by Olga Rukovets
Although the last goal of the 2014 World Cup was scored last Sunday, the action is far from over. The Fédération Internationale de Football Association (FIFA) is now facing criticism over the handling of head injuries during the international soccer games, according to an editorial in the Lancet Neurology. After watching Uruguayan defender Álvaro Pereira return to the field shortly after an apparent concussion, the world players’ union, FIFPro, has called for an investigation of concussion protocols and return-to-play standards. The Lancet editorial noted that this public failure to “recognize and remove” an injured athlete from play emphasizes the need for better education of players and the public and increased research efforts into both short- and long-term effects of concussion and traumatic brain injury.
Another major sports-related event also took place last weekend in Chicago; the American Academy of Neurology (AAN) held its first-ever Sports Concussion Conference. Before the Conference, the AAN released a new position statement on the ethical and legal obligations of doctors who treat concussion. Published in the July 9 online edition of Neurology by Matthew P. Kirschen, MD, PhD, a neurologist with The Children's Hospital of Philadelphia, and colleagues, the paper highlights the ethical obligation of doctors “to educate and protect athletes from sports concussion and clear them to play only when the athlete is medically ready, standing firm against objections from players, parents or coaches.”
The report also includes strategies for addressing the framework in place when making difficult treatment decisions, which includes considerations of professionalism, informed decision-making, patient autonomy, beneficence, nonmaleficence, conflicts of interest, and distributive justice.
Dr. Kirschen and colleagues call for wider use of baseline cognitive testing, the addition of concussion evaluation and management training to neurology residency programs, and the development of a national concussion registry with mandatory reporting. Above all else, treating physicians have an ethical obligation to always prioritize the athlete’s present and future mental and physical wellbeing when evaluating for concussion, and "to facilitate informed and shared decision-making among athletes, parents, and medical teams while protecting athletes from potential harm," the position statement concludes.
Look for coverage of the Sports Concussion Conference in an upcoming issue of Neurology Today, and follow #AANSCC on Twitter to receive updates. Read more about concussion research in our archives: http://bit.ly/concussionNT.