The Politics of Risk - Professional Boxing

[ryanman]

What follows here is a case study I wrote last year, the title explains its content. Thought i'd put it up see what you guys think. It was an MA piece, but i didn't execute it too well. Please forgive the at times tedious nature and sloppy writing. Feel free to rip to it bits, it won't offend me, it was well received by my mentor. Uts a bit of a long read but give it a go if you fancy it.
P.s please don't plagerise, you are only cheating yourself!!

The Assessment, Management and Communication of the Risk of Serious Injury in Professional Boxing

The purpose of this case study is to analyse how the risk of sustaining a serious/fatal injury resulting from participating in professional boxing is assessed, managed, and communicated. It is a highly publicised area, with two distinct, opposing sides competing for their opinion to become prevalent. The case study will focus on the powerful medical bodies, particularly the British Medical Association (BMA), that wish to see the sport banned on safety grounds. It will also examine the role pro-boxing bodies, in particular the British Boxing Board of Control (BBBofC), have had in the management of the risk, as well as their attempts to communicate the level of risk. In undertaking an examination of this debate we are helped to understand how, on an issue of risk, totally opposite conclusions can be reached by two different, yet equally qualified, sides . This in turn leads us to question the infallibility of experts, as they can, when analysing the same facts, come to entirely different conclusions. It is an area that has spawned a great deal of risk assessment, which in turn has led to numerous attempts to better manage the risks involved.
The communication of risk is particularly interesting and the rival factions, both with vested interests, argue their case publicly and vehemently. The media is an important mouthpiece for both sides when communicating their views of the risks involved. However, despite the degree of publicity the BMA’s campaign has achieved, it has thus far failed in its stated goal of bringing about the complete ban of boxing. This raises interesting questions about the gap between expert opinion and public perception. Interestingly, this is contradicted by the fact that boxing in the last 20 years is safer than ever, yet the campaign to ban it has never been better supported, could this be seen as evidence of Beck’s ‘risk society’? Analysing this subject also shows the apparent distortion between facts and opinion that occurs so often in all areas of risk. In a public survey of the most dangerous sports boxing would be likely to feature heavily, yet statistics show that there are more deaths in several other sports, including rugby union, American football and even angling. Which factors cause this situation? Could it be the success of the BMA in communicating their message? Or perhaps it demonstrates how people have a natural human instinct as to the risks of something and that these are difficult to change even with facts. All of these factors make the analysis of this subject interesting and meaningful.
Many members of the medical profession see boxing as an unnecessarily dangerous sport. This is reflected in the British Medical Association’s (BMA) long-standing desire to see the complete ban of the sport. Whilst they concede that there are other sports that cause more deaths in participants they contend that this is insignificant when compared to the recorded numbers of boxers suffering serious brain injuries. Furthermore, they argue that many brain injuries go unrecorded as they do not always become apparent until many years after the participant was stopped competing.
The British Medical Association‘s boxing spokesman Dr Bill O‘Neill, states that viewing external injuries could indicate the extent of the unseen damage that takes place within the skull:

‘Imagine the boxer’s nose and the repeated fractures of the nose and transpose that to what’s going on inside the brain. The boxer can recover from a broken nose -he can breathe again. But at the end of the day he’s got a very scarred and misshapen nose. Now picture that going on inside the brain’
(www.bbc.co.uk)

