Thoughts on the ethics of medical hardships

Submitted by Erik_in_Dayton on

I was like many Mgobloggers yesterday in being unhappy to learn of the acrimonious end of Ondre Pipkins’ career at Michigan but also uncertain of whether the coaching staff did anything wrong.  Regardless of the specifics of Pipkins’ situation, it raises this difficult question: When is it appropriate to for a player to take a medical hardship?  Edit:  I presented the question I addressed below poorly.  The question is:  When - if ever - is it appropriate for a program to try to impose a medical hardship on a player?  The analysis below is from the point of view of the school.  I thought that was obvious, but it was not.

I think we can all agree that a medical hardship is appropriate when a player, his doctor(s), and the coaching staff all determine that the player cannot or should not play football again.  This is the Platonic ideal of medical hardships.  It doesn’t require discussion, because of what I assume to be a consensus on its propriety.

Reality rarely fits, though, so neatly into such a category.   It is uncommon, as far as I know, that a player becomes incapable of playing football in the most literal sense.  Antonio Bass stands out to me as the only player I know to have left Michigan while being truly unable to carry out the basic functions of a football player.  We are accordingly left to sort out what a program ought to do regarding a medical hardship when faced with various shades of grey.

To help think about medical hardship situations, I refer below to an imaginary player, Player X, who plays wide receiver for State University (“SU”), a major-conference Division 1 team.  When uninjured, he has the speed to be a deep threat, runs good routes, has good hands, and is a willing and capable blocker.  It is realistic to believe that he can catch 75 passes for 1,200 yards.  To make this all easier, assume that he is neither a positive nor a negative presence in the locker room.

To further help think about medical hardships, I list below a series of situations in which Player X suffers an increasing accumulation of injuries but – crucially – does not want to leave the team.  I’ve done this because I think considering plausible scenarios – but not real players who played for schools we may like or dislike – keeps us grounded in reality but not so grounded that we make choices based on our fandom.  Many injured players will not fit exactly into the situations I describe, but I believe I’ve broadly covered the possibilities. 

A final thought before we start: When thinking about what SU should do when Player X has suffered an injury or injuries, we have to consider SU’s ethical duty to Player X, to its competitors, and to its own program.  The need for SU to consider its duty to Player X is obvious.  It may be less obvious (to an Alabama fan) that SU has to consider the rightness of its actions in relations to its competitors, but it does.  A team that removes injured players from its 85 man roster more liberally than its competitors will likely have an advantage over them in terms of talent (thus the long-time complaints about Nick Saban).  Finally, I think SU has at least some ethical duty to its program – its coaches, players, etc. – when considering whether to give a player a medical hardship.  We can at least imagine a player or players who insist they can still play despite the fact that they have no realistic chance of contributing and who become, at the risk of being crude, dead weight that takes up reps, time in the weight room, scholarships, and fall camp slots* that could go to players who can help the team win.

 

*Poster Reader 71 pointed out yesterday that the NCAA limits you to having 105 total players – scholarship or walk-on – in fall camp. 

 

All of that having been said, on to the hypothetical situations:    

Situation No. 1: Player X suffers an ACL tear, and he can now realistically be expected post-recovery to catch 50 balls for 500 yards in a season. 

I think the vast majority of us will agree that SU owes a duty to Player X to keep him on the team here.  50 catches for 500 yards are the numbers of a very valuable player even if they are not as good as those Player X could have produced pre-injury.  And we have to assume that he still takes satisfaction of some sort in playing football.  We can hardly say that he has broken any obligation to the program by “only” gaining 500 yards or that he is not still benefitting from being on the team.    

I think the vast majority of us will also agree that SU would be violating an ethical duty to its competitors by pushing Player X out the door in this case if it did so to replace him with a better player.  I’m not sure anyother program would cut Player X here (maybe Tom Crean if this were basketball), but we can certainly say that most would not and that pushing him out here would violate the intent of the medical hardship rule.  SU, then, would at least potentially gain an unfair competitive advantage by cutting Player X to make room for, say, an all-everything high school wide receiver or an All-American wide receiver transferring from another school. 

As for SU’s duty to its program in this case, Player X could possibly be replaced by a better player, but he is hardly a non-contributor.  Cutting him and replacing him with a better player would improve the talent on SU’s team but also likely hurt team chemistry and player morale. 

Considering all of SU’s ethical duties in this case, it’s easy to say that they should keep Player X.  Using a medical hardship in this instance would be wrong.

