Adopted by the 35th World Medical Assembly, Venice, Italy, October 1983
and editorially revised by the 170th WMA Council Session, Divonne-les-Bains, France, May 2005
and revised by the 68th WMA General Assembly, Chicago, United States, October 2017
1. Boxing is a dangerous sport. Unlike other sports, its basic intent is to produce bodily harm by specifically targeting the head. The main medical argument against boxing is the risk of chronic traumatic encephalopathy (CTE), also known as chronic traumatic brain injury (CTBI), and dementia pugilistica or “punch-drunk” syndrome. Other injuries caused by boxing can lead to loss of sight, loss of hearing, and fractures. Studies show that boxing is associated with devastating short-term injuries and chronic neurological damage on the participants in the long term.
2. The past few decades have witnessed vigorous campaigns by national medical bodies to have all forms of boxing abolished. In the absence of such a ban, a series of boxing tragedies worldwide has pressured various sports regulatory bodies to adopt a variety of rules and standards to enhance the safety of boxers.
3. Despite regulation of boxing in various countries, injuries and death still occur as a result of boxing related head trauma, indicating that regulation does not provide adequate protection to participants.
4. In addition to regulated boxing, unchecked and unsupervised boxing competitions (bareknuckle battles or “street fights”) still take place in many parts of the world. This underground boxing puts at risk the lives and health of a significant number of persons who participate in these fights.
5. Health and safety concerns in boxing extend to other professional sports where boxing is a component, such as mixed martial arts (MMA), kickboxing etc. For this reason, the recommendations in this statement should be applied to these sports as well.
6. The WMA believes that boxing is qualitatively different from other sports because of the injuries it causes and that it should be banned.
7. Until a full ban is achieved the WMA urges that the following measures be implemented:
7.1 Boxing must be regulated and all boxers licensed. Boxers should be provided with written information on the risks of participating in boxing.
7.2 No children (as per country-specific definition) should be permitted to participate in boxing.
7.3 A national registry of all amateur and professional boxers, including sparring partners, should be established in each country where boxing is allowed. The registry should record the results of all matches, including technical knockouts, knockouts, and other boxing injuries, and compile injury records for individual boxers. All boxers should be followed up for a period of at least twenty years to document long-term outcomes.
7.4 All boxers should undergo a baseline medical examination, which should include neurological assessment, including brain imaging, at the beginning of their careers. Medical and neurological assessments should also be performed before and after each event. Boxers who do not pass the examination must be reported to the national registry and must not be allowed to participate in future matches.
7.5 Personal protective equipment recommendations (such as size and weight of gloves, head gear and gum shields) should take into consideration medical recommendations.
7.6 A physician serving at a boxing match has a professional responsibility to protect the health and safety of the contestants. To that end, the physician should receive specialized training in athlete evaluation, especially traumatic brain injury assessment. The physician’s judgment should be governed only by medical considerations, and the physician must be allowed to stop any match in progress to examine a contestant and to terminate a match that, in the physician´s opinion, could result in serious injury.
7.7 Funding and sponsorship of boxing should be discouraged, and TV coverage of boxing events should be age restricted and include a warning statement on the risks of boxing.