Dr O’Neill goes on to state that the precautions taken by the boxing authorities to ensure the competitors safety are irrelevant as long as headshots are not outlawed. The statement concluded with Dr O’Neill saying ‘If they were to ban punches above the shoulder, we would have to reconsider our policy’.
Further evidence of the damage long term participation in boxing can produce comes from the American Association of Neurological Surgeons (AANS) who contend that 90% of boxers sustain a brain injury (Men's Health - Men's Guide to Fitness, Health, Weight Loss, Nutrition, Sex, Style and Guy Wisdom). Whilst this stat is startling it may not have much value beyond that of shock, and ultimately that is likely to be the aim. The term ‘brain injury’ goes undefined, it certainly does not refer solely to serious brain injuries, as these are relatively rare. It is likely to be more akin to brain injuries suffered by footballers due to repeated heading of heavy footballs. This is an example of clever communication on the part of the AANS, based on the understanding that the public can easily be swayed by shocking headlines, particularly if they come from a respected source.
The BMA’s position is that boxing is not unique in its capacity to cause serious brain injuries, but that it is by far the most prolific. In 1974 a survey of British neurologists was carried out to establish the amount of cases of chronic traumatic encephalopathy (CTE) , per sport, they had encountered. This survey yielded the results of - twelve jockeys, five soccer players, two rugby players, two professional wrestlers, one parachutist and 294 boxers. They have also estimated that boxing has a fatality rate of 92 deaths per 1 million participants. (British Medical Association (BMA) Homepage). They argue that boxing is different to other sports that carry high injury risks as its fundamental aim is to inflict harm. The BMA does not seek to ban what they regard as ‘proper’ martial arts such as karate ‘where avoidance of harm is intended, and the onus is on technical ability with wins scored on points’ (British Medical Association (BMA) Homepage). This statement is either a display of ignorance on the part of the BMA or wilful deception. The British Boxing Board of Control argue that the sole purpose of a competitor in a professional boxing match is not to inflict harm, and is in fact similar to ‘proper’ martial arts where avoidance of harm is intended. The onus in boxing is on technical superiority and points victories (BBBofC - British Boxing Board of Control). This BMA’s position is further flawed as even if the main object of boxing was to inflict harm, this intention alone would not be grounds to deem it dangerous. Taking the BMA’s argument to its logical conclusion, if three people a day died playing football this would be acceptable as the intention to commit harm is absent. Later we shall see from the BBBofC’s guidelines that referees are instructed to stop the contest if one participant is deemed to be in danger, and indeed many contests are stopped without any knockdowns being suffered.
Records show that 140 boxers, have lost there lives whilst participating in bouts or training since 1990 (British Medical Association (BMA) Homepage). Again this statistic is startling yet its usefulness is diminished by the failure of the BMA to provide a comparison. To this end Dr Nigel Warburton, a professor of Philosophy, argued in March's Journal of Medical Ethics that the policy (of the BMA) is ‘inconsistent, paternalistic, and too weak to justify a change to criminal law’. He said that between 1986 and 1992, boxing accounted for three deaths in England and Wales compared with 77 deaths from motor sports, 69 from air sports, 54 from mountaineering, 40 from ball games and 28 from horse riding (BBC - Homepage). These figures undermine the BMA’s claims about the dangers of boxing both in terms of number of deaths and the ratio of deaths to participants. Also, the use in his statement of the word ‘paternalistic’ is interesting as it highlights the adult-child relationship in all aspects of risk. In this instance this refers to both the adult-child dynamic present in the relationship between experts and the public, as well as in the relationship between those that seek to influence policy and the public. These statistics also demonstrate another aspect of risk communication, namely that the same statistics can be used to attempt to prove the opposite sides of any debate. Or to borrow a famous phrase, there are lies, damn lies, and statistics.
In a response to the statistics that show boxing does not have a high fatality rate when compared to numerous other sports the BMA state that these statistics ignore the high number of serious, non-fatal, injuries suffered by boxers. It is their contention that much of the damage is likely to be hidden until the end of a boxer's career or even after retirement. These findings are supported by the World Medical Association who found that boxing 'can result in death and produces an alarming incidence of chronic brain injury' (British Medical Association (BMA) Homepage).
Cont...

