Ethics

On Concussions, the NFL, and Neuroethics (Goldberg)

By Daniel Goldberg

First, thanks to Adam for the chance to guest-blog here again.

As we gear up for the Stupor Bowl [sic], the newswires exploded with news of the latest study of chronic traumatic encephalopthy ("CTE") in a former professional football player.  A bit of context here:

What if the risks of traumatic brain injury that stem from playing football are much closer to the risks of TBI from combat sports (like MMA, which I have personal experience with, or professional boxing)? The rules and regulations for the latter are quite strict regarding neurological trauma, as the career of Joe Mesi amply illustrates.

In contrast, there are no rules and regulations regarding the treatment of concussions in the NFL, or mild TBI ("mTBI").  The story here is extremely complicated, involving structural features of occupational medicine in the NFL, rampant conflicts of interest, and profound uncertainty regarding the sequelae of even a few concussions.  Despite this uncertainty, the evidence is mounting that neuropathological effects of concussions are protracted (such that even when persons appear uninjured 15 minutes after a concussion, they may in fact suffer neural damage), and that severe long-term neuropathology can be caused by relatively few concussions (though no one knows how many, it is very likely less rather than more), among other recent findings.

The latest findings stem from the efforts of Chris Nowinski, a former Harvard football player and professional wrestler, who has devoted much of his time and energy to this particular issue.  He co-founded the Sports Legacy Institute, which sponsored the latest study. 

In any case, the NFL is clearly on the defensive on this issue, as, IMO, they ought to be.

For some reason, Adam was kind enough to permit me to borrow this blog for some shameless self-promotion, so I can say that readers interested in knowing more about this issue are invited to check out an article of mine recently published in HEC Forum:

"Concussions, Professional Sports, and Conflicts of Interest: Why the National Football League?s Current Policies are Bad for Its (Players?) Health," HEC Forum 20, no. 4 (2008): 337-355.

Those among you with no interest in this issue should still check out HEC Forum, as the issue is a theme issue on Clinical Neuroethics Consultation, guest edited by Paul Ford.  Lots of articles in there that the readers of this blog will probably find interesting.

Full post as published by Neuroethics and Law on January 28, 2009 (boomark / email).