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the AMA vs BOXING

                            The Hypocrisy of Selective Concern
                          (c) Copyright 1988 Robert J. Hustwit

With this edition of the Informer we begin our second year
of publication. You might be wondering what boxing or the
AMA have to do with philosophy.  Here at the Institute we
always try to entertain as well as to inform; this month's
edition of the Informer is no exception.  In this issue
we're going to take a look at a very powerful philosophical
tool, the Hypocrisy of Selective Concern and we'll use the
AMA vs. Boxing to demonstrate it.

Over five years ago, the American Medical Association launched
a vicious attack on the sport of boxing, actually calling for
it to be banned. The attack was contained in two editorials published in the
January 14 1983 edition of the "Journal of the American Medical Association",
or "JAMA", as it is called.

At the time, the editorials caused quite a stir.  They were based on 
an AMA report presented by Jack E. Battalia, MD, and his colleagues, titled
"Brain Injury in Boxing," and also to a lesser extent on an independent report
by Ronald J. Ross, et al., "Boxers--Computed Tomography, EEG, and Neurological
Evaluation", published in the same issue of JAMA.  My references to a report
will be to Battalia's work, unless otherwise noted.

The boxing world was stunned.  It tried to defend itself, saying that
boxing really wasn't that dangerous.  But, along with most of the people
who heard this, I thought that boxing was dangerous.  Since I love the
sport of boxing and have been a lifelong fan, I certainly didn't want it
banned.  Even so, I thought that the AMA must have a point.  I naturally
assumed that if an organization as prestigious as the American Medical
Association took its time, money, and reputation to conduct scientific
studies, and came to the conclusion that boxing should be banned, then they
were trying to save tens of thousands of lives a year.  I assumed that
hundreds of thousands of boxers would be spared brain injury.  I was wrong.

According to Ralph Citro, Inc., a worldwide database of boxing, which
covers all commissions, fewer than four professional boxers worldwide die
each year from injuries sustained in the ring. (June, 1988)

Since 1979, Citro says that there has been a total of 30 professional
boxing deaths worldwide.  This figure agrees with the statistics offered on
page 255 of the AMA's report.  On the same page, the AMA guesses that
"perhaps 15% of professional boxers" suffer brain damage each year.  Citro
counts between 12 and 30 thousand professional boxers worldwide; that means
that if the AMA's guess is correct, somewhere between 1,800 and 4,500
boxers per year "perhaps" suffer brain damage.  All of my references to
boxing in this article are to professional boxing.  As near as I could
determine, there are about four or five deaths a year worldwide in amateur
boxing and a much lower incidence of brain damage; however, in the absence
of current hard data on amateur boxing, I will discuss only professional
boxing, even though the AMA does on occasion refer to the amateurs.

As tragic as any premature death may be, and as dreadful as brain damage
certainly is, somehow or other, the AMA's call to ban boxing didn't seem to
be justified by the facts.  So I sent for copies of JAMA's editorials and
scientific reports to see for myself what the AMA's stand was and how they
explained it.  What I learned was shocking.  I am going to share it with
you here, and use what I learned to illustrate a wonderful tool I call The
Hypocrisy of Selective Concern.  This tool can help in sifting through and
analyzing information; it can be used to help correctly evaluate the deluge
of information that hits us every day.

When I received my copies of the articles, I was surprised at the
editorials. They are titled, "Boxing Should Be Banned In Civilized
Countries", by George D. Lundberg, MD, and "The Deadly Degrading Sport", by
Maurice W. Van Allen, MD.  Somehow this didn't sound like the calm,
dispassionate, reasoned approach I had expected from doctors.  In fact the
editorials are not at all reasoned, certainly not calm or dispassionate,
but rather appear to be emotional tirades.  The words and phrases used are
adult, but the tone of the editorials is decidedly juvenile.  After reading
them, I was convinced that the scientific report which followed must cite
some appalling statistics on death and brain injury in boxing in order to
elicit the kind of emotional outrage exhibited in the editorials.  I was in
for a surprise.

