Should Performance-Enhancing Drugs be Legalised?

EPOEvery now and then I get an email from a reader asking whether all the anti-doping hand-wringing is necessary. Why go through so much trouble to hunt down picograms of banned molecules in the Contador “steak” case when the quantities involved don’t alter the racing? Some see a bigger picture where dopers are more than just a step ahead of the testers. Why not just let adults decide what to do? It’s not just a question for curious newcomers. Julian Savulescu is a professor of ethics at the University of Oxford and he says prohibition is only helping organised crime and that doping should be allowed for the good of sport. This is an argument worth exploring. I think the basic premise is so wrong it needs shooting down with a hail of bullet points. Professor Savulescu’s thoughts are interesting and stimulate debate but away from theory, cycling’s own past suggests it can’t work.

The general argument of legalising performance enhancing drugs (PEDs) tends to say that because it is difficult to stop determined cheats that it’s not worth imposing the cost and even the pretence of testing. Like other forms of prohibition, banned PEDs just sends athletes into clandestine channels and this tends to profit the suppliers, whether crooked doctors or outright criminals. Far better to make doping legal so that athletes turn to regular doctors and safe advice. It sounds seductive but for me it doesn’t work. Here’s why:

  • first most banned substances are banned for a reason. Take growth hormone, consume enough to alter performance and you are consuming enough to cause medical concerns, say, raising the risk of cancer or heart disease
  • second this is not like prohibition of alcohol or narcotics. Many drinkers might want a bottle of beer or a glass of wine but in doping the point is to get the edge on a rival, to consume more than others. It’s not like anyone is yearing for a sip of beer, to borrow the drinking language, if someone has a tipple of EPO, someone else will binge-inject. Indeed if some athletes were to take substances under correct medical supervision then others will not. They will seek out doctors willing to give them megadoses or harmful medicine in order to get an edge
  • third the two first points combine as you end up with people taking large doses of dangerous products
  • next is also a practical consideration as drugs like the blood-boosting EPO just aren’t available for sports use. A doctor can’t prescribe them unless a patient is sick and even if sport allowed the use of these substances, wider society still regulates pharmaceuticals more than almost any other product, these substances are often illegal to acquire for recreational use
  • Also would you like to turn pro if taking pharmaceuticals was part of being a professional? Would this not encourage amateurs to imitate? Again it does not seem a very encouraging prospect

Mythologies: There are other reasons too. Cycling’s suffered from doping because fans did not know what they were watching was real. But imagine if we took this further, you could quickly dehumanise the sport. The Tour de France and most other races trade on a reputation for toughness, of being longer and harder than any other mainstream sports contest. To this day the public wonders how riders cope with the rain, the heat and the distance. But if they believe the answer is found inside a syringe then there’s a good chance they wouldn’t bother to watch. A race at 43km/h is not necessarily any more interesting than one at 39km/h but the amazement vanishes if the riders become computer games characters with infinite lives and endless energy re-ups. Professor Savulescu The Academic case As you’d hope from a professor of ethics at Oxford University, Professor Savulescu’s argument is more sophisticated. He’s saying that elite sports have become genetic sampling events where the winners represent a genetic elite and sometimes a financial elite too. This contest devalues sporting notions of determination, commitment, tactics and training. Given this we should allow some moderate use of PEDs to rebalance things, just as athletes can spend time and resources on nutrition, training or equipment; but here I think you don’t balance much as you can’t equalise, say, Vo2 Max or haematocrit because the athlete with the genetic headstart will just extend this.

Professor Savulescu is also pointing out that chasing down every last molecule of banned substances is excessive, that the money spent on the “war on doping” should be more pragmatically spent on protecting athlete health. Given doping is a fact in many sports, why not accept this and try to manage it? For example if some are going to cheat why not let others use certain substances under appropriate supervision so they can close the gap with the cheats? This way an “innocent” athlete does not lose out so much and the “cheat” who goes to excessive lengths does not gain such an advantage. In short we change the dynamics of the cost-benefit so that the cheats don’t get so far ahead. It’s this managed aspect that seems to differentiate the professor’s argument from the “just do it” concept. Savulescu says EPO should be allowed so cyclists can top up their red blood cell count, the haematocrit. After all athletes can go to altitude or use a tent so using EPO is fair too and a course of EPO is cheaper than spending weeks at altitude. If the result is the same then we should test for the health of athletes, for example checking that their blood is not too thick.

