Hastings Cent Rep. 2016 Nov;46 Suppl 2:S33-S34. doi: 10.1002/hast.655.
The job of being a sports team physician is difficult, regardless of the level, from high school to the National Football League. When a sports league receives the intensity of attention leveled at the NFL, though, a difficult occupation becomes even more challenging. Even for the NFL players themselves, players' best interests regarding health issues are often unclear. Football players are, as a lot, highly competitive individuals. They want to win, and they want to help the team win. It's a warrior culture, and respect is earned by playing hurt. Should the team physician respect a player's autonomy when this means allowing him to make choices that might lead to further personal harm, especially if the player's choices align with the preference of the coach and management? Or should the doctor set limits and balance the player's choices with a paternalistic set of constraints, perhaps in opposition to both the player's and the team's desires? Simplification of this web of conflicts of interest is the goal of the model proposed by Glenn Cohen, Holly Lynch, and Christopher Deubert. In my view, their proposal is very clever. As an idea, it meets the expectations its authors set, namely, to minimize the problem of conflict of interest in the delivery of health care services to NFL football players. The ethics of the proposal align well with certain moral goals, like treating the player's interests more fairly and treating the player's health as an end instead of as the means to an end. But will such a proposal ever make headway in the pressurized environment of the NFL?
作为一名运动队医生，无论处于哪个级别——从高中到国家橄榄球联盟（NFL），这份工作都极具挑战性。然而，当一个体育联盟受到像 NFL 这样的高度关注时，原本艰难的职业变得更加充满挑战。即使对于 NFL 球员自己来说，他们的健康问题也常常难以说清。很多橄榄球运动员都极具竞争意识。他们想要赢，也想帮助球队赢。这是一种战士文化，而受伤作战则赢得尊重。当这意味着允许球员做出可能导致进一步个人伤害的选择，尤其是如果球员的选择符合教练和管理层的偏好时，队医是否应该尊重球员的自主权？或者医生是否应该设定限制，以家长式的约束来平衡球员的选择，也许这与球员和球队的愿望都背道而驰？格伦·科恩（Glenn Cohen）、霍利·林奇（Holly Lynch）和克里斯托弗·德伯特（Christopher Deubert）提出的模式旨在简化这一利益冲突网络。在我看来，他们的提议非常巧妙。作为一个想法，它满足了作者设定的预期，即最大限度地减少向 NFL 橄榄球运动员提供医疗服务时的利益冲突问题。该提案的伦理道德与某些道德目标相一致，例如更公平地对待球员的利益，并将球员的健康视为目的本身，而不仅仅是达到目的的手段。但是，这样的提议在 NFL 的高压环境中是否会有进展呢？
