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Chronic Traumatic Encephalopathy in

the National Football League

Michael Espino

University of Arizona
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Abstract

The purpose of this paper is to demonstrate how Chronic Traumatic Encephalopathy (C.T.E.) as

well as other brain diseases cause ethical issues within the National Football League (NFL).

Brain diseases effect players that are hit hard in the head repetitively, causing impulsive

behavior, depression, and even suicidal thoughts. This disease has been diagnosed to many

former NFL players. With the NFL taking notice of C.T.E. research conducted by Dr. Ann

McKee, the NFL is now faced with possible stakeholder, financial, legal, and ethical issues

within their organization as the C.T.E. data has been brought to light.
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On January 2nd, 2018, an American football quarterback at the Washington State

University named Tyler Scott Haun Hilinski committed suicide. The twenty-one-year-old

junior’s suicide shook not only the university, but also his hometown of Claremont, California.

Hilinski attended Notre Dame High School in Sherman Oaks, California and during his time as

the quarterback on his high school football team he passed for over three-thousand yards and

thirty-six touchdowns. In his household he grew up with an older brother that was also a

quarterback at Notre Dame High School and a younger brother that was also a quarterback at

Orange Lutheran High School.

Hilinski was set to be the starting quarterback for Washington State during the 2018

season. Although it may have seemed like the young football star had a bright future ahead of

him, Hilinski committed suicide by a self-inflicted gunshot wound to his head. This left his

family wondering why he would have taken his own life. The family decided to have his brain

tested by Mayo Clinic after his death. The medical examiner found that Tyler did not have drugs

or alcohol in his system during his suicide. However, the examiner did find that Tyler did have

the first stage of chronic traumatic encephalopathy (C.T.E.). This confused doctors and family

members because Tyler suffered from this disease that is mostly caused by excessive trauma to

the head as a quarterback, which is the most protected position on the football field. A doctor

also mentioned that the twenty-one-year-old football player had a brain that looked “like that of a

much older, elderly man” (Sports Illustrated).

The family came to the conclusion that Tyler was dealing with feelings that the family

could not understand, but Tyler’s mother did not blame the sport for her son’s disease. Chronic

traumatic encephalopathy is a degenerative brain disease that is mostly found in athletes, military

veterans, and people that have also endured repetitive head trauma during their lifetime.
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According to The New York Times, during 2014, Dr. Ann McKee, a MED professor of neurology

and pathology, conducted an experiment on two-hundred and two brains that were donated from

former football players. The data from this research showed that of the two-hundred and two

brains, one-hundred and seventy-seven brains did have C.T.E. One hundred and eleven of these

brains were former NFL players and ninety-nine percent of these brains did have C.T.E. Football

players as young as high school age were conducted in this research as well, of fourteen brains

there were three brains that had C.T.E.

The research done by Dr. Ann McKee gave the world much more information about

C.T.E, this also included the NFL. Shortly after, the NFL issued a statement regarding their

thoughts on the research results. The NFL stated “We appreciate the work done by Dr. McKee

and her colleagues for the value it adds in the ongoing quest for a better understanding of C.T.E”

(NFL). With the research introducing the C.T.E. disease to the world, the NFL had very little

knowledge about the disease as well. Just a year before, the football organization was faced with

lawsuits involving more than 4,500 former NFL athletes. These ex-players were suing the

organization for their health issues that they believed were caused by the sport’s danger of

excessive head traumas. Some of these athletes were suffering from dementia, depression, or

Alzheimer’s disease. In defense, the NFL denied their part in any wrongdoing, however the NFL

Commissioner Roger Goodall felt that it was important to “do the right thing” for their ex-

players. After the settlements, the NFL awarded $5 million to ex-players with Alzheimer’s

disease, $4 million to the families of ex-players that died with the brain condition C.T.E., and $3

million to ex-players with dementia. This did also include the former NFL players that were not

included in these lawsuits. In addition to these lawsuits, the NFL has also created a total of 47
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rule changes to the sport since 2002 to protect their athletes, practice healthier play on the field,

and to help teach players about their health in the sport.

Although the NFL must take care of the health of their players, the NFL also has a duty

to pay their players, staff, and sponsors as well. This is done by selling football tickets,

merchandise, and the most popular NFL official jerseys. The fan base of the NFL exceeds those

of other professional sports. According to The Washington Post, six in 10 American are fans of

the professional football league. With this new information of C.T.E. possibly being caused by

the sport, many fans acknowledge the dangers that the sport exposes to their favorite football

players, but they still choose to watch the games anyways. An interview was conducted by The

Washington Post where the interviewer asked a 70-year-old football fan her thoughts about the

mental health of football players and responded with “Since it is their long-term health, I

shouldn’t be expected to pay for it. I don’t have a problem watching it if they are dumb enough

to make those choices for the big bucks”. With that said, the average salary of NFL players is

$2.1 million, but other high-performing players are paid well above this. However, this may

make someone question if players are obligated to be more reckless on the field to make plays

that draw the fan’s attention and award their team and individual attention that may potentially

cause an increase in their salary. The woman that was interviewed by The Washington Post was

not the only person to feel this way, another supporter of this is President Donald Trump. While

bashing the NFL on their response to the issue of NFL players kneeling during the National

Anthem, he also mentioned that the new rules and efforts by the NFL to prevent head injuries to

their players makes the game less enjoyable. He stated “Because you know, today if you hit too

hard — 15 yards! Throw him out of the game. They had that last week, I watched for a coupled

of minutes. Two guys, just really, beautiful tackle. Boom! 15 yards. The referee goes on
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television, his wife's so proud of him. They're ruining the game! They're ruining the game”

(Business Insider). This is just an example of how some people feel the sport should be like, the

game is to be as violent as can be for their enjoyment.