 

Situation No. 2:  Player X suffers yet another knee injury and can now realistically only be expected to catch 25 passes for 250 yards.

I think the vast majority of us will still agree that SU owes a duty to Player X to keep him here just as they did in Situation No. 1.  The same reasoning applies despite the fact that Player X is less valuable than he was before.  25 catches for 250 yards is a nice contribution even if it likely won’t get you on an honorable mention all-conference list.  It’s also still the sort of contribution a player presumably takes pride in making.  Player X has not broken any duty to SU that would allow them to impose the end of his playing days, and football is likely still rewarding to him.   

I think the vast majority of us will also still agree that SU owes a duty to its competitors not to cut Player X to make room for a better player in this instance.  The same reasoning that applied in Situation No. 1 makes sense here.  Rule-abiding teams do not get rid of guys who can catch 25 passes.

As for SU’s duty to its program here, the same reasoning applies as applied in Situation No. 1, though I think we have to concede that – all things being equal – team morale will take less of a hit when a player who catches 25 balls is pushed off the team than when a player who catches 50 balls is pushed off the team.  The player with 25 catches is less obviously succeeding, and so it is easier to find logic in getting rid of him (even if that logic seems more misguided than not).  And I think we have to concede that a potential replacement of the 25-catch player has a better chance of improving the production of SU’s wide receiver position than would a replacement of a 50-catch player (the replacement of the 25-catch player only has to catch 26 passes for there to be an improvement).  So the team is more likely to lose out on increased production by keeping the 25-catch player than it is by keeping the 50-catch player.    

Considering all of SU’s ethical duties in this second situation, it is still fairly easy to say that SU should keep Player X on its roster here.  A replacement of Player X who is better than him could be found somewhat easily, but that consideration is trumped by all the others by a wide margin. 

 

Situation No. 3:   Now things get a little harder.  Player X tears an Achilles.  He can only be expected post-injury to catch 10 passes for 75 yards, serve as a decent blocker, and play a bit on special teams.

My guess is that Mgobloggers are somewhat divided over a case like this.  I believe, though, that the reasoning of Situations 1 & 2 still applies here as far as SU’s duty to Player X.  10 catches for 75 yards is not a lot, but it’s still a contribution.  And Player X made no promise when he accepted a scholarship that he would play football with any particular degree of success.  He also likely feels some satisfaction in what he provides to the team.

As to SU’s duty to its competitors here, I believe it would still be an unfair competitive advantage to dump Player X in this situation.  We might say that a player who is only going to grab 10 passes for 75 yards didn’t pan out, but not all players pan out.  And the medical hardship rule was not designed – nor is it generally used – to allow teams to cut a player simply because he might be considered a bust. 

As for SU’s duty to its program in this situation, I think we have to conclude that dropping 10-catch Player X will hurt team morale but – all things again being equal – not hurt it as much as dropping 25-catch Player X would.  It is relatively easy to see 10-catch Player X as having failed and therefore to rationalize his departure.  It is also the case that replacing him with a wide receiver who can out-perform him will be that much easier than it was for 25-catch Player X.

Balancing all of SU’s ethical duties here, I believe SU must keep Player X on the roster.  He is not giving SU a great deal, and he could likely be replaced by someone who would help the team more.  But SU would be violating the agreement it made with Player X when it offered him a scholarship to play football, robbing him of a still-rewarding experience, and gaining an unfair advantage over other schools.

 

Situation No. 4:   Now we will certainly be divided.  Player X tears a hamstring and suffers an MCL tear and ACL tear to his other knee.  He is capable of running routes in only the most literal sense, and he is a poor blocker.  He gives 100% effort at all times, but he produces no more than a good intramural player off the street could.

SU’s duty to Player X in this instance is difficult to pin down.  They offered him a scholarship to play D1 football.  He can now do so in a literal sense, but he will never contribute to a win.  We could thus arguably say that Player X now has – through no fault of his own – reached a point at which he is failing to live up to his end of the scholarship-for-play bargain.  And it also becomes fair to question how rewarding football could still be for Player X, though it is ultimately only Player X who can make that determination.

SU’s duty to its competitors here is also hard to determine.  Is the medical hardship rule generally taken to mean that a player like Player X can be pushed into leaving the roster?  My sense is that it is, and this is partly informed by posts by Reader 71, who played at Michigan. 

SU’s duty to its program, when considered in isolation, points toward pushing Player X to take a medical hardship.  Every practice rep that he takes could go to a player who might help the team win.  And his scholarship could be used for a player who could help the team win.  There would presumably be some morale loss by pressuring him into a medical hardship, but it would be relatively easy for players to rationalize this action.