[ryanman]

...One aspect of the risk involved in boxing that is ignored by the BMA and understated by boxing organisations is the one in which participating in boxing reduces risks.
Taking part in boxing has significant health benefits. The practise of boxing reduces fat whilst increasing muscle mass and has significant cardiovascular benefits (Associated Content - associatedcontent.com). These health benefits can help prolong the life of participants through the avoidance of disease. It is probable that boxing has saved numerous lives, through the exercise involved and the necessary avoidance of potential killers such as tobacco.
Analysing the attempts to manage the risks involved in competing in professional boxing can be approached from two angles. Here this subject has an extra dimension as the two competing sides of the debate are both involved in managing the risks. The BMA attempts to completely eliminate the risks involved by bringing about a total ban. Conversely, organisations such as the BBBofC seek to minimise the risks involved through their multitude of rules and regulations. The safety measures in place are too numerous to mention them all thus what follows is an edited selection taken from the BBBofC’s (BBBofC - British Boxing Board of Control) rules of boxing:
The opponents in any one Contest must be engaged at the same weight
All Boxers must weigh-in not less than 24 hours or more than 36 hours before the commencement of a tournament
The Promoter shall ensure that a minimum of two doctors, one of whom must be practised in the management of an unconscious or partially conscious patient, who have been approved by the Area Medical Officer, attend at all Promotions
All Boxers shall be medically examined after the weigh-in or immediately prior to the commencement of the Promotion. Each Boxer must also be medically examined after every Contest. If the examining doctor considers it necessary to do so he shall send a report to the Board or Area Council. A doctor must be available to give immediate attention to any Boxer should this be required.
The Ruling regarding the timing of the weigh-in is a relatively new, and crucial innovation. A great deal of evidence suggested that the greatest threat to a boxer’s health in the ring came from dehydration. Previously competitors weighed-in on the day of the fight, which left them exposed to severe dehydration due to the demands to weigh-in under the limit. The tragic injuries suffered by boxer Paul Ingle in 1999 were attributed to severe dehydration and this forced the BBBofC to amend their rules and allow for at least 24 between the weigh-in and the fight itself, this, in theory, gives the competitors adequate time to safely rehydrate (The Independent | Sport | Latest Sport News). One further measure was to introduce annual, compulsory, MRI scans for boxers. Also they increased the length of time that a boxer that had suffered a knockout had to wait before being allowed to box again, from 28 days to 45 days (The Independent | Sport | Latest Sport News). This allows a more adequate recovery time, as well as protecting fighters from unscrupulous managers/promoters that may seek to place them back in the ring sooner.
Whilst medical opinion appears to be fairly united in its view that boxing is unacceptably dangerous the sport is not without some support from the medical fraternity. Dr Whiteson, the chief medical officer of the BBBofC is of the belief that boxing is not overly dangerous. He contends that chronic injuries, particularly with the brain, are extremely rare in the modern era. He also shares the concerns of many others that the banning of boxing would lead to it going ‘underground’, where participants would face far greater risk of injury. He also espouses a popular claim among the pro-boxing fraternity, that participants are often from underprivileged backgrounds and boxing provides them with discipline and can lead them away from a life of crime. He also argues that when undertaken correctly boxing is ‘one of the safest sports’ (BBC SPORT). The BMA counter this by declaring that the argument that boxing gives working class boys a chance to ‘better’ themselves is patronising and that the government should give more consideration to the provision of leisure facilities for the young, particularly in inner cities (www.bma.co.uk). This is however a flippantly dismissive attitude to a potentially key aspect to the debate.
The British Medical Association’s argument appears to be partly scientific and partly moral. This raises ethical questions as to the role science has, or should have, in campaigning on issues of morality. Perhaps the motivation of the BMA in employing such a tactic is due to an acknowledgement that complex medical opinions are not easily digested. This would suggest that the process of risk communication is largely a pragmatic one, and that actors are likely to communicate only certain portions of information. Furthermore, an overriding point of the BMA’s argument is that damage to the brain in most sporting activities is incidental but that in boxing, the damage is deliberate. This again carries moral overtones and displays a certain ignorance of the subject matter, but in this case it is probably intended ignorance. They will be aware that for many boxing is a minority sport, people are likely to read something from a respected body such as the BMA and take it as fact. Consequently they will gain support for their aim by presenting opinion with fact.
Of further interest is that both sides emphasis different areas of the debate. This creates a situation in which neither side attempts to wholly disprove the other‘s arguments but rather simply argue that the factors they themselves choose to emphasise are of the most importance. Whilst attempting to downplay the danger, boxing bodies do not claim that the sport is completely without risks, however, their main focus however is on the social aspects participants are offered. Members of the pro-boxing fraternity have an oft repeated statement that many boxers who have gone on to become world champions have declared that without boxing in their lives to give them a sense of discipline, they would have most likely ended up in a life of crime,which of cause carries inherent risks of its own (www.safesport.co.uk/boxing-dangers). The fact that boxing is widely regarded to be one, if not the most, dangerous sport is in large part due to the BMA’s long term strategy and demonstrates vividly the value of possessing an effective mechanism of communication.
There is evidence in this debate of Ulrich Beck’s work on risk society being present. It is indisputable that boxing has never been safer than it is at present, yet the controversy surrounding it and the movement for banning it have never been greater. This mirrors the fact that we as people and society have never been safer, yet have never felt more unsafe.
The Availability Hiuristic is another important aspect of the subject. People can only understand a subject by the information that is available to them. Consequently, boxing is seen as dangerous by a majority of the public, although this is not to say a majority would advocate a complete ban. People will generally only hear the dangers of boxing discussed following a high-profile injury or fatality and therefore the perceived risk of competing in the sport far exceeds the actual risk (Belton 2003 : 3-1. For many in the media good news is no news, meaning people do not hear about the vast majority of boxing matches that are concluded without injury, which is understandable considering the commonality of that situation renders it not newsworthy. Furthermore, natural human instinct leads people to remember vividly traumatic events whilst forgetting quickly happy events.
The public ignorance model states that in order for issues to be resolved science needs people to understand. It is this ignorance of the people in terms of scientific facts that prevent issues being dealt with effectively (Belton 2003 : 3). But this model relies on the premise that science in itself is value free. This case study has shown that science is neither value free, nor does it attempt to be - seen in this case through the BMA’s moral as well as scientific objection to boxing. In reality, far from being value free, scientists and science operate in the same social structure as the public or ‘consumers’ and thus their advice and evidence should be noted and considered by the public, rather than simply taken as fact.

