Ethics In Professional Sports Teams

Physicians in Professional Sports Teams
The role of physicians employed by professional sports teams creates conflicts of interest and raises ethical concerns. The team physicians have a moral obligation to promote the health of their patients, but their actions are heavily influenced by outside variables and by the patient’s susceptibility to influence and personal characteristics. The opposing need to protect the athlete’s health and the player’s desire to succeed interferes with the physician’s ability to make ethical decisions and impedes promises to commitments and adopted health care virtues. In this paper, I will discuss how the conflict between moral obligation to individual health and the stress of achievement threatens autonomy and

confidentiality.
Throughout the history of sports, physicians have been employed by professional sports teams to care for and prevent injuries, assess eligibility to play, monitor compliance with laws regarding substance use, and educate the teams and coaches about safety.

In particular, in 1966 the National Football Associated founded the NFL Physicians Society to provide care for athletes and support athletic trainers (“The NFL Physician’s Society,” 2012). The physicians, therefore, are dedicated to promoting the health of their patients and protecting them from injury. The physicians promise to follow the code of ethics, including autonomy, informed consent, beneficence, non-maleficence, confidentiality, and justice. Sports, however, are heavily supported by the nation and highly competitive, resulting in conflicts in interest in health care from team physicians. Team physicians are influenced by coaches, parents, teammates, the nation, the need for success, and the players themselves to play athletes without full recovery, allow controversial procedures, decide whether to report violations in drug enhancing tests, and make decisions on disclosing personal information. Players elect to play for reasons that do not reflect an understanding of consequences and physicians struggle with controversial decisions to break confidentiality and report a player’s inability to play in order to prevent injury or harm. Physicians are required to follow the Health Insurance Portability and

Accountability Act of 1996, which prevents a physician from disclosing personal health information, except when it is “necessary to prevent or lessen a serious and imminent threat to the health or safety of the patient “(“Understanding Health Information Privacy,” 2015). In specific circumstances regarding injuries, physicians must decide if playing an injured player follows risk to imminent self-harm and therefore, if it is morally justified to break confidentially. A physician is elected to be employed by a sports team and although conflicts of interest arise that may hinder individual and team success, the primary role of physician is to protect the rights of the patient and prevent harm.
Team physicians swear an oath to respect patient autonomy, meaning that physicians will respect the decisions made by competent patients based on their personal values and beliefs.

Outside influence and the desire for team and individual success threatens autonomy, however, team physicians are committed to respecting the decisions made by the individual patient. According to Kantian Ethics, people have the right to autonomy because humans are innately rational beings, capable of deliberating actions in order to meet desired end goals and to decide which end goals are worth pursuing (Pierce & Randels, 2010, p. 48). However, Kantian Ethics does not consider the effects of influence from outside variables, including friends, family, coaches, and teammates or from inside conflicts such as the desire for success and fame and the fear of failure. For example, pretend a high school running back with a scholarship to a division one college tears his ACL during a game near the end of the high school season. The physician tells the football player that he can undergo two different types of surgery. One will require him to not play football for six months, which means he will red shirt his freshmen year of college and could possibly lose his chance at playing football in college and consequently the future, but his knee will be fixed without any long-term complications or limitations. The other option will allow him to leave for spring training on time to play college and will require

removing a tendon from his ankle, which will make him more susceptible to future ankle problems and increase his risk of spraining his ankle multiple times, resulting in life-long pain. The patient has been made aware of the risks and is fully informed of both surgeries. The patient, however, choses the surgery with the higher risk for long term complications because of the fear of failure and possibility of short-term success. In this case, the player was informed and competent to make his own decision, but should the physician allow the patient to autonomously make a decision evidently influence by desire for success in his future and fear of failure from his parents, coaches, and peers? The conflict of external and internal influence from the desire for individual and team success results in physician’s actions threatening patient autonomy. According to Julius Sim, “A person to be considered truly autonomous, he must be able to remain free from controlling interferences” (Sim, 1993). Patient autonomy is threatened in professional sports because of the heavy influence from individuals, parents, peers, coaches, and teammates to be the best and win consistently. Patients make rash decisions without weighing the long term consequences for short-term rewards; however, similar to Kantian Ethics, the ability to deliberate actions is innate in humans, and therefore, autonomy is also innate. If provided informed consent, competent team players are capable of rationalizing and deliberating decisions in order to pursue their end goals, which in return, physicians must respect and uphold.