Online Program

331047
Identifying Ethical & Policy Priorities in the Prevention and Management of Chronic Illnesses Associated with Sport-Related mTBI


Monday, November 2, 2015 : 11:15 a.m. - 11:30 a.m.

Daniel Goldberg, J.D., Ph.D, Department of Bioethics & Interdisciplinary Studies, The Brody School of Medicine, East Carolina University, Greenville, NC
background/purpose:

The majority of public health scholarship and action connected to sport-related mild traumatic brain injury (“mTBI”) addresses concerns of long-term neuropathologies such as chronic traumatic encephalopathy (“CTE”).  In this context, questions of evidence and interpretation center the significance of neuro-anatomy.  The purpose of this paper is to challenge the dominance of this conversation, and to argue that such an approach deflects needed resources from deeply impairing chronic illnesses – especially pain – for which the causal connection to sports-related mTBI is far less controversial. 

methods:

Scholarly papers as well as commentaries drawn from mass and social media will be reviewed to show the dominance of neuro-anatomy and neuro-pathologies like CTE.  Public health ethics analysis will be used to argue for a specific rank-ordering of priorities in implementing public health interventions regarding health consequences over the life-span of participation in contact sports.

results/outcomes:

The review shows the dominance of neuro-anatomy and neuro-pathology in public health conversations.  Morbidities that are strongly linked with sport-related mTBI and that exact an enormous toll on participants across the life-span (e.g., chronic pain, depression) enjoy comparatively little attention and resources within public health practice and policy.

conclusions:

Analysis of priority-setting in public health shows the current resources devoted to neuro-pathology and neuro-anatomy is ethically suboptimal.  Given the immense burden illnesses like chronic pain cause as well as the quality of the evidence supporting such morbidities’ connections to sport-related mTBI, the allocation of public health resources targeted at the sequelae of mTBI ought to be altered.

Learning Areas:

Ethics, professional and legal requirements
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Identify the dominance of CTE and neuro-anatomy in the literature on sport-related mTBI. Describe why the large allocation of resources directed to CTE and neuro-anatomy as to prevention and management of mTBI-associated health problems is ethically problematic. Describe two policy recommendations for shifting the allocation of resources towards chronic illnesses that are more prevalent and more directly-linked to sport-related mTBI.

Keyword(s): Traumatic Brain Injury, Ethics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been researching and publishing on sport-related mTBI for over 5 years, drawing primarily on methods in public health law, policy, and ethics. I have produced multiple peer-reviewed publications on the subject in leading ethics, law, and policy journals, and have presented on the subject in multiple research settings. My first academic paper on mTBI and American football has been accessed over 6,000 times, according to the analytics on my academic web site.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.