McNamee Mike, Anderson Lynley C, Borry Pascal, Camporesi Silvia, Derman Wayne, Holm Soren, Knox Taryn Rebecca, Leuridan Bert, Loland Sigmund, Lopez Frias Francisco Javier, Lorusso Ludovica, Malcolm Dominic, McArdle David, Partridge Brad, Schramme Thomas, Weed Mike
Department of Movement Sciences, KU Leuven, Leuven, Belgium
School of Sport and Exercise Sciences, Swansea University, Swansea, UK.
J Med Ethics. 2024 Dec 23;51(1):68-76. doi: 10.1136/jme-2022-108812.
The Concussion in Sport Group guidelines have successfully brought the attention of brain injuries to the global medical and sport research communities, and has significantly impacted brain injury-related practices and rules of international sport. Despite being the global repository of state-of-the-art science, diagnostic tools and guides to clinical practice, the ensuing consensus statements remain the object of ethical and sociocultural criticism. The purpose of this paper is to bring to bear a broad range of multidisciplinary challenges to the processes and products of sport-related concussion movement. We identify lacunae in scientific research and clinical guidance in relation to age, disability, gender and race. We also identify, through multidisciplinary and interdisciplinary analysis, a range of ethical problems resulting from conflicts of interest, processes of attributing expertise in sport-related concussion, unjustifiably narrow methodological control and insufficient athlete engagement in research and policy development. We argue that the sport and exercise medicine community need to augment the existing research and practice foci to understand these problems more holistically and, in turn, provide guidance and recommendations that help sport clinicians better care for brain-injured athletes.
运动性脑震荡小组指南成功地将脑损伤问题引起了全球医学和体育研究界的关注,并对国际体育中与脑损伤相关的实践和规则产生了重大影响。尽管该指南是最前沿科学、诊断工具和临床实践指南的全球知识库,但随后的共识声明仍然受到伦理和社会文化批评。本文的目的是对与运动性脑震荡运动的过程和成果提出广泛的多学科挑战。我们确定了在年龄、残疾、性别和种族方面科学研究和临床指导中的空白。我们还通过多学科和跨学科分析,确定了一系列由利益冲突、运动性脑震荡专业知识归属过程、不合理的狭隘方法控制以及运动员在研究和政策制定中参与不足所导致的伦理问题。我们认为,运动与运动医学领域需要扩大现有的研究和实践重点,以更全面地理解这些问题,进而提供指导和建议,帮助运动临床医生更好地照顾脑损伤运动员。