Public Health Law Map - Beta 5 - Medical and Public Health Law Site

given out of the fear of ending one’s career is coerced. Conversely, physicians are
limited in their right to impose their values on patients. The decision to risk disability
by continuing play is the reasoned choice of some athletes.
Athletes in highly competitive, commercialized sports such as football are under
constant pressure to play when injured and to submit to risky surgery rather than
prolonged convalescence. The risks posed by these actions are much the same for all
athletes. The benefits, however, are vastly different, depending on the athlete’s
status. A veteran professional football player is protected by a pension system and
extensive knowledge of the consequences of various injuries. Such a player is paid
very well to accept the risk of permanent injury.
Moving back in the athletic hierarchy to college teams, players have little protection
if their injuries are permanently disabling. The college athlete faces the pressure to
play but with limited benefit as compared with the risk. This is a special problem for
athletes who are able to attend college only because of athletics. If they aggravate an
injury and are unable to play, few will stay in college as regular students even if they
can continue their scholarship. Since the probability of a given college athlete’s
entering professional athletics is small, it is difficult to justify the risk of aggravating
an injury to play an extra few games in a season.
3. The Child Athlete
College and high school athletes pose additional problems. Persons under the age of
18 are legally able to make their own medical decisions only in certain situations
established by state law. Most states allow minors to consent to treatment for
substance abuse, communicable diseases, pregnancy, and other conditions that pose a
threat to persons other than the minor. No state specifically authorizes minors to
consent to treatment for sports injuries. Sports medicine may not be practiced on
minors without parental consent and this parental consent is constrained by the child
welfare laws.
Parents may consent only to medical care that is in the child’s best interest. If a
physician believes that a medical regime chosen by the parents is not in the child’s
best interest, the physician must report this to the child welfare authorities. Children
themselves are unable to balance the desire to get back in the game against the risk of
permanent injury. A child who is later unable to continue in athletics or is otherwise
disabled may sue the physician for malpractice. Physicians should not allow the
enthusiasm of child athletes or their parents to weigh in medical decisions that will
affect the long-term health of the child. Most parents will not persist if they are fully
informed as to the risks of continued participation by an injured child. If the parents
continue to pressure the child to engage in unsafe activity, then this becomes a matter
of child abuse.
4. Supervision of Nonphysician Personnel
In most cases, the physician is not a full-time employee of the team. Most routine
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