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Journal of Bioethical Inquiry

, Volume 11, Issue 1, pp 65–74 | Cite as

Dazed and Confused: Sports Medicine, Conflicts of Interest, and Concussion Management

  • Brad PartridgeEmail author
Original Research

Abstract

Professional sports with high rates of concussion have become increasingly concerned about the long-term effects of multiple head injuries. In this context, return-to-play decisions about concussion generate considerable ethical tensions for sports physicians. Team doctors clearly have an obligation to the welfare of their patient (the injured athlete) but they also have an obligation to their employer (the team), whose primary interest is typically success through winning. At times, a team’s interest in winning may not accord with the welfare of an injured player, particularly when it comes to decisions about returning to play after injury. Australia’s two most popular professional football codes—rugby league and Australian Rules football—have adopted guidelines that prohibit concussed players from continuing to play on the same day. I suggest that conflicts of interest between doctors, patients, and teams may present a substantial obstacle to the proper adherence of concussion guidelines. Concussion management guidelines implemented by a sport’s governing body do not necessarily remove or resolve conflicts of interest in the doctor–patient–team triad. The instigation of a concussion exclusion rule appears to add a fourth party to this triad (the National Rugby League or the Australian Football League). In some instances, when conflicts of interest among stakeholders are ignored or insufficiently managed, they may facilitate attempts at circumventing concussion management guidelines to the detriment of player welfare.

Keywords

Conflict of interest Sports medicine Concussion Sport Ethics Rugby league Australian Rules football 

Notes

Acknowledgments

Thanks to Wayne Hall and Mal Parker for their comments on an earlier draft of this paper.

Funding and Disclosure of Interests

Brad Partridge receives funding from the Australia’s National Health and Medical Research Council (NHMRC) and the Australian Research Council (ARC).

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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.UQ Centre for Clinical Research (UQCCR)The University of QueenslandHerstonAustralia

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