Intended for healthcare professionals


Ethics in sports medicine

BMJ 2009; 339 doi: (Published 29 September 2009) Cite this as: BMJ 2009;339:b3898
  1. Søren Holm, professor of bioethics12,
  2. Michael McNamee, professor of applied ethics3
  1. 1Centre for Social Ethics and Policy, School of Law, University of Manchester, Manchester M13 9PL
  2. 2Section for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo, Norway
  3. 3Department of Philosophy, History and Law, School of Health Science, Swansea University, Swansea SA2 8PP
  1. Correspondence to: S Holm soren.holm{at}

    Professional standards need to be clarified and acted on

    Doctors and other healthcare professionals have been involved in facilitating both legitimate and illegitimate performance enhancement in sport.1 2 The recent “bloodgate” affair in Rugby Union shows that healthcare professionals can be involved in producing fake injuries in situations where the apparent “injury” creates an advantage for the team.3

    The incident happened last April at the semifinals of the European Rugby Cup match between Harlequins and the eventual winners Leinster. Normally in Rugby Union players cannot return to play once they have been substituted except to replace a player who has a “blood injury.” A Harlequins player produced an apparent blood injury through the use of a fake blood capsule so that a specialist goal kicker could be brought back on to the field to try to secure victory in the last few minutes. At the behest of the head coach, the team physiotherapist had purchased fake blood capsules in advance of the game and had delivered one to the player during …

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