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Should athletes be allowed to use performance enhancing drugs?

Press Release: British Medical Journal Head to Head: Should athletes be allowed to use performance enhancing drugs?

Stories about illegal doping in sport are a regular occurrence. On today, experts debate whether athletes should be allowed to use performance enhancing drugs.

Professor of ethics Julian Savulescu, from the University of Oxford, argues that rather than banning performance enhancing drugs we should regulate their use.
He points out that, since Ben Johnson in 1988, only 10 men have ever run under 9.8 seconds – and only two (including Usain Bolt) are currently untainted by doping. “The zero tolerance ban on doping has failed,” he says. “It is time for a different approach.”

He argues that regulation could improve safety and says “we should assess each substance on an individual basis” and “set enforceable, fair, and safe physiological limits.”
He acknowledges that, if a substance came to dominate or corrupt performance, there would be good reason to ban it. But says, if a substance allows safer, faster recovery from training or injury, “then it does not corrupt sport or remove essential human contribution.”

And he dismisses the argument that allowing elite athletes to take drugs under medical supervision will encourage children and amateurs to imitate their heroes, pointing out that amateur doping “is already happening in an unsupervised manner.”

“Over time the rules of the sport have evolved,” he says. “They must evolve as humans and their technology evolve and the rules begin to create more problems than they solve. It is time to rethink the absolute ban and instead to pick limits that are safe and enforceable.”

But hospital doctors, Leon Creaney and Anna Vondy believe this would lead to escalating use and call for tougher enforcement.

“The argument against doping in sport is moral, not medical,” they write.

“Athletes who wanted to live a healthy existence would be pushed out altogether. Soon, the only competition that would matter would be the one to develop the most powerful drugs, and athletic opponents would enter into an exchange of ever escalating doses to stay ahead of each other.”

They warn that, in some nations, “we might see a return of the state sponsored doping programmes of the 70s and 80s” and say without the anti-doping programme “the use of performance enhancing drugs would expand exponentially and filter deeper into our society.”

Legitimising performance enhancing drugs in elite and professional sport would also change the message sport sends to society, they add. “Would a bioengineered athlete be able to inspire in the same way?”

They dismiss the argument that because we will never be able to catch every cheat, we should give up trying, saying the answer is “to make the anti-doping system more effective.”
If testing was ubiquitous, they say, “it would be virtually impossible to evade detection, and the equilibrium would be reset in favour of not cheating.”

And if a first offence led to a lifetime ban, “the risks involved would become much greater, such that fewer people would take the gamble of getting caught in the first place,” they conclude.
Professor Julian Savulescu, Uehiro Chair in Practical Ethics & Director, Oxford Centre for Neuroethics, University of Oxford, UK
Tel: +44 (0)1865 286 888
Leon Creaney, Trauma and Orthopaedics, University Hospital Birmingham, UK

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4 Comment on this post

  1. Not sure why it needs ‘experts’ to discuss this matter. I am sure with a little effort it could be arranged with most or all of the international and professional sports bodies that they ballot their members to see if they wish for the present ban on doping to be ‘regulated’ in the manner you propose. The experts can have their say before the ballot and then it can be left to the people who really count – the athletes.

    Of course, even if the majority of athletes voted for your proposal, it would still be highly unlikely it could be implemented because it would be blocked by numerous courts throughout the world that would uphold the right of dissenting professional athletes who refused to take drugs and were thereby disadvantaged in their workplace. Nonetheless it would be interesting to know what the athletes think, and if your proposal was voted for it certainly would give it some weight. That aside, I am pretty certain there would be an overwhelming vote to reject your proposal and it could be forgotten about for a few years.

    1. I’m not sure that would work because:

      a) current athletes would be unlikely to vote honestly in case there is some way of identifying individuals who voted for doping
      b) they might also not vote in favour of doping as it is seen so negatively in the public eye that a pro vote would destroy their sport

      In fact, you could say that athletes in some sports have already voted- with their actions. It is pretty conclusively proven now that nearly all and certainly a majority of professional cyclists were using epo whilst there was no effective test (and also afterwards). So much so in fact that there were cyclists who as you describe above had to leave the sport because they did not want to participate.

      1. Sarah

        a) I think it could be arranged to be a secret ballet.

        b) Some may vote against doping for the reason you give. But surely that is quite reasonable; we can’t say their vote is in someway invalid because they take into consideration public perceptions. They may be right that doping would destroy their sport, which is a very good reason to reject Julian’s proposal (with or without a ballet).

        The fact that a large number of athletes take drugs can’t be viewed as a ’vote’ for doping. As I say, I am pretty certain most athletes would reject Julian’s proposal including those that are using drugs at present time and have as yet not been detected (they have an advantage over those that are not cheating and therefore may believe prohibition works in their favour). Nonetheless if, for whatever reasons, the vote was overwhelmingly against Julian’s proposal I think we should respect the vote. Democracy is far from perfect but it surely beats having doping imposed upon even a small minority because a few so called experts think it is better for sport. I agree that this minority, if indeed it is a minority, are in a difficult position now because they may feel they can’t compete in a sport that is riddled with drugs, but their position is not helped by Julian’s proposal unless they give in and start doping. Even then, they might keep to the regulated drugs and doses but find they are still disadvantaged by athletes who exceed the doses and use unregulated drugs.

