Objective Testing of Sports Injuries and Informed Consent

Although the sports medicine community has notdiscover a medical condition that later resulted in injury
come to a consensus, there are two methods ofor death.
objective testing that may satisfy the reasonablenessInformed Consent
test: neuropsychological testing and postural stabilityGenerally the law has found that physicians who
testing.conduct a thorough pre-participation examination in
Neuropsychological testing measures the athlete'sconformity with accepted standards of practice are
cognitive flexibility, attention span, orientation,not liable for the athlete's injuries that occurred post
concentration, visual-spatial capacity, distractibility,examination.
immediate memory recall, and problem-solving abilities.Sports medicine professionals should always consider
These tests directly measure the cognitive qualitiesthe intensity and physical demands of the athlete's
that are affected by head injury and allow athleticsport, all objective clinical evidence, and the probability
trainers to objectively evaluate the athlete's condition.and severity of harm from athletic participation given
The administration of these tests generally occurs in athe athlete's condition. Failure to provide an athlete with
clinical setting, although recent research indicates thatfull disclosure of material information about playing a
athletic trainers may also administer neuropsychologicalsport with a medical condition or the potential
tests on the sidelines and achieve valid results. Theconsequences creates liability for negligence. This duty
National Football League and National Hockey Leagueto disclose relevant information relates to the issue of
currently use neuropsychological testing to assessinformed consent.
professional athletes' cognitive abilities, establishing thatInformed consent is usually a defense for assault and
it is reasonable to employ these tests as a standardbattery, but courts have translated this concept into
for assessing, treating, and making return-to-playnegligence terminology. Informed consent comes from
decisions.the public policy that a competent adult has the legal
Similarly, researchers have established that posturalright to determine what to do with their body. As such,
stability tests are reasonable to use in determiningadults may provide consent, but minors require consent
when symptoms of concussion cease. Theseby a parent or guardian.
objective tests use sophisticated force plate systemsThe consent must represent an informed decision
to challenge sensory systems involved in balance byregarding the risks of treatment and participation. For
altering visual and support surface conditions.an athlete's decision to be informed, the sports
Although it may not be reasonable to expect themedicine professional must clearly warn of all material,
average athletic trainer to have access to this type ofshort-term, and long-term medical risks of continued
equipment, research indicates that there is a significantathletic participation under the circumstances. Athletic
correlation between the results of simple tests that thetrainers and team physicians can share liability if more
athletic trainer can conduct on the sideline and thethan one person, other than the athlete, contributed to
results of sophisticated postural stability tests.any injury.
One of the reasons that athletic trainers rely so heavilyIf negligence can be associated to a sports accident
on subjective measures and personal intuition whenor injury there are potential damages, which the injured
evaluating an athlete with a head injury is that theyparty can collect. The athlete must prove by a
have nothing for comparison. Athletic trainers andpreponderance of the evidence that a breach of
team physicians routinely conduct pre-participationsome type was in fact the legal cause of the injury.
examinations to determine if an athlete has a conditionIn a negligence case, the injured party generally seeks
that would preclude participation in sports.financial damages for the following areas: past,
Although reported legal decisions provide little guidancepresent, and future pain and suffering; past, present,
regarding the appropriate nature and scope of aand future medical expenses; and past, present, and
standard pre-participation examination, many lawsuitsfuture diminution of earning cap.
allege that the sports medicine professional did not