Ethical issues regarding the use of Performance Enhancing Drugs in Sports

In the history of 20th century sports, specifically in the post World War 2 era, there has been an ever increasing use of performance enhancing drugs in all avenues of sport. Sports have become money making machine for both athletes and big business and the “win at all costs” attitude which has permeated itself into all aspects of professional and college level athletics. Winners make money, losers don’t. The temptation of fame, notoriety and million dollar contracts in all venues of sport is a lure for many athletes. Elite professional athletes are worshiped in today’s society.
This paper will elaborate on the use of performance enhancing drugs in the sporting world and the associated sports ethical issues. It is a majority belief in all sporting circles that the “true” spirit of sportsmanship does not allow any aspect of performance enhancing drugs. There are several arguments both in favor and against the use of performance enhancing drugs which will be presented and discussed in this paper.
While addressing this ethical issue, we need to define the term ethics. Ethics can be defined as the socially accepted norms and values. These norms and values are varied from society to society and are based on culture and tradition. Ethics also could be defined as the unsaid, un-written and understood laws that prevail in a society. Ethics also cover what is right and what is wrong in society and teaches individuals to act in the right manner and remain committed towards it.
Taking performance enhancing drugs has a long history in sport. In 1904, a marathon runner nearly died from a mixture of brandy and strychnine, a poisonous substance that in small quantities acts as a stimulant. Amphetamines replaced strychnine as the stimulant of choice among athletes in the 1930s. In the 1950s, responding to news that Soviet Union weight lifters were being given hormones to increase their strength, physician John Ziegler invented a synthetic substitute—anabolic steroids. Anabolic steroids quickly became popular among athletes, including NFL players, seeking greater muscle growth and strength. From the 1950s through the 1980s, drugs were part of the sports and athletic programs of the Soviet Union and its political allies such as East Germany. Since the 1980s, performance enhancing drugs have exploded in all areas of sports.
Although steroids are the most publicized performance enhancement drug utilized by athletes, they are only part the issue. For example, in sports like golf, archery, or pistol shooting, where a steady hand is critical, drugs called “beta blockers” provide a performance enhancing function that counteracts high-pressure situations.
Another example of a different type of performance enhancement drug is the practice of “blood doping”. Blood doping is the practice of boosting the number of red blood cells in the bloodstream in order to enhance athletic performance. Because they carry oxygen from the lungs to the muscles, more red blood cells in the blood can improve an athlete’s aerobic capacity and endurance. The main blood doping drug of choice is erythropoietin (EPO). EPO is used is such sports as competitive cycling, long distance running, triathlons and cross country skiing. The world’s marquee cycling event, the Tour de France, has been marred for the last 20 years of EPO doping allegations and the stripping of titles of past tour winners and allegations that still persist to this day about the American rider Lance Armstrong – who as of the writing of this paper – has not been stripped of his 7 tour wins.
Yet another category is the garden variety stimulants (amphetamines) which have been used in sports since the 1940’s like professional baseball and hockey, whose seasons last over 100 games per year. Amphetamines are also used in sports where the athlete needs to “make weight” like the sports of wrestling and boxing. Amphetamines have also reared their ugly head in the national football league, specifically when NFL all pro lineman Kory Stringer died from complications of heat stroke in 2001. Stringer was taking the amphetamine like supplement Ripped Fuel, which had high doses of ephedrine.
The final category of performance enhancing drug is the most publicized – steroids and human growth hormone. This category of performance enhancement drugs had is the most prevalent, but not inclusive to the sports of track and field, competitive weightlifting, baseball, football and professional wrestling (OK, I know - professional wrestling is “sports entertainment”). We could go on for pages here with all of the instances, Ben Johnson and Marion Jones getting their olympic medals stripped, yearly suspensions of both major league baseball and NCAA and professional football players, yearly steroid deaths weightlifters, bodybuilders, power lifters and professional wrestlers, the infamous Sammy Sosa \Mark McGuire homerun race in 1998, which, to some extent, made millions of dollars for increased viewership for major league baseball.

In considering all the viewpoints about the ethical issues of performance enhancing drugs in sports one must first consider some pro’s and con’s of the categories of the ethical topics at hand. The topics of consideration are; health risks, seeking an unfair advantage, drugs-vs.-technology, coercion, effectiveness of drug testing, legalization of PED, sportsmanship and athletes as role models.

