(1993). Why Olympic Athletes Should Avoid the Use and Seek the Elimination of Performance-Enhancing Substances and Practices From the Olympic Games. Journal of the Philosophy of Sport: Vol. 20, No. 1, pp. 64-81. doi: 10.1080/00948705.1993.9714504.

The debate on the use of performance-enhancing substances or methods to improve refereeing is underdeveloped in the sport philosophical literature. This contrast with the attention scholars have de...

In light of the World Anti Doping Agency’s 2013 Code Revision process, we critically explore the applicability of two of three criteria used to determine whether a method or substance should be considered for their Prohibited List, namely its (potential) performance enhancing effects and its (potential) risk to the health of the athlete. To do so, we compare two communities of human guinea pigs: (i) individuals who make a living out of serial participation in Phase 1 pharmacology trials; (...) and (ii) elite athletes who engage in what is effectively ‘unregulated clinical research’ by using untested prohibited or non-prohibited performance enhancing substances and methods, alone or in combination. Our comparison sheds light on norms of research ethics that these practices exacerbate with respect to the concepts of multiplicity, visibility, and consistency. We argue for the need to establish a proper governance framework to increase the accountability of these unregulated research practices in order to protect the human guinea pigs in elite sports contexts, and to establish reasonable grounds for the performance enhancing effects, and the risks to the health of the athlete, of the methods and substances that might justify their inclusion on the Prohibited List. (shrink)

The current anti-doping policy in sports has enormous costs in economic, social, and human terms. As these costs are likely to become even bigger with the advent of bioenhancing technologies, in this paper I analyze the reasons for this policy. In order to clarify this issue, I compare sports with dance, an activity that has many similarities with sports but where there are no bans on performance enhancers. Considering the World Anti-Doping Agency (WADA) criteria for banning a substance, we (...) argue that two of them, the potential to enhance performance and the risk for health, are similar in dance and sports, thus I claim that the difference had to be in the so-called “spirit” of sports and dance. After looking into this matter and analyzing the special case of dancesport, I conclude that the main difference can be found in the competitive character of sports and the subsequent concern about competitive justice. (shrink)

Following an investigation of the football clubs using hypoxic air machines, the Australian Football League has decided not to ban the machines. This seems, however, to be a reluctant decision since it appears that some AFL officials still feel there is something undesirable about the use of the machines. Use of the machines raises questions about performance enhancement and the role of technology. It prompts consideration of the grounds for banning performance enhancing devices or substances and (...) raises questions about what constitutes a drugA machine being used by Australian footballers, which is designed to imitate the effects of high altitude training and enhance performance has prompted an investigation by the Australian Football League and sparked debate in the media. The AFL decided not to ban the machine but a sense of unease about its use remains and there seems to be some difficulty in articulating the cause of that unease. The league’s medical officers say the hypoxicators do not contravene their antidoping code or the league’s rules,1,2 but according to at least one AFL official, the use of the machines is “sending the wrong message …. (shrink)

Scholars such as Simon (2007; 2004) and Loland (2002) as well as the authors of the World Anti-Doping Code (2001) argue that using performance-enhancing substances is unhealthy and unfairly coercive for other athletes. Critics of the anti-doping position such as Hoberman (1995), Miah et al. (2005) and Tamburrini (2007) are quick to argue that such prohibitions, even though well-intended, constitute an unjustifiable form of paternalism. However, advocates for both of these positions assume that preserving good health and, (...) conversely, avoiding health-related harms, lie at the centre of the debate. Given the apparent stalemate in the debate over the validity of health concerns on performance-enhancing drugs, in this essay, I investigate ethical issues of ‘harm-free’ pharmaceutical performance enhancement. Beginning with the hypothesis that a harm-free performance-enhancing drug may be produced in the future, I ask if there would still be compelling reasons for prohibiting such a drug. I address this question by providing two arguments against allowing athletes to use pharmaceutical performance-enhancing drugs – the damage to the testing and contesting of sport and the loss of internal goods that are intrinsically satisfying. These two arguments taken together, I argue, are sufficient to sustain the prohibition of pharmaceutical performance-enhancing drugs without citing their harmful side effects. (shrink)

Few sports-related events have generated as much controversy as the steroid crisis in baseball. Both ardent fans and casual observers wonder why professional baseball players would choose to use such substances when their use was viewed as outside the bounds of fair play. This article attempts to answer that question by applying concepts from the area of organizational culture. Understanding the culture of baseball and the ways leaders embedded and strengthened that culture adds insight into the decisions by athletes (...) to engage in steroid use. In general, such use was consistent with the already-existing culture. In addition, key decisions and events likely created the conditions in which steroid use was more likely. (shrink)

