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Risk, Regret, and Sport

photograph of two soccer players competing in air for ball

The legendary soccer player Denis Law recently announced that he has been suffering with dementia for several years. Law attributes his dementia to heading soccer balls. We’ve known for decades – in 2002 Jeff Astle’s death from dementia was linked to heading – that there is a link between heading and brain damage.

Other sports face similar issues. American football’s problem with Chronic Traumatic Encephalopathy (CTE) is well documented. CTE can lead to, amongst other things: aggression, depression, and paranoia that can arise in people in their 20s; it also can bring memory loss, dementia, and eventually death. Other sports like rugby and hockey also have links to CTE, and they have their own problems with brain damage.

Broadly, people who partake in sports that involve collisions (including things like headers) are at risk of brain injury. This is true especially when playing at higher levels of competition (as opposed to playing occasional pickup games), where impacts are bigger and players spend more time playing their sport.

How should players think about this risk? Last year, Jamie Carragher, a former top-level player for Liverpool FC and current pundit, said: “If I suffer from dementia in my old age and research suggests that is because of my football career, I will have no regrets.” Carragher recognizes that we are now better informed about the risks and need to make changes to minimize the risks (here is one: fewer headers in training), but he thinks the risks are still worthwhile, and that we must keep some of the risky elements in football: players should still be able to challenge each other in ways that risk sickening head-clashes.

I think Carragher’s thoughts are widely shared. Playing soccer, or rugby, or football is worth the risk of dementia later in life, so much so that players won’t regret playing their sport. But I think this line of thought rests on some troubling assumptions.

The first is the temptation to make a false comparison between the ordinary risks of sport and brain damage. We should obviously grant that some injuries are acceptable risks. I played rugby for over a decade, and I spent several months with sprained ankles and bad shoulders. It’s no surprise that I now occasionally get the odd ache. Almost every sport carries some risk of injury, and if we grant (as I think we should) that playing sports can be a meaningful part of our lives, these risks should not get in the way of us playing. When Carragher says that “there was a danger of injury every time I played,” he is right, but he misses the point. These brain injuries are not the same as (to take his example) a broken leg. They are highly damaging – far more long-term and life-changing than a broken leg usually is.

This leads to a deeper point. Living with dementia can involve a loss of awareness, a loss of memory, and confusion; CTE can lead to personality changes. We might reasonably think of these as transformative experiences. L. A. Paul developed the notion of a transformative experience. To take one of her examples, it’s impossible to know what it is like to be a parent – what it is to love your offspring, what it is to have such a particular duty of care – before becoming a parent. We can only know what it is like to be a parent by becoming a parent. But that means that choosing to become (or not become) a parent is always shrouded in ignorance. (Her other major example is becoming a vampire: we can’t tell what it will be like to be immortal creatures of the night.)

Perhaps the decision to play a sport that might lead to a serious brain injury involves some element of a transformative experience: you can’t know what your life would be like if you had CTE or dementia – confused, with a ruined memory and a changed personality – so perhaps you shouldn’t be so keen to declare that you won’t regret it. You might not feel that way when dementia takes its grip.

Here is another problem. Carragher’s line of thought also assumes that regret lines up with justification. That is to say, if you won’t regret something, then you were justified in taking that risk – you were right to do it. But, as R. Jay Wallace has argued, this isn’t always the case. In Wallace’s example, a young girl might get pregnant. She was far too young, and both she and her child would have had a better time of it had she waited several more years. Her decision to have a child was unjustified. Yet she surely cannot regret her decision: after all, she loves this child.

It isn’t surprising that people who have dedicated decades to their sports – sports that make their lives meaningful – won’t regret what they have done. But that doesn’t mean they made the right choice. There are plenty of other meaningful options out there: like taking up sculpting, squash, or chess.

Yet thinking about regret and justification also brings up something in favor of taking these risks: some people will have nothing to regret at all because brain damage is far from guaranteed, even in football. Bernard Williams argued that we might sometimes take a risk and that risk will be justified by the results. If you abandon your wife and children to set off on a career as a painter, you might have made a grave error if you fail in your career – but perhaps it will all have been worth it if you succeed. Likewise, Carragher, if he avoids dementia, might have been perfectly justified in playing soccer. Others might not be so lucky.

Sports play a meaningful role in many of our lives, and we are all happy to live with some level of risk. But we shouldn’t just say: “I won’t regret playing, even if I get dementia.” To note that you wouldn’t regret playing just because of a broken leg is to compare chalk and cheese; we don’t really know what our lives would be like with dementia, so we shouldn’t be confident in such assertions; and even if we end up with no regrets, that doesn’t mean we did the right thing. This discussion requires serious conversations about risk management and the meaningfulness of sport – it shouldn’t be conducted at the level of glib sayings.

