Lance Armstrong, Barry Bonds, Alex Rodriguez, and Ben Johnson are just a few of the many decorated athletes known to have used performance enhancing drugs (PEDs). These athletes are now considered “cheaters”, shunned for the use of PEDs to achieve a chemical advantage in their respective sports. They violated the rules, the trust of their fans and colleagues, and the spirit of sport. Over recent years, there has been constant moral debate surrounding doping in sports. But the idea of doping is not new—it existed long before modern sport. For example, the Ancient Greeks prescribed their athletes a diet of dry figs and cheese to improve performance and used stimulants like brandy and wine to help aid with recovery and training. Today’s idea of doping revolves more around the use of drugs (e.g., growth hormone) and prohibited methods (e.g., blood transfusions) in which one attempts to gain a chemical edge in their athletic performance.
There are four main categorical arguments against doping in sport. These are: (1) argument from naturalness; (2) argument from an unfair advantage; (3) argument from the spirit of sport; and (4) argument from harm. This article series will be broken into two columns. This column discusses the first three, while the second column will analyse the final argument.
Argument from Naturalness
Sport can be defined as the pursuit of human physical excellence that is guided by a set of rules. If sport is meant to be a test of human physical excellence, then we might come to think that using PEDs is against the nature of sport because it is unnatural. Some argue that doping is an unnatural activity that violates the purity of sport. Doping dishonours the cultivation and display of humans’ natural talents. Taking PEDs removes any sense of naturalness or purity that is found in sport.
There are three problems with this line of argumentation. The first is that we interfere with nature whenever we implement a medical intervention such as vaccination, cancer treatment or antibiotics. If we hold the view that using PEDs is unnatural and that anything unnatural is wrong, then we must be prepared to accept the notion that medical advancements are wrong. I don’t think we are willing to accept that.
The second problem is many of the safe drugs that we want to permit are natural – they naturally occur in the body. For example, drugs like erythropoietin (EPO) and growth hormone are naturally produced in the body. If these drugs naturally occur in the body, then it is difficult to believe that injecting these into our bodies is unnatural.
The third problem is that the false view that if PEDs are permitted, then sport will not remain a test of natural physical talent. PEDs are not some magic elixir. Instead, they merely enable athletes to train harder and longer. There are no PEDs that exist that will increase sport-specific skill, rhythm, and creativity – the tenets of what makes the sport a sport. The matter of fact is that PEDs do not reduce the test of human physical excellence involved in sport or naturalness.
Argument from an Unfair Advantage
Another common argument in the literature surrounding the use of doping in sport is the argument from an unfair advantage. Generally, fairness requires all athletes to abide by the same rules. These rules can be unwritten or written. However, the main idea is that through participating in a sport, athletes submit themselves to the regulations of the sport with the understanding that all other athletes have done the same. The argument from an unfair advantage states that when an athlete uses PEDs, they violate the rules that they agreed upon—they violate a contract. This being said, no contract would be violated if it were amended to permit the use of PEDs. This would eliminate the problem of cheating entirely because doping would not be in violation of the rules.
Nevertheless, another argument from unfair advantage is that there would be a gap between the people who dope and the people who are clean. The gap between athletes already exists, as people are born with different genetic potentials. People excel in sport because they won out in the genetic lottery. If we allow doping in sport, it would level the playing field as opposed to creating a gap between the users and non-users. For example, one human capability that is most used in sporting events is determined by the ability to deliver oxygen to your muscles. Since oxygen is carried through the red blood cells, the more red blood cells you have the more oxygen you can carry. This, in turn, controls how well an athlete can perform aerobic exercises. Erythropoietin (EPO) is a natural hormone which stimulates red blood cell production by raising the packed cell volume (PVC). The average person at sea level has PVC of 0.4-0.5; elite athletes tend to exceed 0.5 due to their training or genetics (or drugs). Currently, there are three ways to increase your PVC: a hypoxic air chamber and tent; to send an athlete to a high-altitude training location; or using EPO, which is currently banned under the World Anti-Doping Agency’s (WADA) prohibited list.
