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Concussion crisis "an institutional obfuscation," with current evidence that "far exceeds that of SARS and Tainted Blood epidemics"

andrew bucholtz
McGill professor Margaret Somerville says the concussion crisis is more disturbing (than SARS or the tainted blood scandal) in that it is deliberately an institutional obfuscation.
McGill professor Margaret Somerville says the concussion crisis is more disturbing (than SARS or the tainted blood scandal) in that it is deliberately an institutional obfuscation.

Arland Bruce's ongoing concussion lawsuit alleging negligence by the CFL's teams and other prominent individuals, including outgoing CFL commissioner Mark Cohon and Dr. Charles Tator, has led to some interesting developments. The league and Tator each filed motions to dismiss Bruce's lawsuit in September, and the process is continuing to play out in court. That's far from removed the focus on concussions in  football and how they should be handled, though. In fact, some prominent outside Canadian doctors and professors have weighed in with strong words, with Dr. Paul Echlin of the Burlington Sport Concussion Library (recently profiled in The New York Times) telling Terry Ott in a piece posted at The Concussion Blog that long-term effects from concussions have more evidence for them than notable past epidemics:

“The issue should not be that significant pathology exists after repetitive brain trauma, or that it has short and long-term effects on the individual. Published peer-reviewed evidence for this already exists. As stated in the Neurosurgeon publication the current evidence concerning concussions far exceeds that of SARS and Tainted Blood epidemics,” said Dr. Echlin.

Ott also spoke to McGill bioethical, legal and medical professor Dr. Margaret Somerville, who said concussions are more troubling than those other scandals:

In a phone interview, Dr. Somerville took Dr. Echiln’s comments a first down further, saying that the concussion crisis was “more disturbing (than SARS or the tainted blood scandal) in that it is deliberately an institutional obfuscation.”

“As a public health crisis, SARS could be distinguished from concussion injury, because all precautions were taken to try to avoid the harm of the former and harm that did occur was unavoidable and not intended, and there was no institutional denial or concealment of the danger or injury,” added Dr. Somerville.

Dr. Somerville also said that the concussion issue was “a very big problem from a legal perspective” in that researchers (italics added) and physicians must be “reasonably prudent and ethically legal….with the primary obligation to the best interest of the player.” Adding, “legally the physician must act as a reasonably competent and careful physician of the required type and level of expertise required by the patient’s condition.”

Those comments from both researchers are interesting, especially considering that the medical research under fire in Bruce's lawsuit hasn't appeared to particularly amplify the long-term perils of concussions. At least four former CFL players have been found to have chronic traumatic encephalopathy (CTE), the concussion-linked disease that played such a crucial role in the U.S. concussion lawsuit, including three of the six brains examined by Tator for a study published in May 2013. However, that study was titled "Absence of chronic traumatic encephalopathy in retired football players with multiple concussions and neurological symptomatically.” (Ott discusses that study and Tator's filed document of defence in detail at The Concussion Blog; copies of his statement of defence and other filings are available there too.)

It's certainly true that not every former player with concussions winds up with CTE, but it's notable that other players examined in Tator's study who were found not to have CTE (Tony Proudfoot and Peter Ribbons) died after battling other neurological diseases (ALS and Parkinson's, respectively). Echlin's comments don't necessarily specifically reflect on the research being debated in the Bruce lawsuit, but they indicate that there's substantial scientific consensus on the disastrous short and long-term effects of concussions, which Bruce is arguing that the CFL and its teams didn't do enough to inform him of.

Bruce's claims haven't been proven in court, and the CFL is arguing that it's done lots to inform its players of the risks of concussions and take precautions to prevent them, including a nationwide summit in 2011 that developed a standardized return-to-play protocol. Whether that protocol is always followed is up for debate, though, as Bruce alleges it wasn't with him, and we've seen plenty of other questionable cases over the years. In the NFL in particular, a key part of the concussion lawsuit was that the league knew the dangers and didn't inform players or take steps to manage concussions properly. That's going to be debated in Bruce's case as well.

It definitely hasn't been proven in court yet that the CFL engaged in "institutional obfuscation," and comments from researchers who haven't as yet been linked to this court case may not wind up meaning anything in the end. However, the tone and strength of the statements by Echlin and Somerville is certainly worth noting. It's going to be interesting to watch how the Bruce court case goes (as well as the potential other cases waiting in the wings), but regardless of the eventual outcome there, it's clear that the concussion epidemic is an issue the CFL (and other sports leagues, both amateur and professional) will be dealing with for a long time.