Genetic Testing and College Athletes

On April 13, 2010, the NCAA made tests for Sickle Cell Trait (SCT) mandatory, effective in August 2010. SCT is a condition where the blood cells are elongated and potentially block blood flow and resist bonding to oxygen. The trait is generally benign but becomes active under extreme physical stress. For athletes, when performing strenuous activities, the trait is sometimes triggered and can potentially cause death. The statute states “student-athletes must be tested for sickle cell trait, show proof of a prior test or sign a waiver releasing an institution from liability if they decline to be tested.”(Brutlag, 2010) SCT genetic testing and NCAA regulations were implemented in order to protect student athletes, but the testing raises questions of who should receive the test results, the use of the results in discrimination against affected athletes and its potential to be cascade towards excessive genetic testing.
In the current legislation, the results from an athletes test are given to the school, the coach and the athlete. This disclosure policy has the potential to be used to discriminate against those who are afflicted with SCT. Although the athlete has the option to opt out of testing initially once they have the test, the disclosure to the school and coaching staff is automatic. The test results should be first given to the student, and then they should have the option to waive liability and not disclose to the university. An alternative option would be to only disclose the test results to the medical staff to give the players proper attention. This would potentially allow the athlete to be monitored and given care at appropriate times, while potentially removing sources of bias from the coaching staff. Disclosing the results to just the medical staff would be an easy way for proper management of the condition to avoid injury.
The current policy would potentially subject students with SCT to discrimination. Unlike in the workplace, where there are GINA laws in place to prevent employers from discriminating based on genetic tests, there are no such statutes in place in the NCAA (Human Genome Project, 2008). When disclosing to coaches, they may not want to recruit players with SCT, because they may be afraid to train the players as tough because of the risk of SCT complications. The discrimination is unwarranted because with simple water breaks the harmful condition is eliminated. Along with appropriately managed testing the NCAA should be concerned with regulating the practices and water breaks at those practices. Safer practices would reduce the risks to student athletes and more than likely improve performance. A better system for handling of athletes with SCT would require adequate education for the student athlete, the coaches and the training staff when a SCT test comes back positive. This would allow for everyone involved to understand the condition, its potential danger, and the steps required to mitigate its risks. An appropriate education program is the best way to attempt to use the SCT test to protect student athletes from both the dangers of SCT, and discrimination and backlash for having SCT.
SCT tests are the first mandated genetic test for student-athletes, and should not become a gateway to excessive genetic testing. SCT test is a unique example of a test that has a low cost, very specific test result, and that result identifies a condition that is deadly but completely preventable. Contrary to some critics, SCT has become the first genetic test because of the 21 deaths, and not because of any racial element, even though the trait is prevalent in 8% African-Americans and less than 1% white-Americans. Going forward, genetic testing should be closely monitored to make sure that it does not become excessive. It should only be allowed when it is preparing for and preventing medical emergencies, not for recruiting purposes. It should not be used as a way to attempt to minimize liability by selecting for “safer” athletes. Genetic testing can be beneficial when used for the right purpose. It should not bar any player from competing if they take personal responsibility, and give informed consent to the risks associated with their condition. It is legal, fair, and not racist as long as players are not treated differently because of the results, except for medical attention if necessary.
The current regulations of the NCAA requiring sickle cell trait tests and disclosure or waivers from testing should be a temporary solution. Although there are no regulations being broken by requiring genetic testing, there are ways to prevent most aspects of discrimination. Two solutions are to limit disclosure to the medical staff and the athlete, allowing for appropriate medical treatment but limiting discrimination from coaches, or alternatively have an extensive education program for all involved to prevent untrue fears and to assure student safety. In an ideal world, each player should have the opportunity to take the test, and without fear of discrimination and have the opportunity to participate in their sport, with appropriate water breaks to prevent SCT caused injury and death.