Chapter 3
The duty of care and ethical
obligations of sports scientists
Athletes do utilise sports
science and it does benefit their performance and aid in their ability to reach
their optimum as high-performing athletes. But they also deserve the protection
against those who might seek to put other interests ahead of the welfare of
those athletes.[1]
Introduction
3.1
The previous chapter identified the
protection of athlete health and welfare as the overriding priority in the
pursuit of improved sporting performance. Up to a point, there will be a strong
correlation between the two: an athlete's wellbeing will contribute to high
performance; and high performance will in turn provide health benefits for the
athlete. There is, however, a point at which the pursuit of high performance
through 'cutting-edge' practices can compromise an athlete's health. This chapter
discusses the duty of care that sports scientists have to athletes, and the
ethical obligations they have to protect and promote the spirit of sport.
Duty of care of sports scientists to athletes
3.2
Government bodies, sporting
organisations, player associations, professional membership bodies and
academics are all united in their view that athlete health and welfare must be
the overriding priority in the pursuit of high performance. However, their
arguments in reaching and interpreting this position differed somewhat.
3.3
The Australian Olympic Committee argued that it is 'imperative that
sports scientists have a duty of care to the athletes they work with' in order
to protect the health and welfare of athletes.[2]
3.4
The Australian Sports Commission (ASC) submitted that the Australian
Institute of Sport (one of the ASC's divisions) 'prides itself on placing
athlete welfare above all other considerations and all its sports scientists
have a duty of care to athletes'.[3]
3.5
The Australasian College of Sports Physicians (ACSP) submitted that 'all
sports scientists involved in the health and wellbeing of athletes have a duty
of care to those athletes'. The College saw this duty of care as ensuring that:
- any research using athletes conforms with accepted standards of
scientific and ethical rigour;
- athletes are not used as experimental models for untested
practices or substances;
- any methods or substances which expose the athlete to the
possibility of an anti-doping rule violation are avoided; and
- any dietary or nutritional supplements provided or prescribed are
safe and efficacious.[4]
3.6
The Australian Athletes' Alliance (AAA), which represents the various
player associations, argued that people who are in positions of responsibility
within clubs have a duty to players. Mr Matthew Finnis, Director of the AAA,
told the committee that players place trust in clubs 'to do not only what is
right by the players in terms of the rules but also what is actually best for
the players in terms of their broader health and wellbeing'.[5] In its
submission to this inquiry, the AAA referred to the principle that:
Athletes want workplaces that protect player health and
safety, while affording them access to the best practices of qualified sports
scientists working within strict professional and ethical guidelines.[6]
3.7
Following the release of the Australian Crime Commission's (ACC) report
in February 2013, the AAA issued a statement expressing alarm at:
... the finding that, in some instances, athletes have
inadvertently become scientific guinea pigs. Those responsible for threatening
the health and careers of players in this way must be held to the highest
standards of the law.[7]
3.8
Academics have pointed to the ACC report as the basis for reforms to re‑establish
the central tenet of duty of care to athletes. Dr Jason Mazanov from the
University of New South Wales, Canberra, argued in his submission that the ACC
report 'has pointed to the very real human element to sports production. In
essence, the ACC report points to the need for Australian sport to evolve'.[8]
Arguing for athlete health and welfare to be the primary concern, he
elaborated:
Sport only functions as a positive force in society when
those who participate find value, whether athletes, administrators, trainers,
scientists or fans. It is incumbent upon Australians to value the people who
make sport happen.[9]
3.9
Dr Robin J Willcourt, a sports scientist, wrote in his submission:
No player should be put at risk. Furthermore, no player
should have to [bear] the consequences of rogue behaviour of its medical team,
as is the current case. It is preposterous that we insist that each player be
responsible for his/her 'treatments'. That is not expected of any patient/doctor
interaction elsewhere and it should not be here.[10]
3.10
On this point, the National Rugby League (NRL) was somewhat guarded:
Where a sports scientist provides services to players at the
direction of an employer club, there is plainly a duty of care owed to the
players in connection with those services by the employer. The professional
nature of the services being provided also raises a real issue as to whether
the sports scientist owes a separate duty of care to the athletes, in the same
way as a medical practitioner does. The NRL believes that focusing on this, and
making sure that sports scientists are appropriately insured, will be an
important factor in raising professional standards.[11]
Ultimately, the NRL considered that the duty of care is the
responsibility of clubs as employers.[12]
3.11
Exercise & Sport Science Australia (ESSA) offered the following,
broader context in which a sports scientist's duty of care should be
considered:
In today's sporting landscape most player contracts have
provisions permitting termination of a contract for reasons relating to player
conduct and bringing the club, game and sponsors into disrepute. It is also
much more likely that a club/player will suffer significant reputational damage
if they are in any way linked to or at least suspected of unethical conduct,
such as the taking of illegal performance enhancing substances.
Any sport scientist who plays a role in administering such a
program may well be seen to be breaching his or her duty of care to an athlete
or club in such matters where they do so without any or any proper informed
consent or direction.
