Ladies and gentlemen, let me call this meeting to order. We are the Standing Committee on Justice and Human Rights. This is meeting number 68. According to the order of reference of Wednesday, November 28, 2012, we are studying Bill , an act to amend the Criminal Code (prize fights).
We are going to have witnesses on this private member's bill until approximately five o'clock, and no later than five, as per the agenda. We have only two witnesses today. I want to thank the clerk for all his efforts over the last two weeks. We had people who were interested in coming but who couldn't make the timeframe or who then cancelled and so forth. On your table the agenda shows the Government of British Columbia, but they have withdrawn because they could not make this timeframe.
We will have two witnesses today, and then we'll go to the clause-by-clause consideration later this afternoon.
I want to welcome our witnesses. First of all, from the Canadian Medical Association, we have Anna Reid, who is the president, and Ms. Ricketts. Then by video conference from Vancouver we have Mr. Gutman, who is president of Rockdoc Consulting. Both organizations will have approximately 10 minutes to give an opening statement, and then we'll go to questions.
We'll start with the Canadian Medical Association. The floor is yours, Ms. Reid.
Good afternoon. I'm very pleased to have this opportunity today to appear before the committee.
Before proceeding, I'd like to remind the committee that I'm not a lawyer and I'm not an expert on mixed martial arts fighting. My expertise is not within the Criminal Code, nor in the particulars of sanctioned versus non-sanctioned fights. My expertise lies in the clinical aspects of emergency and family medicine.
As an emergency physician in Yellowknife, I often treat patients who have received severe head injuries as a result of risky behaviour or of not wearing helmets. I feel very frustrated because these are completely avoidable situations. As a family physician, I see the longer-term impacts of these injuries—lives that are forever changed and more difficult.
I also see patients with injuries that are much more subtle yet almost as devastating. Soft tissue brain injury cannot always be detected on a first visit but can lead to such problems as memory loss, depression, cognitive defects, job loss, and family breakdown. In all of these cases, I worry about my patients' futures.
I'm also here today representing the more than 78,000 Canadian physicians who belong to the Canadian Medical Association. Let me note that CMA policy is based on the decisions made by physician delegates to our annual general council, which this year will take place in Calgary. At our general council in 2010, a decisive 84% of delegates voted in favour of a motion calling for the CMA to advocate for a ban on mixed martial arts, also known as cage fighting. This is consistent with CMA policy set back in 1986 that called for a ban on boxing.
The reasons are not difficult to understand. One of the primary responsibilities of a physician is to promote good health. To this end, we are strongly in favour of physical activity, including martial arts such as judo and karate. However, cage fighting, like boxing, is distinct from many other sports in that the basic intent of the fighter is to cause harm in order to incapacitate his or her opponent. An activity in which the overriding goal is to pummel one's opponent into submission does not promote good health.
MMA fighting as it is currently practised consists largely of punches to the head, which we know lead to injuries to the head, which in turn can lead to brain injury. A study carried out in 1998 at Kingston General Hospital found that in almost 30% of cases of blunt head injury from a variety of causes, the patient showed signs consistent with brain injury.
There are long-term outcomes associated with brain injuries. Up to 40% of patients with mild traumatic brain injuries remain impaired for at least one year, and all individuals who survive these injuries require clinical assessment and follow-up.
I acknowledge that there's a lack of evidence on the nature and rate of severe brain injuries resulting from mixed martial arts fighting, as well as an absence of longitudinal studies on the long-term health implications of this type of combat. However, an extensive review in 2010 in the German medical journal Deutsches Ärzteblatt of the health implications of boxing found that it poses a high risk of acute injuries to the heart, bones, and head.
It also found that 10% to 20% of professional boxers suffer from persistent neuropsychiatric complications. In boxers with longer careers, the consequences of repetitive brain trauma can include Parkinson's disease, tremor, memory disorders, depression, aggression, addiction, and a boxer's dementia with neurobiological similarities to Alzheimer's disease.