In 1984, a number of US cyclists used blood transfusions to boost their performance at the Los Angeles Olympic Games. The cyclists broke no rules and dominated the Games, yet were later maligned as cheaters and dopers?they had, it seemed, violated some important norm, albeit one which was neither an official rule nor otherwise easily identifiable. Their case illustrates the moral ambiguity that arises when a performance enhancement is employed in a sport that has not addressed it. This (...) article takes up the crucial question posed by such moral ambiguity: is it ethical to enhance performance through a substance or technology when no rules exist to prohibit it? We first examine ordinary ethical obligations that athletes carry based on their status as moral agents. We conclude that such obligations provide some guidance, but cannot resolve the issue. We then examine arguments that take sport as a unique social practice that presents its own moral obligation not to use performance enhancers. We argue that these ?spirit of sport? arguments, developed by McNamee and Loland and Hoppeler cannot resolve the issue either. We conclude that when the rules governing sport are silent on the issue of performance enhancement the constraints on its ethical use are limited at best. (shrink)

This article challenges recent assumptions that physicians may ethically and legally prescribe psychopharmacological enhancement drugs to patients and the counterintuitive notion that in some cases ingesting an enhancement drug constitutes the more ethical choice than forgoing this option. Enhancement proponents have touted modafinil as an ideal mechanism to improve concentration, alertness, and forgo sleep and keep pace with our society's demands. However, patients who use modafinil for these reasons risk potentially severe side effects and addiction, and face unintended consequences related (...) to their cognitive, emotive, and physiological functioning. Importantly, prescribing a controlled substance such as modafinil for performance enhancement and sleep avoidance runs contrary to a physician's ethical duty to the patient and the standard of practice set forth in legal requirements governing the prescription of controlled substances. (shrink)

In the March 2010 edition of Mayo Clinic Proceedings, Drs. Rose and Curry declared that resident physicians have an ethical duty to reduce error during periods of fatigue. Problematically, however, they argued this means ingesting a stimulant for performance enhancement and sleep avoidance during a shift when a resident physician is experiencing fatigue as the more ethical choice than forgoing ingesting a stimulant. Rather than accepting enhancement as an unstoppable technological imperative, this article will examine the underlying motivations for (...) enhancement embedded in our culture and the corresponding legal framework relating to stimulant drugs. Although our society seems to be engaged in a pharmacological arms race of efficiency, competition, and self “betterment,” the FDA has not approved stimulant drugs such as modafinil for PESA. As a result, the off-label use of modafinil for PESA means these individuals are part of a large-scale experiment that poses serious immediate and long-term side effects to the individual user as well as society. (shrink)

Torben Kjærsgaard’s argues that the term “cognitive enhancement substances” is an inappropriate term considering that stimulants do not enhance cognition, but rather only enhance motivation. Therefore, he concludes that stimulants are best described as “performance maintenance” and not “performance enhancement.” I challenge his conclusion on the grounds that both life’s ordinary, daily activities and life’s extraordinary activities are types of performances necessary for living the kinds of lives that we want to live, which can be enhanced, not (...) just maintained, with the effects of cognitive enhancing substances. “Cognitive enhancing substances” may be a misleading term, but referring to the effects of cognitive enhancing substances as “performance maintenance,” rather than “performance enhancing,” misguidedly minimizes the role that motivation plays into our self-determined lives. (shrink)

The vagueness or imprecision of ‘the normal’ allows it to be exploited for various purposes and political ends. It is conspicuous in both medicine and athletics; I am going to try to say something about the normal in each of these areas. In medicine the idea of the normal is often deployed in understanding what constitutes disease and hence, as some see it, in determining the role of physicians, in determining what is or ought to be covered by insurance, and (...) in underwriting certain views on social justice. In athletics the use of performance enhancing substances raises different sorts of questions about the normal, especially when it comes to deciding what constitutes an enhancement and which enhancements, if any, are acceptable. (shrink)

