Open Letter to the British Medical Association

Post Reply
Ally
Heavyweight
Heavyweight
Posts: 27
Joined: 13 Oct 2004, 06:16

Open Letter to the British Medical Association

Post by Ally »

This is a response to the following article -


http://www.dailyrecord.co.uk/news/new...mp;siteid=89488

Dear Sirs,

Open Letter to the British Medical Association regarding your hypocrisy on condemning amateur boxing.

As a parent of two young boxers, I was rather annoyed to read recent press articles in which you back the recent refusal the Sick Kids Hospital in Edinburgh to accept a donation from Sparta AAC on the grounds that the BMA condemns Amateur Boxing. Since you appear to have taken it upon yourselves to stand in judgement of my lifestyle and the lifestyle of my children and many of my friends I feel I am owed an explanation.

The most common medical argument is that amateur boxers are disproportionately liable to suffer cumulative brain injury. This is not based on fact. For example Thomassen et al reported EEG, neurologic, and neuropsychological test results in 53 former champion amateur boxers and 53 former first-division soccer players. Forty-five percent (24) of boxers and 70% (37) of the soccer players had slight symptoms, especially involving concentration or memory impairment. The only increased risk for boxers was decreased motor speed in the left hand.
Thomassen A, Juul-Jensen P, de Fine Olivarius B, et al: Neurological, electroencephalographic and neuropsychological examination of 53 former amateur boxers. Acta Neurol Scand 1979;60(6):352-362

The lack of scientific rigour of your argument is further exhibited by the fact that you seem unable or unwilling to draw a distinction between amateur and professional boxing despite the rather major differences between the two sports. The BMA 'mantra' that the 'intention of boxing is to deliberately brain injure your opponent' simply does not apply. Perhaps you should take the trouble to read the rules of amateur boxing. There you will read that unlike professional boxing; a heavy blow scores no more than a lighter blow, a standing count does not result in extra points, one sided contests are stopped even when there is no injury to the boxers.

You further chose to ignore data that points the finger at other sports. A 1998 report in the Medical Journal of Australia from January 1984 to July 1996 shows 115 rugby football players were admitted to the spinal injury units in New South Wales because of spinal cord injuries. Of these, 49 had permanent complete paralysis below the neck, and 2 died of injury within 2 weeks of admission. Compare this to the fact that there has never been a single fatality anywhere in Australia attributed to amateur boxing.

Returning to 'intent', why is boxing singled out? No mention is made by the BMA of more white-collar pursuits such as Karate, Tae Kwon do, and Judo. All these sports have an element of 'intent to harm'. Precisely what is the intention of a crunching rugby tackle? Are the mothers whose sons are returned paraplegic, by their local rugby clubs likely to be consoled by the fact that the player(s) who broke their son's necks 'didn't really mean it?' Of course rugby, although much more dangerous than amateur boxing, is also favoured by the privately educated middle class, coincidentally this is the background most associated with your profession. Indeed if you care to look at the sports where injury and death are much more common the in boxing such as the comparative study below from the USA a clear picture emerges.

Fatality rate per 100,000 participants USA
Horse-racing 128
Sky-diving 123
Hang-gliding 55
Mountaineering 51
Scuba diving 11
Motorcycle racing 7
College football 3
Boxing 1

If the sport in question is favoured by privately educated, middle class people, high injury rates are acceptable presumably because those taking part, are socially and intellectually, equipped to make an informed choice. If however a sport favoured by the great unwashed has even a hint of danger then, obviously, this must be banned as its participants are too irrational or addled with drink to make a similar informed choice.

The report of the BMA Board of Science Working Party on Boxing fails to reference a single pier reviewed study or any source material that would allow for impartial scrutiny of your argument. This paper admits that even the research so far done into injury to professional boxers is inadequate to draw firm conclusions. The section on amateur boxing states that the "evidence (for cumulative brain injury) is far less clear cut". The section goes on to state that the rules of amateur boxing are too varied between countries to make for comparison. This is simply untrue. Amateur boxing is governed by the AIBA and the rules are clear for all to see and national differences are minimal particularly in Europe where there is plenty scope for comparative study. Perhaps before condemning our sport out of hand you may wish to consider actually conducting some worthwhile research in this area, rather than relying on your prejudices. Science demands that you do the research then make pronouncements not the other way round.

