Genes and Juice

I write my column Genes and Juice in TCS Daily on 11 August 2006.

Athletic doping scandals vs. the real benefits of artificial enhancement

Two major scandals in the run-up to this week's European athletics championships in Gothenburg , Sweden, have reignited the debate over doping in sports. American sprinter Justin Gatlin (holder of the men's world record in the 100 metre sprint) and cyclist Floyd Landis, the 2006 winner of the Tour de France, were both found to have synthetic testosterone in their bodies, and now face losing their titles.

Track-and-field has always been the sport in which most doping cases have been discovered. After the fall of the Soviet Union an extensive government-sponsored doping program was unveiled. The various sports federations of the Eastern bloc had methodically doped their athletes. In fact, it is widely believed that many of the astonishing, still-standing world records by Soviet and East German athletes made in the 1980s will be unbeaten for a time long as they depended on artificial help.

The international anti-doping agency WADA and the track-and-field federation IAAF have prepared a wide array of tests for the athletes in Gothenburg, with a higher level of international scrutiny after the Gatlin and Landis cases. Mats Garle, head of the Karolinska doping laboratory and responsible for the doping tests at the European championships, expressed in a bit of resignation in a recent interview in the newspaper Svenska Dagbladet. We will never get rid of doping, he said, but we can stem the tide.

Increasingly, however, European bioethicists are starting to doubt this approach. The test methods have become so sophisticated that if you measure enough values some people will always be statistically suspect, even if clean. The regulatory patchwork has its loopholes and exemptions (such as creatine in Premier League football), and has problems with non-chemical enhancements (such as high altitude tents). Much of the doping practices have also moved into local gyms and fitness tracks, where regular people use unsafe enhancements for their personal fitness.

Thus the British lecturer in bioethics Andy Miah recently proposed in The Guardian to adopt a harm reduction model for doping, allowing some of the safer performance-enhancements in elite sport, thus eliminating the shroud of secrecy, and some of the worst health implications for the athletes involved. As many athletes still get caught using the same dangerous type of steroids used in the 1980s, a great health effect could be achieved by focusing on the harmful effects of doping, rather than their challenge to the spirit of sport.

The main challenge to doping tests is that enhancements are likely to become more advanced in the near future. Gene doping, the modification of the body's own cells to produce various substances, has been much discussed recently. The challenge is not that the method is untraceable or dangerous, but that it builds on treatments that people will need for legitimate medical reasons.

It seems likely we will see more advanced forms of gene therapies being developed that have unintended results in sports. If the same therapy is used for stimulating the healing of a damaged muscle as for enhancing its capability, how can they be considered separately? If you happen to gain muscular strength as a side effect from a treatment, it could well be that many athletes suddenly get "injured" in a way to need that particular treatment.

This complexity stems from the same fact that medicine in general is increasingly turning from curing diseases to preventing them. In that prevention, enhancement of the healthy body becomes more prevalent, especially when dealing with the age ailments of the elderly. Synthetic steroids have been used to alleviate problems connected with the degenerations of the aging body.

Developments in medicine have posed a difficult question for medical ethics, not only in sports, but also when it comes to general treatments. Perhaps we should not look at bioethics as something written in stone. When new, previously unthinkable medical developments are introduced we should concentrate regulations and controls on where they are really needed, and focus on concrete problems. Regulations are not for free, they have a cost for both society and the individual. And if regulations are deemed necessary they should focus more on dangerous uses, not on the enhancement technologies in themselves.