Ethics in Sports Medicine

The American Academy of Orthopaedic Surgeons (AAOS) acknowledges that ethics in the world of athletics has become increasingly blurred recently. Aside from prominent issues like blood doping and performance-enhancing drugs, the physician-athlete relationship itself is under scrutiny due to the often conflicting goals inherent. Often times, immediate athletic performance is prioritized over the future health of the athlete--and it may not even be the doctor's choice, especially when coaches and teammates come into the picture.

Scholarship money and the family's financial means play a role as well, especially with the hyper-inflated tuition costs of some postsecondary schools. Athletic ability could be a student's ticket to higher education and escape from poverty, but it hinges on the condition that the athlete does not sustain an injury. In light of this, many patients choose an anaesthetic injection over rest from play, despite the possibility of future complications, such as osteoarthritis. In the cases of minors who are student-athletes, parental influence may even be detrimental to the health of the patient. All of these factors must be considered by the physician when considering treatment.

AAOS instructs physicians to focus on the following criteria when dealing with underage athletes:

Help the patient achieve a developmentally appropriate awareness of the nature of the condition.
Inform the patient what he or she can expect with various tests and treatments.
Clinically assess the patient’s understanding of the situation and factors influencing how he or she is responding.
Solicit an expression of the patient’s willingness to accept the proposed care without coercion or deception.

To follow the Hippocratic Oath, doctors must "first, do no harm." However, harm, when it comes to student-athletes, is a much more complex and confusing concept than it has been in the past.

#ethics #exercisescience #sportsmedicine