Is This a Spider Bite?

An Ethics Case About Managing MRSA

By game day, Leary's wound is starting to look better. Coach Phillips has a talk with the trainer, and they decide they can bandage the wound sufficiently to allow Leary to play safely. This strategy works well until Leary runs into a defender as she goes up to make a basket. The collision is not only very painful for Leary, but it also makes her wound drain and seep through the gauze bandage. Leary doesn't want to ask for a timeout, so she plays the rest of the quarter with the damp bandage.

In the meantime, since no one else on the team has shown up with MRSA, the diligence of the staff who were responsible for cleaning and disinfecting the facilities begins to decline. Student trainers only wipe down the table at the end of each day and the custodial staff does not clean the bathrooms and showers as well as before. Phillips brings the issue up again with Athletic Director Morgan, but Morgan explains that the department is already short staffed and it is not fair to ask these employees to work longer hours to clean. Furthermore, Morgan says he can't afford to pay them overtime for the sanitary procedures that they would perform. "Can we afford not to pay them to keep the locker room clean?" wonders Phillips. "After all, the health of our athletes and staff is at stake." He considers talking to someone in administration about this "ethics violation."

A week later, three members of the Waynesville Women's Basketball Team and one member of the Men's Swim Team have MRSA, and there is a report of an infection at St. Aloysius. In order to put a halt to the infection, all the athletic facility surfaces must be sanitized and disinfected. However, these cleaning processes are fairly expensive and the department simply does not have the funds at this moment unless they take money from other, important aspects of the University's sports program. Furthermore, the basketball coach now faces the likelihood of having to forfeit games. Because he has been advised to have the ill players sit out until they are once again healthy, he will not have enough players to field a full squad. The potential forfeits will lead to a lack of gate receipts from home basketball games and thus, more fiscal damage to the department.

The athletic trainers have told Phillips and Morgan they feel strongly that all athletic participation by these players be canceled until they fully recover due to the risk they would be to themselves, as well as their teammates and competitors.

Questions

1. What is the right thing for the coach and athletic director do in this situation? Do their jobs obligate them first to the players or the University?
2. Are athletic trainers and coaches obligated, like healthcare professionals, to do no harm?
3. Who is responsible for the hygiene measures to combat the spread of MRSA? Who should foot the bill? How should the cost of these be weighed against other needs of the Athletic Department?
4. Should there be a difference in these practices between schools that have and have not had a MRSA outbreak?

What do the experts say?

Jack Penner, a sophomore public health major at Santa Clara University, is the 2010 Denise and John York/49ers Foundation Fellow in Sports Ethics.

More Resources on Ethics and MRSA