Shared Responsibility
March 26, 2013
My counterpart in Georgia has a nice way with words, and recently used that talent to add his perspective to topics like those we’ve been addressing here in Michigan. In the March 2013 Georgia High School Association newsletter, under the title “All of Us Must ‘Pay the Price’ for Student-Athlete Wellness,” GHSA Executive Director Ralph Swearingin writes:
“In ‘History and Philosophy of Education’ courses many of us learned that an early concept in the American educational system involved the school operating ‘in loco parentis’ – in the place of the parent. During those early days, that concept was applied to the authority of school personnel to regulate the behavior of students. Over time, however, the application of that concept to school discipline has diminished.
“It is interesting to note that school personnel are called upon to fulfill parental roles in ways that were not prevalent in the past. Over time there has been an evolution of responsibilities placed on the educational system to provide services that used to be provided by the family. One such area involves the responsibility to be the ‘health and safety guardians’ of our students. Debates about whether it is the school’s responsibility are non-productive. This responsibility has been thrust upon member schools and state association staff members, and it is doubtful that this trend is reversible . . .
“The very nature of athletics makes it impossible to guarantee the safety of every student in every sport. The goal is to minimize the risk to these students with prudent preparation and vigilant supervision. While the American culture may be thrusting this responsibility on the school personnel, there are productive ways to send some of that responsibility back to the students and their families.
“. . . Students and their families need to be informed about all of these issues. Preseason meetings with players and parents or guardians should involve the dissemination of information about relevant health and safety considerations . . .
“But education of players and their families is not enough. Coaches must be certain to teach techniques that minimize risks, and to be certain that all equipment used in the sport are in good repair and are being used properly. School personnel need to be certain that published guidelines and protocols are being followed. Doing these things involves the expenditure of time and money, but the well-being of our students dictates that we ‘pay the price.’ ”
Cardiac Screening
October 31, 2014
Sudden death among 12 to 25-year-olds is “a low event rate occurrence.”
“There is insufficient information to support the view that ECGs in asymptomatic young people for cardiac disease is appropriate or possible on a national basis for the United States, in competitive athletics or in the general population.”
“At present, there is no mechanism available in the United States to effectively create national programs of such magnitude, whether limited to athletics or including the wider population of all young people.”
“There is insufficient evidence that particularly large-scale/mass screening initiatives are feasible or cost effective within the current US healthcare infrastructure . . .”
“The ECG . . . cannot be regarded as an ideal or effective test when applied to large healthy populations.”
“An additional, but unresolved, ethical issue concerns whether students who voluntarily engage in competitive athletic programs should have advantage of cardiovascular screening, while others who choose not to be involved in such activities (but may be at the same or similar risk) are in effect excluded from the same opportunity.”
The AHA’s Sept. 14 AHA writing group “does not believe the available data support significant public health benefit from using the 12-lead ECG as a universal screening tool. The writing group, however, does endorse the widespread dissemination of automated external defibrillators which are effective in saving young lives on the athletic field and elsewhere.”