Dr. Battalia's report presented no evidence whatsoever to suggest that
boxing should be banned, nor did it draw that conclusion, nor did it make
that recommendation, even though it was clearly biased against boxing. The
report, titled Brain Injury in Boxing, had two things wrong with it.  The
first was its obvious bias, and the second was its hypocrisy.  As an
example of bias, the report states in its very first paragraph, on page
254, that boxing is, "the sport in which the ultimate goal is to reduce the
opponent to a state of total and complete helplessness."  Please note that
this is not the conclusion of the report, this is its starting premise!
While I recognize that this opinion of boxing is shared by many people, it
is after all, only an opinion, not a fact.  For instance, my opinion is
that the ultimate goal in boxing is to win, and the fact is that most
boxing matches are won on points, not by knockouts (Citro).  Even the AMA's
own report (p 255) shows that fewer than 7% of professional (and fewer that
1% of amateur) boxing matches end by knockout.  In fact, a boxer tries to
get points for offense, defense, skill, strategy, tactics, and overall
ring generalship, and yes, he will try to knock out his opponent if the
opportunity presents itself.  But to say that the knockout is the purpose
of boxing is almost like saying that sacking the quarterback is the purpose
of football.  Obviously, in football, the purpose is to win by scoring
points (offense) while trying to keep your opponents from scoring points
(defense), and, if the opportunity presents itself, you bet, sacking the
quarterback.

Now to the point of this article and the second thing wrong with the AMA's
report:  Hypocrisy.  It is the hypocrisy of selective concern.

When you are told something of a factual nature, and you can independently
verify the facts, there's no need to be concerned with the motives of the
person or organization telling you...you can see for yourself.  However,
when you are presented with opinion, bias, and interpretation, it is
perfectly proper to question the motives of the person or organization
doing the presenting.  The AMA is clearly biased against boxing, as even a
cursory reading of their editorials and reports shows.  Therefore, we can
and do question their motives in attacking boxing.  I admit to a bias for
boxing, I love the sport, and so you are free to question my motives in
defending it.  But be sure to note the difference between my defending
boxing, and my pointing out what I call the Hypocrisy of Selective Concern.
Also note that where facts are cited, you can independently verify those
facts and that you can and should draw your own conclusions based on them.

First of all, both Lundberg and Van Allen attack boxing, calling for it to
be banned.  Why?  Why would they and the AMA care one way or the other
about boxing?  Apparently they are concerned with boxing deaths and with
permanent brain-damage caused by boxing (Lundberg, Van Allen 250, Battalia
254).  Let's assume this to be true.

It is here that the Hypocrisy of Selective Concern is particularly useful
and powerful.  First of all, we must understand the difference between the
statistical probability and the actual number of people or things being affected.
While both figures seemingly describe the same thing, in fact each
of them gives very different information.

For example, in the AMA's report on brain injury, page 255, the fatality
rate for both amateur and professional boxing is given at .13 deaths per
1,000 participants per year.  This figure is an example of the statistical
probability of being killed in amateur and professional boxing worldwide.

If we look only at the above statistic, we can easily be misled.  For
example, most people would assume that if the AMA attacks boxing saying
that the death rate is .13 per thousand, hundreds or even thousands of
lives each year could be saved by banning boxing.  But when we get the
complete picture by looking at the actual number of people affected, which
the AMA carefully avoids doing, we come to a very different conclusion.
Between three and four professional boxers worldwide die each year in
boxing.

By looking at the actual number we see that even if we could successfully
ban boxing, we would not save thousands or even hundreds of lives each
year; in stead, for all of our effort, we would save three or four lives.
If we can justify banning boxing based on that, then using the same logic,
we can argue that driving automobiles should be banned, as, according to
Estimated Death

Rates for Selected Causes, 1984-85, in the 1986 World Almanac & Book of
Facts, over forty thousand people each year die in auto accidents.

The AMA, however, appears to be more concerned over the three or four lives
lost in boxing.  They are also concerned enough over their guess that
"perhaps 15% of the professional boxers" suffer permanent brain-damage to
conduct studies, issue reports, write editorials, hold conferences and
insist that boxing be banned, all of which they did in the January 14 1983
issue of JAMA.

Is the AMA concerned with sports deaths and injuries only where boxing is
concerned?  I don't think so, and I believe that the AMA would say of
course not, that they are concerned with any death or injury; yet the AMA
hasn't suggested that college football, motorcycle racing, scuba diving,
or horse racing be banned, even though on page 255 of their own report they
claim that all of them have statistically higher fatality rates than
boxing.  (And, I believe, higher actual numbers as well.)

If the AMA is truly concerned with saving actual numbers of lives, if the
AMA is truly concerned with keeping actual numbers of individuals from
being injured, the AMA need look no further than Doctor of Medicine, the
profession of its own membership.

