Medical Ethics and School Football

Miles, Steven H.; Prasad, Shailendra

doi:10.1080/15265161.2016.1128751

Cited by 20 publications

(13 citation statements)

References 31 publications

(25 reference statements)

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“…There has been growing concern about the long-term health consequences of playing American-style tackle football, driven in large part by high-profile suicides and case reports of chronic traumatic encephalopathy (CTE) among former players [1], increased risks or neurodegenerative disease [2], and associations between concussion history and cognitive impairment and depression later in life [3][4][5]. These concerns have led some medical professionals [6][7][8] and policy makers [9] to propose limiting or banning youth tackle football. Careful estimation of the short-and long-term consequences of playing youth and adolescent football can help physicians better advise families weighing the benefits and risks of football participation [10].…”

Section: Introductionmentioning

confidence: 99%

The association between adolescent football participation and early adulthood depression

et al. 2020

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Concerned about potentially increased risk of neurodegenerative disease, several health professionals and policy makers have proposed limiting or banning youth participation in American-style tackle football. Given the large affected population (over 1 million boys play high school football annually), careful estimation of the long-term health effects of playing football is necessary for developing effective public health policy. Unfortunately, existing attempts to estimate these effects tend not to generalize to current participants because they either studied a much older cohort or, more seriously, failed to account for potential confounding. We leverage data from a nationally representative cohort of American men who were in grades 7-12 in the 1994-95 school year to estimate the effect of playing football in adolescent on depression in early adulthood. We control for several potential confounders related to subjects' health, behavior, educational experience, family background, and family health history through matching and regression adjustment. We found no evidence of even a small harmful effect of football participation on scores on a version of the Center for Epidemiological Studies Depression scale (CES-D) nor did we find evidence of adverse associations with several secondary outcomes including anxiety disorder diagnosis or alcohol dependence in early adulthood. For men who were in grades 7-12 in the 1994-95 school year, participating or intending to participate in school football does not appear to be a major risk factor for early adulthood depression.

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Section: Introductionmentioning

confidence: 99%

The association between adolescent football participation and early adulthood depression

et al. 2020

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“…Likewise, sports physicians or team coaches need to reconcile conflicting needs of concussion risk minimization and athletic activity encouragement, which demands a balance approach to SRC risk management, such as through injury prevention protocols and legal liability limitations. 11 Thus, building on the positions of Corlett, Dixon and Sailors that examine both externalist and internalist perspectives concerning the ethical issue of SRCs in contact sports, López Frías and McNamee argue that an autonomy-based ethical examination of this issue undermines paternalist arguments for a reform or elimination of contact sports. 30,[32][33][34] Furthermore, according to López Frías and McNamee, the nature of the internal or external goods that contact sports players pursue in their athletic careers can be considered as a sufficient ethical basis to justify their acceptance of possible future health risks of various degrees related to on-field concussions and their long-term clinical consequences, which corresponds to the anti-paternalist ethical position.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10] Nevertheless, North American health professionals and medical ethicists have called for significantly reducing football programs in junior and high schools and nonschool settings, which together comprised approximately 4.1 students in 2015. 11 Previous clinical studies suggest the majority of concussion instances among children and adolescents are followed by rapid recoveries with only a minority of head injury patients suffering from ongoing post-concussion syndrome (PCS) symptoms. This paper will provide philosophical argument to strengthen the idea that preventive measures, identification protocols and management procedures in contact sports are needed rather than a paternalist prohibitive stance.…”

Section: Introductionmentioning

confidence: 99%

Ethical aspects of organized contact sports for children as participants

Leyva

2020

Int J Contemp Pediatr

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This paper seeks to review the literature and address ethical implications of organized contact sports, such as American football and boxing, with significant child or adolescent participation. Child and adolescent sport participation act not only as a leisure activity, but also improves physical health and enhances psychological and social health outcomes. However, playing sports may also have negative physiological effects, such as sports-related concussions (SRCs) - a form of traumatic brain injury (TBI) - which are an emerging public health concern. This paper review and explores ethical implications of contact sports in the scientific literature and demonstrates challenged faced on philosophical deliberation on the ethical implications of SRCs and RHIs due to complexities of these conditions and their identification and treatment involving a wide variety of practical situations, which formal sports rules may not adequately address. Since scholarly literature has yet to arrive at a consensus concerning causal link(s) between contact sports participation and significant concussion-related brain damage, the paper argues in favor of strengthening concussion preventive measures, identification protocols and management procedures in contact sports. This article rejects ethical paternalism on the basis of inconclusive empirical evidence concerning associations between contact sports participation and heightened SRC risk. It also rejects Mill’s argumentation against consensualism and suggests prevention is a better solution over inadequately founded philosophical ethical proposals favoring drastically reforming contact sports.

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“…More than 1 million high school students played American-style tackle football in 2014, but many medical professionals have recently begun questioning the safety of the sport (Bachynski, 2016;Pfister et al, 2016) or called for its outright ban (Miles and Prasad, 2016). Concern over the long-term safety of the sport have been driven partially by studies like Lehman et al (2012), which found an increased risk of neurodegenerative disease and Guskiewicz et al (2005Guskiewicz et al ( , 2007 and Hart Jr et al (2013), which highlighted associations between concussion history and later-life cognitive impairment and depression.…”

Section: Full Multivariate Analysis Of the Football Safety Datamentioning

confidence: 99%

Simultaneous Variable and Covariance Selection With the Multivariate Spike-and-Slab LASSO

Deshpande

Ročková

George

2019

Journal of Computational and Graphical Statistics

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We propose a Bayesian procedure for simultaneous variable and covariance selection using continuous spike-and-slab priors in multivariate linear regression models where q possibly correlated responses are regressed onto p predictors. Rather than relying on a stochastic search through the high-dimensional model space, we develop an ECM algorithm similar to the EMVS procedure of Ročková & George (2014) targeting modal estimates of the matrix of regression coefficients and residual precision matrix. Varying the scale of the continuous spike densities facilitates dynamic posterior exploration and allows us to filter out negligible regression coefficients and partial covariances gradually. Our method is seen to substantially outperform regularization competitors on simulated data. We demonstrate our method with a re-examination of data from a recent observational study of the effect of playing high school football on several later-life cognition, psychological, and socio-economic outcomes.

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Medical Ethics and School Football

Cited by 20 publications

References 31 publications

The association between adolescent football participation and early adulthood depression

The association between adolescent football participation and early adulthood depression

Ethical aspects of organized contact sports for children as participants

Simultaneous Variable and Covariance Selection With the Multivariate Spike-and-Slab LASSO

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