“One molecule of a growth hormone could not harm you, neither could two molecules. Finding and administering the safe dose is precisely what would be done in an open doping market.” Der Spiegel, July 2012

It’s here that Savulescu’s argument starts to crumble under the weight of pragmatism. First growth hormones are regulated medicines that come with health warnings, even normal dosages for standard use are normally reserved for those with a clinical need. So while a molecule of growth hormone might be ok, a vial probably is not. Savulescu seems to believe in noble athletes where “everything would take place under the supervision of physicians and only the use of substances that are considered safe would be allowed” but it’s hard to imagine this lasting in practice. Athletes break the rules to get that edge today only tomorrow we won’t be able to tell the ones taking supersize doses of EPO from the regulated ones because they cheats can say they took it under supervision. We’ve seen this already in cycling with the abuse of cortisone. Riders were allowed to use it under medical supervision to treat, say, a saddlesore or a skin rash but in fact use this therapeutic cover is exploited to use large doses on sore muscles. So even small doses of substances for reasonable health reasons will be used as cover by cheats.

On another point the professor rightly points that sport is dangerous, riding downhill at speed is risky so why do we accept these risks but not the health risks via pharmaceuticals? For me it’s simple, negotiating the course is always part of the sport and an accepted skill to master where an cyclist can measure and feel the risks themselves, they’re just not going to have the same intuition when it comes to the contents of a syringe. The same with an altitude training camp or even a hypoxia tent, they are legitimate as they are exogenous factors that make the body respond rather than injected molecules. More profoundly it’s culturally acceptable to practice descending rather than consuming regulated pharmaceuticals.

Geography and budget: It’s normally illegal to purchase many banned substances, especially the game changers, without a prescription so there’s the practical argument about how athletes can get hold of it; we could see cases where athletes from one country are able to buy a substance that is rejected by another nation’s pharmaceutical regulators. Therefore sports might be a question of location and access to pharmacology. Similarly just allowing  the supervised use of some medicines and practices is not so simple, it can be a question of money where being able to buy the best medical advice and products distorts the game, remember the USADA report showed that the US Postal/Discovery was outspending most other teams.

EPO, A Case Study: EPO is a useful study because if it’s not been legal in cycling, its use was widespread. Savulescu’s call to monitor the haematocrit count of athletes instead of test for EPO, to check for overall health rather than the toxicological approach of hunting banned molecules, is exactly what we saw in cycling. In the 1990s the UCI was faced with rampant use of EPO but there was no test. So an arbitrary limit was set on a rider’s haematocrit of 50%, meaning half of the blood volume was composed of red blood cells and going any higher could make the blood too thick and bring health problems. This is pretty much what Savulescu is interested in.

Haemocrit distribution in the pro peloton (source UCI.ch)

Only it never worked. Riders risked their health and went to enormous lengths and expense to game the system. Take 1997 when about one in fifty blood tests saw riders stopped and “rested” after suspicious blood values. The chart above shows the distribution of samples collected in this year. Only we now know the numbers were off and these health checks were inadequate and could be fooled. 1996 Tour winner Bjarne Riis was called “Mr 60%” and although he denies this measurement the point is many were riding with dangerously high haematocrit counts yet resorted to tricks to pass the 50% test: they gamed the health rules. For example when the testers appeared riders would infuse liquids to temporarily dilute the blood and thus score 49.9% in time for the blood test. In other words the 50% limit was never the upper ceiling for health, it was merely a synthetic target for some riders to manipulate their levels down in order to pass the test. In the meantime riders were taking prodigious quantities of EPO with unknown effects on their health. It’s like a speed limit on a stretch of road, once set as the upper limit it quickly becomes the de facto cruising speed and drivers speed and only slow down when they spot a police car or speed camera. In fact the arrival of EPO distorted sport as a genetic and physiological test, arguably it exaggerated this contest. Take two people, one with a natural haematocrit of 37% and another with higher count of 45% and a health limit set at 50%. One can use EPO or blood banking to dope their blood much more so the genetic differences in blood chemistry are not being narrowed, in fact they can be exaggerated.

Summary: Should Performance-Enhancing Drugs be Legalised? No. But the world is more complicated than a one word answer and hopefully I can send fresh email enquiries to this piece. Legalising PEDs is a recurring argument and one that goes from the sports café to Oxford University. It’s right that we question the status quo and constantly evaluate the rules of sport.

