Dean Ottati now leaps into part 2 of 3 in his philosophical, moral, and ethical journey into performance enhancing drugs. To read part 1, click here.
“We live in a world,” writes Harvard philosopher Michael Sandel, “where science moves faster than our moral understanding.” In a recent SwimSwam article, I proposed a thought experiment in an attempt to help us try to improve our moral understating of what might be wrong with performance enhancement in swimming. It went like this:
Imagine a swimmer who has always loved the caress of water across her skin, and she has dreamed of swimming in the Olympics since the first time she dove in a pool. If not the Olympics, maybe just qualifying for the Olympic Trials so that she can at least have one opportunity to take her best shot. Or perhaps earn a college scholarship. But despite a youth spent staring at a black line, pushing herself to her limits every day, forgoing social events, and not so much as indulging in a French fry in favor of her pursuit of excellence, it’s clear she’s going to come up just short.
And one day someone she knows, and even trusts, walks up to the young woman and says: “I’ve got a little something in this vial that the governing bodies will never be able to detect. It’ll give you enough of a boost to get you into the Olympics…”
Should she take what’s in the vial? Why or why not?
Perhaps I should begin by saying that while my moral intuition is that our young swimmer should not consume what’s in the vial, I’m not exactly sure why. I wish I had a silver moral bullet, but I don’t. This is what we athletes and parents have to try to work out together.
Types of Possible Enhancement
It’s probably worthwhile to try to provide a brief sketch of the kinds of enhancements that might be available to swimmers today. They include: Power pills such as steroids and human growth hormone to increase strength and size; Blood doping through transfusions or EPO to enhance endurance and recovery; Gene therapy to improve performance by adding or modifying genes; Surgery and ultimately technological augmentations to help swimmers climb to the top of the podium.
If the modern day Ring of Gyges thought experiment proposed above seemed implausible because there’s always a chance of getting caught, it’s worth noting that the IOC and WADA are worried that gene alterations can’t be detected using standard blood and urine samples and they don’t yet have a reliable test to detect gene doping. Never getting caught is a real possibility.
The Spectrum: From Medical Purpose to Performance Enhancement
Most everybody can agree that any of the above enhancements are perfectly acceptable for the sake of health, such as to treat a disease, repair an injury, or prevent a disorder. The moral quandary arises when people use such therapy not to cure a disease, but to reach beyond health, to enhance physical (or cognitive) capacities, to lift themselves above the norm. For example, people generally welcome gene therapy to alleviate muscular dystrophy and other muscle wasting disorders. But what if that same therapy was used to produce genetically altered athletes?
Researchers have developed a synthetic gene that when injected into the muscles of mice, makes muscles grow and prevents them from deteriorating with age. The success of this work bodes well in the fight against immobility that afflicts the elderly, but it has also attracted the attention of athletes seeking a competitive advantage. The gene not only repairs injured muscles, but strengthens healthy ones. At the very least the widespread use of steroids in sport suggests that if they haven’t already, many athletes will be eager to avail themselves of genetic enhancement. It’s at this point that most people begin to agree that the IOC and professional sport should ban genetically altered athletes. But on what grounds?
Before moving on to questions about why enhanced athletes should be banned, we should pause to take note that the distinction between curing and improving seems to make a moral difference. This could help to explain why, when Yulia Efimova tested positive for DHEA, the Russian Sports Minister immediately claimed it was the result of a legitimate prescription (see here – of course he could be telling the truth too, but that is for others to decide). It’s also worth noting that even the moral distinction between curing and improving leaves us with some challenging edge cases that can paint us into some uncomfortable introspective corners. What about braces for orthodontia? Is that health related to fix a bite, or merely cosmetic to fit a widespread look in our society?
Two Common Arguments Against Enhancement: Safety and Fairness.
Why should enhanced athletes be banned? The two most commonly offered arguments for banning enhancement in sports are safety and fairness.
There are good reasons to question the safety of performance enhancement. Steroids have well known harmful side effects including high blood pressure, thickening of the heart valves, decreased fertility and libido, and changes such as chest hair in women and shrunken testicles in men. What has happened to the East German Women’s Olympic swim team members since their mid 70’s gold-medal-glory is one of the saddest chapters in swimming history.
But suppose for the sake of argument that muscle-enhancing gene therapy turned out to be safe, or at least no more risky than a serious strength training regimen. Would there still be a reason to ban it in sports?
Athlete safety arguments are not controversial. Nobody wants competition to turn into a game of chicken to see who is willing to take the most risk with their health and safety. But in many ways, the safety argument is also the least interesting objection to performance enhancement. It leaves open the question of whether these practices are troubling in themselves. Shouldn’t our hesitation be moral as well as medical?
The other common argument against performance enhancement is one of fairness: An enhanced athlete has an advantage against unenhanced competitors. But the fairness argument against an enhanced athlete has a fatal flaw. To quote Harvard philosopher Michael Sandel: “It has always been the case that some athletes are better endowed, genetically, than others. And yet we do not consider the natural inequality of genetic endowments to undermine the fairness of competitive sports. From the standpoint of fairness, enhanced genetic differences are no worse than natural ones. Moreover, assuming they are safe, genetic enhancements could be made available to all. If genetic enhancement in sports is morally objectionable, it must be for reasons other than fairness.”
So What is Wrong With Performance Enhancement?
If, in a world where science is advancing faster than our moral understanding, safety and fairness aren’t fully adequate reasons to stand against performance enhancement, where does that leave us? If, through the miracle of modern science, performance enhancement could be made safe and available to all, does anything morally troubling still exist?
Harvard philosopher Michael Sandel thinks so (and so do I). In the next installment, I’ll share some of his thoughts on this vexing question. If anybody cares to read ahead, I recommend “The Case Against Perfection” by Michael Sandel. For those who prefer their thought experiments in video format, the movie Gattaca offers a provocative look at what might be lost in a world of genetically engineered children. For us SwimSwamer’s, the bonus in the movie Gattaca is the plot hinges on the results of a swim competition…
For now, I invite reader comments.