AMA meeting: Increasing use of Tasers prompts safety review

Physicians want more safety information about the stun guns.

By Victoria Stagg Elliott, amednews staff. July 7, 2008.

Annual Meeting 2008

Chicago -- In response to concerns about the expanding use of Tasers and their possible impact on health, the AMA's Council on Science and Public Health will gather scientific data on injuries and deaths that may be connected to these electronic control devices for a future report, according to policy adopted at the AMA's June meeting.

"There remains controversy around the safety of Tasers," said AMA Board of Trustees member Steven J. Stack, MD. "Further study is in order to ensure that Tasers present the least possible harm to the people being subdued."

Delegates are seeking this report because Tasers are increasingly used beyond law enforcement.

"Tasers are being used in some school settings and health care settings without any knowledge of the consequences," said Carol Berkowitz, MD, speaking for the American Academy of Pediatrics.

Meeting notes: Public health
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Some people are stunned by the devices as part of the how-to-use training. Background checks are required, but the devices can be legally carried as concealed weapons in many jurisdictions. A version is available to the public in nine colors, including two shades of pink.

"I would caution everyone about arming the world with Tasers. We need the science, and I hope we don't end up killing more people than protecting them," said Robert E. McAfee, MD, a former AMA president and general surgeon from Portland, Maine.

More widespread use also means more questions about whether these devices are overused and how dangerous they might be. The Commission for Public Complaints Against The Royal Canadian Mounted Police, a government-created independent agency, issued a report last month supporting continued use. But, because of public concern raised by several related deaths, the Canadian report urged Taser use be restricted to experienced officers.

The report also found Tasers were most likely to be used on unarmed males aged 20 to 39 who had been drinking alcohol. The document recommended the stunning devices only be used on people who were combative and presented a risk of inflicting death or grievous bodily harm. Medical attention should always be sought afterward.

In the scientific realm, several prospective studies have failed to find any negative cardiac impact, but case reports have documented a handful of associated injuries. A paper in the November 2007 Annals of Emergency Medicine reported details of a police officer who was stunned during training and sustained spinal fractures from the severe, Taser-induced muscle contractions. This possibility is included in the safety information accompanying the device.

"We need to let the public know that they are not as undangerous as they think," said Corliss Varnum, MD, a family physician from Oswego, N.Y., and a representative of the Medical Society of the State of New York.

Delegates were particularly concerned about Taser use outside of law enforcement, and the possibility that the devices could be used to control children or the mentally ill.

"Tasers have now been implicated in several deaths, and those with mental illness seem to be 'Tasered' with disproportionate frequency," said David Fassler, MD, a child and adolescent psychiatrist from Burlington, Vt., speaking for the American Academy of Child & Adolescent Psychiatry.

"When used properly," said Steve Tuttle, vice president of communications for the manufacturer, TASER International, "medical and law enforcement experts have concluded that Taser technology is among the most effective use-of-force interventions available to law enforcement officers to halt violent situations that pose a safety risk."

Statements on the company Web site indicate that 71 wrongful death and injury lawsuits brought against the company have been dismissed.

ADDITIONAL INFORMATION:

Meeting notes: Public health

Issue: Questions have been raised about the role high-fructose corn syrup may play in escalating obesity rates. A review suggested that increasing consumption of all forms of sugar may be involved, but that high-fructose corn syrup could not be singled out.

Proposed action: Encourage independent research into the effects of high-fructose corn syrup and recommend that people limit consumption of all caloric sweeteners. [ Adopted ]

Issue: Research indicates that recommended levels for vitamin D are too low and deficiencies in this substance may play a role in development of chronic diseases.

Proposed action: Urge the Institute of Medicine to re-examine recommended daily intake values for vitamin D. [ Adopted ]

Issue: Many hospitals require physicians to sign a written version of verbal orders within 48 hours, but physicians regard this as a waste of time and lacking evidence that it benefits patients.

Proposed action: Request from appropriate federal agencies evidence supporting this policy, and, if there is none, ask for the requirement to be rescinded. [ Adopted ]

Issue: Many blood-banking organizations regard the lifetime ban on blood donations from men who have had sex with men since 1977 as no longer necessary to keep supplies safe. It also may be discriminatory and stigmatizing.

Proposed action: Recognize that a five-year deferral is supportable by science. [ Adopted ]

Issue: Those living with chronic medical conditions are more likely to be injured or die during a disaster or in its aftermath. This may be due in part to a lack of access to usual medications.

Proposed action: Recommend patients maintain an emergency pharmaceutical reserve and always carry a detailed list of their medications. [ Adopted ]

Issue: Studies have not found "abstinence-only" education to be effective, but state and federal funding supports it.

Proposed action: Urge that mandates for "abstinence-only" instruction end and that money be redirected to comprehensive sex education. [ Referred ]