NFL player health: The role of club doctors

November 21, 2016

How can we ensure that National Football League players receive excellent health care they can trust from providers who are as free from conflicts of interest as realistically possible? The lead article in a new Hastings Center Report special report concludes that conflicts of interest are inherent to the structure of the relationship between players and club doctors and that these conflicts pose a threat to players' health. The article proposes structural changes to reduce these problems.

Doctors and other medical providers who treat football players are hired by the clubs. "The current structure forces club doctors to have obligations to two parties -- the club and the player -- and to make difficult judgments about when one party's interests must yield to another's," states the lead article, "A Proposal to Address NFL Club Doctors' Conflicts of Interest and to Promote Player Trust."

It proposes to "resolve the problem of dual loyalty by largely severing the club doctor's ties with the club and refashioning that role into one of singular loyalty to the player-patient." Specifically, club physicians would be replaced by two sets of medical professionals: the players' medical staff, with exclusive loyalty to the player, and the club evaluation doctor, with exclusive loyalty to the club.

Existing ethical codes and legal requirements are not adequate to ensure that players receive health care that is trustworthy and as free of conflicts of interest as is realistically possible, the article says, making structural change necessary. "This structure--which is flawed even in the absence of ethical lapses by any individual club doctor--may substantially contribute to player health concerns," it concludes.

The recommendations come from The Football Players Health Study at Harvard University, which is working on prevention, diagnostics, and treatment strategies for the most common and severe conditions affecting professional football players and is funded pursuant to an agreement between Harvard and the NFL Players Association. The authors are I. Glenn Cohen, a Hastings Center fellow who is a professor at Harvard Law School, the faculty director of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, and a co-lead of the Law and Ethics Initiative of The Football Players Health Study; Holly Fernandez Lynch, the executive director of the Petrie-Flom Center and a co-lead of the Law and Ethics Initiative of The Football Players Health Study; and Christopher R. Deubert, the senior law and ethics associate for the Law and Ethics Initiative of The Football Players Health Study.

The lead article's recommendations are followed by seven commentaries and a response by the authors of the lead article. Among the commentaries:
-end-
For more information and a list of authors, see the table of contents and abstracts.

The Hastings Center

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