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Ethical Aspects of Doping and Anti-Doping: In Search of an Alternative Policy
Abstract and Figures
The use of certain technologies, especially of specific pharmacological means, with the aim of improving performance, is forbidden in competitive sport. This practice, called doping, is repressed by increasingly strong anti-doping measures, which are overseen by the World Anti-Doping Agency (WADA). Even if these anti-doping developments essentially concern elite competitive sport, they influence society in general. Some agents present doping as a major societal problem, and the dealing with it is therefore considered a political priority. In several countries, the principles of anti-doping in elite sport are now applied outside of competitive sport, such as in the realm of fitness centres, and calls for further extension of regulations are regularly heard. Increasingly specific legislation has been introduced, in some countries in the form of criminal law that is also applicable to non-athletes.
These developments have spawned academic interest, and doping inside and outside elite sport, as well as the anti-doping efforts aimed at eradicating this practice, have become the subject of an active field of scholarly study. There is considerable overlap with two other important societal and scientific debates, one on the regulation of psychoactive drug use and one on overall human enhancement, i.e. the use of technology to improve human performance in general. Regarding sport, two diametrically opposed discourses can be found in the scholarly, but also lay, literature. Today's most vocal discourse is that of a zero tolerance approach, enforced in elite competitive sport by surveillance, repression and punishment. On the other hand, an opposing discourse can also be heard that finds anti-doping illogical and calls for the liberalisation of doping. These opposing positions would seem to have their limitations. Past experience with prohibition has shown that a zero-tolerance stance using stringent repression to curb a forbidden behaviour may lead to important (unintended) side effects, while there is insufficient public and political support for the total liberalisation of currently forbidden substances.
The general aim of this thesis is to contribute to the discussion on doping and anti-doping, and to sketch the outlines of an alternative way of dealing with doping inside and outside of sport. After a short introduction (Chapter 1) that sketches the historical background of the main issues, an analysis of modern anti-doping in elite sport is presented, highlighting some paradoxes and weaknesses at the basis of today's anti-doping policies (Chapter 2). Chapter 3 provides an analysis of the argument that allowing doping would merely result in a uniform shift of the playing field at the cost of greater health risks. It is shown that this is unlikely to be the case and a counterargument in favour of allowing some regulated forms of doping, because potentially leading to a more dynamic playing field, is then presented. Chapter 4 provides a perspective accounting for some of the side effects of modern anti-doping, also from a legal perspective. It highlights some of these side-effects and shows that anti-doping comes at a considerable cost to the individual athlete and the community. Chapter 5 then introduces the idea of using a harm reduction approach in the realm of doping in sport. First the principle of harm reduction is explained, building upon the evidence base in the field of recreational substance use. This is followed by a first attempt of applying its principles to doping practices in sport. Chapter 6 then takes the reasoning of the preceding chapter further by completing it with a specific analysis of the ethical implications of such a harm reduction approach for doping, concluding that such an approach can be defended. Chapter 7 finally provides a general discussion that ends with some conclusions and perspectives. The overarching conclusion of the thesis is that there is no society-wide solution to the problem of doping. Therefore practical ways of dealing with its presence aimed at containing its potential risks may represent preferable policy alternatives as compared to today's runaway effects of globalisation of anti-doping efforts, all while promising to enrich the spectacle of modern elite sport.
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... Overall it would seem that the efficacy of today's anti-doping policy is highly questionable (de Hon, 2016;Dimeo & Møller, 2018;Moston & Engelberg, 2017). Given the likely ongoing undiscovered doping among some of the athletes on the podium, ranking close to (and above!) athletes who do not dope, and the frequent problem of most likely innocent athletes being sanctioned (de Hon, 2016;Dimeo & Møller, 2018), today's anti-doping arguably has immoral 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 side-effects (Kayser, 2018). Thus, current anti-doping policy, in its quest to attain its goal of celebrating 'clean' champions, misses its target, while it uses means that come with non-negligible costs. ...
... These costs are not just monetary but include (mostly unintended but important) side-effects. It follows that current anti-doping policy may be potentially introducing problems of greater impact than are solved (Kayser, 2018), a situation dubbed a major crisis by Dimeo and Møller (2018). ...
... Kayser, Mauron, & Miah, 2005;Kirkwood, 2009;Savulescu, Foddy, & Clayton, 2004). Together with colleagues I have contributed to the development of a framework for a change to anti-doping policy using a harm minimisation approach (Kayser, 2018). Tolleneer and I (Kayser & Tolleneer, 2017) analysed the arguments for and against the introduction of a partial relaxation of the anti-doping rule and the introduction of harm minimisation measures at the level of the athletes themselves, the opponents in competition, the sport at stake, the spectators, and humanity. ...