BackgroundAlthough some of the most radical hypothesis related to the practical implementations of human enhancement have yet to become even close to reality, the use of cognitive enhancers is a very tangible phenomenon occurring with increasing popularity in university campuses as well as in other contexts. It is now well documented that the use of cognitive enhancers is not only increasingly common in Western countries, but also gradually accepted as a normal procedure by the media as well. In fact, its (...) implementation is not unusual in various professional contexts and it has its peak in colleges. Even when certain restrictions in the legislation of a country are indeed in place, they are without doubts easy to overcome. The legitimacy and appropriateness of such restrictions will not be the focus of our investigation.DiscussionOur concern is instead related to the moral and social reasons to publicly acknowledge the use of cognitive enhancers in competitive-selective contexts. These reasons are linked to a more neutral analysis of contemporary Western society: it is a fact that an increasing number of competitive-selective contexts have a substantial number of contenders using cognitive enhancers.SummaryThrough the use of five explicative examples, in this paper we want to analyse the problems related to its use. In particular, it will be our aim to show the tension between one of the main argument used by bio-liberals and the actual implementation of the drugs in competitive, or semi-competitive contexts. (shrink)

From an enactive approach to human activity, we suggest that the use of appearance-enhancing drugs is better explained by the sense-making related to body image rather than the cognitive evaluation of social norms about appearance and consequent psychopathology-oriented approach. After reviewing the main psychological disorders thought to link body image issues to the use of appearance-enhancing substances, we sketch a flexible, dynamic and embedded account of body image defined as the individual’s propensity to act and experience in (...) specific situations. We show how this enacted body image is a complex process of sense-making that people engage in when they are trying to adapt to specific situations. These adaptations of the enacted body image require effort, perseverance and time, and therefore any substance that accelerates this process appears to be an easy and attractive solution. In this enactive account of body image, we underline that the link between the enacted body image and substance use is also anchored in the history of the body’s previous interactions with the world. This emerges during periods of upheaval and hardship, especially in a context where athletes experience weak participatory sense-making in a sport community. We conclude by suggesting prevention and intervention designs that would promote a safe instrumental use of the body in sports and psychological helping procedures for athletes experiencing difficulties with substances use and body image. (shrink)

Should we allow performance-enhancing substances in competitive athletics? The first book of its kind, Well Played answers this question by urging us to a deeper appreciation for the purpose of sport. Giving special reference to performance-enhancing substances, Shafer challenges the incompleteness of the ethical arguments and contributes a Christian voice to the discussion. He initiates a theological conversation that is both scholarly and accessible, arguing that a distinctively Christian understanding of sport will have far-reaching (...) implications for how we treat ethical issues like doping. The values, beliefs, and practices within the Christian tradition show an alternative that prioritizes humility and friendship, grace and gratitude over the "win at all costs" mentality that drives the use of performance-enhancing substances for a competitive advantage. This groundbreaking book ventures into new theological territory as it explores the intersections of theology, philosophy of sport, and the ethics of doping. Theologians, ethicists, and pastors, as well as coaches, athletes, and sports fans will benefit from this book's thoughtful reflection on how Christians can play well in the modern sports culture. (shrink)

Human cognitive performance has crucial significance for legal process, often creating the difference between fair and unfair imprisonment. Lawyers, judges, and jurors need to follow long and complex arguments. They need to understand technical language. Jurors need to remember what happens during a long trial. The demands imposed on jurors in particular are sizeable and the cognitive challenges are discussed in this chapter. Jurors are often subjected to both tremendous decision complexity and tremendous evidence complexity. Some of these problems (...) could be ameliorated if we can somehow enhance the cognitive capacities, including attention and memory, of various players in trials. There are multiple ways in which cognition can be improved either by external tools or by an increasing number of biomedical interventions that act directly on the brain. The article surveys a range of beneficial and detrimental effects that substances can have on cognition. (shrink)

Until recently, the problem of traumatic brain injury in sports and the problem of performance enhancement via hormone replacement have not been seen as related issues. However, recent evidence suggests that these two problems may actually interact in complex and previously underappreciated ways. A body of recent research has shown that traumatic brain injuries, at all ranges of severity, have a negative effect upon pituitary function, which results in diminished levels of several endogenous hormones, such as growth hormone and (...) gonadotropin. This is a cause for concern for many popular sports that have high rates of concussion, a mild form of TBI. Emerging research suggests that hormone replacement therapy is an effective treatment for TBI-related hormone deficiency. However, many athletic organizations ban or severely limit the use of hormone replacing substances because many athletes seek to use them solely for the purposes of performance enhancement. Nevertheless, in the light of the research linking traumatic brain injury to hypopituitarism, this paper argues that athletic organizations’ policies and attitudes towards hormone replacement therapy should change. We defend two claims. First, because of the connection between TBI and pituitary function, it is likely many more athletes than previously acknowledged suffer from hormone deficiency and thus could benefit from hormone replacement therapy. Second, athletes’ hormone levels should be tested more rigorously and frequently with an emphasis on monitoring TBI and TBI-related issues, rather than simply monitoring policy violations. (shrink)

