Emerging intersections of biomedical technology and elite sport: institutions, practices and ethics

Biotechnological medicine and elite sport are two of the most powerful and symbolic institutions of the contemporary era. They spearhead scientific enterprise and public culture. The incidence of injury to elite sports performers is conspicuous, often represented as a crisis of national and individual ambition, and the pressure for state-of-the-art prevention, diagnosis and treatment is severe. There are growing signs of interactions between these two worlds (for example International Football Federation FIFA's rapidly expanding accreditation of globally-distributed cutting-edge medical centres). Yet there is no systematic investigation of the intersections between elite sport and biomedical innovation and the significance for society.

The project will examine the development and application of a set of innovative biomedical technologies relevant to musculoskeletal injury, as a lens through which to explore the emerging interactions. Musculoskeletal injuries are prominent amongst high performance athletes and there is a high level of bio-scientific activity in this field, for example for articular cartilage repair and stem cell research in tendons and muscles. This focus will enable us to ask two types of questions. Against an initial mapping of emerging interactions between the sports and biomedical fields, the research will ask, first: What are the effects of sports patronage and collaboration on biomedical innovation, and conversely, how does biomedical research and technology innovation impact on elite sports and its athletes? Second, the research will clarify the ethical issues raised by these developments in the public sphere and how publics and stakeholders understand and evaluate these issues (including but not confined to the 'human enhancement' debate).

A multi-method research design will set the study in the context of sports in general, focusing on football (soccer) and cycling as case studies because of their different funding regimes and injury profiles. Data will be collected via documents (e.g. medical policies and research policies of sports organisations), interviews (e.g. with medical officers, insurers, biomedical scientists) and observation methods (e.g. at sports' medical conferences). We will carry out ethical analysis and undertake public engagement (deliberative interactive online debate; focus groups) to clarify issues of concern, and to inform and elicit public opinion. Implications will be presented in a policymakers' forum. The research will inform stakeholders in sports and biomedicine and their intermediaries, and will be of value to a range of policy communities including both Science/Enterprise/Business and Culture/Media/Sports, to academic study of emerging scientific economies, science & technology studies and the sociology of sport, and will be of immediate concern to wider publics and sports participants, given special impetus around the London Olympics and other world-level sports events in the UK in this decade. The UK is the primary focus, set in the context of wider regional and global sports organisation and authorities, international bioscientific networks and medical practice. An expert advisory group including sports representatives and a specialist clinical scientist with sports connections will support the project.

This is cross-sectoral research with correspondingly diverse beneficiaries and impacts.

The main beneficiaries are:
- policymakers, entrepreneurs, private and public intermediaries in emerging innovative biomedicine sectors and specifically the sports injury, diagnostic, therapy and rehabilitation marketplace;
- sports institutions, authorities, clubs and their medical and other advisers;
- service providers such as sports injury and rehabilitation providers, planners and representative bodies in the sports-medicine industries;
- educational institutions (HEIs) and public sector research centres: (1) undertaking scientific and clinical research in molecular diagnostics and regenerative medicine in sports-related applications; (2) providing curricula e.g. in Sports Injury, and in specialist medical training in sports medicine, orthopaedics and rehabilitation;(3) sports law and ethics
-publics; amateur sportsplayers; retired and future elite athletes
- London Olympic 'legacy' actors
- journalists.

Economic sector impact: the research will act as a catalyst for technology and service developers in both public and private sectors who see biomedical technology-related opportunities in the sports injury and rehabilitation field. The research will raise awareness of opportunities for biomedical enterprise, spin-offs, and emerging medical business models, in what is undoubtedly a growing niche sector, and will provide signposts for future trends in the emerging marketplace. The types of commercial and public sector contracts that are developing will be ascertained. We will achieve impact here by short 'Research Highlights' publications, and publication in forums where multiple interests converge such as conferences and the 'Regenerative Medicine' journal. Specific forums and bodies in football and cycling will be targeted.

Policy impacts: the research cuts across two main UK government policy departments, namely the Department for Culture, Media and Sport and the Department for Business, Innovation and Skills. Short briefing reports are an appropriate medium through which to achieve a minimum of impact on policymakers' radar here. Looking to longer term impacts, and given general concerns about policy silos, we will engage users in a focused way by convening a future-oriented cross-sectoral workshop of these and other stakeholders, to embed the research in policy debates and to examine the lessons for potential policy intervention for the innovative therapies/sports sector, taking account of ethical perspectives.

Impact on society and publics: The research will also impact on public 'issues' in elite sports that are the subject of debate and controversy, including the player implications of globalisation and commercial exploitation of sports, clubs and players; 'premature ageing'; the lifecourse effects of sports injury and athlete wellbeing; and the enhancement/regeneration debate. Our analysis of the institutional intersections between academic and commercial medical enterprise and sports' institutions/practices will presage future practical developments in 'human enhancement', and our ethical analysis will clarify provide a model for public and stakeholder debates. To achieve impact here we will place the research findings and ethical appraisal in the public domain through narrow and broadcast media, including securing the interest of appropriate specialist journalists in the broadcast media.

The research impact will be sustained through the use of a dedicated, multimedia, updated website with a 'visitor book' comment/feedback facility, and a range of high-quality academic social science, policy-oriented and public outputs. Our advisory group which has expertise and key positions in academic sports-related biomedical and clinical science and in sports policy will act as embedded users of the research, providing direct linkage into academic, public and private sector user networks.