Everton manager Roberto Martinez insists players cannot be allowed to make decisions about their own fitness when it comes to matters of concussion.
The Spaniard found himself closely involved in the issue last weekend when Tottenham's Hugo Lloris was knocked out in the second half of the goalless draw at Goodison Park but played the remainder of the game.
Romelu Lukaku, the striker involved in the collision, had his own similar episode, although not as serious, in September when was so dazed after a clash of heads with defender Joey O'Brien he had to be told by the Toffees physio he had scored the winner.
"At the time I was told he was fine, that it was a knock but it didn't go any further and it wasn't that he lost consciousness," Martinez said.
"He was fine to carry on. It is something you will always see - people will want to follow the player's wishes.
"I've never seen a player who wants to come off, even if they can't walk, but that is the moment when the medical advice has to take the most important part of the decision.
"I don't think it should be a manager's decision whether you take a player off or not.
"If there is a strong view from the medical side that when a player gets concussed he should come off I think we should look into it and make it a rule.
"If it comes as a rule with an understanding for everyone that if that happens the player should come off and it shouldn't count as a substitution that would be a lot easier.
"Because if you are put in a position where a player has to come off when three substitutions have been made it is a real shame as it is going to affect the competition.
"You wouldn't want to see a team down to 10 men but the last thing you want is to put the health of any player at risk.
"It is a debate which needs to be taken to the governing bodies to make it a ruling and that will be easier for everyone - you don't want to see a player upset because he is not allowed to carry on but the most important aspect is the health of the player.
"If we are so clear that it is so dangerous that he shouldn't be allowed to do it that should be part of the ruling."
Spurs boss Andre Villas-Boas' suggestion Lukaku's role in the Lloris incident required further examination and an apology brought not only a strong defence but a riposte from Martinez, who was unhappy Roberto Soldado's apparent elbow on Phil Jagielka went unpunished.
"The good thing is you can watch the replay and see the video evidence," the Spaniard added.
"All Romelu is doing is carrying on his run - he cannot disappear. It is unfortunate.
"I don't think Andre Villas-Boas mentioned there was any intent or any wrongdoing from Romelu - he only mentioned he expected a bit of an apology.
"Obviously we are waiting for Roberto Soldado to apologise to Phil Jagielka and so we can use the same phone call so we don't have to spend on two phone calls."
Asked whether he thought there should have been retrospective action taken against the Spain international, Martinez added: "That is not for me to comment. I don't think it would give anything to Everton.
"That is down to the authorities to decide whether they want to implement it.
"I am more about the referee making decisions in the game and whatever happens in the game is where it matters.
"I'm not too keen about retrospective punishment unless it (the action) goes against the values of the competition.
"I don't think they (officials) saw it obviously otherwise they would've acted accordingly.
"Nowadays you have action replays and you can see everything that happens but for the referee it is very difficult."