Question Number: 34626

Law 5 - The Referee 6/21/2022

RE: Pro High School

Garikai Kondanani of Harare , Harare Zimbabwe asks...

A player is injured during a match. When assessing the player the doctor informs the referee of the risk of serious injury if the player continues playing. Can the referee prohibit the player from continuing.

The player makes a careless tackle in the opponents' penalty area . He touches the opponent's foot.

Answer provided by Referee Joe McHugh

Hi Garikai
Thanks for the question

A referee has no authority to prevent a player from continuing to play with the one exception of a blood injury that continues to bleed or where a player has blood their kit. General injuries are a matter for the team officials including the team doctor. In fact a referee should not be put in this position as it is simply a matter for the team to decide plus the doctor has a responsibility and duty of care in his role to advise the team that a player is not put at further risk by insisting that the player leaves the field of play. If the player refuses to leave or the team decides not to remove the player then the referee restarts the game and it continues.

I suppose the closest we have to an answer is in part of Law 3 where it states that and I quote "" if a player who is to be substituted refuses to leave, play continues""

As to the much talked about concussion in soccer FIFA has guidelines which are vague and based “on the medical freedom of the team doctor” FIFA said it had no authority over this and that it only produces the guidelines but it is the team doctors who make the decision.
A referee could try to use his influence to encourage the removal of the player by a team in certain circumstances. I recall a particular Underage game where a star player was injured with a leg strain. It was clear to me that the player was not fit to continue and he was removed to the touchline three to four times by the coach and each time sent back in again. I thought about getting involved in this yet I felt it was not my role nor had I the competencies to evaluate injury and it took the intervention of the player's father to have the coach substitute the player from the game.

As to your final statement it is a matter for the referee to decide on based on the situation. Was the contact on the opponent sufficient for it to be called as an offence? Not all contact is an offence and a referee has to take into account the level of contact and if it had an impact on the player.
I watched the Wales v Ukraine game recently and there was an incident where there appeared to be careless contact on an Ukrainian player by a Welsh player as he tried to kick the ball. It was not called as a penalty and it was reviewed by VAR who agreed with the on-field decision of the referee.
https://www.youtube.com/watch?v=aS-OqSbaR4c&t=100s

A straw poll of referees would I suspect show a mixed response of those supporting the no call to others who would vote that a penalty should have been called. The key point is that the referee makes the call on the day and that is all that matters.

Answer provided by Referee Peter Grove

Hi Garikai,
Any doctor (in fact, any medical professional) has what is called a "duty of care" towards any person that they treat. This means it is the doctor's duty to take whatever steps are necessary to ensure that a person under their care does not suffer any further harm due either to their actions - or their failure to act.

A doctor who does not uphold their duty of care would be subject to disciplinary action by the relevant medical authorities, up to and possibly including the loss of their medical license. So the idea that a doctor would determine that a player would suffer harm if they continued to play, and then not take action to prevent that harm from occurring would be just unthinkable.

As ref McHugh points out, the referee has no authority to prevent a player from continuing in a game because of injury - but the doctor definitely does. So it's without a doubt up to the doctor to make the call as to whether the player should continue, and not the referee.

As to your second question, that's a YHTBT (you have to be there) situation - based on the limited amount of information given, the call could potentially go either way.

Answer provided by Referee Richard Dawson

Hi Garikai,
it is true that a referee is not RESPONSIBLE for a player who SHOULD not be there on the FOP winds up there by the player's choice of the team/coach's choice to stay or be resubstituted. Only if blood was flowing and it was persistent and unchecked that player would NOT be permitted on the pitch and likely substituted if such was not correctly dealt with.

The referee's authority to HELP convince the player could only be enhanced if CLEAR guidelines are in the bylaws of the competition as to what level of safety is sufficient. For example, ANY loss of consciousness in some tournaments was MANDATORY for a hospital visit. I must say if a doctor, especially a team doctor has publicly claimed it would be unsafe, I find it difficult for the referee to casually say well let's play and see what occurs.

I believe no referee would go ahead until that player left for treatment as advised by the doctor. If the player refused treatment and refused to leave it is so likely that an altercation or confrontation between that individual and others would escalate to where cards are required and mandatory expulsions start occurring. It's a bit different in a cramp or pulled muscle situation where I might want to see the player substituted but they continue to aggravate a bad condition,

However, expressing your personal concerns over a player being reintroduced after a violent or harsh collision and you as referee thinking this is insanity.?

I recall a clash of heads on a high aerial ball. Both players are down, both in Lala land, both helped off the FOP, both substituted, later one returns, goes to forcibly head an uncontested long ball back into the opposition's half. Within a few minutes, the player races off the field throwing up. Suffering a cerebral contusion/concussion with long-term cognitive and psychological effects including loss of memory & motor skills. We can bet the coach, player, and parents all wish a doctor or hospital were consulted after that first impact instead of the way to go attitude and get back in there! As a coach, I would NOT allow any player who received such trauma to be allowed to participate until FULLY cleared by a doctor so it was very difficult not to get into arguments as a referee when seeing the same conditions, where I would not allow my players to play, being ignored!

A careless tackle with minimal contact on the foot inside the PA could certainly be a PK but likely at best cautioned if it stopped a goal-scoring opportunity. Yet too it might be overlooked and deemed inconsequential. Context and circumstances do matter, a slight unfair nudge can make a player miss a wide-open goal just as well as a vicious sliding through tackle taking them out.
Cheers