Ethics, evidence based sports medicine, and the use of platelet rich plasma in the English Premier League

The use of platelet rich plasma (PRP) as a novel treatment is discussed in the context of a qualitative research study comprising 38 interviews with sports medicine practitioners and other stakeholders working within the English Premier League during the 2013–16 seasons. Analysis of the data produced several overarching themes: conservatism versus experimentalism in medical attitudes; therapy perspectives divergence; conflicting versions of appropriate evidence; subcultures; community beliefs/practices; and negotiation of medical decision-making. The contested evidence base for the efficacy of PRP is presented in the context of a broader professional shift towards evidence based medicine within sports medicine. Many of the participants while accepting this shift are still committed to casuistic practices where clinical judgment is flexible and does not recognize a context-free hierarchy of evidentiary standards to ethically justifiable practice. We also discuss a tendency in the data collected to consider the use of deceptive, placebo-like, practices among the clinician participants that challenge dominant understandings of informed consent in medical ethics. We conclude that the complex relation between evidence and ethics requires greater critical scrutiny for this emerging specialism within the medical community

The ‘spirit of sport’, WADAs code review, and the search for an overlapping consensus

In this paper, we argue for the recognition that anti-doping is in itself first and foremost an ethical position. The current World Anti-doping Code formulation of ‘the spirit of sport’ is an acknowledgement of this point and a counterweight against scientific and technicist understandings of the nature of anti-doping itself. We critically review the Code formulations on ‘the spirit of sport’. Based on a theoretical background of various approaches to normative agreement and consensus in a setting of diversity of ‘comprehensive views’, we argue for revision of the Code. Specifically, we argue for a re-formulation of ‘the spirit of sport’ in terms of athlete protection and the preservation of the integrity of sporting competition that could meet requirements on an overlapping consensus among all WADA stakeholders. This is not just a matter of formality and Code acceptance. An overlapping consensus is not a mere modus vivendi but a normative consensus based on fair, honest, and transparent discourse in which participants deliberate in a setting of mutual respect and trust, and of ‘decency’, which is a basis for a consensus that cultivates authentic stakeholder commitment

Tri-meson-mixing of π\pi-η\eta-η′\eta' and ρ\rho-ω\omega-ϕ\phi in the light-cone quark model

The radiative transition form factors of the pseudoscalar mesons {$\pi$, $\eta$, $\eta'$} and the vector mesons {$\rho$, $\omega$, $\phi$} are restudied with $\pi$-$\eta$-$\eta'$ and $\rho$-$\omega$-$\phi$ in tri-meson-mixing pattern, which is described by tri-mixing matrices in the light-cone constituent quark model. The experimental transition decay widths are better reproduced with tri-meson-mixing than previous results in a two-mixing-angle scenario of only two-meson $\eta$-$\eta'$ mixing and $\omega$-$\phi$ mixing.Comment: 8 pages, 6 figures, final version to appear in EPJ

Genetic testing and sports medicine ethics

Sports medicine ethics is neither a well established branch of sports medicine nor of medical ethics. It is therefore important to raise to more general awareness some of the significant ethical implications of sports medicine practices. The field of genetics in sports is likewise in its infancy and raises significant ethical concerns. It is not yet clear how genetics will alter our understanding of human potential and performance in sports. While a number of professional medical bodies accept genetic interventions of a therapeutic nature, we argue that the use of genetic technologies to predict sports potential may well breach both the European bioethics convention and North American anti-discrimination legislation, which are designed to support important ethical ideals and the ongoing commitment of the physician to the welfare of their patient. We highlight further ethical problems associated with confidentiality and consent that may arise in genetic testing as opposed to more conventional methods of testing in sports medicine. We conclude that genetic testing in sport that is not strictly limited to the protection of the athlete against harm, should be viewed in a very sceptical light by sports medicine professionals. © 2009 Adis Data Information BV. All rights reserved