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Sports Medicine and Inherent Ethical Issues

Introduction

The sphere of medicine is an essential part of the sports industry since, to a considerable extent, it influences the careers of athletes. The majority of sports activities are characterized by the high probability of receiving injuries and traumas. As a result, physicians and other doctors play a major role in helping athletes to solve their health problems to be able to compete again. Sports vary in terms of the health risks which are associated with them. For instance, extreme sports tend to have a higher incidence of severe injuries and even deaths compared to traditional sports and thus require a different approach (Laver et al., 2017). Nevertheless, despite the fact that the actual medical problems may differ from one sport to another, doctors continue to face the same ethical issues across all disciplines. Medical specialists working in the sports industry encounter ethical issues on a regular basis, and the ability to deal with them is one of the prerequisites for the job of a sports doctor. There are many different ethical issues inherent to sports medicine, but the most common ones concern confidentiality, conflict of interests, performance enhancement, and the athlete’s autonomy.

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Confidentiality

The work of any healthcare professional is related to the use of medical records of patients, which must always be kept private. Essentially, the information about the health of the athlete is a matter which must be disclosed only to the people the athlete considers trustworthy. At the same time, athletes usually have contracts with sports clubs that also employ physicians and other doctors who work with these athletes. As a result, physicians who are employees of a certain club often have contractual obligations to share all information obtained by them when assessing the health of athletes. Studies show that the majority of physicians working for clubs actually state that they would violate their contractual obligations to keep the information of their patients confidential (Malcolm, 2016). Still, there are also those who say that they would disclose sensitive data to their employers, as well as those claiming that they would convey information partially (Malcolm, 2016). Basically, the issue of confidentiality is ethical since to solve it, doctors rely on their beliefs and personal philosophy.

It is clear that the issue of confidentiality in sports medicine can be approached from different perspectives. Personally, I believe that the physician must always act in accordance with the existing laws, which can be different depending on a certain region in the world (McNamee et al., 2016). It is possible to imagine a case when the contractual obligations of the physician to disclose athlete’s health information to the employer can actually violate the law of the country. Therefore, doctors must always, first and foremost, consider the legal consequences of their decision. Otherwise, their disclosure of the athlete’s health records may lead to serious outcomes, including a lawsuit and potential dismissal from their position.

Conflict of Interests

The problem of confidentiality is closely connected to the ethical issue of conflict of interest and constitutes one of its manifestations. Nevertheless, the topic of conflict of interest is much more diverse and extensive a requires an in-depth analysis. As an employee of a sports club, a physician may actually withhold certain information from the athlete in order to benefit the team. For instance, a physician may intentionally overlook a minor injury that can potentially become a serious one in order to keep the player available for games. Such a decision directly interferes with the responsibility of the physician to the athlete to monitor their health and report both minor and major health problems which they are able to discover. Thus, when facing a conflict of interest, physicians must make an ethical decision to either prevent the athlete from worsening their condition or deceive the athlete telling them they see no problems. It is obvious that a decision not to inform the athlete about their issues can lead to substantial health risks for them, but it is unlikely that it will entail any consequences for the physician.

The conflict of interest is an ethical issue that is inherent to sports medicine since doctors are always employed by teams and not athletes. Nevertheless, I believe that it is important for clubs to mention in their contracts with medical staff that the health of the athlete must be put first. According to the medical code of the Olympic Movement, healthcare professionals should make the health of athletes a priority (“Olympic Movement,” 2016). Thus, I am certain that the only decision which can be considered ethical in the situation of conflict of interest must be the one promoting the health of the athlete.

Performance Enhancement

The utilization of different means to artificially improve the ability of athletes to demonstrate a better performance has been for a long time a topic extensively discussed in media. It is clear that the use of drugs contributing to the performance enhancement of athletes is prohibited by official sports agencies and especially the Olympic Committee worldwide. Moreover, there is a comprehensive system of testing deployed in countries around the world in order to ensure that athletes do not violate the established norms. Nevertheless, every year, news emerges about notable sportspeople using drugs to increase the capacity of their bodies to perform beyond their potential. The role of physicians in illegal performance enhancement is often ignored, but they are actually the people who administer the prohibited drugs. Such physicians and other medical personnel inevitably encounter an ethical issue when they are offered to participate in activities involving the utilization of illicit substances. On the one hand, physicians actually can violate the established laws, while, on the other hand, they can help their team and perform the action to which their client consents.

I think that the only ethical decision in relation to performance enhancement drugs that can be made by physicians is the refusal to participate in such activities. Additionally, as research shows, the effects of performance enhancement drugs frequently can be unpredictable and may involve considerable harm to the athlete’s health (Thom & Farrell, 2018). Therefore, physicians should not risk their reputation and have to always decline such offers, even in situations when they are pressured into it by their team or even members of the national sports committees.

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Athlete’s Autonomy

Another interesting ethical issue that often arises in the sports context is the autonomy of the athlete and their ability to judge their condition clearly. For instance, when suffering an injury, athletes continue to play the game and refuse to leave it. Quite often, such a decision of the athlete is supported by the head coach and managers who believe they do not have any other player to replace the injured one. While such decisions of players may be perceived as acts of bravery by supporters, they may have serious consequences for their health. Physicians are the only people during games possessing the skills and expertise to determine whether the athlete can continue performing. Yet, in situations when the physician actually advises the athlete to leave the game, their opinion is neglected both by the player and management. In such situations, the physician encounters an ethical issue since they can either forcefully make the athlete stop performing by asking the competition officials to do it or simply ignore the problem.

In my opinion, the issue of autonomy in sports medicine can be resolved by holding in-depth discussions with athletes and clubs’ management. Essentially, one of the main principles in the work of every doctor is the respect for the autonomy of their client (Meehan & Landry, 2016). Therefore, physicians should not interfere in the decisions of athletes but only have to provide them with information about their health status and all of the risks related to their condition.

Conclusion

Medical professionals who work with athletes frequently make decisions concerning different ethical issues, including those related to confidentiality, conflict of interests, performance enhancement, and the athlete’s autonomy. Nevertheless, in the majority of scenarios, healthcare specialists always have one option which can be considered correct. For instance, when facing confidentiality issues, physicians must rely on the laws, while encountering conflicts of interests, they need to prioritize the health of the athlete. Similarly, they should never participate in the administration of prohibited performance enhancement substances and have to respect the autonomy of their clients.

References

Laver, L., Pengas, I., & Mei-Dan, O. (2017). Injuries in extreme sports. Journal of Orthopaedic Surgery and Research, 12(1), 1–8. Web.

Malcolm, D. (2016). Confidentiality in sports medicine. Clinics in Sports Medicine, 35(2), 205–215. Web.

McNamee, M., Partridge, B., & Anderson, L. (2016). Concussion ethics and sports medicine. Clinics in Sports Medicine, 35(2), 257–267. Web.

Meehan, W., & Landry, G. (2016). Reason and autonomy. Pediatrics, 137(4), 1–4. Web.

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Olympic Movement medical code. (2016). Olympic Movement. Web.

Thom, R., & Farrell, H. (2018). Pharmacologic performance enhancement: What to consider before prescribing. Current Psychiatry, 17(12), 34–37.

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