Boxer Patrick Day died on Tuesday, days after suffering a traumatic brain injury during his match for the USBA super welterweight title in Chicago on Saturday. The 27-year-old fighter is now the fourth boxer to perish this year from injuries sustained in the ring.

In July, two boxers — Maxim Dadashev, a 28-year-old Russian, and Hugo Alfredo Santillán, a 23-year-old from Argentina — died of brain injuries they received in fights. Dadashev died on July 23, four days after his light-welterweight fight in Maryland, while Santillán died five days after he collapsed following a fight in Buenos Aires.

Then, in September, a Bulgarian boxer named Boris Stanchov died in the ring while fighting under his cousin’s boxing license in Albania, the Washington Post reported.

This latest wave of fatalities has highlighted the intrinsic dangers that come with boxing, giving fuel to the case made by proponents that the sport should be banned.

At the very least, some argue, boxing organizations should implement safety protocols such as adding padding to gloves or shortening fights to lessen the chance a fighter will leave the ring with brain damage or a traumatic injury such as the one Day experienced in the 10th round of his fight.

Although the brain is shielded by a thick skull, the brain itself is only as firm as jello, UCLA professor of neurology, Christopher Giza, explained to Brain Facts. When someone is hit hard enough to render them unconscious, the brain can experience permanent damage as it rattles inside the skull.

“That twisting and pulling can cause brain circuits to break, or lose their insulation, or get kinked up, and that shuts off parts of the brain,” he said. “If the part of the brainstem responsible for consciousness is affected, then you would be knocked out.”

According to a 2008 study published in Neurology, boxers who suffer a knock-out blow will likely experience widespread loss of brain tissue.

“There is more damage and it is more widespread than we had expected,” said the study’s researcher, Dr. Brian Levine of the Rotman Research Institute and the University of Toronto.

“When you have a blow to the head, it causes a neurochemical reaction in the brain cells that lead to cell death,” he told Reuters of the findings. “The more cells that die, the less tissue you have.”

Former English boxer Ricky Hatton was found to generate punch speeds of up to 25 mph, with a top speed of 32 mph, according to Scientific American. Repeated blows to the head of that force only improve the chance a fighter will have lasting damage.

Former light heavyweight world champion Andre Ward weighed in on the need for a change in boxing protocol following Dadashev and Santillán’s deaths.

He suggested that boxing organizations look to the weigh-in process, which usually occurs the day before a fight. Ward says that after making weight, many fighters try to pack on mass in the hours leading up to their fight. This can cause them to become dehydrated, which leaves the brain less protected, according to the Times.

“One of the biggest changes we can bring in the sport of boxing is the weight-in process,” he tweeted on July 25. “Either go back to same-day [weigh-ins], or allow IV’s to be administered in every state [legally]. Lack of fluid around the brain increases the risk of a brain bleed.”

During a meeting of the Association of Boxing Commissions in August, Dr. Michael Schwartz — a co-chairman of the medical advisory committee — said they were going to look for ways to minimize the risks of the sport.

“People are going to get hurt, and people are going to die,” Schwartz said, according to the Times. “But we’re here to do everything we can to minimize those risks.”

After his death, Day’s promoter, Lou DiBella, released a statement that said — despite the risks — participating in the sport is what made the young fighter happy.

“Patrick Day didn’t need to box. He came from a good family, he was smart, educated, had good values and had other avenues available to him to earn a living,” DiBella said. “He chose to box, knowing the inherent risks that every fighter faces when he or she walks into a boxing ring. Boxing is what Pat loved to do. It’s how he inspired people and it was something that made him feel alive.”

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