Helping Children Hurt Themselves: Why Pediatricians Ought to Support Adolescent Football Players in Their Athletic Goals.

Participation in sports such as football puts youth-athletes at high risk of injury. Helmets cannot protect players from the possibility of traumatic brain injury, and repeated concussive injuries can lead to chronic traumatic encephalopathy later in life. In light of such facts, the morally appropriate role of physicians who treat patient-athletes comes into question. I argue that pediatricians ought to be committed to a high level of shared decision making, whereby their goal, rather than being to provide the medically best advice (which, let's be honest, would be to not play football at all), would be to provide the medically best advice in light of patients' honestly professed plans and goals. If patient-athletes see their doctor as an ally, who wants them on the field as much as they want to be there, they will be more likely to trust their pediatrician to help in the realization of those goals, even if they report an injury. While this approach could feel like a medical betrayal, in that the physician could feel complicit in helping a patient to continue engaging in high-risk behavior, I argue that medical outcomes will be better than if patient-athletes see physicians as an obstruction to their athletic goals.