The studies that do exist on mixed martial arts fighting indicate that for every 100 participations in a fight, there are anywhere from 23 to 28 injuries, including, but not limited to, many types of head injury. They include ocular injuries, such as ruptures of the eye socket or of the eye itself; facial injuries, including fractures; ruptures of the eardrum; concussions; and spinal injuries. We also know that deaths linked to mixed martial arts have occurred. A mixed martial arts fighter making his professional debut in South Carolina last summer died from brain hemorrhaging after receiving repeated blows to the head during the fight.
Following an event in June 2010 in Vancouver, a number of professional fighters had to be taken to emergency care at Vancouver General Hospital for cuts, fractured limbs, and severe facial injuries. Just two weeks ago, an Ontario man died shortly after losing an unsanctioned cage fight in Michigan.
The argument goes that unsanctioned fights are different. Is the key to winning any different? Are the injuries that are inflicted any different? These are questions I leave to you to answer.
Of course, cage fighting is not just a physical activity taken up by people as a pastime and a route to fitness. It is also a commercial enterprise. For parliamentarians and for society, the question of whether to legalize mixed martial arts under the Criminal Code comes down to a choice between money and health.
Again, I am not a lawyer. It is my duty to protect the health of patients and to promote non-harmful activities, and it is a mandate of the Canadian Medical Association to advocate for the highest standards of health and health care. For me, as a physician, it is about putting health first. I cannot condone punches to the head. I have too often seen the debilitating effects of head injuries on individuals and have been saddened to see the limitations imposed on their lives and on the lives of their families in the aftermath, limitations that in many cases will last a lifetime.
We therefore urge committee members and all members of Parliament to think long and hard before deciding whether it would be prudent to vote in favour of legalizing prize fights under Canada's Criminal Code.
Thank you very much.
I, too, am an emergency doctor. I'm also a member of the Canadian Medical Association. I echo many of the points and comments of Dr. Reid before me; however, I take a very different perspective on the health of Canadians and the health of my patients.
Conceptually, my approach is one that recognizes the concept of harm reduction. Many Canadians participate in mixed martial arts of all forms. They participate in boxing. They will continue to do so regardless of what this committee chooses to do. Therefore, from my perspective, in the vein of trying to protect the health of Canadians, I would advocate that sanctioning and efforts to improve the quality of oversight of these activities is in fact where we should be pushing our energies and where we should be focusing.
There is a difference between sanctioned and unsanctioned. There is a difference between professional and amateur. While it's true that there is striking involved in mixed martial arts, in contrast to boxing, there are also other ways to win. In fact, in amateur boxing scoring, which does not necessarily involve incapacitating the opponent per se and inflicting brain damage per se, there are other ways to win. In mixed martial arts in particular, there are submission holds and wrestling manoeuvres that do not involve injuries to the head.
Dr. Reid referred to the fight in Vancouver in June 2010. It was a professional ultimate fighting championship mixed martial arts contest. I was the lead physician ringside for the medical team at that event. She is correct in that there were injuries and there were patients sent to hospital.
I would also draw the parallel to any professional sport, particularly hockey, or football, or soccer, where there are head injuries and where there are serious injuries on a regular basis. I would ask the committee to consider whether we would ban hockey in Canada. Of course we wouldn't, but we continue to aggressively pursue ways to reduce the risk of concussions in the efforts we make to reduce the long-term effects of concussions and other head injuries in terms of equipment, playing surfaces, and rulings, and most importantly, in testing both before and after competition, and also after potential injuries occur in terms of assessing return to play.
With regard to mixed martial arts, in my judgment the best way to protect the safety of Canadians is to have proper training of referees who in fact control the action and will prevent repeated strikes beyond the point at which a competitor is able to defend themselves, and also to ensure that there are proper medical assessments before, during, and after events.
