Taryn Knox

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.

Smajdor and Rasanen (2024) argue that pregnant women are routinely denied appropriate treatment because pregnancy is seen as normal, and so they are denied ‘patient status’. They claim that formally classifying pregnancy as a disease may lead to better treatment for pregnant women. In this response, we argue that pathologising pregnancy and classifying all pregnant women as ‘diseased patients’ won’t reconfigure care in ways that benefit all women. Rather, it will likely only embolden the view that clinicians are entitled to exercise jurisdiction over pregnant women and beget the increased use of medical intervention where it is not necessarily needed.

Collision sports pose a high risk of concussion. How to respond to this risk is more ethically complex when considering children and adolescents due to a) incomplete evidence regarding the impact of concussion on developing brains, b) physiological and social vulnerability, and c) the young person’s reliance on proxy decision-makers, usually parents. There is also a lack of clear definitions of (a) collision sport (vs. contact sport) and (b) what constitutes a child or adolescent. We consider whether parents should be free to allow their children/adolescents to play contact or collision sport. The article analyses the harms and benefits of collision sport and methods of determining risk, before outlining our support for the precautionary principle. We then consider whether the ‘best interests’ or ‘right to an open future’ framework ought to be applied to the issue of childhood participation in collision sport. Rather than supporting a ban of child/adolescent participation in collision sport, we argue that permissibility should be decided on a sport-by-sport basis. Moreover, we apply the ‘Accountability of Reasonableness’ framework to ensure that sound ethical values guide and support protections for this vulnerable group in the absence of high-quality evidence.

A modern, highly readable translation of a primary text in Western philosophy. Complete translation in English with introduction, notes and glossary. The glossary is keyed to the primary occurrences of important terms in the text and provides insights into the concepts beyond the translation, especially useful pedagogical device for students coming to Hegel for the first time. Focus Philosophical Library translations are close to and are non-interpretative of the original text, with the notes and a glossary intending to provide the reader with some sense of the terms and the concepts as they were understood by Hegel’s immediate audience.

In his latest paper, Loland1 tackles the question of whether athletes with differences of sexual development may compete in the women’s division. The topic is one of the most complex in sport and, as such, is fraught with debate. On one hand, the higher testosterone levels of athletes with DSD means they have an unfair performance advantage over their female competitors. On the other hand, it is argued that women with DSD should be able to compete in the gender division with which they identify, especially as many will have been raised with a clear gender identity. Loland uses the Rawlsian notion of ‘fair equality of opportunity’ in which individuals with similar talents and ambitions should have roughly equivalent prospects for competitive success. For example, in most situations in society, one’s age, biological sex, ethnic and religious background, colour of skin, or sexual orientation are irrelevant to whether an individual should be given a job or is eligible for social welfare. In addition to being irrelevant, these factors are also stable—they are inequalities that ‘individuals cannot control or impact in any significant way’.1 However, Loland recognises that some stable inequalities, such as biological sex and body size, are relevant to FEO in sport. For example, a featherweight boxer may have similar talents and …

The inclusion of elite transwomen athletes in sport is controversial. The recent International Olympic Committee (IOC) (2015) guidelines allow transwomen to compete in the women’s division if (amongst other things) their testosterone is held below 10 nmol/L. This is significantly higher than that of cis-women. Science demonstrates that high testosterone and other male physiology provides a performance advantage in sport suggesting that transwomen retain some of that advantage. To determine whether the advantage is unfair necessitates an ethical analysis of the principles of inclusion and fairness. Particularly important is whether the advantage held by transwomen is a tolerable or intolerable unfairness. We conclude that the advantage to transwomen afforded by the IOC guidelines is an intolerable unfairness. This does not mean transwomen should be excluded from elite sport but that the existing male/female categories in sport should be abandoned in favour of a more nuanced approach satisfying both inclusion and fairness.