... As shown before using a similar reductio ad absurdum approach for placebos (Kayser, 2020), this points to the arbitrariness of the principle of the two of three criteria for inclusion of substances on the Prohibited List (Heuberger et al., 2022). As argued elsewhere, my analysis is meant to contribute to the discussion on how to develop better anti-doping policies (Heuberger et al., 2022;Kayser, 2018). ...
Rational: To discuss the use of hormonal contraception (HC) in elite women's competitive sports from an anti-doping perspective because 1) it changes the natural female hormonal milieu; 2) is used to manipulate the menstrual cycle with performance enhancement intent; 3) even though lowering endogenous testosterone levels, some HCs contain testosterone-like androgenic compounds with potential performance-enhancing effects. Results: A complex interaction between rapidly advancing sports-relevant biomedical scientific discoveries, societal changes concerning sex and gender, and a zero-tolerance anti-doping ideology, leads to contentious results, jeopardizing the premises defining and protecting contemporary elite sport in general and that of women in particular. Discussion and conclusions: This is in part because of the two out of three criteria for inclusion on the World Anti-Doping Agency's List of forbidden substances and methods: i) actual or potential for performance enhancement, ii) actual or potential for health risk, and iii) counter to the Spirit of Sport concept. These criteria would suffice for the inclusion of HC on the List, especially in their androgenic form. The fact that they are not is good for women's reproductive rights but also illustrates the arbitrariness of the administration of WADA's Prohibited List of substances and methods in elite sports.
... La noción "espíritu deportivo" sintetiza una determinada forma de entender la práctica deportiva que, de acuerdo con los filósofos Xavier Gimeno Monfort y Javier López , puede denominarse "buenista" o "dulcificada", caracterizada por negar todos aquellos aspectos y prácticas indeseadas que forman parte del deporte como la violencia o el uso de drogas para alterar el rendimiento. Para proteger este imaginario, consideramos que las autoridades deportivas actuaron como "emprendedores morales" con capacidad para definir ciertas prácticas como una forma de hacer trampa, de acuerdo con la terminología empleada por el sociólogo Howard Becker Brissonneau y Montez de Oca 2018;Kayser 2018). Por tanto, pese a que la exclusión en base a ciertos consumos de drogas se trata como una cuestión científica y jurídica, en el fondo lo que las autoridades defienden es una moralidad pseudoreligiosa eurocéntrica unida con una visión idealista de la función del deporte en la sociedad (Dimeo 2007). ...
Resumen
En 1965, los ciclistas Luis Pedro Santamarina, Salvador Canet y Jesús Usamentiaga fueron descalificados de la Vuelta a Inglaterra por dar positivo en anfetamina en el control antidopaje. Este artículo pretende analizar la respuesta de los periodistas de ABC y Mundo Deportivo (MD) ante el primer caso de dopaje que implicó a deportistas españoles. Previamente, esos periódicos ya habían informado de casos de dopaje en el ciclismo. La diferencia era que, por vez primera, los acusados eran deportistas de la misma nacionalidad que los periodistas.
El caso se enmarca en los inicios de la política antidopaje, poco después de la celebración del primer congreso europeo sobre dopaje celebrado en el Consejo de Europa (CE). Los médicos asistentes al CE, incluidos médicos españoles como Jesús Fernández Cabeza, expresaron su deseo de que los periódicos hiciesen llegar a su audiencia la peligrosidad del dopaje. En general, los periódicos españoles contribuyeron a difundir el discurso científico hegemónico, aunque como analizaremos en esta investigación, la defensa del héroe nacional pasó por encima de los intereses de los portavoces de la política antidopaje.
Abstract
In 1965, the cyclists Luis Pedro Santamarina, Salvador Canet and Jesús Usamentiaga were disqualified from the Tour of Britain after a positive test on amphetamine in anti-doping control. This article aims to analyze the response of theABCandMundo Deportivo(MD) journalists to the first case of doping that
affected Spanish athletes. Previously, these newspapers had already reported doping cases in cycling. The difference was that, for thefirst time, the protagonists were athletes of the same nationality as the journalists.
The case took place at the beginning of anti-doping policy, shortly after thefirst European Congress on doping held in the Council of Europe (CE). Doctors attending the CE, including Spanish physicians like Jesús Fernández Cabeza, expressed a desire for journalists to bring to their audience the danger of
doping. In general, Spanish newspapers contributed to the spread of the hegemonic scientific
discourse based on evidence, although, as we will analyze in this research, the defense of the national hero passed over the interests of the spokesmen of anti-doping policy.
