Sideline Ethical Dilemmas.

A team physician is covering a local high-school football game. The All-State starting running back injures his shoulder. "David Doe" is in obvious pain. His arm and shoulder are weak, and he is unable to actively raise his arm above 90°. When his pads are removed, there is a noticeable deformity of the acromioclavicular joint. It is the third quarter of the final game of the playoffs, and the winner goes on to the state championship game. David is a college prospect, and there are many collegiate scouts in the stands. David wants to go back into the game, and David's father, who is the offensive coordinator for the team, says he will take the responsibility for sending David back in. The orthopaedic surgeon on the sideline does not return David to the game and, in spite of this, the team wins. After the game, a reporter for the local newspaper approaches the team physician for information on David's injury and prognosis. David does not keep his follow-up appointment in the orthopaedic surgeon's office, but shows up to practice with a note from another physician saying he is able to play.