Let someone take a vial of this or syringe of that and someone else will take double and in no time you’re back to health risks only you’ve surrendered the testing regime that enables you to detect this. I might disagree with Professor Savulescu’s ideas but they’re thought-provoking and for this alone valuable. Savulescu’s ideas cleverly shift the balance to help those wanting to catch up with the cheats. But as pro cycling showed in the 1990s the idea of managing doping for health reasons probably won’t work. Health measures to contain EPO with a haematocrit ceiling quickly established the 50% limit as the competitive minimum rather that the upper ceiling. And once you allow EPO then you can’t test for it. Whilst there’s talk of a “war on doping” what if we saw the existing regime under the WADA Code and cycling’s bio-passport as a net that can’t catch everyone but it does filter out some of the bad stuff? Let’s not pretend it stops doping but can help limit excesses. Out of competition testing and the ability to detect tiny quantities limits the margin to cheat. This protects health and also containing the scandals that undermine the business of sport. Instead of allowing doping perhaps we need more tests more often on more riders as a way to protect the peloton?

78 thoughts on “Should Performance-Enhancing Drugs be Legalised?”

  1. it can be a question of money where being able to buy the best medical advice and products distorts the game, remember the USADA report showed that the US Postal/Discovery was outspending most other teams.

    This is the major point for me. One of the charms of cycling is that money matters much less than in other sports. Of course Sky and Katusha have more possibilities than smaller teams, but the differences are a lot smaller than in football, where you known beforehand that the Champions League final will be contested between about 10 teams, or Formula 1, where the car is more important than the driver. Who had expected Hivert of Sojasun to become the revelation of the early season?

    • My thoughts also went to F1, which is basically now an engineering competition. If PEDs are allowed, then the competition is no longer between the riders, but the team doctors.

      • No, not really. F1 has always had ‘better’ drivers being hampered by driving an inferior car and in F1, that’s all part of the interest and excitement. Seeing a great driver wring some points out of a crap car, even if they don’t win, is great sport and F1 fans know and understand this. But you’re right that this model won’t work in cycling, because no-one wants to see Team Fuentes taking on Team Ferrari.

        You have to question the good professor’s motivation here, because he surely can’t be so naive as to believe some of the ideas he’s come out with. Is he just flying a kite to see how people react?

        • Not so when you compare Moto GP when Valentino Rossi was clearly unable to harness the mechanics of a Ducati that a another world champion was able to win on the seasons prior.
          Drugs in sport play no part in sport no matter whether in a local ‘C’ grade club race or at super elite level.

    • I think one should question INRNG’s statement that the USADA report showed US Postal spent more money than other teams on doing. What the report showed was Armstrong spent huge sums with Dr. Ferrari, but we really have no idea what other teams were spending.

      • Fair question and we’ll never know. But it is a reasonable assumption given Ferrari was on a retainer, the Tour team was doped and things even went as far as using private jets and motorbike couriers to ferry things around.

  2. The argument is definitely thought provoking but as you carefully explained, it’s flawed. One can’t fully justify the ban on doping products but to me, it’s ethically the right decision.

    • Interestingly a writer for that paragon of free markets and freedom in general, the Economist, agrees with you, not because of any moral absolutes, but because of reasons similar to those outlined above by Mr Ring
      http://www.economist.com/blogs/theworldin2013/2013/01/illegal-drugs

      Even if one could ‘manage’ and ‘regulate’ doping – say all Tour contenders got a UCI approved and monitored blood transfusion on each rest day during the race – there is an issue with the sub-elite, amateur and/or youth participants taking matters into their own hands despite not having all the necessary expertise and medical supervision.

  3. Your first point says it all “in doping the point is to get the edge on a rival” if everybody doped to an agreed ‘safe’ level there would be no point – it’s the same as everyone not doping, only more costly. And, if you did leagalise doping to an ‘agreed standard’ then it would be more difficult to identify those outside the standard, as everyone reacts differently.

    The danger of encouraging organised crime is a real one – if they can make a decent profit they will go for it. But that is a different argument and another reason to support WADA’s call for national goverments/law agencies to get involved.