... Empirical and theoretical evidence that anti-doping does not and will not work Between 30% to 49% of the athletes in the 2011 IAAF World Championships and the 12 th Quadrennial Pan-Arab Games admitted that they had knowingly doped in the last year (Ulrich et al. 2018). Compared to the official WADA statistics of only 2% adverse analytical findings in 2011 (WADA 2011), this is a difference of 15x-25x in magnitude and suggests that current antidoping policies have failed (Dimeo and Moller 2018, 109;Dimeo and Taylor 2012;Kayser 2018;Murray 2015). This empirical evidence is important to show that the current system is faulty, but it leaves open the possibility that a better run anti-doping program could succeed where WADA has failed. ...
We propose that doping be legalized under medical supervision. First, we discuss two motivations for allowing medically supervised doping. We reject the ‘compromised choice/harm minimization’ motivation as unlikely to win the support of athletes. We agree that it could lead to an arms race. Instead, we favor full acceptance of doping under medical supervision and answer Reid’s spirit of sport objection to medical manipulation. After presenting a set of guiding principles, we use them to answer the arms race objection and rebut one of the most prominent objections in the literature about the safety of medically supervised doping, the game-theoretic objection.
... This implies that many athletes still get away with doping. This observation, together with the disconcerting finding that up to 40% of AAFs concern cases where there is doubt about the actual intent to enhance performance (de Hon, 2016) suggest that the efficacy of anti-doping is limited while regularly well-meaning athletes fall victim to the system by inadvertence, an imperfection ethically difficult to defend (Kayser, 2018). ...
The placebo effect is a biological response to psychosocial environmental cues surrounding the use of inert or active substances or methods. Placebo effects can be exploited for performance enhancement purposes and their use is not forbidden in sport. WADA's Code stipulates that at least two out of three criteria must be met to put something on the Prohibited List of substances and methods forbidden in sport. These criteria are: Medical or other scientific evidence, pharmacological effect or experience that the substance or method, alone or in combination with other substances or methods, has the potential to enhance or enhances sport performance; Medical or other scientific evidence, pharmacological effect or experience that the use of the substance or method represents an actual or potential health risk to the athlete; and WADA’s determination that the use of the substance or method violates the ‘spirit of sport’ described in the introduction to the Code. By looking at what is on the Prohibited List and by interpreting the discourse surrounding the ‘spirit of sport’ criterion I postulate that substances and methods with documented placebo effects on performance fully meet the inclusion criteria and should therefore be included on the Prohibited List. Such reductio ad absurdum further illustrates the limits of WADA's three criteria framework for inclusion of methods and substances on the Prohibited List and reinforces the calls for a change in the way the Prohibited List is established and maintained.
... The advancement of pharmacology and especially the advent of the easy manufacturing of recombinant human hormones such as erythropoietin led to changes in doping behaviour and the advent of modern anti-doping. This was likely triggered by the so-called Festina affair in 1998, when systematic doping was uncovered in several cycling teams participating in the Tour de France, in whose aftermath the globalisation of anti-doping work by WADA was to result (Kayser, 2018). ...
Short chapter on the future of sport
In this article, our aim is to show why increasing the effectiveness of detecting doping fraud in sport by the use of artificial intelligence (AI) may be morally wrong. The first argument in favour of this conclusion is that using AI to make a non-ideal antidoping policy even more effective can be morally wrong. Whether the increased effectiveness is morally wrong depends on whether you believe that the current antidoping system administrated by the World Anti-Doping Agency is already morally wrong. The second argument is based on the possibility of scenarios in which a more effective AI system may be morally worse than a less effective but non-AI system. We cannot, of course, conclude that the increased effectiveness of doping detection is always morally wrong. But our point is that whether the introduction of AI to increase detection of doping fraud is a moral improvement depends on the moral plausibility of the current system and the distribution of harm that will follow from false positive and false negative errors.
Link to the full publication: https://nih.brage.unit.no/nih-xmlui/handle/11250/2658015 -----------
Doping in elite sport is commonly understood as a moral problem. In line with this view, antidoping work is set out to protect ‘clean’ athletes and ‘the spirit of sport’ from individual athletes’ and accomplices’ lack of moral rectitude. Arguably, such ‘moralized’ and dogmatic descriptions of doping and anti-doping have warranted the development of a sophisticated control regime of biological testing and surveillance: a regime which raises numerous ethical concerns. Moreover, these descriptions have influenced a public anti-doping discourse of scandalization, mistrust and stigmatization.
