Am J Pub Health. September 19, 2019 [Epub ahead of print].
7. Sharfstein JM, Sharfstein SS: Campaign contributions from the American political action committee to members of congress: for or against the public health. N Eng J Med. 1994;330;32-37.