Why do you condemn amateur boxing from a social point of view when there is a rather large body of empirical evidence condemning the pack mentality generated by team sports. Psychologist Chris O'Sullivan, Ph.D., of Buckness University in Lewisburg, Pennsylvania, studied 26 alleged gang rapes that were documented between 1980 and 1990, and found that fraternity groups committed the highest number, followed by athletic teams. In addition, she found that "the athletes who do this are usually on a star team, not just any old team. It was the football team at Oklahoma, the basketball team at Minnesota, the lacrosse team at St. John's. She concludes, "It seems to be our most privileged athletes - the ones, by the way, most sought after by women - who are often involved in gang rape."

Anyone unfortunate enough to have witnessed the drunken abuse, violence and sexual assaults that accompany many Rugby Club nights out would I am sure prefer to be in the company of amateur boxers who are often tea total and tend not share this pack mentality. Y Haglund and E Eriksson, Am. J. Sports Med. 21: 97-109, 1993, Conclude that EEG's indicate that boxers are "less impulsive and more socialised" than the control group of footballers and track and field athletes.

In conclusion there is a lack of any clear evidence that amateur boxing is more dangerous to the participant than many other contact sports and is often less so, no medical case has been made by you or anyone else that can justify your position on amateur boxing. To suggest otherwise is counter to all the available evidence and is as a consequence dishonest. As it has become clearer that amateur boxing is simply another contact sport you have rather coolly altered the argument to set your sights on the morals of boxing. Such studies that have been done indicate that boxers tend to be rather well adjusted and pose less of a social threat than other accepted subcultures. That aside, the morals of boxing are, frankly, none of your business. You are not the nations moral guardians, social engineers, or lifestyle gurus, you are medics. As such you have a duty of care. By ostracising the amateur boxing community in the manner you currently do is to put the participants at greater risk than if you showed genuine interest in amateur boxers welfare. Rather than ill informed criticism, based on little or no research, you could actually engage with our sport by helping us look into such matters the effects rapid weight loss and or dehydration and brain injury. You could work with us, researching into means of lessening the infinitely more common eye and hand injuries to boxers. This would sit more comfortably with your duty to care than treating a group of people, like social pariahs merely because they offend your sensibilities. Your current position of singling out amateur boxing for special treatment has no medical basis, it is not scientific, and unless you apply the same conditions to other contact sports simply amounts to intolerance.



Yours sincerely




Alasdair Tennent
Father of
Calum Tennent and
Fergus Tennent (2003-4 Eastern District Champion)
bennie
Heavyweight
Heavyweight
Posts: 15244
Joined: 15 Nov 2002, 09:53

Post by bennie »

The BMA is arrogant, out of touch, misguided - a joke.
Rage
Heavyweight
Heavyweight
Posts: 25
Joined: 20 Jul 2004, 14:00

Post by Rage »

An absolute discrace, if boxing was such a dangerous sport why would there be so much coverage on television?

I think the BMA should walk around with thier heads held LOW from now on, they should be ashamed of them selfs.
Ally
Heavyweight
Heavyweight
Posts: 27
Joined: 13 Oct 2004, 06:16

Post by Ally »

bollocks wrote:Wow, powerful and very well put together letter. One that won't get a response
I have just come back from holiday to find that the British Moral Association have condescended to reply. However from first glance it is a holding manoeuvre. No response to any of my queries, no acknowledgement of their own admission that there is no clear cut evidence against Amateur boxing, and no willingness to address research that refutes their position. This is what I both wanted and expected and I now have the ammunition I deed to take this to the next stage.
bigped
Heavyweight
Heavyweight
Posts: 1571
Joined: 05 Jul 2004, 16:26

Post by bigped »

whens you boys up again nxt?? Im im edinburgh myself..
Ally
Heavyweight
Heavyweight
Posts: 27
Joined: 13 Oct 2004, 06:16

Post by Ally »

bigped wrote:whens you boys up again nxt?? Im im edinburgh myself..
My youngest has a match with a lad from Bolton for the Sparta show at the Grosvenor Hilton on Nov 5.
bigped
Heavyweight
Heavyweight
Posts: 1571
Joined: 05 Jul 2004, 16:26

Post by bigped »

good stuff i will be there, hes been coming up on a mon sometimes on a wed with Jack Graham to clovenstone for extra training, i boxed on sunday in Glenrothes was beatin on points.

anyway good letter mate keep up good work
Ally
Heavyweight
Heavyweight
Posts: 27
Joined: 13 Oct 2004, 06:16

Post by Ally »

bigped wrote:good stuff i will be there, hes been coming up on a mon sometimes on a wed with Jack Graham to clovenstone for extra training, i boxed on sunday in Glenrothes was beatin on points.

anyway good letter mate keep up good work
Cheers Bigped,

He might enter the schoolboys this weekend if a slight injury clears up enough. I am off to Camburlang regardless as I am judging.

