Managing Sports-Related Concussion

Ethical and Legal Matters

By Dr Shermella Roopchand-Martin, head of UWI Mona campus' Academy of Sport

Man­age­ment of ath­letes with sports-re­lat­ed con­cus­sion pos­es sev­er­al eth­i­cal and le­gal chal­lenges, be­gin­ning with who makes the de­ci­sion re­gard­ing re­moval from the field or re­turn to play. The Con­cus­sion in Sport Group en­cour­ages a mul­ti­dis­ci­pli­nary, col­lab­o­ra­tive ap­proach. How­ev­er, it places the fi­nal de­ci­sion in the hands of the team clin­i­cian or an ap­pro­pri­ate­ly li­censed health­care pro­fes­sion­al. This pos­es a chal­lenge, since a team physi­cian is em­ployed by the sport­ing or­gan­i­sa­tion to look af­ter the team and not just in­di­vid­ual ath­letes. At a sport­ing event, the team doc­tor is faced with tremen­dous pres­sure from mul­ti­ple sources. The de­ci­sion to re­move a play­er can have a neg­a­tive im­pact on team psy­che and ad­verse­ly af­fect tour­na­ment out­come, re­sult­ing in harm for the en­tire team. This may re­sult in the team doc­tor fac­ing threats from the ath­letes, the or­gan­i­sa­tions, fam­i­ly mem­bers and the pub­lic. It is not an un­com­mon prac­tice there­fore to see in­jured play­ers re­turn to the field be­cause the risk/ben­e­fit analy­sis falls in favour of ‘re­turn to play and deal with the in­jury lat­er’.