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Concussions in Collegiate and
Professional Football
Overview
The storm had been brewing for several years, and by 2018, football player concussions had become a
hotly discussed topic—both on and off the field—as football organizations were scrambling to reduce the
incidence of head injuries, and players became increasingly active in attempting to redress their injuries.
In 2016, the Centers for Disease Control estimated that between 1.6 million and 3.8 million concussions occured
in sport activities each year. Not everyone accepted the connection between concussions and brain injury, despite
an increasing volume of studies, and publicity that moved the contact sport–brain damage issue to center stage
in athletics. Although some refused to accept the link between concussions and brain damage, in October 2015,
an HBO Real Sports/Marist Poll found that the majority of Americans were aware of the football and long-term
brain injury correlation. About a third of those surveyed said the potential for brain injury would make them less
likely to permit a son to play football. According to the Sports & Fitness Industry Association, between 2009 and
2014, participation in football declined by 3.7 percent, perhaps related to increasing awareness of the dangers. A
reason that more professional football players were retiring early was new information surrounding concussion
statistics and brain damage resulting later in life.
As recently as 2013, a concussion study funded by the NFL and conducted by the Institute of Medicine reported
that it was unclear whether repetitive head injuries led to long-term brain disease. The study found that high
school players (11.2 per 10,000 games) were about twice as likely to sustain concussions as were college players
(6.3). According to the study, in most cases, symptoms of concussion disappeared within two weeks; however,
symptoms persisted for weeks, months, or years for 10 to 20 percent of individuals. More alarming, the study
identified an athletic culture that repressed self-report of concussions. Athletes believed that the game and their
team were more important than their health and, consequently, they played with a concussion rather than let
down the team, coaches, school, and parents.
: Who Has
Responsibility to Protect Players?*
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Lawsuits against schools, athletic associations (NCAA, NFL, NCAA conferences), and helmet manufacturers
became common, and lawyers solicited concussion cases, fighting among themselves for positions in court
as concussions became a next big plum for the legal community. The NCAA and NFL scrambled to provide
increased concussion protection for players and rules were amended to reduce head injury. Legal expenses and
compliance costs soared as schools, teams, associations, and helmet manufacturers were faced with increasing
expenses to develop and implement concusson management plans and deal with the attacks.
In May 2018, as off-season workouts were beginning for the NFL players, in the midst of the rabid rush of
lawyers filing class action lawsuits attempting to collect millions of dollars, a clear question emerged: Who was
responsible for brain damage due to football concussions? Was it the colleges and their teams, the NCAA and
NFL, helmet manufacturers, or the athletes themselves? If an athlete capable of being in college, or at the age
of adulthood, made the conscious decision to play football after being made aware of the risks associated with
concussions, should he be able to collect purported damages from others?
There is ample detail in the case for students to evaluate and discuss:
The schools of thought of ethical behavior
The impact of organizational culture on an ethical issue
The relevant macro-environmental factors that may affect an ethical issue
Suggestions for Using the Case
This brand new and highly interesting case should generate considerable student interest, and provoke spirited
class discussion about the ethics of the football concussion issue. Students will be familiar with the problem of
football concussions, some will know football players, and you may have players in your class; consequently,
there will be considerable first-hand knowledge of the issue. There will be varying opinions of the problem
ranging from ‘athletes are adults and should be allowed to play contact football if, when, and how they wish’, to
‘football should be banned because it cannot be made safe’.
This case traces the concussion issue from the initial awareness of the problem, through the most recent attempts
to reduce the frequency and magnitude of head injuries. Because of the wide publicity of the football concussion
problem, and the students’ familiarity with college football (and likely the NFL also), this case presents a unique
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Students are especially interested in the ethics and practicality of continued efforts to reduce the head trauma/
concussion/CTE problem: invariably there will be a group of students who believe that additional restrictive
rule changes will reduce contact football to “flag football” and consequently destroy the popularity of the sport.
The most interesting part of using this case is the attempt to link the concussion problem to ethics: why is it an
ethical issue for football and not NASCAR, professional rodeo, boxing, cage fighting, judo, soccer and lacrosse?
