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Ban fights, head shots in pro hockey: CMA Journal editoral

Fighting and intentional head shots in hockey should be banned because of the risk to players of serious brain injury, says a doctor at the helm of the Canadian Medical Association Journal.

In an editorial headlined, "Stop the violence and play hockey," interim editor-in-chief Rajendra Kale writes that, as a relative newcomer to Canada, he was amazed to see the skill, speed and physical fitness exhibited by players of what is arguably the country's favourite game.

"Simultaneously, I was appalled by the disgraceful and uncivilized practice of fighting and causing intentional head trauma," the neurologist said in an interview from Ottawa.

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"It doesn't seem to fit in. ... I almost thought that these were two different games being played," said Dr. Kale, who moved to Canada from London more than three years ago.

His is the latest voice to call for an end to incidental and intentional head-bashing in professional hockey, which has led to a growing list of players sustaining concussions that have sidelined them from the game – among them top goal-producers Sidney Crosby and Claude Giroux and veteran defenceman Chris Pronger.

While the National Hockey League has instituted some rule changes to cut down on head shots and is punishing offenders with tougher penalties, the league and others argue that fights and hard checks are integral parts of the game. Ridding hockey of such physicality could lead to fans deserting the game for other entertainment, they say.

"It is an argument, but I think it is an extremely weak argument," Dr. Kale countered. "If you ban the fighting and the intentional head-hitting, you do not know what's going to happen."

He cites the example of legislation to ban smoking in bars and restaurants, which owners predicted would decrease the number of customers and sound the death knell of their businesses.

"This did not happen," Dr. Kale writes. "Instead, the rates of admission to hospital for heart attacks and lung diseases decreased.

"If fighting is banned, several spectators who currently do not watch the game may start watching it."

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There is mounting scientific evidence to suggest that repeated concussions – and even multiple subconcussive brain injuries over time – are linked to chronic traumatic encephalopathy(CTE), an irreversible condition that progressively destroys brain tissue and leads to dementia.

"You don't have to be a great expert in neurology to understand what's going on," Dr. Kale said. "The simple, plain message is that the brain does not like being hit, and if you hit it repeatedly, it will get damaged. It's a delicate organ."

As awareness of the dangers of sports-related concussion and progressive brain injury grows, Dr. Kale hopes that other doctors will join him in speaking out about hockey violence – "an aberration that we all need to get rid of."

He is aware of those players who say hits and fighting should be accepted as just part of the fast-paced game and that it's unrealistic to believe those aspects can be dissected out of the sport.

Dr. Kale's response is that he would like to ask those players a question: "Do you want to be rich, famous and demented and dead at 40?"

"They need to think about that seriously. They must be clear in their mind that there is a huge risk in this for themselves."

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The Canadian Press

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