The committee recommends the implementation of a comprehensive approach for preventing and reducing firearm injuries that includes firearm surveillance, firearm safety regulation, multidisciplinary research, enforcement of existing restrictions on access by minors and other unlawful purchasers, prevention programs at the state and local levels, and mobilization of public support.

Ongoing Controversies

The firearms debate is often contentious and polarized. In contrast to highway safety policy, no consensus has emerged among policy makers regarding many aspects of firearms policy. Although recent public opinion surveys reveal a large area of agreement on many policy issues (Teret et al., 1998), agreement is lacking among policy makers about the goals of national policy, or indeed whether there should be a national policy in this area; about the benefits and costs of restrictions on ownership, availability, and use of firearms; and about the balance that should be struck between safety-enhancing regulation and individual freedom. Some of these ongoing controversies are briefly described below.

Issues of Individual Freedom

There is ongoing debate over balancing the rights of individuals to own firearms for self-protection (and the security of loved ones) or for recreational use (e.g., hunting, target shooting) against societal concerns about the risk of harm in other contexts. There is general acceptance of the concept that individuals have legitimate rights to engage in recreational hunting or target shooting and to protect themselves and their families and friends, as well as ample evidence that handgun ownership provides a sense of greater security (Cook and Ludwig, 1996). The policy issue is how to balance the values of individual autonomy with the community's interest in reducing the risk of firearm fatalities and injuries.

Instrumentality and Availability

One of the issues examined in ongoing studies is the extent to which guns are instrumental in increasing the risk of death or injury, independent of other factors. The type of weapon used in any violent act, including suicide, may be an important determinant of whether the victim survives and of the risk of disability. Studies of this issue focus on the lethality of various types of weapons; the extent to which the intent of the assailant, rather than the weapon, determines the injury outcome; and the extent to which an individual's choice of weapon is calculated to ensure injury or death or is a matter of chance or access.

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