When we refer back to the 83% of Canadian physicians, I believe it was, who voted in favour of the ban on mixed martial arts, I would suggest that the vast majority of them have never been to a mixed martial arts event. Perhaps they have seen it briefly on television, but they likely have no direct understanding of what assessments are required before, during, and after in order to protect the safety of competitors. Thus, further training and education of physicians and those involved in the sport would result in reduced risks and more safety for the participants.
My experience has been extensive in both amateur and professional mixed martial arts, as well as boxing, as a ringside physician and as an advocate for safety. I thank you for the opportunity to present and to discuss this topic further.
It's certainly a good testimonial to have doctors on both sides of the issue and it's most helpful. I thank you for your testimony.
Dr. Reid, it's clear that the CMA is opposed to mixed martial arts. I note that you're looking at the blunt head injury in particular and your perceived, at least, intent that the purpose of the sport is actually to injure people.
We know that your association is against the sport because it doesn't like the fighting techniques of striking and kicking, but the CMA, as you've told us, encourages traditional martial arts, which are certainly not for wimps. Karate is a pretty violent sport. What's the primary concern? Why is it that you can support the traditional martial arts, yet not this sport?
Thank you to the witnesses for appearing.
I don't want to repeat the same line of questioning, I guess, because we seem to see a lot of blows in all sports, whether intentional or unintentional. We'd like to see the focus be on making sports more secure, whether blows to the head are legal or not legal. We see it in sports like hockey and football. It's not supposed to be legal but it happens anyway, and it sometimes goes unpunished. I understand where you're going with this, but it doesn't necessarily mean that I agree.
I'm aware of one study in particular that was done in 2006 with the Johns Hopkins University, in which they stated that concussions from MMA combat were not more susceptible to head injuries. I'm just wondering if you have any recent studies that would help your position.
First of all, thank you, doctors, for being here in our extreme sport arena—better known as Canadian politics.
I think I understand. And to my mind, everyone around the table understands as well. In any case, I would have been pretty surprised to see the Canadian Medical Association giving us its official okay on
the MMA sport. I would have been in shock, actually, if you had.
But this is where we might differ a bit.
In your presentation, Dr. Reid, you made it clear that you weren't a lawyer. But what the Standing Committee on Justice and Human Rights is trying to determine is whether it is still appropriate for the Criminal Code to qualify the practice of a certain sport as a crime when, in reality, it is not treated as such. The criminal aspect has been completely overlooked for some time now. UFC specials have been around for a number of years. I see them on several TV channels almost every day. Spike TV airs one or two matches with no problem.
We may be dealing with some hypocrisy here. And I'm not referring to your position but to the fact that the practice is criminalized in the Criminal Code. In your opening remarks, you made a statement that also appears in the notes you provided:
For parliamentarians, and for society, the question of whether to legalize MMA under the Criminal Code therefore comes down to a choice:
A choice between money and health.
That comment bothered me a bit, for the simple reason that the issue has nothing to do with that in my opinion. Nor is it a matter of legalizing something. You talk about legalizing MMA, but we're actually talking about decriminalizing an activity, not legalizing it. The provinces and territories can put certain rules in place, but that doesn't mean the passage of Bill would legalize the practice. All it would do is decriminalize an activity that, in actual fact, has not been treated as a crime for quite some time.
That is the reality of Bill . As my colleague Mr. Seeback pointed out, your opposition is based on the intent of the sport. In other words, the foot and elbow strikes dealt directly to a participant's head during mixed martial arts, or MMA, matches make this activity different from other sports. My understanding, then, is whether it happens in boxing or MMA, you're against it as a matter of policy, as doctors.
However, when two hockey players decide to fight during a game, taking off their helmets and gloves so they can punch each other freely in the face, it is clear to me there's an intent there as well. Therefore, I imagine you would like to go as far as to ban fighting in hockey, adding it to your policy on boxing and MMA.