If the AMA is genuinely concerned with saving lives, then why engage in an
expensive, futile, and time-wasting exercise in rhetoric against boxing,
when, according to Inlander, Levin and Weiner, in their book, Medicine on
Trial, merely by having medical doctors eliminate unnecessary surgery, they
could save between forty and eighty thousand lives per year in this country
alone?!!(p 113)  Unnecessary surgery is surgery performed when, in the
prevailing opinion of the medical fraternity, there is an equally effective
non-surgical remedy.

Remember, in professional boxing worldwide, three or four people tragically
die each year.  Everyone connected with boxing wishes it were zero and
constantly tries to make it so.  But between forty and eighty thousand people
each year die in the United States in unnecessary surgery.  Over two
thousand people die each year as a direct result of "human error" in the
administration  of anesthesia by qualified medical doctors (Inlander 51).

100,000 people each year die of diseases that they contract while in the
hospital (Inlander 124)!  And finally, incredibly, over 78,000 people each
year are given cancer as a direct result of medical/dental X-rays (Inlander
106).

Now (believe it or not) this is not meant to be an attack on the AMA or the
medical fraternity (it really isn't).  The above numbers are simply facts.
Appalling facts to be sure, but nonetheless verifiable facts known to the
AMA.

What can we deduce from these facts?  Let's first of all ask why the AMA
hasn't taken an editorial position to ban incompetent Medical Doctors.

Certainly they would save many more lives than by banning boxing.  It is
here that we finally get to the heart of The Hypocrisy of Selective
Concern.  You see, if the AMA is really concerned with saving lives and
preventing injury, it obviously has better ways to show that concern than
by trying to ban boxing. . . beginning with the statistically twice as
deadly college football (Battalia 255) and ending at their own doorstep.

Here then, is the use for the concept of the Hypocrisy of Selective
Concern: We can clearly determine what a person's or organization's primary
motive cannot be, regardless of what they claim.

In the example of the AMA vs. Boxing, for instance, we can't know what the
AMA's motives really are, but an understanding of the Hypocrisy of
Selective Concern shows us that their primary motive cannot have been to
save lives and prevent injury.

I do not know Dr. Lundberg or Dr. Van Allen, the two men who wrote the
scathing editorials, but I personally do not believe that they are bad or
stupid men.  I have no idea what kind of doctors they are; I do not know
how they live their lives.  I do know, however, that in the instance of
these editorials, they acted as mean-minded, immature individuals.  I am
sure that most of us have at one time or another acted in this fashion.
However, we normally try not to go public with our occasional bouts of
mean-spiritedness and immaturity.  The good doctors have the unfortunate
distinction of putting their foolishness in writing.  I believe that the
primary motive for their attack was simply the immature exercise of power
by the two so-called editors.  They had the opportunity to say something
bad about something they didn't like, and they took it, using the aura of a
supposedly respectable medical journal for legitimacy.

In terms of the AMA's so-called scientific report, however, I believe there
is another, larger motive, a motive that is probably subconscious on the
part of the AMA; I call it the Professor Harold Hill Syndrome.  It is
expressed in the conclusion of their "scientific" report on boxing, on page
256, which reads: ". . . strict medical supervision should be required for
the sport of boxing."  And guess who's going to supply that required
medical supervision. Those of you who are familiar with the wonderful
Broadway musical "The Music Man", by Merideth Wilson, will recall Professor
Harold Hill, played by the late Robert Preston, arriving in River City,
Iowa, and convincing the residents that they, "had trouble, trouble right
here in River City . . .," in the form of a pool hall, and, guess what,
Professor Hill could solve the problem.  Well, in the musical, the pool
hall wasn't really a problem, but a ploy used by Professor Hill to help him
sell his boy's band paraphernalia.  I think the AMA is using the same
tactic, trying to convince us that there are problems in boxing but not to
worry, they can solve them.  In fact there are problems in boxing, no one
denies it, but I don't believe (my opinion) that the AMA knows what they
are, nor do I believe they have the answers.  They can't even solve their
own problems.  They can't even agree on what their problems are.  To be
fair, some of their recommendations on boxing seem to be useful, but they
are recommendations long advocated by the boxing industry itself.