When balancing the above considerations, I still lean toward believing SU would be wrong to force Player X to take a medicalhardship.  As I noted regarding Situation No. 3, Player X never promised to play football with any particular success.  And we have to assume that being on the team is still rewarding for him even if an outside observer might question that, because the cost to him of staying on the team in terms of time and energy spent is very high.  He is being rewarded – at least in a subjective sense – by remaining on the roster, or he is self-destructive, and we have no right to assume the latter.

SU seemingly wouldn’t gain a competitive advantage by cutting Player X, and the program as a whole would benefit from removing him from the roster.  But my instinct – and I admit this is a conclusory statement – is that SU’s ethical duty to Player X is more important than its ethical duty to the rest of its program within the context of considering his scholarship.  I do not feel particularly strongly about this, though, and readily admit that I may be discounting the wellbeing of the program as whole.

Another thought:  The question of whether Player X has a duty to his teammates to take the medical hardship here is an interesting one, though one I don’t have time to take up.

 

Situation No. 5:  Player X suffers multiple concussions, a neck injury, or something similarly serious.  He can play post-recovery, but his doctors tell him he is at risk of experiencing a lifetime of unpleasant and debilitating symptoms if he endures another injury of the same type.

I believe SU is free to take a paternalistic approach here and tell Player X that, while he is free to transfer and risk his health with another program, they are not going to watch him leave the field on a cart in an SU uniform.  If the coach of SU wants no part of Player X having to spend years sitting in a dark room because, like former New York Jet Al Toon, he becomes dizzy and experiences terrible pain if he stands or sees light, then the coach is free to tell Player X that he has to play elsewhere if he is to play at all.

If SU is willing to keep Player X on the roster, then I think they at least owe him a duty to explain to him the potential risks and the potential rewards of continuing to play football.  Perhaps a potential top-10 pick could rationally choose to continue to play even if he faced, say, a 25% chance of paralysis.  But he should make that decision with as must information as possible.

There is no problem here as far as SU’s duty to its competitors.  A great many programs would, I think, push Player X into a medical hardship here.

As far as the program as a whole, the question hinges in part on how well Player X can play.  Can he still gain 1,200 yards?  Then the program obviously benefits from keeping him around.  Can he only gain 75 yards?  Then the program might gain by being rid of him.  But regardless of his remaining ability, it is worth considering the potential damage to the program in terms of morale and image that would result from having a player seriously hurt (consider the Shane Morris incident last year).

The issue of how well Player X can play, though, is very small in relation the potential that he suffers a debilitating injury.  The consideration that dwarfs all others is whether he ought to risk his health in order to gain from remaining on the team and potentially playing professional football.

 

Summary:  This isn’t an easy issue. Some cases will be black and white, but the right answer is often unclear – and arriving at it requires a good deal of detailed information about the given situation.  I lean toward believing programs should keep players on their rosters in almost all instances, but there is room for reasonable argument as to when exactly they are not required to do so. And there may even be cases in which a program should force a player to take a medical hardship.

Comments

Reader71

June 30th, 2015 at 8:46 PM ^

I dont think OP is proposing any new system. He is trying to describe what actually happens, every day, in every program, right now. And he's on to something. If you really think that coaches dont weigh these concerns ever time a guy gets injured, you are naive. Again, there is nothing nefarious in most of these situations. The two year starting QB will get every opportunity to heal up and come back, whereas the 13th best OL will be on a shorter leash. That's just how it goes.

gbdub

June 30th, 2015 at 2:54 PM ^

In Pipkins case in particular, has the guy ever been able to play more than a few games without a significant injury? Yeah, bad luck and all that, but for whatever reason he seems particularly high risk for future injury, and it sounds like he's not, and won't be, 100% from his previous injuries any time soon. Obviously this sucks for him, but it's hard to blame the coaches and med staff for looking at that history and saying, look, this just isn't a good risk to take.

Again, Pipkins is a highly rated guy at a spot we need help, and Michigan hasn't been particularly profligate with medical hardships in recent years, so the benefit of the doubt seems fair.

Honestly the OSU and Alabama stuff DOES seem objectively shadier, in that we can point directly to a "replacement" player, and some of the guys getting bounced were performing recently with no obvious injury. Vs. Pipkins where he probably won't be immediately replaced, except maybe by a walk-on, and we know for a fact he's gone down with multiple injuries.