Justice Committee on April 15th, 2013

[The Chair, Conservative, Mike Wallace]

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 S-209, 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 On your table the agenda shows the Government of British Columbia, but they have withdrawn because they could not make this timeframe.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.

[Dr. Anna Reid, President, Canadian Medical Association]

Thank you very much.

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.

[The Chair, Conservative, Mike Wallace]

Thank you, Ms. Reid, for that presentation.

Next by video conference, Mr. Gutman, the floor is yours.

[Dr. Samuel Jeffrey Gutman, President, Rockdoc Consulting, As an Individual]

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.

[The Chair, Conservative, Mike Wallace]

Thank you, sir, for that presentation.

We will now go to questions. Our first questioner, from the New Democratic Party, is Monsieur Dubé.

[Matthew Dubé, NDP, Chambly—Borduas, QC]

Thank you very much, Mr. Chair.

Thank you for taking the time to appear before us today. I think it's important that we hear all the points of view on a topic like this, given that it affects people's health.

We're talking about sanctioned versus unsanctioned fighting, but even if you're against the practice, it is still going to go on. If there is a total ban, people will probably still participate in underground fights, so it's better to ensure the activity is properly controlled.

What would you say to that? Has your association discussed that aspect?

[Dr. Anna Reid]

The CMA is advocating on behalf of patients, and we're interested in the health of patients. The argument you're having is about big business. You're saying that big business is going to keep the spark going even if it's kept illegal and that it will keep going on unsanctioned.

We believe that even if the sport is sanctioned, it's a different approach than it is for hockey, say, or skiing, or other sports where we do see injuries. This is because the whole key to mixed martial arts is actually to cause injury. The intent of the sport is to cause to injury to your opponent, whereas in the other sports these are byproducts of the sport, if you like, so we actually feel very strongly that we need to continue to advocate for a ban on it.

[Matthew Dubé, NDP, Chambly—Borduas, QC]

My goal isn't to defend the businesses that make these competitions possible. My thoughts are of people like Georges St-Pierre, who grew up near Kahnawake. He would fight in the basements of bars on the reserve. That's not a very safe environment. We have to think about health and safety.

I am not referring to the UFC specifically, but the opposite is happening. This may sound quite cliché, but I am talking about cage fighting without any oversight whatsoever, like what you would see in a movie. Doesn't that worry you? Wouldn't shining a spotlight on it lead to better oversight?

[Dr. Anna Reid]

There will always continue to be street fights and brawls and fights. Whether it's sanctioned or unsanctioned, even if there are sanctioned fights there will still continue to be fights that are unsanctioned, I'm sure. There will still be people fighting for money through other avenues that are not sanctioned, and so we remain opposed to the whole concept of this kind of fighting.

[Matthew Dubé, NDP, Chambly—Borduas, QC]

Dr. Gutman, do you have any comments on that?

[Dr. Samuel Jeffrey Gutman]

I do. In fact the vast majority of professional mixed martial arts fights are not of the stature of the UFC, as Monsieur Dubé points out. The vast majority of them are small. In fact, even at the UFC level, the vast majority of competitors make a very small amount of money.

Money is not the motivator from the point of view of the combatants. Our common goal is to protect the combatants as opposed to the corporations. In fact, restricting these competitions and not enabling them to be handled in an organized fashion, will, in my estimation, drive them underground and, as stated, result in many more injuries and a much higher risk to the participants.

[Matthew Dubé, NDP, Chambly—Borduas, QC]

I want to come back to the CMA's position. I think, earlier, hockey and football were mentioned. I am thinking about football, in particular. When you play defence, the whole goal is to physically prevent the other player from getting past you. And like it or not, injuries are commonplace.

Does the CMA have a similar stance on football? I, myself, don't play football, since I am nowhere near big enough. But a 300-pound defender's only goal is to rush a player to stop him from getting by.

Have you taken a similar stance on sports like that?

[Dr. Anna Reid]

Well, the difference there with those sports is that it is not the intent of the sport to create injury to the other person, whereas in mixed martial arts, or in the cage fighting, that is part of the intent of the sport.

[Matthew Dubé, NDP, Chambly—Borduas, QC]

Thank you.

Thank you, Mr. Chair.

[The Chair, Conservative, Mike Wallace]

Thank you very much.

Our next questioner is Monsieur Goguen from the Conservative Party.

[Robert Goguen, Conservative, Moncton—Riverview—Dieppe, NB]

Thank you, Mr. Chair.

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?

[Dr. Anna Reid]

Our big concern is in regard to blows to the head and brain injury. That is our big concern with respect to the sport.

[Robert Goguen, Conservative, Moncton—Riverview—Dieppe, NB]

And karate wouldn't cause a blow to the head nor would judo by a flip or a fall...? I mean, what's the distinction? We've talked about hockey and football, which is off topic, but many sports have blows to the head.

[Dr. Anna Reid]

Again, that is not the purpose of those sports.

[Robert Goguen, Conservative, Moncton—Riverview—Dieppe, NB]

But can we really say that the purpose of the sport is to kick someone, is a blow to the head? Is that the primary objective, really? I mean—

[Dr. Anna Reid]

Of mixed martial arts?

[Robert Goguen, Conservative, Moncton—Riverview—Dieppe, NB]

Yes.

[Dr. Anna Reid]

Well, the primary objective is to incapacitate the player so they can no longer participate in the sport.

[Robert Goguen, Conservative, Moncton—Riverview—Dieppe, NB]

As in karate?

[Dr. Anna Reid]

Pardon me?