Yes— Julian Savulescu
The zero tolerance ban on doping has failed. The second fastest runner ever, the American Tyson Gay, recently tested positive for a banned substance, along with Jamaican sprinters Asafa Powell and Sherone Simpson. There is evidence of widespread doping across many sports including athletics, tennis, and cycling.1 Recent evidence from Germany suggests doping is rife in football.2 Despite apparent advances in the “war on doping,” our success in detecting drug misuse is limited. In 2000, the first tests for erythropoietin were introduced.3 Yet in 2012, the US Anti-Doping Agency expert Larry Bowers said that a negative test cannot be equated with the absence of doping.4
According to Hermann and Henneberg, “Using typical values of detectability . . . the probability of detecting a cheater who uses doping methods every week is only 2.9% per test.”5 It is time for a different approach.
Human nature
It appears we reached the limits of human performance in sprinting about 15 years ago. Starting with Ben Johnson in 1988, only 10 men have ever run under 9.8 sec. Only two (including Usain Bolt) are currently untainted by doping.
To keep improving, to keep beating records, to continue to train at the peak of fitness, to recover from the injury that modern training inevitably inflicts, athletes need enhanced physiology. We have exhausted human potential. But to be human is to be better, and doping is not going to go away.
Regulation could improve safety
The strongest argument against doping is safety. Since there have been no scientific tests of the effects of doping in healthy athletes, there are few good data available. Some have pointed to deaths of athletes as proof, but there is little evidence to attribute many of these to doping.6 In fact, a recent study shows French Tour de France competitors (1947-2012) had 41% lower mortality than the French male population as a whole.7
Modern doping with anabolic steroids, growth hormone, erythropoietin, and blood can be tightly monitored and, as we put together the evidence, safe limits set. An indication of their likely safety is that most current doping agents are routinely used for patient care under medical supervision. For example, growth hormone is given to children who have normal levels but who are a certain amount below the height expected for their age.8
Pushing humans way beyond what is physiological can have ill effects, as the East German experiments with steroids in the 70s showed. On the other hand, extreme exercise itself depletes natural levels of red blood cells,9 testosterone,10 and other hormones.11 But testosterone and growth hormone can all be increased within physiological endpoints (which still constitutes doping) safely under medical supervision with clear, well understood risk-benefit profiles.
Anything is dangerous if taken to excess. Caffeine, a legal and popular performance enhancing substance, has been linked to deaths and dangerous overdoses.12 Yet it is consumed by both athletes and the general population, including children, as a performance enhancer, usually safely.
Moreover, there is no such thing as risk-free sport, or life. We need a balance between the values of safety, human contribution and participation, enforceability, and spectacle. Elite sport is itself risky. Around 20% of professional riders starting the Tour de France do not complete, many because of crash injuries. Since 1980, at least 21 cyclists have died during competition.13
We should assess each substance on an individual basis. We should set enforceable, fair, and safe physiological limits. For example, blood doping and the use of erythropoietin could be dealt with at a stroke by allowing doping up to a blood cell count of 50%.
Spirit of sport
A second objection lies in the nature of the intervention. If a substance came to dominate or corrupt performance, there would be good reason to ban it. For example, if drugs cause boxers to feel no fear or ? blockers cause archers and pistol shooters to have steady hands, they should be banned because overcoming fear and tremor are integral to these sports.
But if a substance allows safer, faster recovery from training or injury then it does not corrupt sport or remove essential human contribution. Indeed, analgesics and anti-inflammatory drugs are already widely used to enhance performance after injury, in competition and out. That is more unnatural and probably more dangerous than physiological doping.
Athletes are using many doping products to optimise their physiology, just as they do with diet, fluid, and glucose management. Cyclist Tyler Hamilton claims in The Secret Race that he lost a race because he did not take a 100 calorie energy gel at the correct time (despite the fact he was also doping).14
Will allowing elite athletes to take drugs under medical supervision encourage children and amateurs to imitate their heroes?
Again, the current ban fails this test. Amateur doping is already happening in an unsupervised manner. There is doping at college,15 and it is estimated that 3-5% of school athletes use doping.16
It is better to send the message that you can safely enhance physiology with a doctor when you are an adult. Many practices that have risks if taken to excess, or carried out recklessly, like driving a car or drinking alcohol, are banned for children.
Over time the rules of the sport have evolved. 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.