Ally
Ally
Heavyweight
Heavyweight
Posts: 27
Joined: 13 Oct 2004, 06:16

Post by Ally »

This is the response from the BMA.

They pretty much failed to address any of the points raised focusing instead on taking umbrage to the accusation on references and trying to sell me a book. I have responded with a numbered list of questions. As I have copied ministers and MPs they will be under some pressure to respond. Should they fail reply in depth I will be on the hunt for pro boxing MPs/MSPs to ask parliamentary questions. If you know of any such politicians please post their names here and I will contact them. I would also be interested in contacts in the fields of medicine and sports science.
--------------------------------------------------------------------------------

Thank you for your letter to the British Medical Association, regarding our policy on Boxing.

The BMA's policy position on Boxing has not changed since the publication of the report published in 1993 'The Boxing Debate.' The BMA backs the refusal of the sick kids' hospital in Edinburgh to accept a donation from Sparta AAC on the basis of medical evidence that repeated blows to the head as sustained in boxing can cause brain damage and, in some cases, acute brain haemorrhage that can cause death.

It was unclear from your letter if you have read the evidence in our report, but we would like to respond to some of the specific points in your letter:

The three articles that you refer to would not shift the balance of medical evidence against our position. In our report we reference a large number of peer reviewed articles that support the BMA's conclusion that boxing does cause cumulative brain injury. It is, therefore incorrect to state that the BMA fails to reference a single peer reviewed study or source material. References are clearly listed at the end of every chapter and we also include an appendix of published studies. The chapter on mechanism of injury sustained during boxing contests' contains 18 references alone, including articles published in the BMJ, Sports Medicine, The Lancet and JAMA. If you do not have access to the full report, you can order a copy from the BMA bookshop: http://www.bmjbookshop.com.

You state that other sports have higher risks of injury and site a report that was published in Australia in 1998. The study in the Medical Journal of Australia appears to have only looked at acute injuries over a period of 18 months, and did not consider the cumulative longer term effects of boxing. A small number of boxers are killed in the ring or immediately afterwards, but many more are exposed to the longer term health effects. Furthermore, while injuries can be sustained during any sporting activities, boxing is the only sport where the intention is to cause injury.

The BMA concludes that the scientific evidence clearly shows a risk of acute and chronic injury to the brain and eye in both amateur boxing and we remain firmly opposed to its promotion as a sport suitable for children. We agree that more research should be conducted on boxers over long periods of time. The BBBC and the Amateur Boxing Association (ABA) are in a unique position to assist in recording injuries to the brain and eye.

Yours sincerely
Marcia Darvell
Public information manager.

My response


Dear Ms Darvell,

Open Letter to the British Medical Association regarding your hypocrisy on condemning amateur boxing. - Initial Reply to your Response

I thank you for your response to my letter of 13th October. My letter was rather more specific than you state. It is actually regarding your 'policy' on Amateur Boxing.

The report I referred to in my letter is on your web-site titled "Boxing debate August 2001 - Second report of the BMA Board of Science Working Party on Boxing (This briefing paper applies to the UK)". There are no references on this document or on similar documents published on your web-site. I will obtain the originals you mention and in the fullness of time, source each reference. However, in the meantime, such independent enquiry that I have carried out can find only five major studies into head injury in amateur boxing. So far I have found nothing to suggest the disproportionate dangers that you infer actually exist. Some indeed suggest the opposite, that amateur boxing is rather less dangerous than other sports that you do not condemn.

