The International Association of Athletics Federations (IAAF) continues to be in the news recently regarding allegations of widespread doping and subsequent cover-ups. While reading all this coverage, it reminded me of an essay I wrote for my law Masters discussing the premise that doping (and, further in the future, genetic enhancement) was a natural progression of sport and therefore a positive thing. I’ve re-written and expanded on portions here to make it a little more readable. Let the debate commence!
Bleeding edge science often finds itself chasing a moving target. For example, in 1997, chess was seen as the epitome of human intelligence yet as soon Deep Blue beat Garry Kasparov, many were quick to extoll the differences between intuition and algorithms and the beauty of the mind’s expertise with the brute force of assessing 200 million chess moves a second. Just as Deep Blue generated discussions on the definitions of “true” intelligence, humanity and many peripheral philosophical discussions, the massive advances in pharmaceutical sciences and, more recently, genetic therapies have opened a similar frontier in athletics —with one key difference.
Artificial intelligence is just that: artificial. Doping and genetic therapies are about “improving” humans and our own abilities to perform and push those boundaries. So while as a society, humans ordinarily embrace and celebrate our technological advances, recent years they have started to impinge on what it means to actually be human. However, ever since humans have competed in sporting and athletic events, they have tried all means available to them to achieve their best possible results.
As such, when Julian Savulescu, Professor of Practical Ethics at the University of Oxford, argued that “[g]enetic enhancement is not against the spirit of sport; it is the spirit of sport” it was guaranteed to divide opinions. So, was he right?
Doping: A Medical or Ethical Dilemma?
Athletes have long used artificial means to augment their performance such as stringently managing their diets or training in unusual conditions like high altitudes. At the end of the 19th Century, endurance bicycle races were being conducted where the athletes were under such pressure that their teams administered nitro-glycerine, causing hallucinations and other health complications. Numerous highly-publicised incidents quickly turned public opinion against “doping”, seeing it as brutally forcing individuals to perform beyond their natural means.
Despite this, numerous instances of unsafe (and occasionally fatal) doping practices such as the use of strychnine, anabolic steroids and amphetamines continue pepper Olympic history . Doping was therefore banned in an effort to ensure that our entertainment did not incentivise athletes to detrimentally affect their health.
This has proven to be an insufficient deterrent to stop athletes doping. Why?
There is no denying the phenomenal emphasis modern society places on sport with considerable newspaper column inches and TV airtime dedicated every single day. This, combined with the psychology of elite athletes and the potential financial gain of winning leads many to take risks to push their bodies further.  Furthermore, the boundaries between medical ethics and elite sport are problematic as the innately competitive nature at the highest echelons mean that teams are incredibly secretive about the methods used to gain the minute performance increases needed – whether they are legal or not. As a result, upcoming youth and elite athletes are often used as unregulated human guinea pigs — potentially falling prey to the well-documented pitfalls of medical research ethics.
Therefore, by strongly associating the stigma of being branded a “cheat” and of going against the “spirit of sport”, governing bodies hope this acts as a sufficiently strong psychological deterrent both with the athletes and their supporting teams across all ages and competitive leagues. However, what is this nebulous concept of a “spirit of sport”? While many use it as a way to highlight “ethical” sportsmanship, others take a different view, such as Moller (2008):
“The spirit of sport that restrains the athletes makes them show consideration for each other even in hard competitions. This is why intentionally causing another rider to crash or causing intentional injury in soccer are violations of the spirit of sport and are always to be condemned. But standing outside the world of sport and asserting that doping violates the spirit of sport is just a way of disguising an impulse to moralize that is rooted in one’s own personal distaste for the practice. On the deepest level, this is just a way of showing that one does not accept the essence of sport, the pithiest formulation of which is found in the Olympic motto: faster, higher, strong, and that manifests itself in what at times can be a ravenous will to win.”
So in the same way Deep Blue’s win over Kasparov caused people to debate on the meaning of human intelligence, moralising over doping points to a wider concern over what it means to be naturally human.
Sporting is not the right forum to have these deliberations and moving the doping debate away from these ulterior concerns back to their genuine medical roots would be a universally beneficial step. Indeed, our pharmaceutical technology and knowledge has advanced to the point that drugs and enhancements could be offered in safe, transparent and regulated fashion. Moving these techniques out from the shadows reclassifies them from illicit “doping” to legal “enhancements”, levels the playing field and ensures sport is once again about the competitive spirit and physical prowess. Is this not more conducive to the spirit of sport than the genetic lottery that it currently is?