  2. Thank you Pieter for your kind post. I hadn’t listened to your lecture as of my previous posts as I was reacting to specific claims made in the transcript. Let me now try to briefly address some of the issues you raise in your last post.

    On drug use in sports

    You seem to believe that a good reason for banning drug use in sports relies on drugs’ risk-inducing dispositions; and you seem to believe that the following sentence follows from this idea:

    If one can show that taking a certain instance of a drug does not put the health or agency of the user at risk at one or repeated occasions, then one has seriously undermined the justification of the ban for this drug.

    If this your view, then it seems to me open to the following objection: the consequent of the italicized passage does not follow. Here is an argument showing why (let us call it the “Risk Argument”):

    P1. Risk-inducing dispositions of drugs manifest along a non-discrete, non-linear scale and are very sensitive to other drugs – to the effect that only after many uses with varying quantities and many different combinations of other drugs is it possible ascertain the probability that drugs have negative effects on users’ health (i.e. tissue damage) and agency (i.e. addiction-conducive mechanisms).

    P2. Given this epistemic indeterminacy, most sportsmen will have good reasons to believe that rival contestants will take the risk nevertheless and that, as a result, will outperform them, and thus are likely to use drugs preemptively.

    P3. Drugs come with a “de-sensitivization” threshold (the fact that you need to take more of it to get the same effects), to the effect that those who take drugs will have to take more of them to get the same effects.

    By (P2) and (P3), sportsmen that take drugs preemptively will have to increase their drug consumption in order not to be outperformed.

    By (P1), we are likely to detect hypothetical health and agency issues caused by drug use too late for preventing them and therefore that we should take action right now to prevent those issues.

    But, by (P1) again, the prevention cannot be focused solely on specific kinds of drugs; any substance that have risk-inducing dispositions is a priori concerned.

    Therefore, we should not allow anything with risk-inducing dispositions mentioned in (P1), i.e.we should ban drug use.

    The Risk Argument explains why the italicized sentence in the first paragraph above does not follow from the sentence just before: the possible undesired effects of drugs considered collectively, combined with group pressure stemming from their desired effects, open the door to losses in health and/or in agency.

    Unless you can help me see some logical flaw, maybe you could tell us which premise(s) of the argument would you reject and why?

    On enhancers in general

    Some premises of the above argument admit of an interesting generalization that collides with what friends of enhancers would have their audience believe (let us call it the “Abilities Should Be Authored by Their Owners Argument):

    PI. Some institutionalized human activities should be constrained by “Abilities Should Be Authored by Their Owners” principles.

    PII. Such principles rule out any enhancers that enhance abilities pertaining to the success conditions of the actions that are part of the activities mentioned in (PI).

    Therefore, some institutionalized human activities should be free of these enhancers, i.e. using such enhancers in situations that the relevant institutions define should be forbidden, to the effect that using those enhancers should be completely banned from certain occurrences of these activities.

    Here is very roughly the idea behind (PII). To do a particular activity, a sport say, you have to go through a bunch of mental operations that collectively bring about the distinct (non-purely mental) actions in which the activity of doing the activity (sport) consists. Now to be good at this sport is to go through similar mental operations and then apply some try-and-adjust operations on these so as to optimize them, that is, so as to make it the case that the non-purely mental actions in which the activity consists come out in a way that it better than the way of other contestants, and in a way that you will remember.

    Of course, how your non-purely mental actions that make up the activity come out compared to other contestants do not depend solely on your mental operations. Your physical constitution matters, too. But by the same token, if you want to improve your physical constitution you have to go through similar mental operations, this time trying to act on your own body as opposed to some conventionally specified goal. So in the end training boils down to this: optimization and remembering via mental operations.

    Now enhancements interfere on this optimization either by decreasing the need for improving one’s physical set-up or by decreasing the need for optimizing one’s mental operations in the course of doing the activity. In either case enhancements do some work of the users that is part of the institutionalized activity for which the user is using enhancements.

    But – and this is the idea behind (PI) – we have reasons to protect the interests of those who engage in the institutionalized activity without having part of or all their work done for them, be it by enhancers or any other kind of help. That is, anybody that participates in those activities and wants to create her own abilities by engaging in the optimization process described above is setting herself constraints that add-up to the constraints created by doing the activity along with other contestants which together determine the standards according to which, putting aside the immediate results in the competitive environment, determine the standards of appropriateness for evaluating her. She therefore has interests in not being compared to enhanced folks whose enhancements mess up those standards of evaluation, and as long as those interests are morally relevant (and they are since the determine how that particular person will be evaluated and then the extent to which she will be offered professional and other kinds of opportunities), they ought to be protected.

    From (PI) and (PII) it follows that we should either ban those enhancers from activities where such interests are morally relevant.

    Notice, though: the conclusion is compatible with these activities having different categories of participants, with one category free of enhanced folks and one category with only enhanced folks. The argument is just not compatible with mixing the two as far as it messes up with the moral claims grounded in the interests of the non-enhanced folks. Also, the Argument applies to any kind of activity where participants have structurally similar moral claims (school, university, etc.).

    I’d be glad to know what you object against here.



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