Health Risks:
Pro: "If each of us ought to be free to assume risks that we think are worth taking, shouldn't athletes have the same freedom as anyone else? In particular, if athletes prefer the gains in performance allegedly provided by the use of steroids, along with the increased risk of harm to the alternative of less risk and worse performance, what gives anyone the right to interfere with their choice? After all, if we should not forbid smokers from risking their health by smoking, why should we prohibit track stars or weightlifters from taking risks with their health in pursuit of their goals?" (1)
Con: "Performance enhancers, like steroids and other forms of doping, have a negative effect on long-term health. For then users of these enhancers are hurting themselves in the long run without on the average improving their short-term rewards from athletic competition, as long as competitors also use harmful enhancers. This is the main rationale for trying to ban steroids and other forms of doping from athletic competitions." (2)
Seeking an Unfair Advantage:
Pro: "There is no coherent argument to support the view that enhancing performance is unfair; if it were, we would ban coaching and training. Competition can be unfair if there is unequal access to particular enhancements, but equal access can be achieved more predictably by deregulation than by prohibition."(3)
Con: "Remember that athletes don't take these drugs to level the playing field, they do it to get an advantage. And if everyone else is doing what they're doing, then instead of taking 10 grams or 10 cc's or whatever it is, they'll take 20 or 30 or 40, and a vicious circle simply gets bigger. The end game will be an activity that is increasingly violent, extreme, and meaningless, practiced by a class of chemical and or genetic mutant gladiators. The use of performance-enhancing drugs is not accidental; it is planned and deliberate with the sole objective of getting an unfair advantage." (4)
Drugs vs.: Technology
Pro: "Sport is for enjoyment and competition, and usually aims to improve; but what is the difference between increasing skill and performance by training, and taking drugs? If it is the use of personal effort rather than outside help, then what of ropes, crampons and oxygen for climbing? What of advanced training by teams of sports physiologists who wire athletes to equipment monitoring heart, muscle, brain and nerves to optimize activity; or teams of sports psychologists improving your responses and neutralizing those observed in competitors? What of dieticians tampering with foods and additives - drugs by any other name - to improve performance?
What is more 'fair' - the use of a team of sports specialists or a simple pill? What is the difference between training at altitude and taking erythropoietin to achieve a similar effect? And why are the strips of adhesive plaster on the nose - absurdly believed to increase oxygen intake - more acceptable than a drug which reduces airway resistance?" (5)
Con: "When used by fully trained, elite athletes, [performance-enhancing] drugs can improve performance to a much greater extent than any combination of the most intensive, sophisticated, and costly no pharmaceutical interventions known to modern sports science. Scientifically based training regimens, special diets, and complex physiological and biomechanical measurements during exercise and recovery cannot match the enhancing effects of drugs... Thus, drug use in a subgroup of athletes who -- even in the absence of drugs -- are able to compete at an elite level causes their separation into a distinct athletic population, distanced from 'natural' humans by a margin determined by the potency of the drug combinations that are used." (6)
Coercion
Pro: "Why should we think that those who take drugs to remain competitive with the drug users are coerced into doing so? No one is forced to become a competitive athlete. The pressures that the non-drug users may well feel are no different than any other pressures that come with committing oneself to playing the game at a relatively high level of competition. If some athletes spend much more time in the weight room than others and thereby build their muscular strength to levels significantly higher than their opponents, those opponents who want to remain competitive may feel compelled to also put in more time with weights. But there is nothing unethical or immoral about the situation that should lead those interested in maintaining sportsmanship to forbid or severely regulate weight training...” (7)
Con: "One athlete's decision to use performance enhancing drugs also exerts a powerful effect on the other athletes in the competition. As reported by Sports Illustrated, half of all recently surveyed Olympic athletes admitted that they would be willing to take a drug -- even if it would kill them eventually -- as long as it would let them win every event they entered five years in a row. This type of 'win at any cost' mentality is pervading sports at all levels of competition and results in athletes feeling coerced to use substances just to remain on par with other athletes." (8)
Effectiveness of Drug Testing
Pro: "According to the IOC [International Olympic Committee] director general... the fact that only eight athletes out of 11,000 Olympic competitors tested positive is proof that 'the war on doping is being won.' But the argument that the small number of athletes testing positive is indicative of the low prevalence of doping is nonsense.
The number of positive tests is an extremely poor indicator of the prevalence of doping... There is general recognition among those involved in elite level sport that those testing positive represent only the tip of the iceberg. It is impossible to estimate precisely how big that iceberg is, but it is clearly very large...
Firstly, drug-using athletes often beat tests because they have access to specialized medical advice from sports physicians... Secondly, there is evidence of collusion between dope-using athletes and senior officials. Positive tests have been 'lost' at several Olympics." (9)
Con: "The detection methods are accurate and reliable. They undergo rigorous validation prior to being introduced... WADA is, of course, keenly interested in the efficiency, as well as the effectiveness, of the global anti-doping system and supports research to help enhance testing efficiency...
Working collaboratively with national anti-doping agencies such as the U.S. Anti-Doping Agency (USADA) in the sharing of information has uncovered the designer steroid THG, and WADA-certified laboratories continue to keep a watchful eye for previously unknown doping agents...
The I.O.C. retains ownership of the athlete's samples (blood and urine) for eight years following the Olympic Games... During the ensuing eight years, if a technique is developed that would enable the detection of a prohibited substance... the stored specimen could be tested for that specific substance and the athlete would be held accountable." (10)
Legalizing Performance Enhancing Drugs
Pro: "We believe that rather than drive doping underground, use of drugs should be permitted under medical supervision.

