Publications

Violence: directions for Australia

Minority report I: boxing

W E Lucas, P E Quinn and D Chappell

We believe the issue of boxing requires further comment in opposition to the majority decision on boxing.

In October 1983 at the 35th World Medical Assembly the World Medical Association issued the following statement on boxing (Medical Journal of Australia, March 31, 1984)

Recommendations Concerning Boxing

Boxing is a dangerous sport. Unlike other sports, the basic intent of boxing is to produce bodily harm in the opponent. Boxing can result in death and produces an alarming incidence of chronic brain injury. For this reason, the World Medical Association recommends that boxing be banned. Until the goal is achieved, the following recommendations should apply to boxing:

1. Request National Medical Associations (NMAS) to encourage the establishment of a "National Registry of Boxers" for all amateur and professional boxers, including "sparring mates", in their country. The proposed functions of the registry would be to record the results of all licensed bouts, including technical knockouts, knockouts, and other boxing injuries, and to compile injury and win/ lose records for individual boxers.
2. Request NMAs to plan and conduct conferences with interested members of the medical profession, medical representatives of various government boxing commissions, and representatives of organised professional and amateur boxing organisations, to review criteria for the physical examination of boxers, to determine other comprehensive medical measures necessary for the prevention of brain injury in the sport, and to develop specific criteria for the discontinuance of a bout for medical reasons.
3. Recommend to all boxing jurisdictions that the ring physician should be authorised to stop any bout in progress, at any time, to examine a contestant and, when indicated, to terminate a bout that might, in his opinion, result in serious injury for either contestant.
4. Urge boxing jurisdictions to conduct frequent medical training seminars for an ring personnel.
5. Recommend to all boxing jurisdictions that no amateur or professional boxing bout be permitted unless:
   1. the contest is held in an area where adequate neurosurgical facilities are immediately available for skilled emergency treatment of an injured boxer;
   2. a portable resuscitator with oxygen equipment and appropriate endotracheal tubes are available at ringside; and (c) a comprehensive evacuation plan for the removal of any seriously injured boxer to hospital facilities is ready.
6. Inform boxing jurisdictions that unsupervised boxing competition between unlicensed boxers is a most dangerous practice that may result in serious injury or death to contestants, and should be condemned.
7. Urge all boxing jurisdictions to mandate the use of safety equipment such as plastic safety mats and padded cornerposts and to encourage continued development of safety equipment.
8. Urge all boxing jurisdictions to extend all safety measures to sparring partners.
9. Urge all boxing jurisdictions to upgrade, standardise, and strictly enforce medical evaluations for boxers.

A review of medical literature since 1984 reveals a continuing medical concern about boxing and mounting evidence about serious injuries to boxers, particularly to the brain (Lishman 1988; Enzenauer & Mauldin 1989; Enzenauer et al. 1989; Giovinazzo et al. 1987). Enzenauer et al. (1989) suggested that the promotion of boxing by the United States military needed to be addressed. Little appears to have changed in the control of boxing in the United States since the WMA statement (Ross et al. 1987). What has occurred in Australia requires review.

Lishman's valuable 1988 review examines the psychiatric consequences of brain injury in boxers, noting paranoid illnesses (including psychosis), morbid jealousy and rage reactions - all conditions associated with serious violence. Amateur boxers have no immunity to brain damage - they have less occupational exposure and some protective gear - and neuropsychological testing is the most sensitive method of detecting early impairment (McLatchie et al. 1987).

The arguments commonly used to support boxing are that it is an art of self-defence, amateurs are not at risk, and that it provides a social and financial ladder for disadvantaged young. All these arguments are seriously flawed. The final one is sad in that it allows for disadvantaged youth to be exposed to the risk of further handicap in the, for most, illusory hope of advancement.

Boxing is a minor sport in Australia but it has medical, social and symbolic significance in the context of an investigation into violence. Brain injury is a major public health problem in young Australians. The Committee has made statements against the condoning of any form of violence and recommends that violence in sport not be glorified. Not to support the eventual banning of boxing in Australia, is in our opinion inconsistent.

Our minority recommendations are:

1. We endorse the 1983 statement on boxing of the World Medical Association, in which it recommends that boxing be banned. We further endorse the Association's recommendations for action until the goal of banning is achieved.
2. We recommend that in view of the lapse of time since the statement of the World Medical Association the appropriate bodies, medical and sporting, review the situation in Australia regarding the control of boxing and its elimination as a sport.

References

• Enzenauer, R.W. & Mauldin, W. 1989, "Boxing-Related Ocular Injuries in the United States Army 1980 to 1985", Southern Medical Journal, vol. 82, no. 5, pp. 547-9.
• Enzenauer, R.W., Montrey, J. Enzenauer, R.J. & Mauldin, W. 1989, "Boxing Related Injuries in the U.S. Army 1980 through 1985", Journal of the American Medical Association, March 10, vol. 261, no. 10, pp. 1463-6.
• Giovinazzo, V., Yannuzzi L., Sorenson, J., Delrowe, D. & Campbell, E. 1987, "The Ocular Complications of Boxing", Ophthalmology, vol. 94, no. 6, pp. 587-96.
• Lishman, W. 1988, Organic Psychiatry. The Psychological Consequences of Cerebral Disorder, (2nd edn), Oxford, Blackwell Scientific Publications.
• McLatchie, G. Brooks, N., Galbraith, S., Hutchison, J., Wilson, L., Melville, I., & Teasdate, E. 1987, "Clinical Neurological Examination, Neuropsychology, Electroencephalography and Computed Tomographic Head Scanning in Active Amateur Boxers", Journal of Neurological and Neurosurgical Psychiatry, vol. 50, no. 1, pp. 96-9.
• Ross, R. Casson, 1, Siegel 0. & Cole, M. 1987, "Boxing Injuries: Neurologic, Radiologic and Neuropsychologic Evaluation", Clinical Sports Medicine, vol. 6, no. 1, pp. 41-51.

Originally published:
Violence: directions for Australia / National Committee on Violence.
ISBN 0 642 14975 5
Canberra: Australian institute of Criminology, 1990; pp 249-251