  4. “Why not have a totally OPEN tour where anything goes?” That’s what I’ve heard, and yes there’s a part of me that wants to see what happens – what PED’s can do when everyone’s at it. Then I pause to think what this really means: we follow, participate and enjoy cycling because it’s supposed to be fun. It’s supposed to be a sport. It’s supposed to be fair-play. However, we’re looking at a whole different dimension here: the pro-peoloton. Not to say there not having any fun, and that many riders are clean, but just like any sport, it is susceptible to cheats. As a big money-maker, more so now as the ‘revival’ of British Cycling draws our Football nation to pedals and cleats, and see TV rights go the way of pay-per-view, we would certainly be naive to think our pristine sport would not attract darker interests. So what to do? Protecting and testing the peloton is a start. After all they are professionals, we would expect the same in every walk of life. At the same time, they are also people who can make poor choices just like the rest of us. We need to be able to accept that everyone who comes to the table may have a history. What we then decide to do at the table is something we all have to work out.

  5. Great piece, as thoroughly thought-through as I would expect of your work!

    It is always a thought provoking suggestion to legalise PEDs, but history also shows us how willing athletes are to exploit potential gains from new compounds still under clinical development. Ozone therapy, gene therapies, etc, etc. Whilst some of this is due to new compounds being used to avoid tests, it is also driven by that desire to find ‘an edge’ over oponents.

    Would you allow athletes to enter into clinical trials? Or would you ‘restrict’ their diet of PEDs to registered drugs only? In which country? For what use?

    • Exactly, if the use of PEDs are allowed but is limited somehow then surely nothing changes, the bar just gets set higher. The rule abiding cyclists stick to the allowed drug programme and then other (less honest) athletes can game the system and use more than allowed, still banned, or newer experimental drugs.

  6. I always think that people arguing this course of action have never thought out the logical consequence of the theory. As you have clearly described the conclusion would be pretty horrific.

  7. It seems Professor Savulescu is more interested in the theoretical underpinnings of the antidoping issue than in its practice, which is what one should expect from a Professor. But, not having read his report, what I gather from this good article is that he doesn’t seem extremely smart at it. He seems to fail to grasp the very nature of sport (maximizing performance and outperforming competitors) and I just don’t see what values he intends to uphold. To me there is only one ethical issue: that riders shouldn’t harm their health in improving their performance. And this has to made compatible with the basic requirement of a competition: effective rule-enforcement (effective to a satisfying degree, because there will sadly always be cheaters who get away with it, in all walks of life). This implies doing away with, first, all the bans and limitations that do not clearly affect riders’ health and performance (it has to affect both, riders should be free to damage their health if this means no performance gain, and should be free to boost their performance in not unhealthy ways), and, second, bringing bans in line with enforcement and detection capacities. It was absurd and hollow to ban EPO before it could be detected. But it made sense to ban it once it was possible to trace it… except for the difficult question (difficult because I still haven’t heard a clear-cut answer): is it dangerous or unhealthy to race with artificially-boosted haematocrit levels, say 47% for someone who has an average of 42%? At any rate, the passport seems a great tool, not only for enforcing bans, but especially to investigate what should and should not be banned.
    Another suggestion: isolate riders when they apply for a pro license, long enough for all their vital statistics (natural blood levels and the like) to be studied and measured with no outside interference. And start the passport from there.

    Keep up the good work, Mr. Inrng.

    • I’ve often wondered if the isolation and testing set up would work. How long would they need to do it though? A small inconveineance but if it meant you could then trust the passport more surely it’s worth the effort.

  8. In addition to the arguments above, if you allowed doping then presumably guys with a firm stance against it (again presumably due to ethical considerations) would leave the sport. I’m thinking primarily of Dave Brailsford, but also some sponsors would be less keen to have their family-friendly brands associated with a sport where drugs were allowed – so Sky’s millions would disappear as would Garmins?

    As you’ve highlighted elsewhere sponsors have proved hard enough to come by already.

  9. A well argued piece filled with evidence and experience which, furthermore, was done in your spare time around, one presumes, a full time job. It seems suprising therefore that an oxford don who does this as a career cannot do, or even get others to do, a modicum of research to back up his assertions.

  10. Are we not already part way there with the current arbitrary maximum haematocrit level? The level is unrealistically high even for a trained athlete and as long as it is not exceeded then there is no ban.

  11. Really interesting piece, which demonstrates that nothing is as black and white as it seems.

    Drugs represent a potential health risk to athletes. So does riding down a hill at 60 MPH dressed only in lycra and polystyrene. Should we enforce a speed limit on descents?

    Drugs represent an unbalanced playing field. So do bigger R&D budgets, national sports funding and a million other factors. Should we enforce a cap on team budgets or national investment in sports?

