NCAA asks colleges to prohibit romantic relationships between athletes, coaches
However, the information received in the care of professional athletes by team Is it ethical to disclose this information without the consent of the player? .. up to date; guidelines can help to standardize treatment and improve safety. . is to provide “advice and guidance regarding the provision of preventive, medical. “Sexual relationships between coaches and student-athletes have over the athlete – rendering an athlete's consent, stated or unstated. As I'm nearing 30, I look back on my dating life and a pattern emerges; my significant others either loved sports or played sports (professionally).
Return-to-play decisions After a player gets hurt, the team physician must make a return-to-play decision both during the game on the field and during the period of injury management i. When the injury is a concussion, the return-to-play decision involves the evaluation of severity measured by duration of loss of consciousness, amnesia, and confusionother symptoms lingering headache, fatigue, photosensitivity, etc.
Return-to-play guidelines following concussion exist to minimize the risk of long-lasting effects Yard and Comstock These guidelines establish that any player who had loss of consciousness in the field should not return to play in the same day Pellman et al.
A retrospective study performed by the National Football League using data from — compared NFL players who experienced concussion and returned to the field on the same day with those who were removed from play. The study concluded that the guidelines might be too conservative for professional players Pellman et al. NFL team physicians use clinical judgments rather than guidelines when making return-to-play decisions Pellman et al. The burden of responsibility on the team physician is great in such cases due to the possibility of catastrophic outcomes following a bad decision.
Health care professionals identify return-to-play decisions as one of the main ethical conflicts in sports medicine Anderson and Gerrard The coach and manager also need the player to be back on the field. The team physician might be the primary person whose main concern is to evaluate and decide on the basis of both the short- and long-term health of the athlete Johnson Ideally, the decision should not be dominated by the desire to affect the outcome of the competition or by the coaches, but should be based instead on the risks and consequences to the health of the athlete Burgess Return-to-play decisions are unique to sports medicine and can be challenging because, while the primary aim of the team physician is the well-being of the athlete, he or she also must support the team goals Johnson Awareness of this conflict is the first step to solving the problem, but more studies and regulations are needed to address it effectively.
Advertising Medical advertising was once considered illegal and unprofessional in the United States and is still illegal in countries such as Italy and Germany Capozzi and Rhodes Today, advertising is considered essential to the promotion of merchandise in the United States, and it is founded on the idea that democratic societies have freedom of expression and trade Capozzi and Rhodes If medical advertising in the United States is legal and culturally accepted, then what is the ethical concern in the case of sports medicine?
The main concern is that some clubs are accepting bids from physicians or medical groups to serve as a team physicians in exchange for the public relations opportunities that the position might entail Johnson The collision of major market forces over the past four to five years has made this behavior the rule rather than the exception. One suggestion for solving this important ethical conflict is full disclosure. The team physician should fully disclose any financial relationship with a given club in all advertisements and promotions Attarian Research in progress and the lack of evidence-based medicine Team physicians have to deal with many unanswered questions that hinder decision-making.
A study in NFL retired players showed that 1. Other sports involving repetitive concussion are also associated with chronic traumatic encephalopathy, such as professional hockey and professional wrestling Baugh et al.
The hypothesis that repetitive brain trauma leads to early dementia is not yet proved, however. How should physicians proceed during the informed consent process considering the high degree of uncertainty in sports medicine? Should they be more conservative and err on the side of player protection, or should they just base their decisions on strong evidence? Are the tendencies of the physicians to be conservative or permissive affected by whether the club pays their salary?
The rapid technological evolution of sports medicine paired with its huge financial implications and the small sample of professional athletes available for research collectively contribute to a lack of evidence-based medicine in this field Dunn et al.
Team physicians must rely on their own knowledge when choosing new interventions and use clinical evidence whenever possible to make therapeutic decisions. Most importantly, the lack of evidence-based medicine must be communicated to the athlete Dunn et al.
Use of medical innovations is associated with three important consequences: Dealing with these consequences can lead to ethical conflicts. Studies, even small ones, help us test safety and effectiveness of drugs and devices.
