Ethics and injury risk in World Rugby and England Rugby tackle-height trial

Concerns about concussion in contact sport have permeated debate within sports medicine.1–4 Considerable scientific attention has been focussed on the short-term and long-term outcomes of concussions, as well as the strategies to reduce the risk of traumatic brain injury. The practicalities and impact of altering rules (laws) in sport—including the evaluation of outcomes—are often considered. In the elite setting, World Rugby recently opted to lower the permitted tackle height in Championship Rugby.5 6 We believe this research intervention7 raises some ethical questions around informed consent and the right to withdraw, since the players were contractually compelled to participate. Unfortunately, rather than reducing injury risk, this research intervention also resulted in an increased risk of concussion. Thus, we alert the reader to issues relating to the ethics and increased risk of injury following this research intervention and make some recommendations for the future. We are concerned by the ethical approval and participant selection processes employed in this research intervention. Indeed, this trial was conducted by World Rugby following research published by World Rugby employees.5 …