Art, Art History, Humanities, Music, Philosophy, Political Science, and Religion Departments, Hillsborough Community College,Tampa, FL USA.
J Clin Ethics. 2020 Winter;31(4):326-330.
Participation in sports such as football puts youth-athletes at high risk of injury. Helmets cannot protect players from the possibility of traumatic brain injury, and repeated concussive injuries can lead to chronic traumatic encephalopathy later in life. In light of such facts, the morally appropriate role of physicians who treat patient-athletes comes into question. I argue that pediatricians ought to be committed to a high level of shared decision making, whereby their goal, rather than being to provide the medically best advice (which, let's be honest, would be to not play football at all), would be to provide the medically best advice in light of patients' honestly professed plans and goals. If patient-athletes see their doctor as an ally, who wants them on the field as much as they want to be there, they will be more likely to trust their pediatrician to help in the realization of those goals, even if they report an injury. While this approach could feel like a medical betrayal, in that the physician could feel complicit in helping a patient to continue engaging in high-risk behavior, I argue that medical outcomes will be better than if patient-athletes see physicians as an obstruction to their athletic goals.
参与足球等运动项目会使青年运动员面临较高的受伤风险。头盔并不能保护运动员免受外伤性脑损伤的可能性，而反复的震荡性损伤可能会导致日后患上慢性创伤性脑病。鉴于这些事实，治疗运动员患者的医生的道德适当角色就成了问题。我认为，儿科医生应该致力于高度的共同决策，他们的目标不是提供最好的医学建议（坦率地说，这将是根本不踢足球），而是根据患者诚实表达的计划和目标，提供最好的医学建议。如果运动员患者将他们的医生视为盟友，就像他们自己一样希望他们在场上，那么他们更有可能信任儿科医生帮助实现这些目标，即使他们报告受伤。虽然这种方法可能感觉像是医疗背叛，因为医生可能会感到自己在帮助患者继续从事高风险行为方面有牵连，但我认为，如果运动员患者将医生视为他们运动目标的障碍，那么医疗效果会更好。