Video for Use with the Concussions in Collegiate and Professional Football: Who Has
Responsibility to Protect Players? Case. There is a 2018 YouTube video interview with Brett Favre that you
may wish to show in class or have students view on their own. The 12:14-minute video entitled “Brett Favre on
Making Football More Safe: Don’t Play” can be accessed at https://www.youtube.com/watch?v=IG7FdapKwck.
In our experience, it is quite difficult to have an insightful and constructive class discussion of an assigned
case unless students have conscientiously made use of pertinent core concepts and analytical tools in preparing
substantive answers to a set of well-conceived study questions before they come to class. In our classes, we
To facilitate your use of assignment questions and making them available to students, we have
posted a file of the Assignment Questions contained in the instructor resources section of the
Connect Library for the 22nd Edition.
Utilizing the Guide to Case Analysis. If this is your first assigned case, you may find it beneficial to have
class members read the Guide to Case Analysis that follows Case 32 in the text and is also available in the
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Suggested Assignment Questions for an Oral Team Presentation or Written Case Analysis.
We believe the “Concussions in Collegiate and Professional Football: Who Has Responsibility to Protect
Players?” case is very well-suited for written assignments and/or oral team presentations. Our suggested
assignment questions are as follows:
NFL Commissioner Robert Goodell has employed you as a consultant to assess the ethical implications
of the football concussion problem, how the problem could impact the NFL, and what actions the
league could take to deal with any ethical issues arising from the concussion issue. Prepare a report to
Prepare a brief report to the Presidents and Athletic Directors of NCAA schools which sponsor contact
football, that evaluates the basis (which ethical standards best fit the situation) of the ethical component
Assignment Questions
1. Consider the three schools of thought regarding ethical standards. Which school of thought best describes
the football concussions issue? Why?
2. Does the culture of contact football put winning and profitability above player safety? Support your answer.
3. Consider the relevant factors in the Macro-Environment of collegiate and professional football. Prepare a
PESTAL analysis. Which of the factors appear to have the greatest effect on contact football?
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Teaching Outline and Analysis
1. Consider the three schools of thought regarding ethical standards. Which school of thought
best describes the football concussions issue? Why?
Schools of Ethical Standards
Ethical Universalism:
The School of Ethical Universalism believes that the most fundamental conceptions of right and wrong are
Ethical Relativism:
There are unquestionably some universal moral laws or principles such as not lying; however; there is
also variance among societies regarding what is ethical versus unethical behavior. Various social customs,
Integrated Social Contracts Theory:
The Integrated social contracts theory is a middle position between the views of universalism and relativism.
This theory propounds that companies should attempt to uphold ethical standards that are governed by
The School that Best Describes the Football Concussions Issue
The Ethical Universalism theory best describes the football concussions issue. Football is an American sport
and exists within one culture and society. There is no room for variance regarding ethical versus not ethical
views among various religions with respect to the concussion issue. The only ethical path is the universal
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2. Does the culture of contact football put winning and profitability above player safety?
Support your answer.
The culture of football had historically been an athletic culture that placed winning above all else, and, as
the case points out, even repressed self-report of concussions. Athletes believed that the game and their
team were more important than their health and, consequently, they played with a concussion rather than let
down the team, coaches, school, and parents. The rather questionable ethics of the football culture developed
and existed largely because the colleges, professional football teams, fans, and most importantly, injured
3. Consider the relevant factors in the Macro-Environment of collegiate and professional
football. Prepare a PESTAL analysis. Which of the factors appear to have the greatest eect
on contact football?
Political factors
There is no specific data presented in the case that indicates a strategically relevant impact of political
Economic factors
Legal and regulatory
Although there were no regulations or laws addressed in the case that affect the football concussion
problem, the strategically relevant impact of the legal system is quite important to the issue. Lawyers
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Sociocultural forces
The trend in dealing with the football concussion problem can be examined from the sociocultural
aspect. Changing societal values, attitudes, lifestyles and the trend toward healthier lifestyles have
shifted over the years and had significant effects on contact football. The case traces the evolution of
the concussion problem from the 1939 NCAA requirement that players were required to wear helmets,
Environmental forces
Technological factors
Technology is a strategically relevant factor that is having a bearing on decisions made about contact
football’s long-term direction, objectives, and strategy. New technology is showing promise in diagnosis,
The greatest influence on contact football:
Although sociocultural and technological factors have an influence on contact football, the greatest influence
is from legal/regulatory factors. Examples of the tremendous influence of the legal/regulatory factors are
the U. S. District Courts’ involvement in the settlement of a suit between a group of athletes and the NCAA
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concussive and sub-concussive blows to the head and long-term neurological problems. Absent a well-
developed social responsibility strategy, the NFL, NCAA, and universities would eventually be unable to
sustain the costs of litigation related to CTE.
