Sports medicine professionals are facing new dilemmas in light of the changing dynamics of sport as an enterprise. These changes have considerable ethical implications as sports medicine team members are placed in challenging ethical decision-making situations that often create values tensions. These values conflicts have the potential to threaten and degrade the trust established through the mutual expectations inherent in the social contract between the health care providers and society. According to Starr,1 the social contract is defined as the relationship between medicine and society that is renegotiated in response to the complexities of modern medicine and contemporary society. Anchored in expectations of both society and the medical professions, this tacit contract provides a strong compass for professional practice as it exemplifies the powerful role and examines the deep responsibilities held by health care providers in our society. Although governed by professional boards and organizational codes of ethics, sports medicine professionals are challenged by the conflicts of interest between paternalistic care for the athlete and autonomous decisions often influenced by stakeholders other than the athletes themselves. Understanding how the construct of sport has impacted sports health care will better prepare sports medicine professionals for the ethical challenges they will likely face and, more importantly, facilitate awareness and change of the critical importance of upholding the integrity of the professional social contract.
Kimberly S. Peer
Values guide behaviors, and consistent behaviors guide practice. Professionals are bound by social contracts to provide high-quality services with the interest of the patient as the primary consideration. Most healthcare professions have a codified standard for ethical behavior, however, the manifestation of ethical decisions can violate the social contract if not carefully considered. Healthcare professions have experienced considerable empathy decline and moral distress both in professional preparation and clinical practice. These emerging trends have created concerns about the structure and function of ethics education in the health professions. Several conceptual, pedagogical strategies have been promoted to engage learners in purposeful reflection about ethical dilemmas. Healthcare educators need to consider different strategies for encouraging ethical reflection and engagement to prevent moral distress and empathy decline. Various pedagogical strategies are discussed with a conceptual framework proposed for reconsidering ethics education in healthcare professions.
Lisa Custer, Kimberly S. Peer and Lauren Miller
Muscle fatigue and acute muscle soreness occur after exercise. Application of a local vibration intervention may reduce the consequences of fatigue and soreness.
To examine the effects of a local vibration intervention after a bout of exercise on balance, power, and self-reported pain.
Single-blind crossover study.
19 healthy, moderately active subjects.
After a 30-min bout of full-body exercise, subjects received either an active or a sham vibration intervention. The active vibration intervention was performed bilaterally over the muscle bellies of the triceps surae, quadriceps, hamstrings, and gluteals. At least 1 wk later, subjects repeated the bout, receiving the other vibration intervention.
Main Outcome Measures:
Static balance, dynamic balance, power, and self-reported pain were measured at baseline, after the vibration intervention, and 24 h postexercise.
After the bout of exercise, subjects had reduced static and dynamic balance and increased self-reported pain regardless of vibration intervention. There were no differences between outcome measures between the active and sham vibration conditions.
The local vibration intervention did not affect balance, power, or self-reported pain.