This week the Association of Ringside Physicians published the third installment of their Journal of Combat Sports Medicine (available on line to ARP members).
Among the articles was a thoughtful piece by Dr. Nitin K Sethi, a neurologist and ringside physician, who discussed the tensions between ethical medicine and the duties of being a ringside doctor.
Among Dr. Sethi’s insights were that ‘no amount of boxing or MMA is good for the brain’ and that a ringside doctor must have the lowest threshold of all participants when it comes to deciding when a fight should be stopped.
I encourage those with access to the article to read it in full. Among Dr. Sethi’s comments were the following useful observations –
As physicians we too are professionals,
skilled and trained to do our job which
is to protect the athletes’ health. The fighter and
his corner may want the fight to continue even at
the expense of a fighter’s health. As physicians, we
cannot allow that. “Do no harm” is the oath we
take as physicians and allowing an injured fighter
to continue goes against that oath. I realize that
my threshold of stopping a fight may differ from a
fighter’s or a fan’s or even a referee’s threshold of
stopping a fight. The doctor’s threshold of stopping
a fight should be the lowest. “When in doubt
about fighter’s health and safety stop the fight”,
should be the guiding tenant of a ringside physician.
As physicians, and especially for me as a
physician neurologist, we cannot defend combat
sports by saying that boxing or MMA is good for
the brain or the body. No amount of boxing or
MMA is good for the brain; not one round, not
one punch to the head. Ringside or cage-side physicians
need to remain objective, completely free
of any bias, and make a call to stop a fight based
solely on the medical facts in front of them and
not the fighter’s past fight record, how big the fight
is, or how much money is at stake. The minute
we do that, we fail to remain objective; instead,
we turn into spectators who are sitting ringside or
cage side rather than in the stands. Our judgment
and medical decision-making are going to be biased
and now we are primed to fail in our only
duty, which is to protect the athlete’s health.