Unless I am mistaken, you're position applies to all cases where an individual uses a body part to strike another person's head on purpose. The head is the main issue for you, is it not?
I thank all the guests here today for their testimony.
I would like to start, Mr. Chair, by saying that there are some elements of this bill that maybe all of us can agree on, including our witnesses.
Bill proposes to extend the exemption in section 83 for amateur boxing contests to cover other amateur combative sport contests, including contests in sports such as judo, karate, tae kwon do, and kick-boxing, as well as mixed martial arts. The bill would also clarify that the exemption in section 83 that currently covers professional boxing contests would then include professional mixed martial arts contests.
To both of our witnesses, do you think the proposed changes to the legislation modernize a relatively unused section of the Criminal Code and legitimize sports such as judo, karate, and mixed martial arts?
I'd like to start with the CMA, please.
I think your characterization is accurate that this is an outdated clause or section of the code and that this is merely an issue of updating it to reflect the reality of today. I would also point out that it has been reiterated several times that, to be clear, there are other ways to win a mixed martial arts contest in addition to striking. Similar to things like judo and others, striking is a part of the sport. It is not the only way, and incapacitation by knockout is not the only way to win the contest.
Lastly, if I could take the opportunity to point this out, it hasn't been mentioned what definition we're using in terms of huge health outcomes. I'm an emergency physician and have been in practice for 25 years. I have seen a handful of concussions caused by mixed martial arts. I've seen many, many caused by snowboarding, by skiing, and by many other sports. So in proportion to participation, this is a very small blip on the horizon, on the radar, relative to other sports.
I appreciate hearing that testimony.
I'm going to be switching back to the CMA for a moment, Mr. Chair.
I had the opportunity to teach martial arts professionally for 15 years and certainly I am alarmed when I hear that someone equates mixed martial arts or other disciplines to barroom brawling. To me that is an indication that my former field needs to do a lot more work to present its many health benefits. Furthermore, Dr. Reid, when you say that someone is just there, regardless of discipline....
By the way, Mr. Goguen is correct. There is full contact karate. Certain systems teach full contact karate and concussions do sometimes happen. However, to say that a player or an athlete is there simply to harm another human being, that takes away from all the tenets of traditional martial arts: respect, discipline, focus. Again, this is an athletic endeavour and that kind of equation is disrespectful, given the many things that structured sport does.
Yes, hockey, football, mixed martial arts, these sports have to improve. I simply point out that banning an activity can create an underground economy where there is very little sanctioning and oversight, and where children and young people could get into it and be harmed. I think that would be disappointing.
I also find it disappointing that we are not pointing out the specifics as to how mixed martial arts, as a discipline and an athletic endeavour, could improve its outcomes, whether that be through better sanctioning, whether that be through, as Mr. Wright said, more international standards to make it truly an Olympic or amateur sport, or through ensuring that the instructors who are currently teaching our young people are teaching in a way that emphasizes health and safety throughout.
In most martial arts schools, particularly with submission wrestling or judo, one of the first things they teach you is how to bow. The second thing they teach you, Mr. Chair, is how to tap, so that you're training in a safe environment. The importance of that is stressed. While I totally respect where the Canadian Medical Association is coming from, for you to advocate a ban without any data and put more people at risk, rather than make suggestions that can be implemented—
I won't suggest anything about lawyers. It would be unbecoming of me as a guest of the justice committee to suggest something, Mr. Chair.
I, like my friend, Madame Boivin, am not surprised about the CMA's position. Clearly sport, especially a contact sport—and I'll use contact sport in a general term.... Mixed martial arts is a contact sport. In fact basketball is a contact sport. In fact Wilt Chamberlain said that basketball is a contact sport, but football is a collision sport. So it is a question of large folks quite often up against each other in one form or another, the difference being that there are certain rules.