The main aim of this dissertation is to develop and examine the implications of a philosophical understanding of anti-doping that challenges the dogmatic descriptions and addresses the ethical issues of current anti-doping policy and discourse. Towards this aim, the philosophical methodology of redescription is employed. This approach draws on the neopragmatism of Richard Rorty. The main impetus of Rortyan redescription is the deepening and widening of solidarity. Thus, the dissertation endeavors to develop and examine the implications of a philosophy of anti-doping as solidarity.
Four individual papers contribute towards the main aim. Paper 1 places anti-doping within a wider, historically qualified and fallibilistic endorsement of liberal values. The paper develops and examines the implications of ‘ironism’ as a philosophical basis for anti-doping commitment. It suggests that ironism contributes to more compassionate forms of commitment: more tolerant of intentionally doping athletes as persons and more aware of sport organizations’ responsibilities to all athletes.
Paper 2 develops a philosophical basis for sport organizations’ anti-doping policy and rhetoric. Redescribing ‘fair play’ as athletes’ expression of loyalty to larger groups, the paper inserts a picture of sport organizations such as the International Olympic Committee, as coordinating bodies of larger groups that appeal, through policy and rhetoric, to athletes’ larger loyalty. Anti-doping policy and rhetoric, in this picture, are developed and critically scrutinized according to their potential for fostering a sense of common interest, interdependence, and reciprocal trust across larger sporting communities.
Paper 3 examines whether, and if so how, the purposes of redescription can be served by doping-related stories, playing out in elite sport, narrated through the media and enacted by celebrity-athletes. The paper discusses two stories about athletes sanctioned for doping, interpreted as redescriptive narratives challenging dogmatic descriptions prevailing in respective sporting communities. The story of Justin Gatlin is seen to communicate to the international athletics community the idea that after serving a suspension, it makes sense for an athlete to be included as ‘one of “us”’. Similarly, the paper suggests that the story of Therese Johaug conveys to the Norwegian sporting community that some of these athletes remain ‘one of “us”’ throughout the judicial process.
Paper 4 addresses the ‘confession dilemma’ faced by former elite athletes pondering upon the question of whether to publicly confess to doping. The paper sheds light on the dissertation’s main aim by rendering visible ethical problems with the dogmatic, moralized descriptions and introducing the idea of redescription as a means to foster and cultivate alternative understandings of doping-related dilemmas.
Overall, the dissertation aspires to show that, conditional upon further development and refinement, there is promise to the philosophical understanding of anti-doping as solidarity. As a main contribution, the dissertation proposes the idea that for anti-doping policy and discourse to progress towards solidarity, what is needed in the current situation are ‘sociological’ redescriptions that draw attention to doping as a social phenomenon, playing out in social networks, fostered and made possible by the social structures of elite sport. Such redescriptions can alter the course of sport communities’ conversations away from prevailing moralized descriptions of doping and anti-doping, towards a wider discourse of cultural and political change in the organization of elite sport.
This article proposes a reflection on the value of interdisciplinary approaches applied to anti-doping. It aims to show that interdisciplinary research and collaborative work is central to establishing sound anti-doping policies. After presenting some fundamentals of interdisciplinary approaches, the article analyses how these can apply to doping as a “wicked” problem, highlighting the importance of clarifying policy goals as a prerequisite for applying interdisciplinary tools. The article then focuses on some features of “interdisciplinarity” that are critical to anti-doping practice and involve creating common ground on concepts, assumptions and methodologies. Having regard to the challenges involved in integrating scientific research and evidence for policy-making purposes, transparency and procedures may equally come to play a critical part, to which interdisciplinarity can contribute. If anti-doping policies inevitably incorporate some subjectivity rooted in stakeholder values, we should strive for such subjectivity to be an “informed” one. The legal profession can have a key role in this regard. Lawyers—whether academic researcher or practitioner—must evolve into being the (co-)actors of a broader reflection on the finalities and means of anti-doping, one that will encourage the creation of truly interdisciplinary platforms and ensure that the resulting insights are appropriately transposed into regulatory terms.
Whenever (national) anti-doping organisations ((N)ADOs) based in the European Union (EU) wish to transfer personal data related to athletes to their partners in “third countries” (countries outside the EU), a set of specific and exacting legal requirements must be met. One of these requirements is the demonstration of a valid legal base. While a previous article focussed on the use of consent, this article weighs the advantages and drawbacks of statutory provision, under EU and German law.