Given that the playing careers of most professional
footballers in Australia is not much greater than 10 years, the reputation of
the player is a priority concern to the players, officials and fans alike
because any loss of reputation is likely to mean a drop of value in what is
already a very competitive marketplace.[13]
3.12
Accordingly, ESSA argued that 'while the duty of care owed by sports
scientist to athletes exists, more is required to positively promote ethical
practice'.[14]
The ESSA Code
3.13
Membership of ESSA requires acceptance of the ESSA Code of Professional
Conduct and Ethical Practice (the ESSA Code). The code is a key document in
promoting the health and welfare of athletes in a sports science context. It
states:
Clients must not be subjected to undue risk prior to, during
and following testing procedures, exercise or treatments prescribed by an
exercise and sports science professional.[15]
3.14
According to the ESSA Code, ESSA's members are expected to:
... maintain professional objectivity and integrity; to apply
professional knowledge and skills to all work undertaken; to actively seek the
objective of advancement of knowledge; and to respect the cultural environment
in which they work.[16]
3.15
In a media release dated 22 March 2013, ESSA stated that:
... sport scientists who are a member of ESSA are bound by a
code of ethics, and the protection of a client’s welfare is central to that
code. The notion of 'do no harm' that governs medical practice, also
governs the practices of a sport scientist. ESSA would be very pleased to work
with the AFL (and other sports) to ensure that this code of ethics meets the
rapidly‑change sporting landscape.[17]
3.16
In 2013, ESSA reviewed its Code and the scope of practice to ensure that
the work of sports scientists was adequately covered.[18]
ESSA released Version 2 of its Code shortly before this inquiry's public
hearing.
3.17
Sports Medicine Australia (SMA)—an
umbrella body which brings together several groups including ESSA—identified the ESSA Code
as 'the most relevant code for sport scientists currently operating within the
industry'.[19]
SMA noted, however, that:
What has become apparent in a number of the recent incidents
involving questionable athlete performance enhancement methods by purported
sport scientists, has been the lack of accountability to such a code which may
have provided some reference point for employers, athletes and the
practitioners involved.[20]
3.18
As chapter 3 of this report notes, the voluntary nature of ESSA
membership for individuals operating as sports scientists means that no
mandated duty of care currently exists for sports scientists. Dr Michael Burke,
Senior Lecturer, School of Sport and Exercise Science at Victoria University,
noted:
Medical doctors have legal duties and responsibilities to
assist their decision making. But for sports scientists, accreditation with
their peak body [ESSA] is voluntary and not a requirement for paid work with
elite sporting clubs.[21]
3.19
Dr Brian Morton, Chairman of the Australian Medical Association's
Council of General Practice, has also drawn a parallel to the ethical
professional standards of doctors and medical staff. It would not be
acceptable, he said, 'if the patient is not fully aware of what they're
taking'.[22]
3.20
The Coalition of Major Professional & Participation Sports (COMPPS)
supported the 'formulation of a duty of care for sports scientists, using
ESSA's Code as a guide which recognises the paramountcy of athlete welfare'.[23]
Ethical obligations of sports scientists
in relation to protecting and promoting the spirit of sport
The spirit of sport
3.21
COMPPS submitted that the 'spirit of sport' is a difficult concept to
define.[24]
However, it noted that at the fundamental level the spirit of sport 'seeks
to identify sport at its best and use that as a standard for all participants'.[25]
3.22
The National Institute Network (NIN) submitted that:
Sport scientists work with their athletes’ conflicting
priorities (eg. winning, making money, entertaining, health and wellbeing, fair
play) in their effort to promote the spirit of sport. In the NIN, concepts such
as long term athlete development, health and wellbeing, and the health of the
sport are primary concerns of sport scientists, and balanced carefully against
other values and outcomes such as winning.[26]
3.23
The World
Anti-Doping Agency (WADA) refers to the spirit of sport as being what is
intrinsically valuable about sport:
... it is the essence of Olympism; it is how we play true. The
spirit of sport is the celebration of the human spirit, body and mind.[27]
3.24
WADA lists 11 values in its 'Spirit of Sport' statement:
- ethics, fair play and honesty;
-
health;
-
excellence in performance;
-
character and education;
-
fun and joy;
-
teamwork;
-
dedication and commitment;
-
respect for rules and laws;
-
respect for self and other Participants;
-
courage; and
-
community and solidarity.[28]
3.25
Dr Mazanov noted that that the statement has been criticised for being
ambiguous and open to 'creative' interpretation and reinterpretation.[29]
He submitted that there is therefore:
... no coherent set of well defined principles that establishes
expectations or guides behaviour within the Australian sporting sector. Sports
ethics then reflect the cocktail of individual beliefs, and interests across
the corporate, public health and government sectors.[30]
3.26
Dr Mazanov submitted that 'an Australian sports ethic needs to recognise
the multiple stakeholders and realities of modern sport rather than relying on
outdated and romanticised notions of sport'.[31]
To this end, he suggested that the ASC or the National Integrity of Sport Unit
could deploy resources towards developing a 'more vibrant ethics of Australian
sport'. Dr Mazanov submitted that this could include:
... helping Australian sporting organisations implement those
ethics as part of professional and athlete development. It may also be useful
to exploit existing government funding for sports health science, such as
establishing philosophy and ethics of sports health science as part of the
Anti-Doping Research Program.[32]
3.27
The objective would be:
... a set of well-defined values that guide decision making and
can be used as a reference point in other contexts. This would be a 'living
document' as evolution in sports health science and sports science more
generally compels re-evaluation of what might be considered 'right' for
Australian sport.[33]
3.28
The committee supports Dr Mazanov's
view that a statement of ethics should be established and agrees that this
should be a 'living document' which reflects the changing values and
expectations resulting from evolving technologies and scientific advancements.