Although the NFL have fully acknowledged that C.T.E. and football do have correlation,

even football players feel that the sport is not doing enough to fully support their players well-

being. An example of this is the former UCLA wide receiver Cordell Broadus. Cordell is the son

of famed rapper Snoop Dogg. Cordell began playing the sport very young, his father was even

the coach of this youth football league team, and Cordell has stated that he played the sport so

much because it gave him connection to his father. Broadus later made it to the UCLA where he

was already being scouted by the NFL, but he decided to part ways with the sport all together.

The main reason for his departure was because of the health risks associated with C.T.E.

The NFL may have awarded former players money for their conditions, but that does not

necessarily mean that they will continually give money to current and future players that are

affected for a lifetime by head trauma. The NFL may have realized that the game did cause many

of their former players, such as former New England Patriots tight end Aaron Hernandez who

suffered from C.T.E after his autopsy results showed signs of C.T.E. Hernandez also committed

suicide in prison while serving time for being convicted of three murders. The organization has

taken the precautions from more incidents like this happening again by educating their

organization and enforcing new rules to prevent players from enduring head trauma. This may

cause the NFL to not be of liability since they did what they could to help players and it was the

players responsibility themselves to comply with the rules and practices based on the training

and education provided by the NFL. If the NFL pushes for more rules to provide safety to their

players, this may result in more fans becoming angry that the sport is becoming too “boring”. By
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fans no longer being entertained, the NFL also runs into the issue of losing money as people no

longer support their organizations and stadiums no longer fill up. With the demand for football

merchandise and tickets decreasing, this would later take an effect on the player’s salaries also

making them unhappy with the NFL. From a legal standpoint, if the NFL continues to promote

violent actions within their games, this will result in more lawsuits in the future when current

football players, and even future NFL players are diagnosed with brain diseases. In the case of

Tyler Hilinski, his brain tissue had been tested for having C.T.E. at just twenty-one-years-old.

This is a sign that the cases of C.T.E. and other brain diseases will definitely increase in the near

future as the NFL continues their recruitments of college students. Ethically, the NFL needs to

find a way to maintain the huge fan base it has as well as promoting the best health standards for

their athletes. Whether it be losing potential players like Cordell Broadus that lost interest in the

organization after the C.T.E. issue in football was first brought to him, or contribute to the

deterioration of mental health in their young football stars like Tyler Hilinski.

I am a fan of football and I do find it entertaining to watch players get hit hard. However,

brain damage is no laughing matter and should definitely be controlled in the game for the

player’s safety. I believe that the NFL should continue on with adding rules, similar to the head-

to-head contact penalty, or even creating better equipment such as increased protection on NFL

helmets, to their players to use in order to ensure their safety on the football field. The players

signed a contract to play, but that does not mean they should be having to sign up for any long-

term damage on their health. The NFL has many young children that wish to make it into their

organization, it is important for the NFL to change the current culture of dangerous actions in the

game to promote safe gameplay for future generations. This may cause a change in regards to
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their fan base and their finances, but this is the ethical decision to make for their current football

players and the future players to come in the future.

Reference

Brennan, C. (2018, October 24). Merril Hoge, co-author of new book are way off target in

discussing football, CTE. Retrieved from

https://www.usatoday.com/story/sports/christinebrennan/2018/10/24/cte-football-merril-hoge-

ignores-evidence-facts/1750125002/

Chantilly Post. (2018, September 26). Snoop Dogg Proud Of His Son For Quitting Football After

Studying Dangers Of CTE. Retrieved from https://www.hotnewhiphop.com/snoop-dogg-proud-

of-his-son-for-quitting-football-after-studying-dangers-of-cte-news.60734.html

Kilgore, A., & Clement, S. (2017, September 06). Poll: Nine in 10 sports fans say NFL brain

injuries are a problem, but 74 percent are still football fans. Retrieved from

https://www.washingtonpost.com/sports/poll-nfl-remains-as-popular-as-ever-despite-head-

injuries-other-concerns/2017/09/06/238bef8a-9265-11e7-8754-d478688d23b4_story.html?

noredirect=on&utm_term=.b972dd8f7505

Loria, K. (2017, September 26). Trump suggested the NFL is being ruined now that it's addressing

brain injuries - here's what collisions do to players. Retrieved from

https://www.businessinsider.com/trump-nfl-criticism-concussions-brain-injuries-cte-2017-9

Person. (2017, July 26). NFL issues response to CTE research report. Retrieved from

http://www.nfl.com/news/story/0ap3000000822159/article/nfl-issues-response-to-cte-research-

report

Tyler Hilinski had Stage 1 CTE. (n.d.). Retrieved from https://www.si.com/college-

football/2018/06/26/tyler-hilinski-stage-1-cte-washington-state

Tyler Hilinski. (2018, September 11). Retrieved from https://en.wikipedia.org/wiki/Tyler_Hilinski

What is CTE? (2018, November 06). Retrieved from https://concussionfoundation.org/CTE-

resources/what-is-CTE

Ward, J., Williams, J., & Manchester, S. (2017, July 25). 111 N.F.L. Brains. All But One Had

C.T.E. Retrieved from https://www.nytimes.com/interactive/2017/07/25/sports/football/nfl-

cte.html