Antidoping policy regulates and punishes the use of substances that are listed on a Prohibited List (PL). These substances are colloquially known as ‘performance-enhancing substances’. There is very little empirical evidence of enhancement for most of the substances on the PL raising the possibility that the perceived enhancement of performance experienced by an athlete is a placebo effect. A placebo effect is a response to an inert substance that is strongly influenced by psychological (...) and social cues in the surrounding environment. It is our contention that, given the lack of proper empirical testing of the substances on the PL, it is in fact the appearance of a substance on the PL that has the strongest performance-enhancing effect in elite athletes. This disconnect between science and WADA’s code raises the question of what we really object to: real performance enhancement achieved using substances on the PL or performance enhancement that occurs because WADA has told us that the substance will enhance performance by placing it on the PL? In this case, antidoping policy would punish those who believe the performance-enhancing myth at the heart of the PL thus leading to a deeply flawed policy that creates its own victims. (shrink)

The World Anti-Doping Code (2021) includes a substance on the prohibited list if it meets at least two of the following: (1) it has the potential to enhance or enhances sport performance; (2) it represents an actual or potential health risk to the athlete; (3) it violates the spirit of sport. This paper uses a case study to illustrate points of tension between this code and enhancements that are appropriate to ban; we argue that there are banned drugs (e.g., (...) acetazolamide and dexamethasone) the use of which we have good reason to not only permit but encourage for high-altitude sports. Drawing on lessons from this case study, we propose a reformulation of the Code that requires (1–3) be met but offers preferable ways of unpacking conditions (1) and (3) – and in a way that better preserves how the spirit of sport condition should be indexed to particular sports. Our formulation is inclusive enough to rule in drugs like acetazolamide and dexamethasone as permissible in high-altitude sports while at the same time ruling out problem cases – including many drugs already on the prohibited list. The result is an attempted alignment between the conditions specified and those drugs that should be banned. (shrink)

This article discusses substances/techniques that target the brain in order to enhance sports performance (known as “neurodoping”). It considers whether neurodoping in mind sports, such as chess, is unethical and whether it should be a crime. Rather than focusing on widely discussed objections against doping based on harm/risk to health, this article focuses specifically on the objection that neurodoping, even if safe, would undermine the “spirit of sport”. Firstly, it briefly explains why chess can be considered a sport. (...) Secondly, it outlines some possible substances/methods that could be used in order to enhance chess performance and justifies the article’s focus on one potential form of neurodoping in particular – “mental stamina enhancement”. Thirdly, this article casts doubt on certain arguments that mental stamina enhancement would be unethical and contrary to the spirit of sport (as defined by WADA). This article stresses the importance of distinguishing the ethical argument that doping violates the “spirit of sport” from the definitional objection that once doping becomes routine in a certain “sport”, it would not count as a sport anymore. The fourth section discusses the definitional objection and argues that mental stamina enhancement in chess might disqualify chess from being a “sport” (according to traditional, rather than revisionist definitions of sport). Yet, it argues that this definitional objection does not provide strong enough grounds to justify the state or sports authorities imposing severe penalties (such as criminalisation or life-long suspensions from competing) for non-harmful neurodoping. The fifth section of the article argues that criminalising non-harmful neurodoping would be disproportionate. (shrink)

Sport builds character. If this is true, why is there a consistent stream of news detailing the bad behavior of athletes? We are bombarded with accounts of elite athletes using banned performance-enhancing substances, putting individual glory ahead of the excellence of the team, engaging in disrespectful and even violent behavior towards opponents, and seeking victory above all else. We are also given a steady diet of more salacious stories that include various embarrassing, immoral, and illegal behaviors in (...) the private lives of elite athletes. Elite sport is not alone in this; youth sport has its own set of moral problems. Parents assault officials, undermine coaches, encourage a win-at-all costs mentality, and in many cases ruin sport for their children. (shrink)

The book Philosophy of Sport: International Perspectives represents the work of some of the leading moral and philosophical academics in the popular practice of sport. All contributors are scholars and researchers in the area of the Philosophy of Sport, a growing area of serious study within universities and colleges across the world. The contributors are also active members of the International Association for the Philosophy of Sport a worldwide organisation dedicated to the development of the philosophy of sport as a (...) serious and influential area of academic study. The book adds to the growing literature, which focuses on rigorously examining the global significance that sport plays in the fabric of twenty-first century life. Articles within the book provide a diverse set of ideas related to sport from more familiar issue related to the ethics of performance enhancing substances and fair play, to issue of nationalism, and the way sport can contribute to human well-being. (shrink)

