A great deal of public attention has centered around the new book League of Denial, and rightfully so. ISLE is particularly pleased that the authors, Steve Fainaru and Mark Fainaru-Wada, found time in their busy schedules to speak at our recent symposium on sports-related concussions.

Somewhat lost in the significant attention paid to the book and to the highly gripping PBS Frontline movie of the same name is a survey done recently by the Chronicle of Higher Education involving athletics trainers at big-time college football programs.

The results are very disturbing, and I recommend the linked Chronicle article highly to anyone interested in college sports.  The potential ethical conflicts arising from situations in place at some big-time football programs are significant.

Once you read the article, which contains survey results indicating the extent to which football coaches at big-time programs intrude on the health-evaluation process of their players, perhaps you’ll react as I did, which was to ask these questions:

Given all the minutiae regulated by the NCAA in the business of college athletics and the lives of student-athletes, why can’t the NCAA implement a rule that addresses the most important issue, that of student-athlete health and safety?

Specifically, why can’t the NCAA implement a rule that clearly states that athletics department trainers must be free to make decisions and recommend courses of action to team physicians with no fear of reprisals from football coaches (or any coaches, for that matter)? How is it possible that at some institutions, trainers actually report to the head football coach? How can it ever be in the best interests of the players for their coaches to have any input into medical decisions?

I don’t mean to come off as some kind of holier-than-thou critic. In fact, I think that if I were a head coach at a big-time football school, I probably would be tempted to do all I could to keep my lucrative compensation package in place.   That means above all I would need to win games, plain and simple.  And if I thought a player in borderline health could give me an edge, you bet I’d be putting pressure on the medical folks if I could.

The potential damage to a player is obvious in that scenario, and I’m not proud of my admission, but there you have it. I think an annual salary in the average range of $1.5 to $2 million dollars, plus a car or two, plus country club memberships, plus endorsements, plus whatever else my creative agent could secure for me, all would combine to make it a challenging ethical situation for me, and perhaps for others in that situation as well.

To turn the tables, if I were a trainer and the football coaches were allowed to criticize my opinions and undermine my ability to do my job, or if a coach had the ability to control my employment status, I would clearly have a tough ethical challenge. Do I risk losing my job by holding firm to my professional opinions, or do I cave in to the desires of the coaches to bring players back earlier than I think is right?

It’s easy for me to say that if I were a trainer I would hold firm to my opinions and not risk a player’s health, even if that decision were to jeopardize my employment. But I’ve never been in that situation. I can imagine a trainer being forced to balance his family’s needs on the one hand, and a player’s health on the other hand, and that would be a terrible dilemma.

So in my view, the fact that there are any institutions of higher education at which it is possible for a coach to affect a trainer’s employment based on the trainer’s exercise of his or her professional judgment is a recipe for disaster. Surely we can do better than that, can’t we?

Comments? Please contact me at mgilleran@scu.edu. Thanks.

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