    I dont agree that drugs should be allowed and ‘managed’, but I think that this study helps dispel the myth of ‘Olympian Ideals’ in professional cycling, which is a multi-million dollar promotional exercise for selling everything from bikes to bank accounts. Its not ‘fair’ and never has been. As soon as you introduce large prizes and sponsorship into sport, you have a spectacle, but not a sporting ideal.

  12. The answer is not medical, it’s legal… and I don’t mean more enforcement.

    All the health arguments you use about riders taking beyond safe limits, or getting dodgy prescriptions would fall apart if teams and their doctors were made strictly liable for the health of the athletes and what they take.

    Whether the teams cared or the doctors cared wouldn’t matter – the insurance companies would care. If EPO and HGH etc are really endangering health then the athlete could sue the team. The insurers would stop it faster than Nibali off the Poggio.

    There is no force on earth more powerful than an insurance company’s reluctance to pay out, and nobody more vigilant – just ask Mr Armstrong.

    • A different perspective. But how do we assess the risks. Take cigarettes and lung cancer, there can be a causal link but proving this is another. If you take product X and develop Y illness can you prove the link in court?

  13. While I am not entirely sympathetic with Prof. Savulescu’s position, I think there are a couple of flaws in your responses. Regarding competitive advantages, there are always geographical and economic grounded inequality and PEDs are not unique here. Think of training at altitude, oxygen deprivation tents, having private coaches or nutritionists/sports scientists to boost your performance. Those with the money and geographical access will always have an advantage. What Savulescu and others point out is that we feel differently when that advantage comes from a pill or injection. Why? Isn’t this an arbitrary feeling?

    On the therapeutic vs. enhancement distinction, many pharmaceuticals which are initially produced as therapies are found to have enhancement effects and the pharma companies are all too ready to spend the money to show what the safe levels are and get approval so they can enhance profits. The pragmatic limits are by convention and, IF the science is solid that these drugs can be used safely within certain limits, then the conventions will change.

    In regard to protecting athletes from the temptation to go beyond the recommended limits, this a problem regardless of whether the PED is banned or not. Athletes who disregard their own safety for the sake of advantage will be found under both scenarios and Savulescu argues there will be actually fewer such cases if PED use is handled by competent doctors.

    I think your last bullet point is the most compelling. Do we want a culture where people feel as though they have to pump themselves full of PEDs to even find out if they are good enough to compete at the various youth and amateur levels and eventually at the professional level. I think not but this a very different argument than Savulescu is considering.

    • Thanks, on the “abitrary feeling” point, I know that subjects like altitude camps or hypoxic tents are grey areas. For me the difference is that they’re encouraging a natural, endogenous response which is arguably more genuine although it still remains complicated.

      • On the subject of tents: http://www.ncbi.nlm.nih.gov/pubmed/22234397

        Everyone who plays Monopoly to win, knows the orange strategy. If you don’t know the optimal strategy to win a game within a set of rules, it’s your own damn fault for not learning. And if you lose to someone else who also knows the strategy – well, fair game. Let’s play again.

        Someone/some governing body decided that PEDs are not allowed. That’s the line. Yes, it is arbitrary in the sense that aero clothing/components are allowed and PEDs aren’t. But that is the established confines of the sport. Why? My guess is the health risks, the stigma of medical crutches, and possible drug abuse. No one could die in their sleep with 90mm deep dish wheels on their bike. No one could contract a STD sharing aero booties. I’m almost certain there is no correlation between doing recon rides and alternative drug abuse. With drug use, even monitored drug use [read state funded heroin clinics] – it opens up a lot of dark alleys.

        Are these alleys worth exploring because some dinkos decide they want to break the established rules? So instead of enforcing a pretty reasonable boundary of performance enhancement – we should open up the gates?

        There are will always be inherent advantages and asymmetries in life. We watch to see the impossible. How is it that bib #179 finished first on this mountain stage? How did Guesdon outsprint everyone in the 97 PR? How does a guy with cancer from his testes to his brain, recover, and win 7 consecutive Tour de Frances? How did it feel to you when he admitted? How did the memories of amazement change? If we raise the bar on what’s allowable – the bar of what amazes us scales accordingly.

        It is rather telling, how much someone is unwilling to accept their life and themselves, and the proportional actions they take to break the laws of nature.

  14. “This way an “innocent” athlete does not lose out so much and the “cheat” who goes to excessive lengths does not gain such an advantage. In short this changes the dynamics of the cost-benefit so that the cheats don’t get so far ahead.”

