Firearm deaths in Sweden

Sweden's firearm legislation obligates physicians to report patients that are deemed unsuitable to possess a firearm. This study aimed to explore the involvement of firearm use in firearm fatalities and to evaluate physician reporting concerning cases of firearm deaths.

Fatal firearm suicides and homicides in Sweden were studied for the years 2012-2013, accidental deaths and undetermined manner of deaths for the period 1987-2013. Police reports and autopsy protocols were collected from the National Board of Forensic Medicine, health care data in 1 year before the fatality from the National Board of Health, and information about physician reports and firearm licences from the Swedish Police.

A total of 291 firearm deaths (213 suicides, 52 accidental deaths, 23 solved homicides and 3 cases with undetermined manner of death) were identified. Firearm suicides were positively correlated with the number of licensed firearm owners. Legal firearm use predominated in firearm suicides and accidental deaths, illegal in homicides. No suicide victim or shooter in an accidental death was previously reported by a physician to the police according to the firearm law. The majority of the shooters in accidental deaths and suicides had no registered health care visits. Less than half (42%) of all suicide victims had a previous health care contact due to mental health problems.

Not one single suicide victim nor any shooter in accidental deaths in the present study had been reported according to the firearm law, bringing the evidence of a suboptimal framework.