The development of prescription medication for smoking cessation and the introduction of evidence-based guidelines for health professionals has increasingly medicalised smoking cessation. There are debates about whether medicalisation is a positive development, or whether it has devalued unassisted quitting. In this debate the views of smokers have been neglected. This study explored the attitudes of smokers towards a range of quitting methods, and their considerations when judging their value. We conducted semi-structured interviews with 29 smokers and analysed data using thematic analysis. The results show that the perceived nature of an individual smoker’s addiction was central to judgments about the value of pharmacological cessation aids, as was personal experience with a method, and how well it was judged to align with an individual’s situation and personality. Unassisted quitting was often described as the best method. Negative views of pharmacological cessation aids were frequently expressed, particularly concerns about side effects from prescription medications. Smokers’ views about the value of different methods were not independent: attitudes about cessation aids were shaped by positive attitudes towards unassisted quitting. Examining smokers’ attitudes towards either assisted or unassisted quitting in isolation provides incomplete information on quitting preferences.

The inclusion of elite transwomen athletes in sport is controversial. The recent International Olympic Committee (IOC) (2015) guidelines allow transwomen to compete in the women’s division if (amongst other things) their testosterone is held below 10 nmol/L. This is significantly higher than that of cis-women. Science demonstrates that high testosterone and other male physiology provides a performance advantage in sport suggesting that transwomen retain some of that advantage. To determine whether the advantage is unfair necessitates an ethical analysis of the principles of inclusion and fairness. Particularly important is whether the advantage held by transwomen is a tolerable or intolerable unfairness. We conclude that the advantage to transwomen afforded by the IOC guidelines is an intolerable unfairness. This does not mean transwomen should be excluded from elite sport but that the existing male/female categories in sport should be abandoned in favour of a more nuanced approach satisfying both inclusion and fairness.

The Concussion in Sport Group guidelines have successfully brought the attention of brain injuries to the global medical and sport research communities, and has significantly impacted brain injury-related practices and rules of international sport. Despite being the global repository of state-of-the-art science, diagnostic tools and guides to clinical practice, the ensuing consensus statements remain the object of ethical and sociocultural criticism. The purpose of this paper is to bring to bear a broad range of multidisciplinary challenges to the processes and products of sport-related concussion movement. We identify lacunae in scientific research and clinical guidance in relation to age, disability, gender and race. We also identify, through multidisciplinary and interdisciplinary analysis, a range of ethical problems resulting from conflicts of interest, processes of attributing expertise in sport-related concussion, unjustifiably narrow methodological control and insufficient athlete engagement in research and policy development. We argue that the sport and exercise medicine community need to augment the existing research and practice foci to understand these problems more holistically and, in turn, provide guidance and recommendations that help sport clinicians better care for brain-injured athletes.

It is difficult to develop good arguments when the central terms of the discussion are unclear – as with the current confused state of sex and gender terminology. Sports organisations and sports researchers often talk in gender terms when they mean sex; or use the sex and gender vocabularies interchangeably. We propose the use of terminology that distinguishes sex from gender. Historically, sport has been based on sex, as seen in various sex verification procedures specifying female eligibility, based on the determination of sex by biological criteria. We think that this should be reflected in the vocabulary used for the two sport categories (‘male’ and ‘female’, not ‘women’ and ‘men’); and for referring to the binary as the sex binary (not the gender binary); and for calling the procedures sex verification (not gender verification).

Cage-Fighting, also known as Mixed Martial Arts (MMA), is a combat sport that allows participants to grapple, punch, kick, elbow and knee—a combination of elements from many martial arts. While it is debatable whether adults ought to be free to engage in risky sports such as MMA, the question of whether children ought to partake in MMA is even more fraught. This is for two reasons. Firstly, MMA is riskier for children than adults due to their very vulnerable brains and undeveloped and fragile skeletal structure. Secondly, as most children will not have the capacity to consent to engaging in MMA, the decision falls to the parents or guardians. Hence, there is a tension between the parental right to make decisions on behalf of a child and the right of the child to be protected from harm. This paper begins by assessing the empirical evidence concerning the harms and benefits of kid’s MMA, and note the potential for the evidence to be value-laden. We assess the risk associated with kid’s MMA using a rubric that considers both the likelihood and severity of harm. Despite the lack of conclusive empirical evidence, we consider the harm associated with kid’s MMA to be substantial. The paper then outlines the tension between parental autonomy and a child’s right to be protected from harm. After considering the frameworks of best interests, the zone of parental discretion and a child’s right to an open future, we conclude that parents should be able to allow their children to participate in MMA—that kid’s MMA should not be banned.

Smajdor and Rasanen (2024) argue that pregnant women are routinely denied appropriate treatment because pregnancy is seen as normal, and so they are denied ‘patient status’. They claim that formally classifying pregnancy as a disease may lead to better treatment for pregnant women. In this response, we argue that pathologising pregnancy and classifying all pregnant women as ‘diseased patients’ won’t reconfigure care in ways that benefit all women. Rather, it will likely only embolden the view that clinicians are entitled to exercise jurisdiction over pregnant women and beget the increased use of medical intervention where it is not necessarily needed.