
Raiders' Release Of Christian Wilkins May Conflict With Medical Autonomy Provided For In CBA
Bioethical Considerations
The situation raises serious bioethical concerns. Bioethics refers to the application of ethics – the philosophical discipline pertaining to notions of right and wrong – to the fields of medicine and healthcare. Bioethical analyses are generally conducted through the lens of specific principles, the most commonly-recognized being respect for autonomy, non-maleficence (the duty to avoid harm), beneficence (the duty to do good), and justice.
Of most relevance to Wilkins' situation is the concept of autonomy. As described by leading bioethicists Tom Beauchamp and James Childress, '[p]The Raiders' apparent insistence that Wilkins have another surgery despite his preference otherwise appears to run afoul of the principle of autonomy, i.e., the right to control what is done to one's own body. The Raiders' actions could be viewed as self-serving, or at a minimum paternalistic (a question that has arisen with Miami Dolphins quarterback Tua Tagovailoa).
Who Decides?
The Raiders' position also raises legal issues, as evidenced by the NFLPA's grievance. Specifically, Section 6 of Article 39 of the CBA protects a player's right to receive a second medical opinion from a doctor of his choice and at the team's expense after having been first examined by the team's doctor. That provision also provides that a 'player shall have the right to follow the reasonable medical advice given to him by his second opinion physician with respect to diagnosis of injury, surgical and treatment decisions, and rehabilitation and treatment protocol, but only after consulting with the Club physician and giving due consideration to his recommendations.'
This provision is generally understood to provide players with the ultimate right to choose their own course of treatment, consistent with the principle of autonomy. Additionally, if surgery is required, players are permitted to utilize an appropriately qualified surgeon of their choosing.
The right of NFL players to control their medical treatment is not an approach shared by all sports leagues. While MLB also permits players to make the final decision about their treatment, the NBA, NHL and MLS CBAs provide the clubs with the right to determine a player's course of treatment. (See here for a report I co-authored in 2017 comparing the health-related policies and practices of the different leagues.)
Indeed, this right was a major issue for NHL players in their recent CBA negotiations with the league after a dispute between Jack Eichel and the Buffalo Sabres concerning treatment for a neck and back injury. Whether such a right is now provided for in the recently agreed to CBA has not been publicly revealed and the NHLPA did not immediately respond to a request for comment.
The Value Of A Guarantee
The NFLPA is also likely taking the position that the Raiders' release of Wilkins violated his contract, including specifically the $35.2 million remaining in guaranteed compensation. Portions of NFL player contracts can be 'guaranteed' in a variety of ways. Under the standard NFL player contract, a player's contract can be terminated if:
(1) 'at any time, in the sole judgment of Club, Player's skill or performance has been unsatisfactory as compared with that of other players competing for positions on Club's roster…, [or (2)] during the period any salary cap is legally in effect…, in Club's opinion, Player is anticipated to make less of a contribution to Club's ability to compete on the playing field than another player or players whom Club intends to sign or attempts to sign, or another player or players who is or are already on Club's roster, and for whom Club needs room.'
Player contracts frequently provide that they will continue to receive some portion of their pay despite these two termination rights, known as 'skill' and 'cap' guarantees.
Additionally, player contracts also frequently guarantee that a player will continue to receive his pay despite having suffered an injury. While the player's contract and CBA generally require a player to be paid their salary for so long as they are physically unable to provide their services because of an on-field injury, the duration of the injury and the required payment are frequently a subject of dispute and resolved through a process known as an Injury Grievance. An injury guarantee avoids this uncertainty and offers the player broader protection against release as a result of an injury.
ESPN's report indicates that the Raiders' reason for the release was because Wilkins had failed 'to maintain his physical condition to play.' Wilkins and the NFLPA undoubtedly believe that the real reason for his release stems from Wilkins' on-field injury and that failing to continue paying him will violate injury guarantees in his contract.
The dispute will now be resolved before a neutral arbitrator. In the meantime, Wilkins is free to sign with another club. And in the event Wilkins prevails in his grievance, the Raiders will likely claim that any pay Wilkins received from another club should offset any amounts owed by the Raiders.
The Raiders did not respond to request for comment and the NFLPA declined to comment about Wilkins' situation.
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