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It is in the nature of medical practice that it is always likely to yield ethical problems because of the role that health, illness and injury play in the lives of patients. Sports physicians can find themselves in particularly difficult (though not unique) contexts because of the role of the body in athletic performance, especially at elite and professional levels. Contrary to recent articles,1,–,4 however, Sports Medicine should not be viewed as giving rise to distinct or unique ethical difficulties. Such difficulties as arise in Sports Medicine merely reflect the kinds of challenges and dilemmas (eg, confidentiality, conflicts of interest, consent, disclosure, working with vulnerable populations) as are found in other branches of medicine, though not necessarily in precisely in the same configurations.
One common professional response to the recognition of ethical demands and professional ambiguity is to establish codes of conduct such as those published by the American College of Sports Medicine (ACSM),5 the Australasian College of Sports Physicians (ACSP),6 the International Federation of Sports Medicine (FIMS)7 and the Faculty of Sport and Exercise Medicine (FASEM).8 Within the literature of applied ethics,9 sports ethics10 and sports medicine ethics,11 the limitations of these codes as instruments of education, guidance and punishment have long been noted.
Most recently, within BJSM, the ACSP has presented and defended their new Code within the broad aim of contributing to the development of a professional community of practitioners.12 One of the merits of the Code that the article draws attention to is the articulation of standards of expectation, differentiating among other things between those actions that are, on the one hand, compulsory from exhortations to best practice on the other. (They capture the distinction in ‘must’ and ‘should’ statements.) Nevertheless, that code …
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