The Real Debate Over Potentially Life Saving EKGs Is Who Should Foot The Bill

February 9th, 2016 | by Karen Gross
The Real Debate Over Potentially Life Saving EKGs Is Who Should Foot The Bill
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EKG

Recently, Roger Goodell spoke in his annual NFL address about the ongoing efforts of the NFL to protect its players from injuries. Many were surprised, me included, by his comfort level with football concussions and his willingness – in theory – to say that he would let his own son play football if he had a son (he has daughters).  Given the recent evidence of CTE in former players who have died or committed suicide, his position seems more than a tad out of touch with reality – and I am a football fan.

Goodell’s remarks come on the heels of an Op-Ed in the New York Times suggesting that it would be wise for at least some college athletes to have mandated electrocardiogram (EKG) screenings, a measure designed to prevent sudden death due to heart disease and heart defects.  It seems that the NCAA’s chief medical officer has backed off his original and wise suggestion of mandatory use of EKGs because of pressure from some colleges and universities, although the issue is far from over.

Some healthcare professionals and medical organizations dispute the importance of EKGs, and let’s concede for a moment that there is a justified lack of agreement on this issue on the merits at present. Not being a medical expert, I can’t and won’t wade into the controversy on the medical bona fides of the arguments pro and con. But, it is worth noting that professional athletes and collegiate athletes in some countries are required to have EKGs.  A sizable number of colleges, even in the absence of an NCAA ruling, are mandating that some athletes have EKGs.

EKG

So, for me and as noted in the Time’s Op-Ed noted above, the EKG question boils down to a moral dilemma. In the absence of medical consensus, is it worth the candle to save the lives of perhaps a handful (or more) collegiate athletes?

My answer to that quandary is influenced by these factors: As a former college president, the idea of a tragic and unnecessary death of a student-athlete is abhorrent.  I did not want and would not now want to be the person calling the parents to explain such a death, let along witness it.  Second, as a generalizable matter, I operate from the premise that it is better to be safe than sorry.  That’s why, at least in part, we have designated drivers when there is drinking. That’s why we have guardrails to prevent needless falls on stairs. That’s why we encourage (despite some serious controversy) flu, pneumonia and shingles vaccines. That’s why we have “life alert” pendants for the elderly, should something unexpected occur. Third and finally, I remember, as if it were yesterday, the death of Hank Gathers on the court and that memory haunts me still.

These reasons, among others, lead me to the conclusion that mandatory EKGs for the most at risk collegiate athletes makes sense and are worth the cost, the time and the effort.  I think we have a responsibility to our athletes to protect them, even if there are false positives and the careers of some student-athletes might be cut short (perhaps even needlessly). Stated another way, we can benefit from being paternalistic/maternalistic in life and death matters.  Indeed, the doctrine of in loco parentis has appeal here. Parents would decide to protect their children I suspect at any cost. I would.  So, colleges and universities with the responsibility for these same young adults should do all things that are reasonable and in their power to protect them.

“… 4800 student-athlete lives would be saved over 20-years…”

I appreciate that the actual number of collegiate student-athlete deaths that would be prevented by mandatory EKGs would not be large.  One group estimated that approximately 4800 student-athlete lives would be saved over 20-years at a cost $50 billion (that’s roughly $10 million per person saved).  We can question the accuracy of this calculation but regardless of the actual number of lives saved, the real question is what is a human life worth, whether measured in dollars or other measures?  It is a question that has plagued philosophers and economists for centuries. It is a question eloquently described by Kenneth Feinberg, charged with distributing payouts to the survivors of 9/11 among other tragedies, in his book titled, appropriately, What is Life Worth?.

I get that life is filled with risks. I get that it is too expensive to disable or prevent all risk.  I understand that even with protections, there could be deaths. I recognize, too, that we cannot live in protective bubbles, even if that would curb broken bones and colds and infections.  

But, that proverbial but: it does not seem over the top to require that potentially at-risk collegiate student athletes be given EKGs.  We ask these individuals to represent our institutions.  We recruit them, often aggressively, to our colleges and universities.  It doesn’t seem unreasonable to take steps to prevent their sudden death.  I assume the military requires an EKG for recruits, even those not going into battle.



Now, as to the question of costs, I am sure that smart folks could figure out ways to reduce the costs of mandatory EKGs for subgroups of collegiate athletes. For collegiate athletes participating in NCAA sanctioned sports, why couldn’t the NCAAa wealthy institution with a remarkably high revenue stream and a sizable endowment – pay for an EKG program?  

Seriously and I am not being flip, if you look at the NCAA budget, this screening is more important in the grand scheme of things than huge convention costs with custom banners and die-cut programs, an office in Indianapolis with abundant amenities and outsized salaries for some administrators.  NCAA President Mark Emmert makes more than many college and university presidents. To be sure, he makes less than some head coaches, but that is a different issue.

Here’s the point: saving lives matters.  There is a cost to be sure but I think the NCAA could support this effort, and they could do so without passing on the costs to their college and university membership. It seems to me that this is the least the NCAA can do to protect student-athletes.  After all, the NCAA is the institution charged with student-athlete well being.

Karen Gross About Karen Gross
Karen Gross is the former President of Southern Vermont College, an NCAA DIII institution fielding 13 teams. She was the president of the college's Athletic Conference, the NECC. She also served on the NCAA DIII Presidents' Advisory Council. A lawyer by training, she represented an NFL quarterback (decades ago) and is a serious professional and college sports fan. She currently is senior counsel to a crisis management firm in DC where she specializes in education. A Red Sox fan, she knows a lot about losing and winning. Her son, now a professor, is a former NCAA Division I athlete.

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