[The "vulnerable person" and the role of the treating physician]. / La « personne vulnérable ¼ et le rôle du médecin traitant.

One major concern in the management of the COVID-19 pandemic has been to ensure the protection of certain categories of population considered to be at especially high risk in the event of an infection. This article gives an overview of the legal status of the «vulnerable¼ person in Switzerland and explores the role of the treating physician in this context, particularly with regard to labour law. The physician will have to assess the status of «vulnerable person¼ and, where applicable, issue a vulnerability certificate that can be presented to the employer. In the face of a legal framework that is often ambiguous and in continuous evolution, this role places significant responsibility on the physicians, who will need to ensure that they stay within a clinical evaluation and the scope of their expertise. Accepted practices in relation to medical certificates for work incapacity may act as valuable guidance.

Une préoccupation majeure dans la gestion de la pandémie de Covid-19 a été de garantir la protection de certaines catégories de population particulièrement à risque en cas d'infection. L'article propose un aperçu de la situation juridique concernant la « personne vulnérable ¼ en Suisse et du rôle du médecin traitant dans ce contexte, notamment en matière de droit du travail. Le médecin devra évaluer le statut de la personne vulnérable et, le cas échéant, établir une attestation de vulnérabilité à faire valoir auprès de l'employeur. Face à un cadre légal souvent ambigu et en constante évolution, ce rôle implique des responsabilités importantes et le médecin devra veiller à rester dans le cadre d'une évaluation clinique en lien avec ses compétences. Il pourra s'inspirer des pratiques reconnues en lien avec le certificat médical pour incapacité de travail.

'Clean athlete status' cannot be certified: Calling for caution, evidence and transparency in 'alternative' anti-doping systems.

Athletes, sponsors and sport organisations all have a vested interest in upholding the values of clean sport. Despite the considerable and concerted efforts of the global anti-doping system over two decades, the present system is imperfect. Capitalising upon consequent frustrations of athletes, event organisers and sponsors, alternative anti-doping systems have emerged outside the global regulatory framework. The operating principles of these systems raise several concerns, notably including accountability, legitimacy and fairness to athletes. In this paper, we scrutinise the Clean Protocol™, which is the most comprehensive alternative system, for its shortcomings through detailed analysis of its alleged logical and scientific merits. Specifically, we draw the attention of the anti-doping community - including researchers and practitioners - to the potential pitfalls of using assessment tools beyond the scope for which they have been validated, and implementing new approaches without validation. Further, we argue that whilst protecting clean sport is critically important to all stakeholders, protocols that put athletes in disadvantageous positions and/or pose risks to their professional and personal lives lack legitimacy. We criticise the use of anti-doping data and scientific research out of context, and highlight unintended harms that are likely to arise from the widespread implementation of such protocols in parallel with - or in place of - the existing global anti-doping framework.

Time for change: a roadmap to guide the implementation of the World Anti-Doping Code 2015.

A medical and scientific multidisciplinary consensus meeting was held from 29 to 30 November 2013 on Anti-Doping in Sport at the Home of FIFA in Zurich, Switzerland, to create a roadmap for the implementation of the 2015 World Anti-Doping Code. The consensus statement and accompanying papers set out the priorities for the antidoping community in research, science and medicine. The participants achieved consensus on a strategy for the implementation of the 2015 World Anti-Doping Code. Key components of this strategy include: (1) sport-specific risk assessment, (2) prevalence measurement, (3) sport-specific test distribution plans, (4) storage and reanalysis, (5) analytical challenges, (6) forensic intelligence, (7) psychological approach to optimise the most deterrent effect, (8) the Athlete Biological Passport (ABP) and confounding factors, (9) data management system (Anti-Doping Administration & Management System (ADAMS), (10) education, (11) research needs and necessary advances, (12) inadvertent doping and (13) management and ethics: biological data. True implementation of the 2015 World Anti-Doping Code will depend largely on the ability to align thinking around these core concepts and strategies. FIFA, jointly with all other engaged International Federations of sports (Ifs), the International Olympic Committee (IOC) and World Anti-Doping Agency (WADA), are ideally placed to lead transformational change with the unwavering support of the wider antidoping community. The outcome of the consensus meeting was the creation of the ad hoc Working Group charged with the responsibility of moving this agenda forward.