Concussion and head injuries are an increasingly important issue in all sports, but rugby union, with its enormous physical demands, has a particularly close association with the condition.
George North, the giant Wales wing, was involved in a concussion controversy during last Friday’s Six Nations curtain-raiser against England after the Welsh medical team deemed him fit to carry on playing. Video images (see below) would clearly suggest otherwise.
But why is the current system failing to protect players? And what can be done to ensure that rugby remains as safe as possible?
Part of the problem in the case of George North and Wales on Friday was because of the importance of the fixture, combined with the pressurised situation within the match, the Welsh management team clearly did not want to lose its most destructive runner.
This is not to say that the leadership breached rules or knowingly took a risk with George North, but appreciating the concussion's context is crucial to understanding the current problems affecting safety in rugby.
It needs to be recognised that the setting put mammoth and unfair pressure on the Wales medical staff.
Everyone in rugby openly acknowledges that player safety must come first, but in the heat of the moment, say in a World Cup final, it would only be human nature for a doctor to give a more optimistic diagnosis, especially when the player is adamant he is fine to continue.
If he is as good a player as George North, the consequences on the team of losing him could make a huge impact on the result.
Tweeting during the match, former England captain Will Carling had this to say:
Brian Moore, writing in The Telegraph, argued that Wales should be punished for their reaction to the North incident.
"You cannot say that the Welsh medical team were negligent and/or that they did not follow the protocol without more evidence," writes Moore. "You can say that there was a glaring deficiency in Wales’ game management team as a whole that allowed a serious incident, one seen by many others, to go unobserved and unremedied."
This pressure needs to be relieved from the team’s own medical staff. The sport’s governing body, World Rugby (the new name for the International Rugby Board), should intervene and mandate that in cases of suspected concussion, a doctor must be called upon who is not attached to a team.
These independent doctors should be experts in dealing with blows to the head. That way, we can be more certain that player safety is being prioritised, and team medics can be spared difficult situations and focus on other injuries.
The good news to come from the George North injury is that World Rugby has announced that it will be introducing video review for head injuries in time for the 2015 World Cup, which begins in England in September.
Football’s laws now require the referee to stop the game in the case of a head injury, and cricket has reflected on helmet safety and the bowling of bouncers following the tragic death of Australian batsman Phillip Hughes in November.
Now rugby union, a far more physical sport, must ensure that player safety is sacrosanct.