The persistence of doping in professional sports—either by individuals on an isolated basis and by whole teams as part of a systematic doping programme—means that professional sport today is rarely if ever untainted. There are financial incentives in place that incentivise doping and there are data that show that doping is often a systematic, organised enterprise. The main question to be answered today in professional sports is whether doping’s repressive anti-doping policies do not have greater negative consequences for society. Whilst (...) some have suggested legitimising safe doping under medical control, in this paper, I argue that doing so will do little to prevent clandestine use of dangerous performance-enhancing substances, and suggest an alternative solution to lifting the ban on doping, i.e. starting from extending liability for doping in sport beyond athletes to those holding power and authority over athletes, to changing winning incentives for doping, to making sport sustainable in the longer time by devising ways of providing athletes with a steady income which is not linked to record breaking or sponsorships. (shrink)

The most plausible line of anti-doping argumentation starts with the fact that performance enhancing substances are harmful and put at considerable risk the health and the life of those who indulge in the overwhelming promises these substances hold. From a liberal point of view, however, this is not a strong reason neither to morally reject doping altogether, nor to put a blanket ban on it; on the contrary, allowing adult, competent and informed athletes to have access (...) to performance enhancement drugs is often showcased as a liberty-related right of noninterference. In this article I will first discuss doping from the liberal point of view, especially in the light of the harm principle as it was introduced by Mill and elaborated by his successors, most notably by Joel Feinberg. Then I will examine whether – and to what degree – one’s decision to receive performance enhancement drugs would mean to use humanity in one’s own person only as a means, which would be self-defeating in the light of Kantian ethics. From this I will move one step backwards to what I consider as the core question concerning the ethics of doping, the one that is logically prior to any other in my view, and concerns the consistency of the thesis that doping may be compatible with sport. I will argue that there is an inherent logical antinomy between doing sport and using performance enhancement drugs, one that presents any argumentation in favor of doping as essentially self-contradictory. (shrink)

The current ban on certain performance enhancing substances in sport such as erythropoietin faces a line-drawing problem: what is the moral difference between taking an EPO injection to incre...

Becoming an expert in any knowledge domain takes time and a great deal of learning, both theoretical and experiential. The individual’s knowledge is often supplemented through knowledge exchanges with other experts. Such exchanges are facilitated by events such as conferences or meetings. For two years we have been investigating the high profile work of scientists who work in the accredited anti-doping laboratories that are located in various countries around the world. These scientists work to curb doping in sport by conducting (...) urinary analyses which detect athletes’ use of performance enhancing substances. These international experts, in the field of anti-doping science, work in a complex socio-technical context comprising both scientific and general anti-doping practitioners such as the staff of anti-doping agencies, sporting federations, sports physicians, coaches, athletes and the media. In order to maintain the high level of expertise necessary for this work, anti-doping scientists continuously search for and integrate new knowledge into everyday laboratory practice. To facilitate this process anti-doping scientists have developed working relationships and networks with other scientists working in the area. A major enabler of this process is the annual Manfred Donike Workshop on Dope Analysis. This paper describes the contribution of this event to the work of these expert scientists from an Activity Theory perspective. (shrink)

Ethics in sport demand not only that we respect ourselves and others, but also that we respect sport itself. But the question of respecting sport seems to create a kind of moral dilemma between the obligation to “play one’s best” by maximizing performance, and the obligation to follow rules and traditions that ban the use of ergogenic aids. It is often argued that bans on performance-enhancing substances, equipment, and training techniques are paternalistic and violate athletes’ liberty (...) to rationally accept risks in their pursuit of excellence. Against advocates for the legalization of ergogenic aids, however, I argue in this paper that such bans must be respected because they are an essential part of the nature of sport. Whether one understands sports metaphysically to be Suits’ “voluntary attempt to overcome unnecessary obstacles” or a MacIntyrean social practice, inefficiency of means is an essential component sport that demands respect from all participants. The performance principle in sport is ontologically posterior to the prescription of inefficiencies upon which sport depends, so ethical respect for sport demands that we limit the efficiencies provided by ergogenic aids. (shrink)