CONTEXT: Recent international developments have served to solidify the international approach to doping in sport. The development of the World Anti-Doping Agency (WADA) has resulted in new, coordinated efforts to address this important sport issue. An array of new efforts and initiatives has been initiated by the new agency. The Sydney and Salt Lake City Olympics were characterized by intensive efforts to minimize doping. The antidoping environment is evolving rapidly, and several profoundly important developments will take place in the immediate future. OBJECTIVES: To outline the challenges, opportunities, and changing circumstances of the current antidoping environment so that sport medicine practitioners might understand the context in which a variety of new initiatives and approaches will develop. At the same time, to ensure that practitioners understand the importance of appropriately developed and delivered antidoping policies, programs, and procedures, and the need for their harmonization. To ensure that sport medicine practitioners appreciate the need for a comprehensive approach to doping control, i.e., programs that include much more than drug testing. DATA SOURCE: A review of relevant policy documents derived from a variety of sport and antidoping organizations; selected references drawn from MEDLINE; and materials prepared by colleagues drawn from the international antidoping community. CONCLUSIONS: The increased global effort to address doping is welcome. It will require that several critical issues be addressed that will test the resolve of all involved.
Through the widespread availability of location-identifying devices, geolocalisation could potentially be used to place athletes during out-of-competition testing. In light of this debate, the WADA Ethics Panel formulated the following questions: (1) should WADA and/or other sponsors consider funding such geolocalisation research projects?, (2) if successful, could they be proposed to athletes as a complementary device to Anti-Doping Administration and Management System to help geolocalisation and reduce the risk of missed tests? and (3) should such devices be offered on a voluntary basis, or is it conceivable that they would be made mandatory for all athletes in registered testing pools? In this position paper, the WADA Ethics Panel concludes that the use of geolocalisation could be useful in a research setting with the goal of understanding associations between genotype, phenotype and environment; however, it recognises that the use of geolocalisation as part of or as replacement of whereabouts rules is replete with ethical concerns. While benefits remain largely hypothetical and minimal, the potential invasion of privacy and the data security threats are real. Considering the impact on privacy, data security issues, the societal ramifications of offering such services and various pragmatic considerations, the WADA Ethics Panel concludes that at this time, the use of geolocalisation should neither be mandated as a tool for disclosing whereabouts nor implemented on a voluntary basis.
The sense of crisis that pervades global sport suggests that the war on doping is still very far from being won. In this critical and provocative study of anti-doping regimes in global sport, Paul Dimeo and Verner Møller argue that the current system is at a critical historical juncture. Reviewing the recent history of anti-doping, this book highlights serious problems in the approach developed and implemented by the World Anti-Doping Agency (WADA), including continued failure to accept responsibility for the ineffectiveness of the testing system, the growing number of dubious convictions, and damaging human-rights issues. Without a total rethink of how we deal with this critical issue in world sport, this book warns that we could be facing the collapse of anti-doping, both as a policy and as an ideology. The Anti-Doping Crisis in Sport: Causes, Consequences, Solutions is important reading for all students and scholars of sport studies, as well as researchers, coaches, doctors and policymakers interested in the politics and ethics of drug use in sport. It examines the reasons for the crisis, the consequences of policy strategies, and it explores potential solutions.
We critically discuss a recent paper in favour of criminalising doping in the legal order of the UK. We revisit the arguments put forward and put them in context with regard to their political, ethical and legal implications. On this basis, we then address the question whether drawing upon the ‘spirit of sport’ as defined in the World Anti-Doping Code is warranted in view of supporting the idea of criminalising doping, and finally present counter arguments that plead against the criminalisation of doping.
In this paper, I explore the idea that under one way of understanding cheating, Armstrong did not fulfill any of the three necessary conditions: (1) that cheating violates a rule—I will make the case that though doping was against the official rules, it was not against the rules the athletes used; (2) that it is cheating if the intent is to obtain an unfair advantage—I will argue that dopers were not attempting to obtain an unfair advantage, at least on one plausible understanding of fairness; and (3) that cheating requires fair enforcement of the rules—I will show that the official rules against doping were hardly enforced at all, much less fairly enforced, and thus lacked enough sufficient normative force to deem breaking them cheating.
A number of high profile revelations concerning anti-doping rule violations over the past 12 months has outlined the importance of tackling prevailing challenges and reducing the limitations of the current anti-doping system. At this time, the necessity to enhance, expand and improve analytical test methods in response to the substances outlined in the World Anti-Doping Agency's (WADA) Prohibited List represents an increasingly crucial task for modern sports drug testing programs. The ability to improve analytical testing methods often relies on the expedient application of novel information regarding superior target analytes for sports drug testing assays, drug elimination profiles, alternative test matrices, together with recent advances in instrumental developments. This annual banned-substance review evaluates literature published between October 2016 and September 2017 offering an in-depth evaluation of developments in these arenas and their potential application to substances reported in WADA's 2017 Prohibited List.