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Athletes Are Guinea Pigs
American Journal of Bioethics 13 (10):13 - 14 (2013)
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The principle of informed consent is so firmly established in bioethics and biomedicine that the term was soon bowdlerized in common practice, such that engaging in the informed decision-making process with patients or research subjects is now often called “consenting” them. This evolution, from the original concept to the rather questionable coinage that makes consent a verb, reveals not only a loss of rhetorical precision but also a fundamental shift in the potential meaning, value, and implementation of the informed consent (...) process. Too often, the sharing of information has been replaced by the mere acquisition of agreement with the authority ostensibly offering a choice.Scholars of informed consent agree that its salience and its legitimacy derive from a fiduciary duty to inform, in order to respect, protect, and promote autonomous decision making by those to whom the duty is owed. (shrink) | |
How can we ensure that players in the National Football League receive excellent health care they can trust from providers who are as free from conflicts of interest as realistically possible? NFL players typically receive care from the club's own medical staff. Club doctors are clearly important stakeholders in player health. They diagnose and treat players for a variety of ailments, physical and mental, while making recommendations to the player concerning those ailments. At the same time, club doctors have obligations (...) to the club, namely to inform and advise clubs about the health status of players. While players and clubs share an interest in player health—both of them want players to be healthy so they can play at peak performance—there are several areas where their interests can diverge, and the divergence presents legal and ethical challenges. The current structure forces club doctors to have obligations to two parties—the club and the player—and to make difficult judgments about when one party's interests must yield to another's. None of the three parties involved should prefer this conflicted approach. We propose to resolve the problem of dual loyalty by largely severing the club doctor's ties with the club and refashioning that role into one of singular loyalty to the player-patient. The main idea is to separate the roles of serving the player and serving the club and replace them with two distinct sets of medical professionals: the Players' Medical Staff and the Club Evaluation Doctor. We begin by explaining the broad ethical principles that guide us and that help shape our recommendation. We then provide a description of the role of the club doctor in the current system. After explaining the concern about the current NFL player health care structure, we provide a recommendation for improving this structure. We then discuss how the club medical staff fits into the broader microenvironment affecting player health. (shrink) | |
The persistence of doping in professional sports—either by individuals on an isolated basis and by whole teams as part of a systematic doping programme—means that professional sport today is rarely if ever untainted. There are financial incentives in place that incentivise doping and there are data that show that doping is often a systematic, organised enterprise. The main question to be answered today in professional sports is whether doping’s repressive anti-doping policies do not have greater negative consequences for society. Whilst (...) some have suggested legitimising safe doping under medical control, in this paper, I argue that doing so will do little to prevent clandestine use of dangerous performance-enhancing substances, and suggest an alternative solution to lifting the ban on doping, i.e. starting from extending liability for doping in sport beyond athletes to those holding power and authority over athletes, to changing winning incentives for doping, to making sport sustainable in the longer time by devising ways of providing athletes with a steady income which is not linked to record breaking or sponsorships. (shrink) | |
Our article “NFL Player Health Care: Addressing Club Doctors’ Conflicts of Interests and Promoting Player Trust” focused on an inherent structural conflict that faces club doctors in the National Football League. The conflict stems from club doctors’ dual role of providing medical care to players and providing strategic advice to clubs. We recommended assigning these roles to different individuals, with the medical staff members who are responsible for providing player care being chosen and subject to review and termination by a (...) committee of medical experts selected equally by the NFL and the NFL Players Association. Recognizing that the problem of structural conflict of interest is deeply entrenched and that our recommendation is a significant departure from the status quo, we invited comment from a diverse and highly qualified group of experts. There is considerable common ground among the commentators. All but one agreed with us that, despite the best intentions of upstanding professionals, there is a structural conflict of interest in the club doctors’ relationship with players, and the commentaries were generally supportive of our recommendation for change. There are also meaningful disagreements, however. Some commentators think that the proposal is on the right track but does not go far enough to reduce the structural conflict of interest, and one commentary wholly disagrees with our analysis and recommendations. (shrink) | |
The World Anti-Doping Agency was created in 1999 with the goal of making elite competitive sports free of doping practices. Since then, it has grown into a powerful organization that oversees national anti-doping institutions and a majority of international sports federations. Anti-doping regulations means that the use of performance enhancement drugs or methods is prohibited in elite sports competition, and athletes who do not comply are sanctioned through a ban from competition and loss of titles and prizes link to them. (...) The recent discovery of a systematic doping scheme in Russia has shown that the regulations currently in place have failed to offer the 'clean' environment promised to athletes and the public. While there is an understandable call to reform WADA's practices to further the anti-doping fight, I suggest that the purpose of WADA itself should also be reconsidered. In taking a step back from the current controversy and urge for stricter regulations, this thesis will first ask if performance enhancement in sports should really be understood as unethical and undesirable. Favouring a interdisciplinary approach to this problematic, I will take a look at the scholarly debate on doping and critically analyze arguments from both positions including theoretical ideas on doping itself and practical concerns about WADA's current measures to prevent doping. This overview, while it does provide an unequivocal answer about the ethicality of doping, will show a wide range of counterarguments to the prevailing anti-doping stance, and raise numerous concerns about the current system. In doing so, it indicates the need for a larger, inclusive of all stakeholders, deliberation on the anti-doping position, a position which remains so far mostly uncontested outside of academia. In the second part of my thesis, this rejection of a by-default anti stance to doping in sports will then lead me to explore whether there is a more suited alternative to dealing with issue of doping in elite sports than the current zero tolerance approach. Finally, I conclude that a harm reduction approach provides a suitable answer to both moral concerns and issues of feasibility, even though it may be difficult to incorporate into WADA given the number of stakeholders involved. Still, the identification of this alternative, conjointly with the Russian scandal, serves to justify why there should be further deliberation about WADA and the anti-doping movement that goes beyond accepting the status quo and the Agency's idealist notion of achieving completely doping-free sports. (shrink) No categories  |
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