The World Anti-Doping Agency (WADA) could enforce a whitelist of approved enhancements rather than fighting an arms race of blacklisted substances. While an in-depth look at the pros and cons of this is a much larger discussion, Camporesi and McNamee (2014) propose an interesting solution based upon the Precautionary Principle, whereby athletes could use any enhancement as long as they could prove there were no detrimental health effects.
So should there be a blanket approval of all “safe” pharmaceutical and genetic therapies? Some argue that domain-specific enhancements such as beta blockers in shooting or archery events should be banned. In my opinion, this just seems little more than the previous argument watered down. However, looking at genetic therapies in particular, there are several candidate proteins that have a high probability of being used in sporting and have broad-ranging effects: ?-Actinin-3 (ACTN3) for strength and PPAR?, PEPCK-C and EPO for endurance.   At a genetic level, this form of doping provides fundamental improvements, although often targets specific muscle groups.
So is genetic therapy safe? In its current level of maturity, there are still a huge number of complications that can arise: gene silencing, immune reaction, viral integration, infection of germ cells, overexpression and unknown long-term complications.  Regardless of whether we are applying the Precautionary Principle or not, genetic therapies in its current form should be prohibited on these safety grounds alone.
In conclusion, I feel that while doping bans originally arose out of a concern for athletes’ wellbeing, the “spirit of sport” tenet in WADA’s charter has diluted and complicated the matter and is currently used to moralise the humanist debate. Savulescu’s argument is that the “spirit of sport” is purely competitive, and athletes fully informed of the risks of doping or genetic therapies should be allowed to participate in enhancing their performance as they see fit.
As such, while I agree with Savulescu’s overarching proposition that genetic enhancement falls within his definition of the spirit of sport, until gene therapy has reached the maturity of being able to deliver targeted alterations safely, it should be banned from sport.
|1||Sheehan O, Quinn B. Doping in Sports – A deadly Game. [Internet]. Available from: http://www.theathlete.org/doping-in-sport.htm.|
|2||Moller V. The Doping Devil. 2008. Cited from http://sportsanddrugs.procon.org/view.answers.php?questionID=001243#answer-id-006730|
|3||van der Gronde T, de Don O, Haisma HJ, Pieters T. Gene doping: an overview and current implications for athletes. Br J Sports Med. 2013;47:670-678.|
|4||Camporesi S, McNamee M. Performance enhancement, elite athletes and anti doping goverance: comparing human guinea pigs in pharmaceutical research and professional sports. Philosophy, Ethics and Humanities in Medicine. 2014;9:4.|
|5||McDermott D. Yes, Computers Can Think. [Internet]. 1997 Available from: http://www.nytimes.com/1997/05/14/opinion/yes-computers-can-think.html.|
|6||Foddy B, Savulescu J. Ethics of Performance Enhancement in Sport: Drugs and Gene Doping. Principles of Health Care Ethics. 2007:511-519.|
|7||Berman Y, North K. A Gene for Speed: The Emerging Role of ?-Actinin-3 in Muscle Metabolism. Physiology. 2010;25:250-259.|
|8||Wang YX, Zhang CL, Hu RT, Cho HK, Nelson M, Bayuga-Ocampo C, Ham JH, Evans R. Regulation of Muscle Fiber Type and Running Endurance by PPAR?. PLoS Biology. 2004 October;2(10):1532-1539.|
 McDermott (1997) published a great New York Times articles published shortly after Deep Blue’s victory that encapsulated many of the feelings of the time.
 Exploring Goldman’s Dilemma and the change in attitudes of athlete’s (and the general population) is anecdotal evidence to support the ideas around the psychology of elites as well as the changing attitudes over time.
 Vulnerability, voluntariness, undue influence, full disclosure, equitable subject selections, conflict of interest (van der Gronde, 2013).
 Not just a bad sporting pun, this is probably the most controversial statement. However, Foddy and Savulescu (2007, p517) make a good argument for this as their fifth misconception regarding drugs in sports. 
 WADA does “define” what it means by ‘spirit of sport’ but, as Savulescu (2007) points out, while aspirational it is a truly terrible set of criteria for choosing what drugs to ban.
 Camporesi and Silva argue that the Precautionary Principle should be applied when there are “reasonable grounds to infer a performance enhancing effect, or risk to the harm of the athlete”, whereas I believe it should only be in relation to the health of the athlete.
 A detailed look at these proteins is beyond the scope of this essay but Gronde et al. (2013), Berman and North (2010) and Wang et al (2004) all provide interesting insights into the functioning of these proteins and their applicability in sport.