Sports Medicine and Ethics
Conflicts of interest should be disclosed. Conferences, seminars, and discussion forums can help to keep physicians up to date; guidelines can help to standardize treatment and improve safety. But the fundamental issue of lack of evidence will continue to affect patient and physician decision-making. A physician should operate according to his or her best assessment of the current data, taking into account the relative risks and benefits of different strategies and considerations about where evidence is lacking, and should not let short-term needs allow for decisions that make the risks unnecessarily high.
Drugs and performance enhancement: Regarding legal performance-enhancing substances, is the athlete the only person responsible for assuming the risk of use, or should the team physician actively work to help the athlete with that decision? In simple terms, the rules are violated when: Prohibited drugs include anabolic agents, peptide hormones and growth factors, beta-2 agonists, some hormones, metabolic modulators, and diuretics.
Blood doping and other techniques for enhancement of oxygen transfer are prohibited methods, as is gene doping WADA According to FIMS, the use of prohibited drugs is unethical and strictly forbidden, and the sports medicine physician should oppose their use FIMS position statement.
The NFL policies also establish that all players will be tested for prohibited substances at least once per year or more often at random NFL Given the regulations against the use of performance-enhancing drugs and their numerous health risks, it seems clear that team physicians should strongly discourage their use.
In the eyes of some ethicists, a physician who assists an athlete in doping is being unethical, often outside the law, and is therefore jeopardizing his career Finnoff et al. While this may be the most widely accepted opinion, it is not a consensus position. Some believe the physician should discourage the use of legal or illegal performance-enhancing substances but should not end the medical relationship if an athlete insists on using drugs, particularly if they are technically legal.
There is no question that the physician should follow the health of the athlete and continue to warn him about the risks and legal consequences of substance use Dunn et al. Others go further and argue that androgenic steroids in particular should not be banned but rather considered a part of a comprehensive training program in sports Finnoff et al.
Ketorolac Toradol is another example of a controversial drug widely used in professional football. Ketorolac is a moderately potent analgesic and anti-inflammatory drug that serves to attenuate the aches and pains of a high-contact sport with bruises and joint and muscle aches. The risks of ketorolac are not fully understood, but it clearly has renal toxicity and may potentiate the risk of concussions Belson and Pilon In addition, players pre-treated with ketorolac may not be fully aware of the physical effects of their activities and thus may risk more damage than they would otherwise incur.
Local anesthetic injection is considered a method of performance enhancement by some authors. Its use is controversial and poses an important ethical dilemma in sports medicine, despite not being considered a performance-enhancing substance by the World Anti-Doping Agency. Although use of such injections is widespread, little is known about their associated complications Orchard A case-series of players who had received anesthetic injections on occasions concluded that most of the procedures were safe, but some have been associated with substantially worsened performance Orchard et al.
If there is evidence that the procedure can worsen the injury, should the athlete decide whether future consequences are more important than absence from a game?
The complexities of short-term gains for a football player who chooses to stay on the field by limiting pain and enabling maximum performance are enormous. The athlete must be well-informed of short- and long-term risks Orchardbut should he have the final say in the matter? Genetic testing Advances in genetic testing have raised new ethical concerns. Although these advances have potential for increasing the health and well-being of patients, they also have potential to cause harm depending on how they are used Williams New findings in genetic testing have raised the possibilities of enhanced sports performance and sports potential prediction Savulescu and Foddy However, genetic tests can also be done for safety purposes McNamee et al.
Genetic screening is indicated for athletes who have a family member diagnosed with hypertrophic cardiomyopathy or certain arrhythmias Trusty et al. With a positive genetic screening in hand, what is the role of the team physician?
If the physician does not allow the athlete to play, it can be considered discrimination and the Genetic Information Non-discrimination Act, as described earlier. The team physician may decide to allow the player to participate after informed consent.
Again, the decision-making process, in the context of professional sports, is affected by many external influences. If the screening is positive and the athlete ignores its results to continue playing, should the physician disclose the information to the coach and team management? Confidentiality and trust between patient and doctor would probably be broken if the information was disclosed.
Another example of a genetic test that could significantly affect NFL players is the identification of apolipoprotein E4. Adults who are positive for E4, even as a single allele, are more likely to have poor long-term central nervous system outcomes after traumatic brain injury Zhou et al.