Elite athletes are characterized by their high level of performance in sport. Since the very beginnings of sport, it has been understood that physical and physiological abilities influence the performance of athletes. Advances in scientific knowledge, especially sport psychology and neuroscience, seem to confirm this intuition and consequently it is possible to characterize elite athletes as having an extraordinary combination of physical and mental abilities. Techniques and substances that contribute to enhancing physical characteristics of athletes have (...) also been well known for ages. But it is now possible to make use of other techniques and substances that not only enhance physical abilities but also cognitive capabilities, which seem to require greater consideration given their direct impact on the athlete’s brain. In this article, we examine two such techniques, cognitive enhancers and transcranial stimulators, and highlight the potential advantages and drawbacks that applying each one may have on sport. Given the relative novelty of these enhancement techniques and substances and the absence of conclusive evidence regarding their short- and long-term effects, we deem that their use ought to be strictly governed by cautionary principles. But due to that same lack of evidence, we believe that the possibility of examining the feasibility of applying these techniques to sport should not be denied. (shrink)

Better memory, greater motivation and concentration lead to greater productivity, efficiency and performance, all of which are features that are highly valued in a modern society focused on productivity. In the effort for better cognitive abilities, otherwise healthy individuals use cognitive enhancers, medicines for the treatment of cognitive deficits of patients with various disorders and health problems, such as Alzheimer’s disease, schizophrenia, stroke, Attention Deficit Hyperactivity Disorder or ageing. The use of these is more common in professions with emphasised (...) cognitive abilities, or in occupations that require more attention, focus and alertness. Their use is also associated with the general working population, in that they are supposed to use them to alleviate the effects of sleep deprivation and to cope with increasing workloads. In the paper, we are addressing the ethical issue and the dilemmas of the use of pharmaceutical enhancements by healthy people who have no medical reason for taking such substances, in the context of improving their cognitive functions. (shrink)

This chapter contains sections titled: Caffeine: A Brief History of the Buzz Caffeine as a Mental Performance‐Enhancing Drug Caffeine as a Physical Performance‐Enhancing Drug Caffeine as Doping Cheating and Unfairness Unnaturalness Harm.

The use of certain performance-enhancing drugs (PED) is banned in sport. I discuss critically standard justifications of the ban based on arguments from two widely used criteria: fairness and harms to health. I argue that these arguments on their own are inadequate, and only make sense within a normative understanding of athletic performance and the value of sport. In the discourse over PED, the distinction between “natural” and “artificial” performance has exerted significant impact. I examine whether (...) the distinction makes sense from a moral point of view. I propose an understanding of “natural” athletic performance by combining biological knowledge of training with an interpretation of the normative structure of sport. I conclude that this understanding can serve as moral justification of the PED ban and enable critical and analytically based line drawing between acceptable and nonacceptable performance-enhancing means in sport. (shrink)

Morgan has argued that attitudes to the medicalisation of sports are historically conditioned.While the history of doping offers contested versions of when the sports world turned againstconservative forces, Morgan has argued that these attitudes are out of step with prevailingnorms and that the World Anti Doping Agency's policy needs to be modified to better reflectthis. As an advocate of critical democracies in sports, he argues that anti-doping policy mustacknowledge and reflect these shifts in order to secure their legitimacy. In response, (...) wecritically present the World Anti-Doping Agency's policy that incorporates the Prohibited Listof Substances and Methods for athletes. We evaluate the validity of the therapy-enhancementdistinction in relation to its role in both justifying and sustaining the operation of theProhibited List. In particular, we focus on the case of thyroxine, which has been the subjectof controversy in athletic doping. While thyroxine is not currently banned, critics haveclaimed that its use in the absence of a relevant pathology is tantamount to doping. Wechallenge Morgan's claim that a conventionalist defence of the therapy-enhancementdistinction is the best available, and his conclusion that this properly supports a morepermissive stance towards performance-enhancing drug use. Furthermore, we reject hisconventionalist support for democratic line drawing in relation to doping and in particular thestatus of thyroxine with regard to the prohibited list. We offer a modified defence of the statusquo, a qualified, naturalist account of health and disease, where athletes may be prescribeddrugs that are genuine responses to medical necessity that do not, or do not typically, threatenthe goods of athletic excellence. (shrink)

(1984). Performance-Enhancing Drugs in Sport: The Ethical Issue. Journal of the Philosophy of Sport: Vol. 11, No. 1, pp. 23-28. doi: 10.1080/00948705.1984.9714410.