Obviously there are certain rules in mixed martial arts, and I can appreciate what my friend, Mr. Albas, was saying earlier, because clearly I'm not someone who has participated in those things, albeit I headed a soccer ball for a long time and maybe that's what caused me to come into this field. I don't know. Then again I'm a Scotsman, so maybe that's the case.
I'm not surprised by what you have said. Actually it's hard to disagree that striking someone will cause an injury. I think we all know that. I think if Mr. Albas were to come over here and strike me on the side of the head—of course he would never do that—it could be hurtful and could do who-knows-what kind of damage. I think we all get that. The issue becomes what we do in a legal process. I think you said earlier you're not really prepared as a physician—a very qualified and eminently qualified physician, I may add—to try to do this.
Let me turn to your colleague in Vancouver, who talked about how we need to do harm reduction, because I actually know a fair amount about harm reduction. I come from a family whose careers are in Canadian mental health and who talk about harm reduction, especially with schizophrenics and bipolar folks who also are dually diagnosed with addiction issues.
So sir, I look to you to give us some suggestions given what you see, since you're looking at it at an upper level, if you will. These are prize fights, and quite often you might be a ring physician.
One of the things that strikes me about it—no pun intended—when I watch—and I only see things on television—is that the difference between boxing and cage fighting.... I don't want to use mixed martial arts in this sense, because it gives the wrong connotation sometimes, even though they use that. I think Mr. Albas is correct. Mixed martial arts as was taught by him and by his colleagues in the field may look a lot different from that. The difference is that in boxing if you knock the opponent down, you can't hit them again. But if you knock your opponent down in that particular cage, you can hit them again. The referee is supposed to step in and do all those sorts of things, but how many times have you seen someone, whose eyes are literally starting to roll back in their head, still receive two or three blows while they are on the ground? I don't mean on the way to the ground, because in boxing clearly you can hit an opponent on the way to the canvas.
What do you see as that harm reduction strategy you're suggesting that might actually be helpful for this committee to know about? Because I don't think we are going to get a legal opinion from either one of you, quite frankly, about the clause. I'm interested in what you have to say about that.
With regard to just using the term “cage fighting”, I think that's a loaded term. Mixed martial arts occurs in a ring as well. The connotation of cage fighting brings with it something distasteful, perhaps, so I prefer the term mixed martial arts.
With regard to harm reduction, I divide it into pre, during, and post in terms of the medical assessments that occur, the referees, and sanctioning.
First and foremost, before the fight, before the competition, it's important to assess the weight classes to ensure that it is an equal competition of skill, not unmatched. In the professional ranks, matchmaking is a crucial portion of protecting the athletes. If a very highly skilled competitor goes against an amateur, the risk to the amateur, or a new amateur, is substantial. So matchmaking is important.
Physical assessments in terms of capability to compete at that level, cardiovascular fitness, vision testing, CT scanning, electroencephalograms, plus or minus cognitive testing using some of the validated concussion assessment tools—some of these things are currently in play and some of them should be in play. I would suggest that opening this debate up further to the medical community and engaging as opposed to banning would enable some of these pre-competition metrics to go into force.
During the competition, the safety of the athlete is wholly dependent on the skill, experience, and training of the referee. The referee is the one who will stop that second, third, fourth blow that you referred to. Yes, by rules, they can continue to strike until the opponent is unable to protect themselves, which is a judgment call by the referee. Therefore, higher-skill-level referees, more training, protect the athletes further.
After the competition, assessment by an experienced physician who has the capacity to make an assessment using a standardized scale and then apply a prohibition to competition for 30, 60, 90 days or more, subject to additional conditions such as assessment by neurologists and the like, occurs in the professional ranks, where there's appropriate sanctioning, versus underground.
I have one example here from the Lower Mainland. One competitor was in a professional fight in one location. The next night they competed in another location. That is completely unacceptable in any rank. However, there is no governing body. There is no ability to prohibit that in many of these competitions.
