AMA pulls no punches, reiterates Boxing ban
Ringside physicians were denied endorsement for their efforts to make the sport safer.
By Victoria Stagg Elliott, amednews staff. July 8/15, 2002.
Is boxing just another hazardous sport like football or hang gliding that needs to be made safer? Or, is it a form of violent entertainment with no redeeming qualities?
For physicians, the debate becomes whether caring for a boxer during and after a bout is akin to standing by as a death sentence is administered to a convicted criminal or whether, instead, it is the same as caring for any patient with an injury that results from an unhealthy lifestyle choice.
These are some of the issues the American Medical Association wrestled with at its Annual Meeting in Chicago last month.
The organization considered a policy that would endorse the American Assn. of Professional Ringside Physicians, an organization of doctors working in the sport of boxing.
The proposal ultimately failed, primarily because the AMA has a long-standing position calling for the sport to be banned.
"There is absolutely no way you can make boxing safe," said Nelson Richards, MD, a delegate from the American Academy of Neurology who proposed the original resolution to ban the sport in 1983.
(Neurologists first called for boxing to be banned in 1983.)
The AMA has no formal ties with the Ringside Physicians Assn., and there were many questions about how effective the organization really could be in making the sport safer.
"I don't know if we can support an organization over which we have no control," said Stephen L. Hansen, MD, an internist and California delegate from San Luis Obispo. "Also, the doctor doesn't have the control to stop the fight, and the referees may not realize when someone is in trouble."
Injury prevention, or Band-Aid?But during the debate, two clear camps emerged.
1. There were those who felt that the long-standing AMA position against boxing had had little positive impact and
2. that the presence of ringside physicians might better reduce the mortality and morbidity associated with the sport.
It was also argued that
3. the policy might even have had a negative impact by discouraging physician involvement.
"[This new resolution] is a positive and practical step to make one of the most popular sports in the world safer," said Robert S. Rigolosi, MD, an alternate delegate from New Jersey and former college boxer.
"I encourage the AMA to accept the reality that boxing is here to stay but continue to make positive contributions on how make it a safer sport."
But then there were those who felt that the harm-reduction model was not the way to go and there was little that the presence of a physician could do to make the sport safer.
"There is something wrong with a doc standing there watching harm being created," said Erica Frank, MD, MPH, an alternate delegate from the American College of Preventive Medicine. "It's akin to docs participating in the death penalty. By being there we endorse the activity."
Although endorsement of the ringside physicians' group was denied, the AMA has passed resolutions and reports in the past focusing on ways to make the sport safer until it can be eliminated. Delegates said they would consider such motions again.
"I hope those physicians who are serious about safety would come back to us with resolutions suggesting increasing time between rounds for adequate medical evaluation -- no hitting above the clavicle and mandatory CT scans," said former AMA President Robert E. McAfee, MD, a long-time anti-violence activist and former college boxer. "Until then, we cannot allow our patients who happen to be boxers to sustain serious life-threatening injuries without prevention."
Meanwhile, a spokesperson from the Ringside Physicians Assn. said the ban was shortsighted and that he would be encouraging the 250 members of his organization to end their affiliation with the AMA.
"If the AMA would like boxing to take place in bars and backrooms where there's no medical supervision, then they're going to have deaths," said Michael Schwartz, DO, an internist based in Darien, Conn., and chair and president of the organization.
"Football and auto racing are much more dangerous than boxing, but I don't hear the AMA calling for bans on those sports."
WeblinkAmerican Assn. of Professional Ringside Physicians (http://www.aaprp.org/)
AMA Council on Scientific Affairs 1999 report on boxing injuries (no longer available)
Copyright 2002 American Medical Association. All rights reserved.
AMA pulls no punches, reiterates boxing ban - amednews.com