Recommendation 1
3.29
The committee recommends that
the federal government consider developing a statement of ethics that would
apply to all Australian participants in sports.
Ethical obligations of sports
scientists
3.30
COMPPS submitted that sports scientists have an ethical obligation to
maintain a 'level playing field' by ensuring that all practices are compliant
with the WADA code:
In many Australian sporting codes, sports scientists have
gained increasing influence over decision making within the club. Given this
influence, sports scientists have an ethical obligation to promote and
encourage training and competition in a doping-free sporting environment. This
will help to protect and promote the spirit of sport not only among the
athletes that they work with, but also among young athletes who are influenced
by the practices of their sporting heroes.[34]
3.31
ACSP submitted that sports scientists have ethical obligations to
maintain the integrity of sport, which involves 'maintaining standards of
ethical and professional behaviour to ensure there is no danger of sport being
brought into disrepute'.[35]
It noted that adoption of the ASC's AIS Sport Science/Sports Medicine Best
Practice Principles—discussed
in chapter 6 of this report—would assist with this.[36]
3.32
Dr Hugh Seward, Chief Executive of the Australian Football League
Medical Officers Association suggested to the committee that sports science
courses in tertiary institutions should:
... include ethics training, as found in courses for medical
disciplines, to assist undergraduates in their understanding of the
responsibilities and limitations before venturing into the practice of managing
athletes. In particular, regard for the overall wellbeing and health of the
athlete, both in the short and the long term, must be considered in relation to
the short-term performance outcomes.[37]
3.33
ASCP suggested that all athletes entering professional and/or high‑performance
sports programs should undertake a mandatory education course:
The athletes would be provided with comprehensive education
on matters related to integrity in sport, including but not limited to: doping,
nutrition, use of supplements, illicit drugs and involvement in sports
research.[38]
3.34
Dr Peter Larkins suggested a publicity campaign:
... using some of our really high-profile, successful role
model athletes talking about how they made it to the top and did not cheat and
used genuine things. I think there is a real opportunity for the sporting
alliance groups to involve athletes, such as one of our Socceroos from last
night or people like Pat Rafter, Michael Klim and Cadel Evans—those sorts of
people who currently have a profile in the minds of young athletes—and to use
these people to show that they can reach the top by the hard work and God-given
talent that people have. I think that is a really powerful message that we need
to put out as a country.[39]
Committee's view
3.35
The committee notes concerns that performance may be prioritised above
athlete health and welfare by sports scientists, coaches, teams, sporting
organisations and athletes themselves. The committee is of the strong view that
athlete health and welfare must be paramount in all decision making related to
performance, recovery and ability to play/compete. The committee also notes
that protecting athlete health and welfare and pursuing high performance may
often be compatible goals.
Recommendation 2
3.36
The committee recommends that tertiary institutions offering
sports science courses include topics on ethics, which should refer to the duty
of care of sports scientists to athletes and the importance of protecting
athlete health and welfare.
3.37
The committee also believes that coaches, teams and sporting
organisations have a responsibility to educate athletes—especially young athletes who are
particularly vulnerable—about
the importance of protecting their long-term health and welfare. While the
committee notes that athletes may choose to engage in reckless and harmful
behaviour, such as the use of illicit substances, the committee believes that
they should be encouraged at every opportunity to recognise the long‑term
implications of their choices.
3.38
An improved integrity culture also needs to be promoted within
sports that recognises the long-term implications for engaging in practices that
bring teams, codes and sport in general into disrepute. Younger players in
professional sports and amateur competitions need to be educated about their
rights and responsibilities in terms of upholding the spirit of sport and
protecting their long-term health and welfare.
3.39
The committee is of the view that education of athletes on the topics
suggested by ASCP should be implemented by all sporting clubs and organisations
in Australia. The committee recommends that the Australian Sports Integrity
Network, established by the National Integrity of Sport Unit, be utilised to
develop an education program that can be delivered at both the elite and the
grassroots level by sporting bodies.
Recommendation 3
3.40
The committee recommends that sporting organisations and/or clubs
provide all athletes entering professional and/or high‑performance sports
programs with specific training on sports ethics, integrity issues and their
rights and responsibilities in relation to their long-term health and welfare.
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