Sha’Carri Richardson and the Spirit of the Game

photograph of blurred sprinters leaving starting blocks

Sprinter and Olympic hopeful Sha’Carri Richardson made headlines recently when she was suspended from the US women’s team after testing positive for THC, a chemical found in marijuana. Using marijuana is in violation of the World Anti-Doping Agency’s (WADA) World Anti-Doping Code, which includes “all natural and synthetic cannabinoids” on its prohibited list. Richardson has accepted responsibility for violating the rules, and while she stated that she is not looking to be excused, she explained that learning about the death of her biological mother and the subsequent emotional suffering was the reason why she used marijuana, despite knowing that it is a prohibited substance.

Many online expressed their confusion as to why Richardson should be reprimanded so harshly as to potentially miss the upcoming Olympic games, as well as why THC would be on WADA’s list of banned substances in the first place. For instance, while WADA’s justification for including THC on its list of prohibited substances is that it “poses a health risk to athletes, has the potential to enhance performance and violates the spirit of sport,” many online have pointed out that it is debatable as to whether it poses health risks to athletes (especially when compared to other substances which are not the prohibited list, such as alcohol and cigarettes), and that it is a stretch to say that it could enhance one’s athletic performance.

What about marijuana usage violating “the spirit of the sport”? WADA defines this notion in a few ways: as the “intrinsic value” of the sport, “the ethical pursuit of human excellence through the dedicated perfection of each Athlete’s natural talents,” and “the celebration of the human spirit, body and mind” which is expressed in terms of a number of values like “health,” “fun and joy,” “teamwork,” etc. Let’s focus on the second one: what might it mean to “ethically pursue” human excellence in the way that WADA describes, and did Richardson fail in this regard?

Unfortunately, the WADA Code does not go into details about what is meant by “ethical.” Perhaps the example of an unethical pursuit of human physical excellence that comes immediately to mind is the use of anabolic steroids: the use of such substances may be considered unethical as they represent a kind of shortcut, providing a distinctly unnatural way to enhance one’s talents. Other substances on WADA’s banned substance list potentially provide routes to excellence in sports in more subtle ways: for instance, beta-blockers – which reduce blood pressure and make one’s heart beat more slowly – provide a seemingly unnatural advantage when it comes to sports like archery and shooting. One way to violate the spirit of the sport, then, may involve taking shortcuts to physical improvement and the overcoming of physical obstacles.

As we have seen, however, marijuana does not provide any performance-enhancing effects to sprinters, and indeed is likely to be detrimental, if anything. It is clear that Richardson’s use of marijuana is thus not unethical with respect to taking shortcuts.

Presumably, though, there are more ways to fail to ethically pursue excellence in athletics than using performance-enhancing drugs. For example, if I were to consistently berate my teammates for failing to meet the standards of my supreme physical prowess in an attempt to get a higher spot on the roster, I would presumably be acting unethically in a way that violates the spirit of the sport, as I would be violating numerous values on WADA’s list (I would not, for example, be exemplifying the value of “fun and joy”). Another way to violate the spirit of the sport may thus involve an attempt to succeed by deliberating and intentionally thwarting others in a way besides simply being better at some given competition.

Again, it seems clear that using marijuana to help cope with the emotional pain of a personal tragedy also fails to fall into this category. What about the celebration of “the human spirit, body, and mind”? Maybe one could reason in this way: smoking pot is a trait possessed by the lazy nogoodniks of society, not Olympic athletes. Pot-smokers are not out there training every day, pushing themselves to their physical limits in the pursuit of excellence; instead, they are sitting on the couch, eating an entire pan of brownies, and giggling to themselves while watching Arrested Development for the tenth time. This is the kind of person who does not celebrate the human spirit, or body, or mind.

While this is a caricature, it is perhaps not far from WADA’s own reasoning. For instance, in a recent guidance note, WADA clarified that it identifies some “Substances of Abuse” on the basis of their being “frequently abused in society outside the context of sport.” In addition to marijuana, cocaine, meth, and ecstasy make the list of Substances of Abuse. None of these drugs offer any obvious performance enhancing effects, and it is unclear why they would be included on the list besides the stereotype that the kind of people who use them are, in some way, “bad.” It is unclear, however, why using a drug that can be abused outside of the context of sport should be considered in violation of the spirit of the sport if one is not themselves abusing it.

There are potentially many more angles form which one could approach Richardson’s suspension – for instance, in a tweet Alexandria Ocasio-Cortez highlighted how marijuana laws in the U.S. reflect “policies that have historically targeted Black and Brown communities,” that such laws are beginning to change across the U.S., and that marijuana is legal in the state in which Richardson used it. While there is no doubt that Richardson violated WADA’s rules, it also seems clear that there is good reason to revise them. Indeed, by WADA’s own standards, Richardson’s actions were not unethical, and did not in any way violate the spirit of the game.