“Shake-it-off” laws: Legal and policy approaches to preventing repeated concussions in youth contact sports

Media coverage of tragic events involving the death or severe injury of adolescent athletes resulting from repeated concussions is widespread, prompting national and international sports medicine and neurological organizations to issue guidelines for concussion management. Perceiving a need for uniform and compulsory standards, state and local governments have also begun to enact legislation and adopt regulations designed to improve awareness, prevention, and treatment of concussions in youth sports. State laws employ various approaches, including mandatory training for coaches, players, and parents; time restrictions and/or mandatory medical clearance before returning to play after an apparent concussion; and monitoring of players' past head injuries.

Such legal approaches are critical to changing the prevailing “shake it off” sports culture and preventing the serious lifelong physical, neurological, and mental health problems that can follow repeated head trauma. But they are not without limitation. Certain approaches may raise questions of law and ethics, particularly as rural and poorer communities struggle with implementation of more stringent requirements. For example, do sweeping requirements with which poor or rural communities cannot comply raise concerns of equal protection or distributive justice? Might such laws impact tort liability in these states? Do certain legal requirements create ethical problems for medical practitioners? This presentation will: (1) describe and compare the various policy approaches adopted by states to date, as well as the underlying research supporting these approaches; (2) evaluate the potential legal and ethical issues associated with them; and (3) discuss how Congress might act to alleviate some of these issues.