Legalization of the use of drugs in sport might even have some advantages. The boundary between the therapeutic and ergogenic - i.e., performance enhancing - use of drugs is blurred at present and poses difficult questions for the controlling bodies of antidoping practice and for sports doctors. The antidoping rules often lead to complicated and costly administrative and medical follow-up to ascertain whether drugs taken by athletes are legitimate therapeutic agents or illicit.

Furthernore, legalization of doping, we believe, would encourage more sensible, informed use of drugs in amateur sport, leading to an overall decline in the rate of health problems associated with doping. Finally, by allowing medically supervised doping, the drugs used could be assessed for a clearer view of what is dangerous and what is not...

Acknowledging the importance of rules in sports, which might include the prohibition of doping, is, in itself, not problematic. However, a problem arises when the application of these rules is beset with diminishing returns: escalating costs and questionable effectiveness." (11)
Con: "There are several reasons to ban performance-enhancing drugs: respect for the rules of sports, recognition that natural talents and their perfection are the point of sports and the prospect of an 'arms race' in athletic performance...

The rules in each sport in effect determine which characteristics among all possible sources of difference influence who wins and who loses...

Rules are changed at times to preserve a sport. Basketball banned goaltending—swatting the ball away just as it was about to go into the hoop—when players became so tall and athletic that they could stand by the basket and prevent most shots from having a chance to go in...

Sports that revere records and historical comparisons (think of baseball and home runs) would become unmoored by drug-aided athletes obliterating old standards. Athletes, caught in the sport arms race, would be pressed to take more and more drugs, in ever wilder combinations and at increasingly higher doses...

The drug race in sport has the potential to create a slow-motion public health catastrophe. Finally, we may lose whatever is most graceful, beautiful, and admirable about sport..." (12)
Sportsmanship
Pro: "How, exactly, does the spirit of sport forbid gene transfer but not carbo-loading? The [WADA] code doesn't say. It defines the spirit of sport as 'ethics,' 'fair play,' 'character' and a bunch of other words that clarify nothing. The definition includes 'courage' and 'dedication.' Doesn't it take more courage and dedication to alter your genes than to eat a potato? Human growth hormone appears on WADA's 'Prohibited List' of substances and methods, even though the Food and Drug Administration, the National Institutes of Health, and the American Association of Clinical Endocrinologists have vouched, to varying degrees, for its safety. Evidently growth hormone violates the spirit of sport, but stuffing yourself with steaks doesn't." (13)
Con: "Anti-doping programs seek to preserve what is intrinsically valuable about sport. This intrinsic value is often referred to as 'the spirit of sport'; it is the essence of Olympism; it is how we play true. The spirit of sport is the celebration of the human spirit, body and mind, and is characterized by the following values:
• Ethics, fair play and honesty.
• Health.
• Excellence in performance.
• Character and education.
• Fun and joy.
• Teamwork.
• Dedication and commitment.
• Respect for rules and laws.
• Respect for self and other participants.
• Courage.
• Community and solidarity.
Doping is fundamentally contrary to the spirit of sport." (14)
Athletes as Role Models
Pro: "Survey data actually shows that teen steroid use has mirrored the use of other illicit drugs over the years. It went up mildly in the 1990's, and has since either dropped off slightly, or leveled off since 2000. It's likely that the same trends that govern cocaine or marijuana use govern teen steroid use far more than what's happening in the sports pages. In fact, a study released last year, and one of the few studies to actually attempt to find out what motivates teen boys to take steroids, found that the most reliable indicator of steroid use was a teen's own self, self esteem and body image. The suggestion and I think we can all agree it's pretty intuitive, is that teenage boys who do take steroids do so not because they want to look like Barry Bonds or Mark McGwire, but because they want to look good for teenage girls." (15)
Con: "For many male high school athletes, pro athletes are major influences. They are the role models. They choose the jersey numbers of their favorite professional players. They emulate their training regimens. They emulate their style of play. And they are influenced by their drug use. When a professional athlete admits to using steroids, the message young athletes hear is not always the one that is intended. Young athletes often believe that steroid use by their role models gives them permission to use. That it is simply part of what one must do to become an elite athlete." (16)