There is increasing interest in using neuro-stimulation devices to achieve an ergogenic effect in elite athletes. Although the World Anti-Doping Authority does not currently prohibit neuro-stimulation techniques, a number of researchers have called on WADA to consider its position on this issue. Focusing on trans-cranial direct current stimulation as a case study of an imminent so-called ‘neuro-doping’ intervention, we argue that the emerging evidence suggests that tDCS may meet WADA’s own criteria for a method’s inclusion on its list of prohibited (...) substances and methods. We begin by surveying WADA’s general approach to doping, and highlight important limitations to the current evidence base regarding the performance-enhancing effect of pharmacological doping substances. We then review the current evidence base for the safety and efficacy of tDCS, and argue that despite significant shortcomings, there may be sufficient evidence for WADA to consider prohibiting tDCS, in light of the comparable flaws in the evidence base for pharmacological doping substances. In the second half of the paper, we argue that the question of whether WADA ought to ban tDCS turns significantly on the question of whether it is compatible with the ‘spirit of sport’ criterion. We critique some of the previously published positions on this, and advocate our own sport-specific and application-specific approach. Despite these arguments, we finally conclude by suggesting that tDCS ought to be monitored rather than prohibited due to compelling non-ideal considerations. (shrink)

As the World Anti-Doping Code is up for revision, the paper proposes a framework for reading the Code based on a relatively literal approach and an almost exclusive focus on the ?spirit of sport? as a key element of the Code. The author argues that this single element can contribute to revealing the underlying rationale of the Code, as it serves to justify bans of doping substances and methods, in some cases without recurring to evidence sustaining the claims made. (...) For a substance/method to be banned, the Code requires that two out of three criteria be met: performance enhancement, health risk and the spirit of sport. The paper demonstrates how these provisions link to other parts of the Code, (under the rules of the Code 2009) in the absence of performance-enhancing properties combined with a health risk. The paper draws implications from these findings regarding terminological (im)precision, legal certainty/predictability, transparency/accountability, limits to arbitrary exercise of power and internal/external validity. (shrink)

The aim of the study was to evaluate the effectiveness of a media literacy intervention targeting, for the first time, the specific topic of Performance and Appearance Enhancing Substances use in high-school students. Overall, 389 students aged between 13 and 19 years participated to a media literacy intervention while 103 students aged between 14 and 19 year were considered as the control group. In two separate occasions over the course of six consecutive months, students in both groups (...) filled out a set of questionnaires which included measures of social-cognitive beliefs and a self-reported measure of retrospective use of doping and supplements. Compared to students in the control group = 1.96; SD= 0.85; and Mean= 2.09; SD= 0.94), intervention students on average expressed relatively stronger attitudes against doping use over time = 2.2; SD= 0.85; and Mean= 2.05; SD= 0.82). Students in the latter group also showed a statistically significant decrease in self-reported supplement use = 6.7%; Use= 3.8%;p= 0.05, McNemar Test). Interestingly, albeit marginally significant, students in the control group showed a relative increment in the self-reported use of supplements over time = 4.9%; Use= 8.7%;p= 0.22, McNemar Test). Overall, the media literacy intervention investigated in the present study was effective in decreasing adolescent student’s positive attitudes toward doping use and in reducing the use of legal PAES. These findings supported the generalizability and the usefulness of a media literacy approach in the specific field of PAES. (shrink)

Doping poses a threat to sport worldwide. Studies have revealed that, in addition to elite athletes, amateur and recreational sportsmen and sportswomen are making increasing use of performance-enhancing drugs. Worryingly this trend has been documented among young people. Anti-doping efforts seeking to deter elite athletes from doping through detection of the use of prohibited substances are costly and have not been completely effective either at the top-level or the amateur/recreational level. A thoughtful education program, inspired by honesty (...) and respect, might be more effective in shaping attitudes towards doping in young people and protecting their health. For these reasons, the Italian “Lotta al Doping” (Fight Against Doping) project sought to cause a cultural shift in young people by taking anti-doping seminars to high schools. In the 2017-2018 school year we reached more than 20,800 students from 157 high schools through 202 seminars. Before and after the seminars, we administrated anonymous, voluntarily completed surveys with a set of questions (items = 15), taken from the WADA-Play-True-Quiz. Upon completion of the 2-hour seminar, the majority of the answers given by the students resulted correct (13 out of 15 items, p<0.000001, McNemar) confirming the value of the initiative. This project stands out as promising in the doping prevention process at the youth and amateur levels. (shrink)

