Good versus bad medical stoppages in boxing: Stopping a fight in time

Abstract

Background: Professional boxing is a popular contact sport with a high risk for both acute and chronic traumatic brain injury (TBI). Although rare, many boxers have died in the ring or soon after the completion of a bout. The most common causes of death in these cases are usually acute subdural hematomas, acute epidural hematomas, a subarachnoid haemorrhage, an intracranial haemorrhage or Second Impact Syndrome (SIS). Ringside physicians are entrusted with the health and safety of boxers in the ring and in the immediate aftermath of a bout. Discussion: As per the Uniform Boxing Rules (approved August 25, 2001, Amended August 2, 2002, Amended July 3, 2008, Amended July 24, 2012, Amended July 29, 2014), the referee is the sole arbiter of a bout and is the only individual authorised to stop a contest. [1]In some states in the United States and in other countries around the world, the referee and the ringside physician are the sole arbiters of a fight and the only individuals authorised to enter the fighting area at any time during the competition and also authorised to stop a fight. This raises the important question of when should a fight be stopped on medical grounds. Conclusion: Standardising medical stoppage decisions in boxing will help to protect a boxer’s health and safety in the ring. Good practice guidelines for medical stoppage due to suspected TBI are suggested. It is recommended that the medical community debate the proposed guidelines vigorously, in order that evidence-based guidelines can be developed in conjunction with professional boxing governing bodies.