The AMA is guilty of hypocrisy...it is the hypocrisy of selective concern.
Selectively, the AMA chose to be concerned over death and injury in a sport
which they consider "uncivilized" (Lundberg 250), "deadly, degrading" (Van
Allen 250), "atavistic" (Ross 211), and in which they claim, "the ultimate
goal is to reduce the opponent to a state of total and complete
helplessness" (Battalia 254).  All of these statements are examples of
opinions, not facts. Imagine the plight of the poor boxer, told by the
medical fraternity that he is engaging in a deadly sport, but not told by
that same medical fraternity, that if he should ever find himself in their
arena (major surgery), his chances of dying are one hundred times greater
than when he is in the ring (Inlander 113).  Just how does the AMA define
deadly, anyway?

In these days of compressed, edited and condensed news, we seldom get the
complete story on anything.  In spite of that, we often feel as if we
"know" that a certain thing took place, or that a certain thing is true.
We may later find (at our expense) that it is not true, that this thing we
thought we knew was really based on false premises or was simply misstated
or misunderstood at the beginning.  Many people, making no distinction
between the AMA's editorial position and the AMA's actual position, heard
that the AMA wanted to ban boxing, and assumed that it had good reasons.
They may even have heard that the AMA had studied the matter, and assumed
that the study was objective and showed that boxing was so dangerous that
it should be banned.  As time passes, most people forget the specifics and
just remember something like "The American Medical Association wants to ban
boxing, therefore boxing probably should be banned."  Well, the facts are
that the two immature and selectively hypocritical editors we mentioned
would love to ban boxing, but the AMA itself does not want to ban boxing
(Battalia 256).

Please note that I have not questioned the AMA's facts, I have merely used
the concept of the Hypocrisy of Selective Concern to question their motives
and conclusions.  I believe they stand convicted of trying to foist an
emotional, irrational, and harmful opinion on us as if it were the
considered rational  conclusion of a scientific, factual investigation.

We are bombarded by more and more information each day.  If we use the
concept of the Hypocrisy of Selective Concern, we can better sort through this
information and really give ourselves a fuller, truer understanding of it.
I have used the American Medical Association's slightly hysterical and
rather absurd editorial position on boxing to illustrate my point.  The
purpose of this article was to demonstrate the value of applying even a
relatively trivial philosophical tool such as the Hypocrisy of Selective
Concern to our everyday lives, not to attack the AMA, medical doctors, or
the medical profession; nor was it to support or defend boxing.

In order to give you a taste for the broad usefulness and real power of the
Hypocrisy of Selective Concern, we'll use it to give a very brief, two-
paragraph analysis of another topical issue: gun control.

Why is all of the time and money spent on trying to ban handguns or other
firearms when according to Murder Weapons, 1981-85 in the 1986 World
Almanac & Book of Facts, even if all firearms were banned, fewer than
eleven thousand lives would be saved in this country?  And that assumes
that everyone killed with a firearm would not be killed with some other
weapon.

I am not trying to trivialize death; I am not suggesting that 11,000 deaths
is something we need not be concerned with;  I am not defending the firearm
industry; I am not a gun person, I don't like guns and I don't own a gun.
The fact is, for the time and money that the gun-control and anti-gun
people are spending, they could save more lives and prevent more injuries
by doing something about world hunger, cardiovascular diseases, or even
that good (or bad) old standby, the flu, which kills almost seventy
thousand people a year in this country, (Estimated Death Rates) or malaria,
which, in their book FATAL FACTS, Long and Reim say kills over one million
people each year worldwide (p 22).

Using the concept of the Hypocrisy of Selective Concern, we can see that
the proponents of those movements must have some other primary motivation
than just saving lives.  This is not to say that they are not concerned
with saving lives, just that it isn't their primary motivation.  Once we
have established that fact, we can put much of what they say into the
proper con text, perhaps that of biased opinion rather than fact; and as
time passes, we will be less likely to have false knowledge mislead us.

Addendum:

I tried to end this article here, I really did, but I find that I must
offer just a few more editorial comments.

There are many inconsistencies, many examples of bias and prejudice, and
many examples of poor scientific observation in the editorials and reports
on boxing in JAMA.  I cannot cite them all here; in fact, some of the
better examples require too lengthy a discussion for this paper.  I would
be happy to discuss them if you drop by the Institute.

The report on which the editorials are apparently based (?) states in its
conclusion on page 256, "Boxing is a dangerous sport and can result in
death or long-term brain injury.  However, other sports may also result in
accidental death or brain injury for participants.[!]" (italics and
exclamation point mine)  If the second sentence is true, then the question
is, why single out boxing?  On the same page, in the section of the report
titled Recommendations, it says, "Moreover, the sport [boxing] does not
seem any more dangerous than other sports presently accepted by society."
(emphasis mine)  The fact is, the only statistics in their report show that
boxing is far, far less dangerous than the other sports cited.  Evidently
they could not bring themselves to say this.