When testing for drug use, the International Cycling Union (ICU) requires athletes to have a PVC no higher than 0.5. If someone was born with a PVC of 0.3, allowing them to use EPO would level the playing field by permitting that person to safely increase their PVC to 0.5. In addition, if someone has a PVC of 0.6, they are not allowed to compete under the ICU due to their PVC being above the threshold of 0.5. In this instance, instead of barring an athlete with a PVC of 0.6 from competing altogether, perhaps the athlete could be allowed to take a drug that would decrease their PVC. If we allow doping (e.g., the use EPO) then we can remove the effects of genetic inequality. Instead of doping making competition unfair, it would promote the opposite—fairness.
However, to believe that doping will level the playing field is problematic because it fails to consider the possibility of elite athletes doping as well—creating an unfair advantage. Though this is true, there can be limits on to how much an athlete is permitted to dope, for example, limiting the PVC of an athlete to 0.5. The reason being, raising the PVC over 50% can yield significant health risks. In limiting the amount of PEDs an athlete is permitted to use, we don’t run the risk of creating an unequal playing field because an athlete who is deficient in one area may use drugs to improve, whereas another athlete might not need drugs due to his genetics. Questions might arise relating to how to monitor the changes that occur in athletes due to doping. In order to monitor athletes to make sure that they do not dope above the limit, we can introduce biological passports which record an athlete’s pattern of physiological values. If there is a serious change in their physiology, for example, and the PVC increases beyond the 0.5 threshold, then further testing or prosecution may follow. Thus, the possibility that elite athletes can dope is not an issue if we can impose a threshold of how much an athlete can dope and record physiological changes.
However, many people think by permitting doping in sport, we would turn sport into a competition of who has the better technology or the better pharmacist. It is evident that there will be a gap between the quality of enhancements available to everyone. Less affluent countries would be at a disadvantage because wealthier countries would be able to afford the new technologies. Yet, permitting drugs could actually reduce the economic discrimination. For example, currently, to raise an athlete’s PVC legally (i.e., permitted under WADA’s guidelines) the two main options are: (1) purchasing a hypoxic air machine and tent, which is about $7000 US, or, (2) by sending an athlete to a high-altitude training location for months at a time, which is even more expensive. Less affluent countries may not be able to afford either of these options, so what can they do? There is a third option – allow doping, specifically, the use of EPO, which would cost $120 US/month. These three methods result in the same outcome (more red blood cells to carry oxygen) but the cheapest method is prohibited. Thus, if we allow doping, we can alleviate the burden of inequality as doping is a cheap, effective, and safe method of improving athletes’ performance for all countries.
Argument from The Spirit of Sport
Another common objection to permitting drugs in sport is the argument regarding the spirit of sport. WADA’s third criteria for banning a drug relies on the notion that if it violates the spirit of sport then the drug must be prohibited. In allowing athletes to dope, we degrade the integrity of the game. Some moral philosophers, like Julian Savulescu, contend that performance enhancement embodies the spirit of humanity because humans have the choice to be better, whereas animals, like racehorses, lack this gift. He argues that the rules in sport have changed over time and they must evolve in the same light as humans and technology evolve. The fact that a belief is widely held does not make that belief true. There were many beliefs that were strongly and widely held that we have changed today because beliefs change with the times. For example, the fact that many people strongly held the belief against gay marriage does not make their homophobic belief right. Society changes. Beliefs change. Rules change. The point of ethics is about what there is good reason to do.
Maybe it is time for a change in how we view the spirit of sport. The reasons why we develop codes of ethics is that they serve as guidelines for behaviour instead of a set of rules that limit one’s freedom. We must use them as a guide and leave open the opportunity for change. I think it is time that we reorganize and realign the defense against prohibiting doping. We must alter our ways of thinking about doping as cheating, unfair, harmful, or against the spirit of sport. We must start to analyze doping from a different perspective and allow the use of safe drugs in sport. It is time to rethink the absolute ban on doping in sport and instead to choose limits that are safe, enforceable, and ethical.
Editor’s Note: In the next edition, Mario will address the final argument against doping in sports.