[ryanman]

Bibliography
Books
Belton (2003) Science in the post modern world in Belton, P.S & Belton, T
Ed Food, Science and Society: Exploring the Gap between expert advice and individual behaviour, Berlin Springer
Websites
http://news.bbc.co.uk/1/hi/health/medical_notes/363957.stmDate Published 24.09.1999
http://menshealth.about.com/od/fitness/a/boxing.htm Date Published 28.03.2006
http://www.bma.org.uk/health_promotion_ethics/sports_exercise/boxing.jsp Date Accessed 05.01.2009
http://www.independent.co.uk/sport/general/board-introduces-safety-measures-692054.html Date Published 16.02.2001
http://www.safesport.co.uk/boxing-dangers-and-safety-precautions.html Date Accessed 04.01.2009
http://www.associatedcontent.com/article/110261/is_amateur_boxing_safe.html Date Published 06.01.2007
http://www.bbbofc.com/rules-of-boxing Date Accessed 08.01.2009
http://www.dca.ca.gov/csac/statutes_regulations/federalact.shtml Date Published 09.10.1996

[ryanman]

Oh crap, didn't realise it would take up that much space! Sorry! But maximum respect to anybody that can be bothered to read it!

[Youngblood]

That was a really good read. Interesting timing too considering we've had a lot of ring related deaths lately, and to professional boxers in general.

I think it boils down to ignorance with preconceived notions of danger, in relation to other sports and %'s of brain injuries, vs risk of reward and life prolonging benefits which you've also covered nicely.

I'm going to read it again shortly, as I'm guessing when you posted it all the paragraphs got pushed together by accident, makin it a bit of a tougher go.

Overall a great read and nice job.

[ryanman]

That was a really good read. Interesting timing too considering we've had a lot of ring related deaths lately, and to professional boxers in general.

