Football is the national game in the United States – and many families and friends bond over their love of the sport. While few people play professional football, many participate in tackle football as children and adolescents. In the last decades, more attention has been paid to the dangers of playing tackle football, including traumatic brain injury and the degenerative brain disease, CTE (chronic traumatic encephalopathy). As more former players donated their brains, the rate of CTE surprised even those already concerned with traumatic brain injury. If the risks are so great, why do more than two million American children under the age of 18 continue to play tackle football? Is it the opportunity to contribute to a team? Overcome adversity? Test personal limits?

In Tackle Football and Traumatic Brain Injuries: Law, Ethics, and Public Health (Johns Hopkins UP, 2024), Dr. Daniel S. Goldberg asks readers to think about American tackle football as an industry – like the American tobacco industry – that sells a product that is dangerous to those who use it. Despite the clearly documented costs to society and individuals who play, the tackle football industry has successfully manufactured doubt about the health hazards. Goldstein argues that a basic familiarity with the history of regulated industries and their intersection with public health is needed both to understand the contemporary debates and to move forward with fair and equitable policy solutions. If the risks to people who play were better known to the public, the profitability and perhaps even the viability of American football would be at risk.

Goldberg draws on public health ethics, public health law, and the histories of occupational and public health to assess the limits of parental choice to expose their children to risks of injury. Goldberg recommends using public health laws to counter the manufacture of doubt – offering specific policy proposals to address the population health and ethical problems presented by tackle football.

Daniel S. Goldstein, JD, PhD is an associate professor at the Center for Bioethics and Humanities at the University of Colorado Anschutz Medical Campus. He is the director of Education at the Center for Bioethics and Humanities and director of the Public Health Ethics and Law Program.

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