4. Identify the relevant parties to the problems of concussions in contact football. Support
your inclusion of each.
Players
Football players are obviously the most relevant party to the concussion problem. It is their brains and
lives that are being directly affected by head trauma, concussion, and Chronic Traumatic Encephalopathy
Players’ families
Although the players directly take the punishment of head trauma, if they suffer lingering or long-term
health problems or disability, their families generally bear the burden of care or arranging for care of
the injured player. Concussions may present physical symptoms such as unconsciousness or amnesia,
Football associations (NFL, NCAA, NCAA conferences)
The football leagues (e.g., NFL & NCAA) are probably the second most relevant parties to the
concussion issue. As the governing bodies for organized football, the leagues develop and oversee rules
and regulations intended to make the game as fair and safe as possible, and act to safeguard to players’
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Lawyers
Lawyers’ interest in the football concussion issue differs from the other relevant parties in that their
interest is personal income rather than concern for the sport or the players. They are a relevant party
because of the force – extraction of monetary judgements, and legal fees – they exert on other parties.
For example, the NCAA’s legal expenses increased 59 percent in calendar year 2013, to $13.8 million
Helmet manufacturers
Players (and other relevant parties) may expect helmets to protect, and helmet manufacturers, coaches
and athletic staffs hold out helmets to be protection. The case provides an example of Riddell marketing
Helmet manufacturers are among leaders for change to reduce or prevent head which could generate
significant profit for the companies.
Football fans
Football fans are the driving forces behind football. Their implicit and explicit satisfaction with the game
Courts/legal system
Courts and the legal system are relevant parties to the football concussion case. Although the courts do
not instigate legal actions against defendants in football concussion cases, they provide the venue, have
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Healthcare professionals
Healthcare professionals have three parts in the football concussion problem. They diagnose and treat
head injuries, and are among those searching for better, faster, and more complete treatment protocols,
Marketers, advertisers and sponsors
Markets, advertisers and sponsors connected to contact football have an opportunity to earn significant
Coaches and athletic staff
Coaches and athletic staffs, next to the players, are generally in the closest proximity to the head trauma
events that cause concussion. Although few coaches and athletic staff have any significant medical
Colleges and universities
As the sponsors of organized contact football, colleges and universities have tremendous influence over
all aspects of the game. In the absence of a universal bar to which everyone must adhere regarding ability
5. Why is acting in an ethical manner in the best interests of the constituencies aected by the
football concussion problem?
There are several reasons for all the constituencies of contact football to act in an ethical manner—not only
is it morally right, it is in the self-interest of almost all relevant parties to do so. There are three types of costs
that can be incurred when ethical wrongdoing comes to light: visible costs (penalties from lawsuits, lower
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Football conferences and leagues, colleges and universities, helmet manufactures, as well as coaches
and athletic staffs, are faced with internal administrative costs due to the concussion problem. Legal and
investigative costs, the costs of providing remedial concussion prevention and treatment, education, and
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6. How does the idea of sustainable business practices apply to collegiate and professional
football?
Sustainable business practices are those that meet the needs of the business in the present but do not
compromise the ability to meet the needs of the future. Sustainability is quite relevant to collegiate and
professional football. The environmental sustainability strategy of a company is comprised of its deliberate
actions to protect the environment, provide for the longevity of natural resources, maintain ecological
In addition to moral reasons for environmentally sustainable business practices, there are good business reasons
why a company should be public spirited and devote time and resources to environmental sustainability.
Environmental and corporate sustainability are directly applicable to collegiate and professional football.
Environmentally sustainable practices in organized football can lead to increased attendance and the resultant
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Epilogue
There were no new developments to report on the topic of concussions in football at the time this note went to
press.