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).
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