In 1996 when Muhammad Ali lit the Olympic flame on international television, the issue of sports-induced brain damage was raised to new prominence. One of the greatest boxers in history, his evident frailty and overt Parkinson’s tremors led many to question the sport of boxing and its future. Since then, countless other athletes, not only from the world of boxing, but from football, hockey, mixed martial arts, soccer and beyond, have shared tragic stories of debilitating sports-related concussions.
Although many sports involve the risk of unintentional injuries, boxing for many raises the issue to an entirely different level. Indeed, it is important for us to inquire about the intended purpose or goal of boxing.
Literature describing the ancient practice of the sport of boxing makes it clear that Greek athletes sometimes suffered permanent injuries or even died during tournaments. During Roman gladiatorial boxing events, they basically fought to the death. Any sporting activity where the declared goal would be to kill one’s opponent would, of course, automatically raise serious moral objections.
Modern boxing has no such goal, though certain elements of bodily harm and violence continue to characterize the sport, with an average of 10 boxing deaths occurring each year since 1900. Among the more serious forms of harm that can occur from competitive boxing is physical damage to the brain. From January 1960 to August 2011, for example, 488 boxing-related deaths were reported, with approximately 65 percent of those deaths involving grave neurological damage.
If the goal of a professional boxing match is “just” to knock out the opponent to gain victory, the purpose of the competition itself still raises moral concerns, because participants are striving to inflict potentially serious harm to their opponent’s brain by causing a concussion, a type of traumatic brain injury.
Suffering a concussion can result in a panoply of symptoms and problems, including fuzzy thinking, painful vision, harmful reactions to light, difficulties with memory and learning, and loss of the ability to focus. Sometimes repetitive brain trauma can result in progressive neurodegenerative disease with significant symptoms arising years later, including dementia.
Our ability to recognize and understand traumatic brain injury is continuing to improve with time. Several proteins, released by nerve cells when they are damaged following a concussion, can often be detected as “fluid biomarkers” either in the blood or in the cerebrospinal fluid. Testing for the presence of these proteins can aid in identifying and confirming even mild traumatic brain injuries that may not be obvious on first assessment.
Neurologists, of course, are among the first to emphasize that a concussion represents a serious medical condition. Treatment options generally remain limited and tend to include the need for extended time to allow the neurological impairment to heal.
Young athletes can be so desperate to compete, nevertheless, that they will say they are fine after suffering an injury even when they are not, and seek to return to the competitive event. A second insult to the brain, without allowing for full healing of the first, can significantly increase the risk for prolonged symptoms.
Considering the intensity of competitive pressure, particularly among young people who may have a limited ability to consider the consequences of their actions and the potential future effects of injuries, the question arises whether there isn’t a broader moral obligation in the community to “save players from themselves” and for those around them to refrain from applying undue pressure to perform on young athletes. Regrettably, undue pressure to participate sometimes arises from parents and coaches, and outside mediators are sometimes needed to assure that young people’s best interests are protected.
One element of responsible gamesmanship in today’s sporting events involves the development and use of appropriate gear to protect athletes from accidental harm. Another involves the establishment of rigorous penalties for players and teams that intentionally seek to cause harm to their opponents during competitions and tournaments.
For the sport of boxing, however, such measures reveal a contradiction. If one were to completely protect a boxer, for example, with appropriate body padding to avoid injury, the sport would lose much of its energy and appeal, since causing injury is central to the process of engagement. If one were to be penalized for intentionally seeking to harm the other boxer, as may be done for other sports like hockey, again, boxing would become eviscerated of much of its core.
There are obvious meritorious considerations to boxing, like the intense training, personal discipline, and resilience involved, all of which are clearly valid on their own terms. St. Paul even uses the analogy of boxing to describe the way we should exercise heroic discipline in the Christian life (1 Cor 9:25-27).
But while there are various elements that can attract us to the sport, the violent goal of the engagement remains gravely problematic at a moral level. The sport of boxing not only risks serious impairment and even death, but poses many uncomfortable questions for us regarding our own appetites as spectators, and our willingness to allow for certain elements of brutality and even barbarism in the practice of sporting events.
“Making Sense Out of Bioethics” is a monthly column by Father Dr. Tadeusz Pacholczyk. He earned his doctorate in neuroscience from Yale and did post-doctoral work at Harvard. He is a priest of the Diocese of Fall River, Massachusetts, and serves as director of education at the National Catholic Bioethics Center in Philadelphia, www.ncbcenter.org and www.fathertad.com.