| The Law and Ethics of Football Injuries |
| Sports medicine differs from other braches of medicine in that it not only deals with ill or injured patients but also with healthy athletes. Consequently, sports medicine physicians or physiotherapists often find themselves in situations which go beyond the usual doctor-patient relationship based upon mutual rights and obligations. Such medico-legal and ethical aspects have to be observed in all medical research projects, including FIFA’s own F-MARC (the FIFA Medical Assessment and Research Centre). All participants have to sign a personal form that they have been sufficiently informed and agree with the tests, and even though the arrangements made with players and teams or coaches stipulate that any health-related problems be disclosed to heir club or association, the F-MARC team may not reveal any information without the consent of the player. The player himself can look at his personal data at any time. In sports medicine, just as in other branches of medicine, a lack of care of knowledge in diagnosing, treating or rehabilitating the injured athlete can have serious consequences. Further, it is common practice today to enhance athletic performance with medical measures and these can cause iatrogenic damage. The methods used often do not comply with medical ethics and can generally be regarded as malpractice. The same kind of care and diligence is expected from a sports medicine physician or physiotherapist in diagnosing or treating a sports-related injury or illness as from any other kind of physician. Any violation can result in a liability suit and can even end up in conviction for negligence or involuntary manslaughter. In professional or semi-profession sport, including football, physicians and physiotherapists are often under contract with a club or association. Pressure from officials, the media or even sponsors can lead to a conflict of two prominent sports doctors from two leading clubs. Players from the one club privately sought the second opinion of the doctor from the other, because of his simultaneous involvement with the national team. The latter often advised a longer lay-off than players’ own club doctor and the public immediately suspected there was something behind it. What made the issue much more serious was that the two doctors discussed the case in public, on the Internet, so that the General Medical Councils had to be called in. Soon, the organizers of major professional football events will have another responsibility. When they inspect the event venue, apart from the technical, social, organizational and financial conditions, they must also look with critical expertise and great attention into the local conditions as regards the health and welfare of the players, managers and spectators, as well as such things as health-care and emergency treatment services. If these conditions are not satisfactory, it may be necessary to cancel the event. Physicians and other medical staff can serve as advisers to the management and to those whose crucial decisions may make them responsible also from the legal and ethical point of view. A particularly sensitive problem in football and in all prominent sports is that of confidentiality and professional secrecy in dealing with information on an athlete’s physical and mental condition, as mental problems are becoming increasingly responsible for negative performances, especially because of increasing media pressure. It is only a short step from uninhibited stories about their psychological or mental problems. Unfortunately we have to note that there is an increasing tendency for officials or sponsors to undermine these principles, and physicians as well as persons and institutions responsible for the health of the players must do everything in their power to counteract this tendency. We must also look at the socio-economic consequences of football injuries. In view of the cutbacks in health care systems everywhere, the responsibility for prevention and adequate treatment of sports-related injuries and illnesses will lie with all persons and institutions associated with sports, since the damage can no longer be covered by the joint community of health insurance payers. Specific treatment methods for typical and common sports injuries must be weighted under socio-economic aspects, and attention paid to the direct costs of early functional treatment and to the indirect costs resulting from the athlete being out of action for this team. |