I think it boils down to ignorance with preconceived notions of danger, in relation to other sports and %'s of brain injuries, vs risk of reward and life prolonging benefits which you've also covered nicely.

I'm going to read it again shortly, as I'm guessing when you posted it all the paragraphs got pushed together by accident, makin it a bit of a tougher go.

Overall a great read and nice job.

Thanks Youngblood. Yea, i obviously had to be neutral to an extent, but my pro-boxing stance does shine through somewhat! Something which my Prof noticed. And yea it was all pushed together when i posted, when i saw it up i thought 'oh crap!' as it does make it heavy going. Thanks for reading.

[Zelley]

You may like to read my topic Commonwealth Games "Counterpunch For Boxing".

For a PHD or Masters, it is important to consider the topic from all angles.
At some point you need to take a position that you can support.

For actual title bouts - the Griffith vs Paret and Ramos vs Moore bouts of the Sixties are important talking points with significant differences in the causes.
You should consider tragic boxing stories and articles about lost warriors
as points to support various issues.

[Gandalf]

An interesting read, though the layout gave me dizzy spells and I think I might need to lay down for a bit.

There are obviously risks involved with boxing. Sometimes tragedies happen, but I think todays boxing is so much safer than it has been in the past. I would never want to see boxing banned, the risks fighters take are their own and they choose to do it. And I see it as an incredibly brave thing to do and to dedicate oneself to the trade is a means of minimising risks further. Boxing has done a whole lot of good and involving people who just want to fight. I look at people like Barrera, Calzaghe and even Wlad Klit. who have sharp minds and faculties well and truly intact over a career of boxing. I look at someone like James Toney who probably wants to do nothing else with his life ever given the chance. It's a brutal sport, but I don't hear about tragedies day in day out. It's awful when they happen and getting hit in the head cannot be good for you. But it's a way some people choose to live and I can see nothing wrong with that. It's up to them to try and get out before they take too much punishment and I think most fighters know that point eventually. Not my most most coherent post and just a collection of thoughts more than anything.

[CGM]

Cool I havaen't had time to read it yet, but I'll bookmark it for future reference.

What's your take on shortening world title fights from fifteen to twelve rounds. I'm interested in two aspects. Did your research cover that? I'm particularly interested in...

1. Whether or not historical statistics supported the contention that rds 12-15 of title fights were a significant risk factor in overall boxing deaths and injuries in the first place.

2. Whether or not reducing the length of title fights actually brought about a significant reduction in overall deaths and injury.

I scanned your thesis and din't see anything on this. I'm aware of the arguments, I'm more interested in evidence.

[jokaleras]

that's an alright article.

[ryanman]

Cool I havaen't had time to read it yet, but I'll bookmark it for future reference.

What's your take on shortening world title fights from fifteen to twelve rounds. I'm interested in two aspects. Did your research cover that? I'm particularly interested in...

1. Whether or not historical statistics supported the contention that rds 12-15 of title fights were a significant risk factor in overall boxing deaths and injuries in the first place.

2. Whether or not reducing the length of title fights actually brought about a significant reduction in overall deaths and injury.

I scanned your thesis and din't see anything on this. I'm aware of the arguments, I'm more interested in evidence.

Interesting points and you're right, they werent covered in the piece, due to the fact i focused more on communication of Risk rather than mangement. What i did notice during research was that there didn't seem to be any evidence that the last three rounds were proportionaly any more dangerous than any others. The dropping down to 12 rounds was made largely as a concession to organisations such as the BMA. Obviously as the BMA wish to see a complete ban on boxing they would welcome any reduction in a person's exposure to punches, however the reduction to 12 rounds wasn't based on evidence that said '12 rounds is safer'. For the BMA, if they can't reduce the number of bouts then reducing the length of those bouts is of some use. Its a chipping away approach, from 15 rounds to 12, then no doubt there will be calls for 10, 8 and so on.
Its an intersting topic and something which i will look into more.
To be honest the piece i've put up here was rushed somewhat, hence it is far from a complete picture and is sloppy at times.