It is not acceptable for you to use phrases such as "can cause" or "shows a risk" without being able, firstly to quantify the alleged risk, and secondly to make reasonable risk comparison with other activities. I note with interest that when you attempt to refute my position on cumulative brain injury you quote the example on acute injury rather than my reference to cumulative injury as studied by Thomassen et al. This is termed by an article, in the Sports Injury Bulletin you mention, as a 'classic study'. The article (Head injuries and brain damage in football: if football players suffer three concussions, does it mean they have to quit the sport? by Owen Anderson) further states that -
30% of the former players complained of permanent problems such as headache, dizziness, irritability, neck pain, and impaired memory(1). In addition, 35% of the active players and 32% of the former players displayed abnormal EEGs, compared with about 12% of matched control individuals. When the former players were subjected to cerebral computed tomography (CT) and a neuropsychological examination, a full one-third of the athletes were found to have central cerebral atrophy (wasting of the central region of the brain), and 81% displayed at least some signs of neuropsychological impairment. Many of these problems were believed to be linked to concussions suffered by the players during their football careers.
You repeat the BMA myth that 'boxing is the only sport where the intention is to cause injury.' Martial arts such as Tae Kwon do, Karate, and Judo, include as well as punches, kicks and elbows to the head along with strangle holds and the use of weapons, all of which are as or more likely to cause injury. As implied by the term "Martial Arts", the intention at the highest level is not to injure. It is to kill. Given that there are many other sports where the rate of head injury is higher then amateur boxing and it is the intention of amateur boxers to brain injure we are, it seems not very good at it. I notice that for example that while my club, Sparta AAC, have recorded no concussions at our club this season, I read in the press that the goalkeeper at Aberdeen FC has been knocked out twice in the same period.

I do not understand your reference to the BBBC, as this organisation does not govern my sons' sport. I equally have no knowledge or dealings with the organisation referred to by you as The A.B.A. and on your web-site as the A.M.A. I am aware of the ABAE which I believe covers England. The fact that you appear unclear as to which body governs my sons' sport or which national association applies, further diminishes the BMA's credibility on this issue.

Although as a parent I have a vested interest in more research into boxing injuries, I would strongly advise Amateur Boxing Scotland Ltd. not to provide you with any such research material. You are currently calling for Amateur Boxing to be driven underground with out any "clear cut" evidence. The BMA therefore has a political agenda and cannot be seen as objective scientists by the amateur boxing community. Assisting the BMA in this matter would be akin to assisting a study on lung disease produced in conjunction with a tobacco company, or giving details of our DNA to eugenicists. Amateur Boxing must seek to assist objective scientific bodies with any such data. We need properly conducted scientific research. This requires control groups, detailed medical history of the subjects. Data such as; birth weight, injuries caused by events not related to the sport under study, other active pursuits (All injuries to Sparta AAC's junior requiring hospital treatment last season were all occasioned playing rugby), the social/medical history of the participants, and crucially comparative studies with other contact sports.

In my previous letter I put some questions that have so far gone unanswered I have listed these questions along with others arising from our communication. I look forward to your considered reply. To avoid further confusion please keep in mind these questions refer to Amateur Boxing as governed by the AIBA/EABA/Amateur Boxing Scotland Ltd.

1. What medical principal allows you condemn amateur boxing when a boxer exhibits signs of brain injury while tolerating similar injury other sporting activities such as football and rugby?

2. Why do you call for amateur boxing to be banned when, by your own admission the evidence to back such a case is 'less clear cut'?

3. Why is the alleged intention to cause injury to an opponent unacceptable in amateur boxing but can be tolerated in martial arts?

4. Since there is injury in many sports, why is your interpretation of 'intent' more important in medical terms than the statistical risk of sustaining 'unintentional' injuries within any given sport?

5. Since there are sports, particularly those that involve leaving the ground, where the chances of sever injury or death are many times greater than amateur boxing why does the very high rate of attrition not lead you to question the risks of such activities?

6. Why is injury, severe disability and/or death caused by brain injury more unacceptable in medical terms than injury, severe disability and/or death caused by injuries to other body parts?

7. By what internal process was your decision to condemn amateur boxing arrived at?

8. Is there a membership vote on this issue?

9. If the answer to 8 is yes who gets to vote and are the details a matter of public record? Where can I access this record?

10. If a board or committee arrives at this decision, how is this body appointed and who sits on it?

11. Since Sparta AAC is an athletic club which includes boxing as one of its activities I am curious to know if you habitually recommend your colleagues to refuse donations from similar bodies because they include amateur boxing as part of their activities. Say for example, an English public school or the armed forces?


Yours sincerely
Alasdair Tennent
Sparta Amateur Athletic Club


CC.