Current general restrictions on performance-enhancing drugs pose a collective action problem that cannot be solved and bring a variety of adverse consequences for sport. General prohibitions of PEDs are grounded in claims that they violate the integrity of sport. But there are decisive arguments against integrity of sport-based prohibitions of PEDs for elite sport. We defend a harm prevention approach to PED prohibition as an alternative. This position cannot support a general ban on PEDs, since it provides no (...) basis for prohibiting non-harmful PED use. We argue that a harm prevention approach to restricting PEDs is ethically justified, has better prospects of compliance, is consistent with respecting the integrity of sport, and holds at least a modest prospect of resolving the collective action problem around PED restriction. (shrink)

The anti-doping policies of the World Anti-Doping Agency (WADA) aim to promote a level playing field and protect the health of the athlete. Anti-doping policy discourages research using performance enhancing drugs (PEDs) or methods and prohibits athlete support personnel, including healthcare providers, from providing advice, assistance, or aid to an athlete or others seeking to use, or using PEDs until harm has occurred. Athletes are individually responsible for the presence of a prohibited substance in their bodies and face (...) sanction regardless of knowledge or intent. I will argue (i) that WADA policies fail to meet the epistemic and control conditions needed to adequately assign individual responsibility and (ii) that transferring responsibility for use of PEDs solely to the athlete results in harm. WADA is drifting perilously close to the morally impermissible ‘doing of harm’ to athletes by initiating or sustaining a causal sequence of events that can result in harm. (shrink)

New scientific advances have created previously unheard of possibilities for enhancing combatants' performance. Future war fighters may be smarter, stronger, and braver than ever before. If these technologies are safe, is there any reason to reject their use? In this article, I argue that the use of enhancements is constrained by the importance of maintaining the moral responsibility of military personnel. This is crucial for two reasons: the military's ethical commitments require military personnel to be morally responsible agents, (...) and moral responsibility is necessary for integrity and the moral emotions of guilt and remorse, both of which are important for moral growth and psychological well-being. Enhancements that undermined combatants' moral responsibility would therefore undermine the military's moral standing and would harm combatants' well-being. A genuine commitment to maintaining the military's ethical standards and the well-being of combatants therefore requires a careful analysis of performance-enhancing technologies before they are implemented. (shrink)

Should the use of performance-enhancing drugs be banned in sport? A proper response to this question depends upon ideas of the meaning and value of sport. To a certain extent, sport is associated with ideal values such as equality of opportunity, fair play, performance and progress. PED use is considered contrary to these values. On the other hand, critics see sport as an expression of non-sustainable and competitive individualism that threatens human welfare and development. PED use is (...) considered a logical consequence of these values. I challenge both views as simplistic and inadequate. I develop what I refer to as the normative structure of sport consisting of self-imposed constraints at three levels: in the formal rules, in norms for fair play, and in the interpretation of athletic excellence as a morally relevant instantiation of human excellence. I argue that the question of a ban on PED should be discussed at the third level and depends upon interpretations of athletic excellence as a form of human excellence. I conclude that, in the current situation of elite sport, proponents of a ban on PED seem to have the strongest arguments. (shrink)

This paper is a critique of the coercion argument against performance-enhancing drugs . According to this argument, lifting the ban on PEDs would undermine the autonomy of athletes by creating a situation where everyone must either use PEDs or not compete at the highest levels of sport. Four problems are raised for this argument and it is concluded that the argument fails. A variation on the coercion argument is also considered and rejected.

What would be objectionable about sports doping if it were safe and legal? Some ethicists have justified their qualms about doping by invoking elusive distinctions between the natural and the artificial. But the harm in doping and other biotechnological enhancements is best understood in terms of the values of athletic competition—specifically, the spectators' identification with the performers, and the continuity and comparability of athletic achievement over time. Instead of endorsing categorical bans on specific enhancements, David Wasserman recommends caution informed by (...) a clear perception of the values at stake. (shrink)

The use of polyurethane swimsuits at the 2009 World Aquatics Championships resulted in world records being set for almost all swimming events. This paper explores the implications that the use of these performance-enhancing swimsuits had on fairness in relative and absolute outcomes in swimming. I claim that the use of ?super swimsuits? unfairly influenced relative outcomes within the competition because not all swimmers used, or had access to, the same types of swimsuit (some of which were clearly ?faster? (...) than others). Furthermore, I claim that the use of performance-enhancing swimsuits by current competitors unfairly influences inter-temporal relative outcomes. It is evident that competitors and coaches in elite swimming place great importance on making inter-temporal comparisons on the basis of absolute outcomes in the sport (as measured by a swimmer's race time). A ban on the use of super swimsuits may be justified in order to preserve the fairness of such inter-temporal comparisons, and records set using performance-enhancing swimsuits at the 2009 World Championships should be demarcated from others. (shrink)