Karren Brady has questioned whether some Premier League clubs "might not have the luxury" of players with deep-seated coronavirus concerns sitting out games.
The West Ham vice-chairman says she "fundamentally" believes footballers should have the choice as to whether they make themselves available whenever the 2019-20 season resumes.
But Brady sees the matter, along with the issue of playing at neutral grounds and the possibility of infections breaking out in the league, among the complications in getting top-flight football moving again.
"Our club is moving quickly and our players have already undergone cardiac screening and blood tests," Brady wrote in The Sun.
"The bottom line is our players have three main points yet to be fully resolved. They are: Will I be forced to training? Will I be forced to play? And what happens if someone tests positive once we are playing?
"Players want it to be their choice whether they turn out or not, letting them decide should they have personal issues, such as living at home with a vulnerable adult or young children.
"Fundamentally, I agree with this position. But in the event of a relegation battle some clubs might not be able to have the luxury of giving a choice to their players.
"How would any club feel if an absence of one or two top men was an element in relegation?
"It might not seem fair to play without them, but neither would it be fair to force players to play if they have genuine concerns about doing so. What is reasonable to one club may end up unfair to another."
Brady detailed a range of measures West Ham are taking to protect players on their return to the training pitch.
With car-sharing and tackling initially banned, the emphasis is on cutting out contact, and Brady said West Ham would disinfect equipment such as corner flags and goals.
"And even the grass," Brady wrote, "although how remains a mystery as that usually kills it."
West Ham sit 16th in the 20-team Premier League, outside the relegation zone on goal difference with nine games remaining.