Ethical arguments for and against performance enhancing drug use falls in four overlapping categories; 1. harm and coercion, 2. moral boundaries, 3. coherence and 4. moral rules that exist in society at any given time.
The harm and coercion argument seems pretty straight forward. This argument may cause harm to both the athletes health and to the actual sport itself – The negative health aspects of doping of athletes is well documented. From the actual sporting perspective – It could label an era – for example , in the 1990s , major league baseball has been know as the “steroid era” – mostly due to the Mark Maguire/Sammy Sosa Home run contest that mesmerized and revitalized the sport in 1998. Historians and fans alike will discredit all records from the period 1988 until steroid testing was implemented by the league in 2003. As we move forward in history of professional baseball, I’m sure that all records during that timeframe will have an asterisk associated with them. Cheating is cheating, weather you purposely lose a game to make financial gains by gambling on your own sport, put a foreign substance on or in a baseball bat or ball, or take performance enhancing drugs to better yourself artificially.
The coercion aspect of this argument goes by the theory that some athletes are “forced” to use the performance enhancing drugs because they need to stay competitive. While this aspect is understood with the argument(s) of “It’s this athletes chance to make millions of dollars for a short period of time” or “ Professional athletics is this athletes way to get out of poverty”, lets apply this rule to everyday life . It’s the same as investing in any sort of illegal activity for personal gains and rewards. Its wrong is society and its wrong in the sporting arena.

The moral boundary argument focuses on the “natural allowed supplements and drugs ” versus the “unnatural banned substances” issue. This argument suggests that some performance enhancing drugs are allowable and some are not. For example, caffeine is allowed but amphetamines are not allowed. Science and medical testing over the years have honed in on exactly what ratios of what substances warrant true performance enhancement. If you drink enough cups of coffee to get the banned amount of caffeine in your system, you will be disqualified from that event. Let’s put this argument in the real world. If you have a 2 six pack of low alcohol beer in 2 hours or 5 shots of whiskey in the same timeframe , criminal courts are not going to take in account whether you were drinking 3% alcohol beer or 80 proof whiskey when your breathalyzer test results are above the legal limit for driving while impaired.
The coherence argument addresses the issue of whether or not an action is consistent with our understanding of the “essence” of an endeavor. We teach and want our children to follow a morally accepted course in life. Sports and sporting events are great social, physical and ethical teaching tools where fair play is valued and purposely operating outside of the rules of sport is frowned upon. Given that definition, performance enhancing drugs falls into the “purposely operating outside of the rules i.e. cheating)..
The moral rules that exist in society argument refer to whether performance enhancing drug use goes against our responsibility to protect our society or the safety of our citizens. In the real world, it’s like any other law to protect citizens from drug abuse – no difference.
There are many views discussed throughout this paper. I am against the use of performance enhancing drugs in sports. Sport is a microcosm of society, and in society it is important to choose an ethical course of action no matter what the results may be. The lure of big money athletics is a temptation for many. Pressures to perform and win can be a heavy burden for athletes. Every athlete wants to be the best and become the next superstar in their sport. As with many areas of life, the better you perform on the field the more prestige, money, and power you will receive. These rewards are very enticing to young athletes, and many would sacrifice profusely to achieve such goals. Getting to such greatness requires a great amount of time, skill, hard work, and luck.
There was a time in the United States where people loved to watch professional sports and they would look up to, and use professional athletes as role models. These men and women athletes have gotten to where they are by undying motivation, tenacity and sacrifice on many levels. Currently, there seems to be a general malaise today in sports fans. They are disenchanted by sport and competition both on the Olympic and professional level due to all the performance enhancing drug issues that have surfaced over the past two decades. So when someone wins, we are all waiting for the other shoe to drop and find out that he or she was on something that is considered banned at the time. It’s ethically disturbing and a short cut to the moral standard and backbone of every parent’s lesson they should be teaching their children today. Don’t take the easy way out, and success only comes with perseverance and hard work. Elite athletes represent this character and the thought of getting their strength and accomplishments through performance enhancing drugs seems shallow and contradicting to their moral obligation to society as a role model.
In life, my role models are my parents. Their generation valued hard work, motivation, and moral values. These values were passed on to me. We are passing them on to our kids. In my microcosm of the world, what gives me the greatest pleasure is to instill my children with these values and watch them grow and prosper with the correct values. This is the main reason I am against performance enhancing drugs in sports. It sends the wrong message to our youth, and sports being a microcosm of society, don’t we have enough scandals in the “real world”? Everywhere you turn in today’s ultracompetitive society, whether it be politics, business or entertainment scandals these are daily events. Let’s keep athletics clean.

