Dr. Ann McKee, director of the CTE Center at Boston University, and her team have examined 202 brains of deceased football players, 111 of whom played in the NFL. Of those 111, 110 showed evidence of chronic traumatic encephalopathy (CTE). Eighty-six percent of former professionals displayed “severe pathology.”

Of those with severe pathology, 89% had behavioral or mood symptoms, 95% had cognitive symptoms and 85% had signs of dementia.

Dr. McKee used a convenience sample, with many brains being donated by families because they exhibited symptoms of neurological decline, so we cannot draw conclusions about the overall incidence of CTE in ex football players, but as the New York Times illustrates in their coverage of Dr. McKee’s research, “About 1,300 former players have died since the B.U. group began examining brains. So even if every one of the other 1,200 players had tested negative — which even the heartiest skeptics would agree could not possibly be the case — the minimum C.T.E. prevalence would be close to 9 percent, vastly higher than in the general population.”

There is little doubt that football is bad for the brain. As the years pass, we will come to understand exactly how bad, but there is already good reason to believe that playing football comes coupled with a significantly increased likelihood of diminished cognitive function and even decreased lifespan.

Given these facts, I think it’s probably time for universities to start considering how they’re going to disentangle themselves from football. It’s not going to be easy, but if it isn’t already apparent, someday it will be clear that institutions which are supposed to help students realize their intellectual and emotional capacities instead sponsor an activity directly linked to the opposite.

In Dr. McKee’s sample, the incidence of CTE for players who stopped at college was 91% (48 out of 53). Fifty-six percent of those displayed severe pathology. The more football one plays, the more damage is sustained, but ending short of the pros doesn’t seem to give players a pass from the risks of the disease.[1]

As cited by the Times, a Stanford study found that a college lineman sustained 62 sub-concussive blows in a single game. “Each one came with an average force on the player’s head equivalent to what you would see if he had driven his car into a brick wall at 30mph.”

It’s possible subsequent research will demonstrate fears about CTE are overblown, but based on the information already available, this seems unlikely. What will universities do if evidence shows that 15% of college football players will one day go on to experience behavioral problems, dementia, or other cognitive decline directly resulting from playing football.

What if it’s 20%?

What if it’s 30%?

In many ways, big time college football is already a devil’s bargain incompatible with the putative values of higher education. The risks of CTE only intensifies these problems.

I can envision a handful of different future scenarios.

Broader societal forces could either end tackle football or alter it in a way that minimizes blows to the head. It may one day be cost prohibitive for municipalities or high schools to field football teams because of the high cost of insurance. Having played football in one’s past could become a kind of pre-existing condition, ex-football players paying an additional premium as smokers do now. If there is no pipeline of players for football prior to college, college football can’t continue.

This scenario seems unlikely to me, or at least will be a very long time in coming, something along the lines of decades, similar to how the danger of smoking was treated, and even today, plenty of people still smoke. Even if football is widely viewed as a danger, some kids will still want to play and their parents will let them. (This is particularly true if an NFL future is still possible.)

Maybe some combination of technology and regulation will be able to make football “safe” within acceptable limits. “Smart” helmets will monitor the total pounds of force each player has absorbed in blows to the head during the game, and players will be pulled as certain thresholds are met. Every player will have a lifetime cap of allowable head trauma. I can imagine a fresh layer of color commentary drama as announcers discuss how that star quarterback is going to have to retire if he’s sacked three more times.

Perhaps paying players would alleviate some of the ethical problems associated with 18-22 year olds damaging their brains while coaches (among others) are paid millions of dollars a year. Rather than being part of the university proper, players could be professionals from the get-go in a minor league system funded by the NFL with team names licensed from the schools.

At the least, some sort of workman’s compensation type fund must be established to provide for players who exhibit symptoms of CTE post football. As that valuable education players received in return for playing college ball becomes less useful because of on-the-job brain damage, a little assistance seems only fair.

So too there may need to be a fund for survivors’ benefits to compensate those who have had to live and care for those suffering from college ball related CTE. Players with CTE may exhibit higher rates of domestic violence. The Jovan Belcher murder/suicide is widely believed to be the result of CTE-related brain injury. And what is owed to the parents of a 23-year-old who has taken his own life because of CTE-related cognitive deterioration?

I don’t believe we should ban football. If the risks are known and informed consent is given, people should be allowed to pursue their passion.

But if what we suspect about football and head trauma turns out to be indisputably true[2] higher education institutions should have nothing to do with the sport. Let it be a concern of private parties.

We don’t have a lot of evidence of institutions managing to adhere to their values when it comes to the temptations of big time athletics,[3] so I’m not actually hopeful they’ll address this dilemma directly, but we should at least acknowledge the hypocrisy.