As we learn about mutations this week, a notable one is the mutation that affects the hemoglobin protein, resulting in the disease known as Sickle Cell Anemia. If you are unfamiliar with the Sickle Cell Trait (SCT), read more about it here.
SCT has been in the news recently due to policy surrounding the testing of athletes. Coaches, school officials, parents, and even players themselves are wondering if knowing their genetic susceptibility to certain conditions can help keep them safe and healthy while competing. The NCAA recently began screening collegiate athletes for SCT. We all have two copies of our hemoglobin gene–one from mom and one from dad, and most of us have two copies of what’s called Hemoglobin A. However, another variant of the gene, called Hemoglobin S, causes a person’s red blood cells to change shape (into a distorted curve that looks like a sickle, hence the name), which causes a lot of health problems. Oxygen cannot get delivered to the body’s tissues as easily, because the blood cells can’t carry it as efficiently, but also because they get lodged in blood vessels more easily and are more fragile. If both of a person’s traits are the Hemoglobin S variant, the individual will have Sickle Cell Disease. If only one of the alleles is Hemoglobin S, and the other is the normal Hemoglobin A, then they are a carrier of SCT. A person with SCT may not have Sickle Cell Anemia, but they are still at a higher risk from complications related to intense exercise and activity, not to mention they can pass the trait on to their children.
For the NCAA, the goal is to save lives. In the United States, African-Americans have the highest prevalence of SCT among ethnic groups, and several athletes have already died during competition from its complications. The resulting lawsuits have initiated SCT sreening, so students can find out whether they carry the trait (it’s actually a required newborn test in every U.S. state, but many people don’t know if they are carriers or not). Not everyone is on board with the NCAA’s decision, however. Many say that’s not the most efficient way to be safe or prevent death. Instead, they say focus on safety conditions, and be more aware of dehydration and exhaustion. The argument is that this is better for ALL athletes, regardless of genetics. Though it is true that people with SCT are more likely to suffer from heat strokes, dehydration, and muscle breakdown.
For a little more background on this situation, please read the following articles:
Now that you fully understand the context of the whole situation, imagine that we had athletic programs here at APUS, and that the school administration was deciding on an institutional policy regarding SCT. How would you advise on such a policy? If you were being consulted, what would be your screening policy, how would you implement it, and how would you evaluate it? Address these questions by focusing specifically on the following list of questions (all 8 of them):
- Should your school screen all athletes or potential athletes for SCT? Why or why not? Do the benefits of doing so outweigh the negatives?
- Why do some people think everyone should be screened (called universal screening)?
- Why are others, including the American Society of Hematology (an organization of blood doctors), against universal screening?
- Explain your reasons for creating this policy. How could your policy help students? Could it harm students in any way?
- How can you ensure that your policy is fair to all students?
- If you argue for SCT screening, how will this policy be implemented? How will the school pay for the screening? What will happen to students who test positive? Note: Students who test positive for SCT in the NCAA are still allowed to play.
- If you argue against SCT screening, what other measures might you propose to keep student-athletes safe?
- How will you evaluate the success of your policy?
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