“New Data Shows 96% of NFL Players Test Positive for Brain Disease” declares the headline of a recent and alarming article from TIME magazine. Surely, if this is the case, why would anyone want to pursue a career in the sport? Well, it turns out, it may not be the case, said Alvaro Pascual-Leone of Harvard University in last night’s International Neuroethics Society event about safety in professional football.
“Much of the information we have today is based on woefully underpowered studies,” he explained. “If you want to make sound inferences of risk you need about 70 percent of the reachable public,“ which in this case would be 10,000 former NFL players (of the approximately 15,000 alive today). To put things into perspective, the study mentioned above only studied the brains of 91 former players.
Pascual-Leone is an associate director of The Football Players Health Study at Harvard University, which aims to improve the health and well-being of former NFL players and to better understand the risks of playing the game. The study has already enlisted about 2,600 players, and while it continues to recruit it is doing case control studies to look at why some people develop problems and others do not.
The study is not limited to brain-related injury but rather takes a more comprehensive and long-term health approach. “This is not a concussion study or a knee study or a CTE study, but about a player’s whole life,” said Pascual-Leone.
Funded by the NFL players’ union, the study is divided into three parts: population studies to figure out the problems, pilot studies to develop interventions, and a law and ethics component to look at the stakeholders involved in players’ health. Former NFL players are participating in each area, to help guide the process and ensure that their concerns are addressed. Though the study is focused on former players, the hope is that the information produced will help current and future players to make informed decisions about their health and participation in the sport.
I. Glenn Cohen, the Law and Ethics co-lead of the Harvard Study, asked the question: “When it comes to players’ health, who’s responsible for what and why?” In the current structure, some of the people most closely involved in player health decisions have an obvious conflict of interest, he said. For example, team doctors, “serve at the pleasure of the owner,” and owner priorities skew toward the business. It’s important to set up a structure that allows people to make the right decisions for them, he said.
One of the guiding ethical principles identified by the Law and Ethics team, and something that repeatedly came up during the panel discussion, is power of autonomy. The main question: Once professional players are adequately informed of the health risks associated with a lifetime of playing, who should ultimately make the call about their health? All panelists seemed in agreement that players should have that final say. “They do have a right to sacrifice their health,” said Cohen.
Panelists Damien Richardson serves as a player advisor to the study and has a fairly unique perspective on the stakes; he is a former NFL player (with two years on injured reserve) now an orthopedic surgeon resident at Banner University Medical Center. “The truth” is how he summarized what former NFL players want—something echoed in a recruitment video for the study, featuring former Patriots and Giants player Ed Reynolds. This, of course, harkens back to informed decision-making and power of autonomy.
Something I’m sure many of us in the audience were wondering, and asked of Richardson in the first audience question at the end of the program, was: If he could do it all over again, knowing what he knows now, would he do it?
“I would play football, but I would have changed the way I played,” he responded. Richardson is optimistic that the study would lead to positive changes in the NFL, which will empower players. And he believes that “[i]f we set the tone in the NFL, others will follow,” ultimately affecting university-level football and programs with younger players.
This public event was held as part of the International Neuroethics Society Annual Meeting in Chicago. Stay tuned to our blog for coverage of other neuroethics panel discussions. We’re also attending the Society for Neuroscience meeting immediately following, and will be posting stories about various events and lectures in the coming weeks. Follow us on Twitter for additional coverage.
–Ann L. Whitman
[photo by Dana staff]