Returning to play? Who decides?

So you lose your star player to injury. If you are a professional team, this may affect gate receipts. If you are in the hunt for a championship, this may cost you the title. So no matter the motivation to get your player back on the field of play, star of the team or not, how is the decision made and who makes it?

Does the athlete decide when they are ready? Should the coach make the final decision? Is it the team doctor, the athletic trainer, the parents or the family doctor? Whether the injury is a head concussion, sprained ankle, stress fracture or leg contusion, return to play protocols are a critical part of a physicians guidelines and they should be given the power and responsibility to abide by them for the sake of the athlete.

Conflicts of interest with players themselves, as well as with team management, are widespread. Because of the pressures associated from bringing together all the decision-making stakeholders involved in an athlete’s career, the decisions made by a physician or athletic trainer regarding an injured athlete’s return to play can occasionally have over-riding ethical dilemmas. Using a moral compass and doing the ‘right thing’ for the athlete, embraces the basic principles of ethical decision making.

And while the decisions need not be perfect, they should reinforce the medical practitioner’s responsibilities to the athlete. Decisions should focus solely on the athlete's welfare and not on the effect those decisions will have on the outcome of a sporting event.

Additional Resources:

• Stovitz, S. D., & Satin, D. J. (2006). Professionalism and the Ethics of the Sideline Physician. Current Sports Medicine Reports, 5(3), 120-124.
• Dunn, W. R., George, M. S., Churchill, L., & Spindler, K. P. (2007). Ethics in Sports Medicine. American Journal of Sports Medicine, 35(5), 840-844.
• International Federation of Sports Medicine / Fédération Internationale de Médécine du Sport – Code of Ethics
• Swisher, L., Nyland, J., Klossner, D., & Beckstead, J. (2009). Ethical Issues in Athletic Training: A Foundational Descriptive Investigation. Athletic Therapy Today, 14(2), 3-9. Available in the SIRC Collection.
• Borowski, Bill, Pack, Cory & Powell, David (2007). Ethical Issues in Sport Medicine. Unpublished. Retrieved from the Internet March 17, 2011.