Head injuries are an inherent risk of participating in the major collision sports played in Australia. Protocols introduced by the governing bodies of these sports are ostensibly designed to improve player safety but do not prevent players suffering from repeated concussions. There is evidence that repeated traumatic brain injuries increase the risk of developing a number of long term problems but scientific and popular debates have largely focused on whether there is a causal link between concussion and chronic traumatic encephalopathy. (...) We argue that the governing bodies of collision sports played in Australia have used uncertainty about CTE to justify a “wait and see” approach instead of attempting to prevent repeated head injuries. This stance is difficult to defend when these governing bodies claim to give a high priority to protecting player welfare. (shrink)

Professional sports with high rates of concussion have become increasingly concerned about the long-term effects of multiple head injuries. In this context, return-to-play decisions about concussion generate considerable ethical tensions for sports physicians. Team doctors clearly have an obligation to the welfare of their patient (the injured athlete) but they also have an obligation to their employer (the team), whose primary interest is typically success through winning. At times, a team’s interest in winning may not accord with the welfare of (...) an injured player, particularly when it comes to decisions about returning to play after injury. Australia’s two most popular professional football codes—rugby league and Australian Rules football—have adopted guidelines that prohibit concussed players from continuing to play on the same day. I suggest that conflicts of interest between doctors, patients, and teams may present a substantial obstacle to the proper adherence of concussion guidelines. Concussion management guidelines implemented by a sport’s governing body do not necessarily remove or resolve conflicts of interest in the doctor–patient–team triad. The instigation of a concussion exclusion rule appears to add a fourth party to this triad (the National Rugby League or the Australian Football League). In some instances, when conflicts of interest among stakeholders are ignored or insufficiently managed, they may facilitate attempts at circumventing concussion management guidelines to the detriment of player welfare. (shrink)

Postmortem evidence of chronic traumatic encephalopathy (CTE) in the brains of American National Football League players who suffered concussions while playing have intensified concerns about the risks of concussion in sport.1 Concussions are frequently sustained by amateur and professional players of Australia’s three most popular football codes (Australian football, rugby league, and rugby union) and, to a lesser extent, other contact sports such as soccer. This raises major concerns about possible long-term neurological damage, cognitive impairment and mental health problems in (...) players of these sports. (shrink)

Postmortem research on the brains of American tackle football players has revealed the presence of chronic traumatic encephalopathy (CTE), a degenerative brain disease caused by repeated head trauma. Repeated concussion is a risk factor for CTE, raising ethical concerns about the long-term effects of concussion on athletes at risk for football-related concussion. Of equal concern is that youth athletes are at increased risk for lasting neurocognitive and developmental deficits that can result in behavioral disturbances and diminished academic performance. In this (...) article, we consider evidence of the effects of concussion in youth athletes, and discuss ethical duties to youth athletes and how these duties might be satisfied, given the intrinsic risks of football. Finally, we evaluate potential strategies for reducing concussions in junior football, and recommend the optimal strategy for reducing brain injury to an acceptable level while still making available the benefits of football participation for youth athletes. (shrink)

A key to modern studies of 18th century Western philosophy, the Treatise considers numerous classic philosophical issues, including causation, existence, freedom and necessity and morality. This abridged edition has an introduction which explain's Hume's thought and places it in the context of its times.

One of Hume's most well-known works and a masterpiece of philosophy, A Treatise of Human Nature is indubitably worth taking the time to read.

One of Hume's most well-known works and a masterpiece of philosophy, A Treatise of Human Nature is indubitably worth taking the time to read.

What can we know and what should we believe about today's world? _What to Believe Now: Applying Epistemology to Contemporary Issues_ applies the concerns and techniques of epistemology to a wide variety of contemporary issues. Questions about what we can know-and what we _should_ believe-are first addressed through an explicit consideration of the practicalities of working these issues out at the dawn of the twenty-first century. Coady calls for an 'applied turn' in epistemology, a process he likens to the applied (...) turn that transformed the study of ethics in the early 1970s. Subjects dealt with include: Experts-how can we recognize them? And when should we trust them? Rumors-should they _ever_ be believed? And can they, in fact, be a source of knowledge? Conspiracy theories-when, if ever, should they be believed, and can they be known to be true? The blogosphere-how does it compare with traditional media as a source of knowledge and justified belief? Timely, thought provoking, and controversial, _What to Believe Now _offers a wealth of insights into a branch of philosophy of growing importance-and increasing relevance-in the twenty-first century. (shrink)

