This month’s issue of Virtual Mentor, the AMA’s online ethics journal, examines the physician’s role in supporting athletes in their endeavors while discouraging risky behavior. 

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Whether the goal is winning, adventure, exercise or just fun, engaging in athletic activity exposes patients to various degrees of harm. Physicians frequently confront ethical challenges in their relationships with athletes and parents of aspiring competitors—whether in weighing the risks and benefits of high school football, clearing an amateur adventurer for a strenuous climb or managing requests for performance-enhancing substances.

Authors of articles in the July issue of Virtual Mentor share their vast knowledge and experience about how those challenges can best be met.

Highlights from this issue include:

  • Addressing concussion in youth sports.” Author Kevin D. Walter, MD, examines one of the greatest concerns in sports medicine today. Dr. Walter explains that one major difficulty in collecting data on which to base injury prevention strategies is the lack of large epidemiologic studies or comprehensive injury surveillance.
  • Drug testing in sport: hGH (human growth hormone).” In this piece, Gary A. Green, MD, surveys state-of-the-art sports drug testing, including its limitations. The only studies in which hGH was shown to have a positive effect on athletic performance were in anabolic steroid users, so testing for hGH alone may not accomplish the intended goal.
  • A patient’s request for steroids to enhance participation in wilderness sport and adventure.” This case commentary by Christopher Madden, MD, Aaron D. Campbell, MD, and Jessica Pierce, PhD, concludes that the use of medication for the prevention and treatment of life-threatening altitude-related illness is very different, medically and morally, from the use of medication to enhance performance. 
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