Sources:
Dr Evan G. Derenzo, “Fooling Mother Nature: An Ethical Analysis of and Recommendations for Oversight of Human-Performance Enhancements in the Armed Forces”, 1997
Fon Hong, “Doping in Sport: Global Ethical Issues”, 2007
Dr. Charles E. Yesalis, Anabolic Steriods in Sports and Exercise,2007
American Medical Association, Policy H470.978 Blood Doping

References:
(1) Robert Simon, PhD Professor of Philosophy at Hamilton College ,Fair Play: The Ethics of Sport 2003.
(2) Gary Becker, PhD Professor in the Departments of Economics, Sociology, and the Graduate School of Business at the University of Chicago "Doping in Sports," Becker-Posner blog, Aug. 27, 2006.
(3) Norman Fost, MD, MPH Professor and Director of the Medical Ethics Program at the University of Wisconsin, "Steroid Hysteria: Unpacking the Claims," American Medical Association Journal of Ethics, Nov. 2005.
(4) Richard Pound, BCL Former President of the World Anti-Doping Agency, Intelligence Squared US debate titled "We Should Accept Performance-Enhancing Drugs Competitive Sports," moderated by Bob Costas, Jan. 15, 2008.
(5) Sam Shuster, PhD Emeritus Professor of Dermatology at Newcastle University "There's No Proof That Sports Drugs Enhance Performance," The Guardian, Aug. 4, 2006.
(6) Timothy Noakes, MD, DSC Discovery Health Professor of Exercise and Sports Science at the University of Cape Town "Tainted Glory," New England Journal of Medicine Aug. 26, 2004.
(7) Peter A. French, PhD Director of the Lincoln Center for Applied Ethics at Arizona State University Ethics and College Sports 2004.
(8) National Center on Addiction and Substance Abuse "Winning at Any Cost: Doping in Olympic Sports," National Commission on Sports and Substance Abuse Report Sept. 2000.
(9) Ivan Waddington, PhD Visiting Professor at the University of Chester and the Norwegian School of Sport Sciences "Olympic Tests for Drugs Need a Shot of Candor," International Herald Tribune Oct. 4, 2000.
(10) Gary I. Wadler, MD Chairman of the World Anti-Doping Agency's (WADA) Prohibited List and Methods Sub-Committee "Dr. Gary Wadler of the World Anti-Doping Agency Gives His Answers to Your Questions (Part I)," New York Times June 26, 2008.
(11) Bengt Kayser, MD, PhD Professor of Exercise Physiology, Faculty of Medicine of the University of Geneva
Alexandre Mauron, PhD Professor of Bioethics, Faculty of Medicine of the University of Geneva Andy Miah, PhD Reader in New Media and Bioethics at the School of Media, Language, and Music at the University of the West of Scotland "Viewpoint: Legalisation of Performance-Enhancing Drugs," The Lancet Dec. 2005.
(12) Thomas H. Murray, PhD President of the Hastings Center "Sports Enhancement," chapter in From Birth to Death and Bench to Clinic: The Hastings Center Bioethics Briefing Book for Journalists, Policymakers, and Campaigns 2008-2009.
(13) William Saletan Journalist for the Washington Post "How High Is Too High in Turin?," Washington Post Feb. 19, 2006.
(14) World Anti-Doping Agency (WADA) World Anti-Doping Code Mar. 2003.
(15) Radley Balko Senior Editor of Reason magazine Intelligence Squared US debate titled "We Should Accept Performance-Enhancing Drugs in Competitive Sports," moderated by Bob Costas Jan. 15, 2008.
(16) Greg Schwab Testimony for the hearing "Steroid Use in Professional Baseball and Anti-Doping Issues in Amateur Sports" before the US Senate Committee on Commerce, Science, and Transportation Subcommittee on Consumer Affairs, Foreign Commerce, and Tourism June 18, 2002.
(17) Lincoln Allison, DLitt Founder of the Centre for the Study of Sport in Society at Warwick University "Faster, Stronger, Higher," The Guardian Aug. 9, 2004.
(18) Nicholas J. Dixon, PhD Chair and Dykstra Professor of Philosophy at Alma College" Performance-Enhancing Drugs, Paternalism, Meritocracy, and Harm to Sport," Journal of Social Philosophy May 27, 2008.