Anyway, seemingly based on this report, Lundberg states in the final three
sentences of his editorial on page 250, "Boxing seems to me to be less
sport than is cockfighting; boxing is an obscenity.  Uncivilized man may
have been bloodthirsty.  Boxing, as a throwback to uncivilized man, should
not be sanctioned by any civilized society."

And here's doctor Van Allen, in the final paragraph of his editorial, page
251, "Is now not the time to suppress exposure of this fragment of our
savagery by the mass media and leave boxing to those who enjoy privately
staged dogfights?"

Naturally, what the public remembers of the AMA's stance on boxing is not
the conclusions of the report it issued, but the hyperbole of its
editorials.

Another very important point that I can only touch on here is that there is
a fundamental difference in kind between the tragic deaths in boxing and
those in, for example, unnecessary surgery.  The boxer willingly accepts
the risks, and, in fact must work very, very hard and train diligently for
boxing, a sport where the mortality rate is .013% (that's thirteen one-
thousandths of one percent); none of us work very, very hard nor do we
train for years so we can go into unnecessary surgery, where the chances of
dying are 1.3%, or one hundred times greater than in boxing (Inlander 113).
Remember that the actual numbers are even more damning: three or four
deaths in professional boxing versus forty to eighty thousand in
unnecessary surgery.

The next time you watch a newscast or read a newspaper, try using the
Hypocrisy of Selective Concern yourself.  Try it out on the nuclear power
issue, or the smoking vs non-smoking issue, and see what you can learn.
From now on, when you see or hear someone claiming that they want to (for
in stance) save lives, use this philosophical concept to see if that really
is their primary motivation.

Finally, on behalf of boxing, remember that, according to the American
Automobile Association, over twenty thousand people a year die in this
country alone as a result of drunk driving.  Remember that in the United
States, incompetent medical doctors kill over 40,000 people a year and that
cardiovascular diseases kill over one million people each year (Estimated
Death Rates).  And then remember that, on average, fewer than four people a
year, worldwide, die in professional boxing.

                                        


REFERENCE LIST:

ALL REFERENCES TO JAMA ARE TO THE JOURNAL OF THE AMERICAN MEDICAL
ASSOCIATION, JANUARY 14 1983.

Battalia, Jack E. MD, et al. Advisory Panel on Brain Injury in Boxing.
Brain Injury in Boxing. JAMA.

Citro, Ralph, Inc.  Computer Boxing Update.  Blackwood, NJ: telephone
interview, June 21, 1988.

Estimated Death Rates for Selected Causes, 1984-85.  World Almanac & Book
of Facts, 1986. Microsoft Bookshelf  CD ROM (computer).

Inlander, Charles B. and Levin, Lowell S. and Weiner, Ed.  Medicine on
Trial. New York: Prentice Hall, 1988.

JAMA.  All references are to THE JOURNAL OF THE AMERICAN MEDICAL
ASSOCIATION, JANUARY 14 1983.

Long, Kim and Reim, Terry.  FATAL FACTS.  New York: Arlington House, 1985.

Lundberg, George D. MD.  editorials, Boxing Should Be Banned in Civilized
Countries. JAMA.

Ross, Ronald J. MD, et al.  Boxers--Computer Tomography, EEG, and
Neurological Evaluation. JAMA.

Van Allen, Maurice W. MD.  editorials, The Deadly Degrading Sport. JAMA.

World Almanac & Book of Facts, 1986.  Microsoft Bookshelf CD ROM
(computer).

 Since I have this little bit of space left, I did want to mention one
curious thing in the saga of  the  AMA vs Boxing.  Boxing, of all
professions, should know that the best defense is a good offense. And yet
when boxing was attacked, most people in boxing, not all of them, but most
of them  figuratively cowered in the corner, defending themselves against
the imaginary blows of their  attacker, and in the process they looked
guilty. If more of those in boxing had gone on the attack,  using the
Hypocrisy of Selective Concern or some other rational idea, boxing might
have actually improved its image instead of losing ground.  Please call or
drop in whenever you're in  the area.  The Institute is open Monday through
Friday from 1 'til around 5 pm, and you are  encouraged to stop by. We
always have good, fresh coffee, tea, cold water, and stimulating
conversation available.
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