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Journal Article

Citation

Adashi EY, Gao H, Cohen IG. J. Am. Med. Assoc. JAMA 2015; 313(12): 1209-1210.

Affiliation

Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard Law School, Harvard University, Cambridge, Massachusetts.

Copyright

(Copyright © 2015, American Medical Association)

DOI

10.1001/jama.2015.1733

PMID

25719264

Abstract

On January 20, 2015, Michael J. Davidson, MD, a cardiothoracic surgeon, was fatally shot on the premises of the Brigham and Women’s Hospital in Boston, Massachusetts. In the year leading up to this tragic day, a total of 14 active shooter incidents occurred in hospitals throughout the United States, leaving 15 fatalities in their wake. This reality and its potential amplification by copycats has reignited the debate over the adequacy of current and future hospital security arrangements. In this Viewpoint, we discuss the evolving frequency of hospital-based active shooter incidents, the relevant legal framework, and the role of hospitals and physicians in countering this threat.

As defined by the US Department of Homeland Security, an active shooter incident is one wherein “an individual is actively engaged in killing or attempting to kill people in a confined and populated area.” By several accounts, the overall prevalence of this otherwise rare occurrence is increasing. A study by the Federal Bureau of Investigation (FBI) reveals the overall number of active shooter incidents to have increased from 6.4 per year (2000-2006) to 16.4 per year (2007-2013). Similar rates have been reported for the hospital setting wherein the average number of active shooter incidents has increased from 9 per year (2000-2005) to 16.7 per year (2006-2011), claiming 161 lives in the process. It would thus appear that the frequency of hospital-based active shooter incidents has evolved to constitute at least a monthly occurrence. Rare as these events might be when considered in light of the enormity of the health care universe, they threaten the all-important sanctity of this benevolent and altruistic enterprise.

The US Department of Health and Human Services (DHHS) has long recognized active shooter incidents as an extant threat to health care facilities. On December 1, 2014, the office of the assistant secretary for preparedness and response of the DHHS issued a planning guide encouraging health care facilities to incorporate active shooter incident planning into their emergency operation plans. Joint signatories to the guide included the Department of Homeland Security, the FBI, the US Department of Justice, and the Federal Emergency Management Agency.

Focused on prevention, protection, mitigation, response, and recovery, the DHHS guide makes special mention of the practical application of the 3-part run, hide, fight protocol....


Language: en

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