are recent cases where former NHL enforcers have suffered severe degenerative brain injuries, to a large extent due to continued head trauma, along with other forms of abuse, such as substance abuse (Branch 2011 ; Kale 2012 ). And, perhaps because of stric- ter reporting requirements, concussions seem to be on the rise (Donaldson, Asbridge, and Cusimano 2013 ). On the other hand, some recent reports minimize the negative impacts of fighting in the NHL. A recent study states that estimated incidence rate of all concussions is at 1.8 concussions per 1000 player-hours or 559 reported concussions in a seven-year period (Bensen et al. 2011 ). In interviews (the results have yet to be peer reviewed), physicians report that only 8% of the total number of concussions are related to fighting; furthermore, in 710 fights, the overall rate of any injury was less than 1.12% per combatant per fight (Klein 2011 ). The conclusion that hockey fights cause significantly less harm than expected has been attributed to the claim that the physics of fighting on ice significantly reduced the force of blows thrown (Milzman et al. 2012 ). Body checking and high speed, random contact are by far the leading causes of head trauma and other serious injuries (Donaldson, Asbridge, and Cusimano 2013 ; Ruhe, Gansslen, and Klein 2013 ). While the debate continues, suggestions that the NHL must do more to help ensure a more reasonable degree of player safety are well taken (Bensen et al. 2011 ; Proteau 2011 , 215–226). Some rather significant suggestions include the following: 1. The NHL should work with owners, players, coaches, and lea- gue representatives to better inculcate the virtues of a good fight and castigate instances of fighting for external goods or fighting as rationalized aggression as sug- gested above. This would require habitually fostering good temper and could help to limit the occurrence and viciousness of fights. 2. The NHL should seek to develop safer equipment, including concussion-reducing helmets or gloves with additional padding. 3. The NHL should include workout regimens, such as instruction on how to protect one’s self in fight and how to fight fairly, in order to minimize head trauma. 4. The NHL should change official rules to include even stiffer penalties for fighting and, perhaps more importantly, revise concussion assessment protocols, such as requiring that all 42 ABE ZAKHEM
players who receive a head-shot during a fight be assessed by a doctor. The latter would increase the player’s off-ice time and likely decrease the occurrence of fights. One could also limit the number of fights by a player in any given year and assess sig- nificant fines or suspensions for players who exceed the limit. 5. The NHL can and must continue to engage in research on fighting and head trauma with transparency and engage in a public discourse to determine, in a more exacting way, what constitutes ‘reasonably safe’ conduct. The third condition is that fighting as a traditional practice must be internally good for the community of participants or, in the context of a sport, fighting must help define and be ultimately good for the game. As mentioned, fighting in the NHL does
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