Scottish Parliament:
Patricia Ferguson MSP (Minister for Tourism, Culture and Sport)
Andy Kerr MSP (Minister for Health and Community Care)
Malcolm Chisholm MSP (Edinburgh North and Leith)
Mark Ballard MSP (Lothian Region)
Lord James Douglas-Hamilton MSP (Lothian Region)
Colin Fox MSP (Lothian Region)
Robin Harper MSP (Lothian Region)
Fiona Hyslop MSP (Lothian Region)
Mr Kenny MacAskill MSP (Lothian Region)
Margo MacDonald MSP (Lothian Region)

British Parliament:
The Rt Hon Dr John Reid MP (Secretary of State for Health)
The Rt Hon Tessa Jowell MP (Secretary of State for Culture, Media and Sport)
Mark Lazarowicz MP (Edinburgh North and Leith)
Ally
Heavyweight
Heavyweight
Posts: 27
Joined: 13 Oct 2004, 06:16

Post by Ally »

Dear Mr Tennent

Further to your recent letter regarding our policy on Boxing, the BMA bord of Science believe that we adequatley covered the basis for current BMA policy in our previous letter to you, dated 19 October 2004.

We have nothing further to add to our original response and the bord of science does not wish to enter into further correspondence with you on this matter.

yours sincerely


M Darvell
Public Information Manager


Impressive response, I am truly intimidated by their intellect.
bigped
Heavyweight
Heavyweight
Posts: 1571
Joined: 05 Jul 2004, 16:26

Post by bigped »

what kind of garbage response was that??? like they dont have a point to make or no they are in the wrong so just dont want to discuss it thats what it seems to me.

You watch the documentry on bbc 1 tonight?? you know any of the boys from amatures i cant say i do but maybe as they are from west and we are east.

cheers
Ally
Heavyweight
Heavyweight
Posts: 27
Joined: 13 Oct 2004, 06:16

Post by Ally »

bigped wrote:what kind of garbage response was that??? like they dont have a point to make or no they are in the wrong so just dont want to discuss it thats what it seems to me.

You watch the documentry on bbc 1 tonight?? you know any of the boys from amatures i cant say i do but maybe as they are from west and we are east.

cheers
Precicely!

The BMA follow the classic profile of that lowest form of deviant, "The Bully". Like all bullies if you stand up to them they can't look you in the eye.


Bullies apparently fall into several categories. The category which I feel fits best is that of The Guru - (Bold text is my emphasis)

The Guru

 Motivation: task focused
 Mindset: confusion, inability to understand how others think and feel,
Often successful in their narrow field of expertise
Regarded as an expert
 Zero people skills
Control freak
Mainly but not exclusively male
 Often has a favourite (Rugby?) who receives extra attention but who is expected to reciprocate with sycophancy
Selfish, self-centred, self-opinionated and thoughtless and with a tendency to pontificate
 Apt to throw temper tantrums when things don't go well or can't get their own way
 Emotionally immature, perhaps emotionless, sometimes cold and frigid
 Convincingly intellectualises feelings to compensate for emotional immaturity
Intelligent (often highly) but lacks common sense
Does not accept responsibility for their own behaviour
 Blames others for own inadequacies
Refuses to recognise that they could have any shortcomings of their own
 Does not live in the present
 Usually extremely neat (for example, desk is always clear)
 Organised (sometimes overly)
When held accountable exhibits genuine confusion as to why their behaviour is inappropriate
 Likes the appearance of normalcy but rejects responsibilities of relationships
 Unable to comprehend or meet the emotional needs of others
 Often puts work and duty above everything, including relationships
 Makes power plays, for example leaves the room when someone is speaking, or pretends not to hear and constantly asking a person to repeat what they just said, etc.
Doesn't share information about self (thoughts, insights, etc) and is not open to receiving this type of information from others (allegedly knows it all already)
Secretive
 May view people as objects (this enables controlling behaviour of other people)
Thinks of self as superior and above the law / rules / regulations etc (these only apply to other people)
Uses denial as a defence mechanism


They know their case is weak and so they resort to stonewall tactics.

Real Quote
"All cruelty springs from weakness."
(Seneca, 4BC-AD65)

Less so -
"And dying in your beds, many years from now, would you be willin' to trade all of that from this day to that, for one chance, just one chance, to come back here and tell our enemies that they may take away equitable medical traetment, but they'll never take our boxing."
Post Reply