While this finding is controversial, it triggers a discussion: What if a gene was found that predicted a higher likelihood of serious risk of brain injury with trauma? Should that person be allowed to play football? What right does a player have to accept a higher risk of injury than average, relative to the responsibility of the team management and team physician?
The solution will not be absolute—it will be one that incorporates degrees of risk and responsibility. It will require review and acceptance or rejection of the data underlying the premise that there is risk and agreement on a plan of management.
As it happens, if a brain injury risk gene is identified, it may also be applied to retired players affecting their insurance and current players affecting how their careers are managed after head trauma. Serious thought should be given to the ethical implications of this area of knowledge because it will affect a far larger portion of the population than just players in the NFL. Not only do we need a more complete picture, we also require studies with larger sample sizes and increased statistical power to address both the ethical and medical issues covered in this review.
Ethics and the law are often closely related Johnson However, in sports medicine, ethics are also closely linked to the safety of the athletes. Decision-making processes in this field can mean the difference between a young player with a long life expectancy and a satisfying career and a former player with a permanent injury or premature dementia.
We need to better understand what is involved in the decision-making process for both team physicians and athletes. Health care educational programs to help the athletes better understand the long-term consequences of their decisions also need to be created and tested for efficacy. A long-term follow-up is needed to evaluate clinical consequences of decisions made and to generate improvement in sports medicine.
Through long-term follow-up, we will also be able to better study satisfaction in decision-making and other aspects related to ethical dilemmas in sports medicine. The other authors have no potential conflicts to disclose. Contractual obligations and the sharing of confidential health information in sport. Journal of Medical Ethics. Ethical issues concerning New Zealand sports doctors.
The Journal of Bone and Joint Surgery. Brain Imaging and Behavior.
Ethics in sports medicine. Clinical Orthopaedics and Related Research. Why players 'cheat' the concussion test. Informed consent in sports medicine. Clinics in Sports Medicine. Ethical issues in return-to-sport decisions. South African Journal of Sports Medicine. Decision-making in the physician-patient encounter: Social Science and Medicine. The American Journal of Sports Medicine. The Journal of Injury, Function, and Rehabilitation.
Patient participation in decision-making.
The Truth About Dating A Professional Athlete
Informed consent for clinical treatment. Canadian Medical Association Journal. United States Statutes at Large. Ethical practice and sports physician protection: British Journal Sports Medicine. The Hastings Center Report. The unique ethics of sports medicine. Athlete or guinea pig? Sports and enhancement research. Studies in Ethics, Law, and Technology.
Return to play following sports-related concussion. HIPAA and the team physician. Genetic testing and sports medicine ethics. Legal and ethical myths about informed consent. Archives of Internal Medicine. I would just say, be cool.
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That's problem,'" she says. You're not a nag. You're my best friend and you're cooler than the other side of the pillow.
You're the coolest person I know. She is so bomb! I'm just very trusting. I feel like you just have to be self-confident. Trust Your Relationship Similar to the first rule, you have to be secure within yourself if you're ever going to be secure in a relationship with a pro athlete. I'm confident in my relationship and that's why we're in a relationship. Being married to or dating a professional athlete is very hard. Their job is extremely time-consuming, so you need to be a selfless woman.
When you're secure within yourself, they're able to thrive within their career. It's very different from being with somebody that works a regular nine-to-five job. You just got to have thick skin for whatever comes your way and just know why you're in it.
You're going to ride or die," she says. I'm not going anywhere and he knows that I'm there for him and vice versa. Whatever comes, bring it on! Do You and Your Man If you want to date a professional sports star, it's also important to have a life outside of your relationship. Have your own identity is basically what I'm trying to say.
I've always been a hard-worker and just because I'm with somebody where I don't necessarily have to work, I still continue to just have my own career. I have groupies too. It's one of those things where it's like we're not on some hierarchy.
We're equal, which is nice. Know Your Worth Just like Drake raps on his song "0 to ," you have to know yourself and know your worth before anybody else can—and Tia wholeheartedly agrees. If you stop believing in yourself, then that's it.