Traumatic Injuries Caused By Hazing Practices

1 ReviewsTraumatic Injuries Caused By Hazing PracticesMICHELLE A. FINKEL, MDHazing is defined as committing acts against an individual or forcing anindividual into committing an act that creates a risk for harm in order forthe individual to be initiated into or affiliated with an organization. Hazingis an enduring activity with roots that date back to the ancient andmedieval eras. It has become increasingly prevalent in fraternities andsororities, high school and college athletic organizations, the military,professional sports teams, and street gangs.

2 Scant information is avail-able in the medical literature regarding Hazing . This article reviews thehistory of Hazing , provides statistics regarding its prevalence, presentsinformation on specific Hazing Practices and consequent Traumatic inju-ries, and assesses alcohol s influence on Hazing . It also offers recom-mendations on how to recognize victims of Hazing in the EmergencyDepartment and proposes guidelines for their treatment. Current legis-lation and information on the prevention of Traumatic Injuries from haz-ing are discussed.

3 (Am J Emerg Med 2002;20:228-233. Copyright 2002,Elsevier Science (USA). All rights reserved.) Hazing Practices have become increasingly prevalent inschools within fraternities and sororities and athletic teams,as well as in nonacademic settings including the military,professional sports organizations, and street gangs. Hazingcan be defined as committing acts against an individual orforcing an individual into committing an act in order for theindividual to be initiated into or affiliated with an of these acts can put the individual at risk forinjury.

4 Hazing victims have suffered severe Traumatic inju-ries including irreversible intracranial damage, blunt intra-abdominal organ damage, third-degree burns, heat stroke,suffocation, aspiration, sexual assault, and death, makingthe topic pertinent to emergency physicians. These patientshave distinct issues, similar to domestic violence patients,because Hazing can be a violent practice that affects indi-viduals on a physical, psychiatric, and social basis and canlead to victims feelings of shame and the consequent po-tential for concealment.

5 This article reviews the history ofhazing, provides statistics regarding its prevalence, presentsinformation on the victims of specific Hazing Practices andtheir Traumatic Injuries , and assesses alcohol s influence onhazing. It also offers recommendations on how to recognizevictims of Hazing in the emergency department and pro-poses guidelines for the treatment of these patients. Currentlegislation and information on the prevention of traumaticinjuries from Hazing are OF DATA ACQUISITIONR esearch for this article included a literature search ofjournal articles on the medical and forensic aspects ofhazing; newspaper, news magazine, and news Web sitereports detailing Hazing incidents; reference texts on Hazing ;a nationwide survey completed by athletes regarding hazingpractices.

6 And social science journal articles on the precip-itants and consequences of OF HAZINGH azing has been practiced for ages, having existed inancient and medieval schools in Greece, North Africa, andWestern Europe. At that time it was calledpennalism, andduring the 1600s it became a requirement for administrators and upperclassmen believed thatunderclassmen were uncivilized and had to be properlygroomed. The pennalism requirement, however, was abol-ished in the 1700s because of serious Injuries and deathscaused by the the 18th and 19th centuries,English secondary schools reported problems with fag-ging, the practice of upperclassmen s coercing underclass-men to act as servants for their senior incidents of Hazing were reported in the late 19thcentury.

7 Including a well-documented Hazing incident of afreshman s being killed after he fell into a gorge trying tofind his way home through the woods at night after hisfraternity brothers abandoned him. Subsequently, severalmore Hazing incidents were reported in the late the early 20th century, Hazing was again accepted bystudents and school administrators as a way for newcomersto learn respect for a school organization. In 1916 a first-year university student was twice seriously harmed by beat-ings once during an initiation and once because he re-ported his Injuries to the school s were reported in secondary schools in the early1900s.

8 The first newspaper record of a high school student spresumptive death in a Hazing incident occurred in 1905. A13-year-old boy died as a result of contracting pneumoniaafter he was held down on the ground by upperclassmenwhile snow was pushed down his New YorkTimespublished the article under the headline Hazing KillsSchoolboy. 1 From the Department of Emergency Medicine, MassachusettsGenera lHospita l; and the Division of Emergency Medicine, HarvardMedica lSchoo l, Boston, received November 11, 2002, accepted November21, reprint requests to Michelle A.

9 Finkel, MD, Massachu-setts General Hospital, Clinics 115, Fruit Street, Boston, MA : violence, trauma, Injuries , 2002, Elsevier Science (USA). All rights $ 1933, educators at 14 colleges signed an agreement toeliminate detrimental Hazing Practices among fraternitiesand , deaths from the Practices including excessive alcohol ingestion, falls, and drown-ings continued throughout the century, including severalwell-publicized the end of the 20th century,the reported incidents had escalated, leaving Hazing andpledging activities the cause of at least 56 fraternity andsorority deaths from 1970 to the presumed massive underreporting of in-cidents, defining the prevalence of Hazing is extremelydifficult and few studies have attempted to quantify it.

10 Aninvestigator from Alfred University, however, conducted anational survey of a random sample of college athletes atNational Collegiate Athletic Association institutions inearly 1999. Of the 325,000 athletes surveyed, 80% of re-spondents reported anonymously that they were subjected to questionableorunacceptableactivities as part of theirinitiation onto a collegiate athletics team. One in 5 wassubjected to, unacceptable and potentially illegal Hazing , including beatings, kidnapping, and number of patients who present to emergency de-partments with Hazing -related Injuries has never been re-ported.