This essay addresses the question: What is the probative value of including neuroscience data in court cases where the defendant might have had a traumatic brain injury? That is, this essay attempts to articulate how well we can connect scientific data and clinical test results to the demands of the Daubert standard in the United States’ court system, and, given the fact that neuroimaging is already being used in our courts, what, if anything, we should do about this fact. Ultimately, (...) I am not sure that there are completely satisfactory answers to this query at this particular time in our legal history. I briefly rehearse the recent use of brain research in our legal system, summarize how neuroscience data regarding TBI and its relation to poor behavioral outcomes are currently used in the courtroom, review challenges with using these data, and highlight fundamental tensions between how the legal system views the causes of behavior and how medicine, neuroscience, and psychology do. Until these tensions are resolved, it is unclear the place neuroscience data should have in courts. (shrink)

Until recently, the problem of traumatic brain injury in sports and the problem of performance enhancement via hormone replacement have not been seen as related issues. However, recent evidence suggests that these two problems may actually interact in complex and previously underappreciated ways. A body of recent research has shown that traumatic brain injuries, at all ranges of severity, have a negative effect upon pituitary function, which results in diminished levels of several endogenous hormones, such as growth hormone and gonadotropin. (...) This is a cause for concern for many popular sports that have high rates of concussion, a mild form of TBI. Emerging research suggests that hormone replacement therapy is an effective treatment for TBI-related hormone deficiency. However, many athletic organizations ban or severely limit the use of hormone replacing substances because many athletes seek to use them solely for the purposes of performance enhancement. Nevertheless, in the light of the research linking traumatic brain injury to hypopituitarism, this paper argues that athletic organizations’ policies and attitudes towards hormone replacement therapy should change. We defend two claims. First, because of the connection between TBI and pituitary function, it is likely many more athletes than previously acknowledged suffer from hormone deficiency and thus could benefit from hormone replacement therapy. Second, athletes’ hormone levels should be tested more rigorously and frequently with an emphasis on monitoring TBI and TBI-related issues, rather than simply monitoring policy violations. (shrink)

A Treatise of Human Nature, David Hume's comprehensive attempt to base philosophy on a new, observationally grounded study of human nature, is one of the most important texts in Western philosophy. It is also the focal point of current attempts to understand 18th-century western philosophy. The Treatise addresses many of the most fundamental philosophical issues: causation, existence, freedom and necessity, and morality. The volume also includes Humes own abstract of the Treatise, a substantial introduction, extensive annotations, a glossary, a comprehensive (...) index, and suggestions for further reading. (shrink)

Sport-related neurotrauma annually affects millions of athletes worldwide. The return-to-play protocol (RTP) is the dominant strategy adopted by sports leagues and organizations to manage one type of sport-related neurotrauma: concussions. RTPs establish guidelines for when athletes with concussions are to be removed from competition or practice, and when they can return. RTPs are intended to be neuroprotective, and to protect athletes from some of the harms of sport-related concussions, but there is athlete resistance to and noncompliance with RTPs. This prompts (...) consideration of whether RTPs, as employed in adult, professional sports, are paternalistic, and if they are, whether they are objectionably so. If RTPs are uniquely effective at protecting current or future athlete autonomy, they might be justified by paternalism. I conclude that RTPs are paternalistic in their effects, but are not adequately justified, and thus they are objectionable. (shrink)

Concussion in professional football is a topic that has generated a significant amount of interest for many years, partly due in recent times to the filing of the class-action litigation and the uncapped compensation injury fund and settlement involving 4,500 retired professional players and the National Football League. The proceedings claimed that the NFL, as the governing body of American football, failed in its duty to protect players’ health during their professional playing careers by exposing players to risks of repetitive (...) concussions and actively concealing links to potential long-term consequences. The NFL litigation sharpened the focus on the fundamental regulatory, governance and ethical considerations for football governing bodies, as self-regulated organisations, when governing the delicate balance between the dynamics of contact and collision sports, entertainment and player-health considerations. It also raised questions about public accountability and responsibilities to all levels of the sport through a framework of public health ethics. The NFL litigation and Congressional hearings have led to changes within the NFL and its regulatory and governance responses. A case study of the NFL responses to concussion in the sport of American football can provide insight into concussion regulation. Australian football governing bodies can align their regulatory and governance responses to concussion within their sports with the aim to avoid similar accusations, and circumvent a more coercive form of intervention. (shrink)

Concussions in professional sports have received increased attention, which is partly attributable to evidence that found concussion incidence rates were much higher than previously thought. Further to this, professional hockey players articulated how their concussion symptoms affected their professional careers, interpersonal relationships, and qualities of life. Researchers are beginning to associate multiple/repeated concussions with Chronic Traumatic Encephalopathy, a structural brain injury that is characterized by tau protein deposits in distinct areas of the brain. Taken together, concussions impact many people in (...) the sporting community from current and former professional athletes and their families to medical and health professionals and researchers. In light of the growing awareness and sensitivity towards concussions, the purpose of this paper is to provide recommendations that are designed to improve player safety in professional hockey and address the ethical issues surrounding these suggestions. (shrink)