That's where people are getting harmed. That's where the second-impact syndrome, as it's referred to, causes extensive damage after a brain has been injured. That's what we're trying to avoid. By bringing this out of the shadows further, we can protect combatants more.
To the witnesses, thank you very much for coming today.
In my 20 years as a police officer, where I was involved in many a barroom brawl, historically there are chairs, tables, and glass bottles involved. Historically it's started by a blind-side hit. Historically it's not one-on-one. It's normally induced by a lot of alcohol and a lot of drugs.
Having said that, my question to both the witnesses is fairly succinct. I'm going to take the opposite side of it, just for that sake. Assuming this passes through this place, passes through the House of Commons, and passes through the Senate, my question to either of you is this. Certainly to the CMA there seems to be some concern with regard to the fighting. Assuming this goes through, what types of protections would you suggest could be implemented to make the sport safer?
Seven or eight years ago, I believe, the unified rules of mixed martial arts were adopted by most. That limited the types of striking that were allowed, which has reduced the incidence of serious injury. I apologize, in that there are no statistics available on what these rates are, but things like elbow strikes vertically to the head have been removed, as have other such dangerous acts. Rules are important.
You're correct when you say that in the professional ranks fighters are not allowed to compete. Jurisdictions are different. Part of the challenge is that there's a patchwork of different sanctioning bodies, unfortunately. The B.C. government is trying to unify it into a provincial commission, which would help, and to have a clearing house where athletes are not allowed to compete for a period of time. Those periods vary, but you're correct.
Additionally, it really falls on the ringside physician who applies a suspension to use some judgment on how long that suspension should be. In my own experience, there were no guidelines and no knowledge or information on how to apply those, so in my own practice I've aggregated information. When there are other physicians working with me, we provide information to them on what recommendations we suggest. In my opinion, those sanctions and prohibitions should be based on a higher level, on a commission level, be it provincially or beyond.
Thank you, Mr. Armstrong.
We have no further speakers, so I will just wrap up by saying thank you to both of our witnesses for coming today.
Regardless of the tough questions, you did a very good job under pressure today. I'd be happy to be...well, I don't want to be in your emergency room, but if you were looking after me I would feel confident. We want to thank all the physicians in this country for the work they do. Everyone who is part of the Canadian Medical Association does great work for Canadians, and we are thankful for that.
Some hon. members: Hear, hear!
The Chair: We are now going to recess for a few minutes and then go to a discussion of the bill, clause by clause.
Thank you again for your time and your comments.
Ladies and gentlemen, I'm going to call this meeting back to order. That looks like five minutes to me. I'm not sure if it was or not, but it's close enough: three minutes in Newfoundland and five minutes here in Ontario, so there you go.
Anyway, I'll call this meeting back to order. We're going to go to clause-by-clause. We've been joined by the counsel from the Department of Justice, Mr. Pruden. Are there any questions? There is actually only one clause.
Before we begin, do you have any questions for the staff from the justice department?
I see none, so let's begin.
Ms. Françoise Boivin: It's going to be an easy one.
The Chair: I guess so.
Shall clause 1 carry?
Some hon. members: Agreed.
(Clause 1 agreed to)
The Chair: Shall the title carry?
Some hon. members: Agreed.
The Chair: Shall the bill carry?
Some hon. members: Agreed.
The Chair: Shall the chair report the bill to the House?
Some hon. members: Agreed.
The Chair: Ladies and gentlemen, that is the end of today's meeting. I will just give you a reminder that the meeting on Wednesday is for the Subcommittee on Agenda and Procedure. Please look at the calendar from here to the end, sometime in June. It's about nine weeks with a one-week break. Have some ideas of what you want to study.
We will be getting Bill eventually. I'm not sure exactly when that's happening, but I'll certainly do my best to find out beforehand. Come prepared to talk about what we'd like to do. I'd like to have it organized for the next couple of months. That would be great.
Is there anything else?
Could I have a motion to adjourn?
An hon. member: So moved.