    I believe this is where we are at present. Doping still occurs but the antidoping measures mean that only marginal or subtle doping escapes the testers. The massive boosts of the Armstrong era are behind us, aren’t they?

    You’re right to point out the long-term risks of various PEDs. Most have kwnon long-term problems when used in therapeutic doses but when used in sports, the doses tend to be far higher, abusive doses. To allow or encourage their use in cycling would destroy any image of its being a healthy pastime or sport. We’d see a massive loss of fans and sponsors, apart from, perhaps, Pfizer, Roche, Bayer, OmegaPharma, Amgen etc. Oh….

  15. Where in this whole thing is the motivation for doing it clean? Yes, if you’re clean then you don’t get popped and you get to ride some more, but what if it were different? what if you had to show 30 days of ‘normal’ passport data to get _in_ to the TdF?

    This whole thing currently is premised on catching the cheats, and necessarily has to eliminate false positives, but anyone who looked at he-who-must-not-be-named’s data (http://veloclinic.tumblr.com/post/42983600065/why-the-biopassport-software-didnt-flag-armstrong) would have seen that it wasn’t ‘normal’.

    Now, I’m not saying that riders would be sanctioned for having ‘abnormal’ blood profiles, just not allowed to race.

    Just a thought…

    • Actually there are plenty of software programmes that would have flagged up abnormal trends – although there are no abnormal trends to flag in those examples. The food industry, for example, uses that type of analysis every day to ensure processes are remaining in control and they only work because they flag a process going out of control well before the catastrophic event.

      http://en.wikipedia.org/wiki/Statistical_process_control

      • Statistical Process Control (SPC) relies upon reliable observations, and a large number at that, to be most effective. My past experience as a reliability engineer has witnessed numerous circumstances where manufacturing divisions “game” SPC measures to abide by incentive/quality tolerances. Ofen, the measures data submitted were falsified (gamed) to meet the “in control” process tolerances. This enabled division managers to pass muster in the short term. In the longer term, these programs fell to pieces as the SPC did not reveal widespread behavior to camouflage the behavior of processes that were out of control. (Instead of the primary intent: identify processes outside of a control range to focus effort to address possible root cause) In summary, statistical measures systems, “big data”, etc., by themselves, are not a panacea for hard problems. Such as the subject article. Cheers.

  16. I think the main effect of allowing the use of PEDs in sport would be more deaths and for that reason only, it should not be permitted.

    On the other hand, I would love to be able to do randomised, double blind, placebo-controlled trials of PEDs in the real world of cycling rather than in the performance lab. It would tell us if using these drugs actually makes a difference.

    • There is a big placebo effect at work. Plus some things seem to work for some but not for others so the efficacy of these methods is not as wondrous as some might think. But you’d need a peloton of hundreds of riders to test.

  17. I don’t think that Professor Savulescu’s approach offers a better solution for professional sports than the approach currently undertaken. The article at http://www.reuters.com/article/2013/02/12/us-doping-wada-howman-idUSBRE91B14L20130212 points out that the control of doping and medical products is a wider problem in society. Professor Savulescu’s approach will not diminish the scope of the bigger problem and will not reduce the involvement of organized crime.

    Recently, I read the suggestion that instead of “doping” as the reference, one should substitute “cheating” as the reference. In that vain, cheating involves people and organizations that want to work outside of the boundary. Changing the boundary does not change the cheating.

  18. You’re covering the ethical side very well, and I think the financial argument doesn’t hold any water either. So much money is made on pro sports by the whole “food chain” of broadcasters, advertisers etc. The amount spent on doping control is very small, if you look at the revenues of the wider sports ecosystem. It would only be fair if everyone who earns on sports, would contribute a fraction of the cost to keep it clean.

  19. Just like alcohol, everyone has a different reaction to dope. Even if it’s legalised and everyone is pumping themselves up to the gills just the same, the racer whose body is more responsive will reap greater benefits, just like the guy who can pull an all-night bender and not have a hangover.
    Also, I think ethics go out the window when you have to worry about putting food on the table. The majority of the peloton has no more than a high school education, if that. For example, if a run-of-the-mill Worldtour domestique is nearing the end of his contract with no results of note to show, with only a few more high profile races left to prove your worth, taking something which will greatly improve your chances of staying at the top level starts to gain traction in your head.

  20. A very interesting piece, my compliments! I (partly) see a parallel between regulation in the Dutch electronic music scene. This was changed a few years back, but the principle is interesting. XTC / mdma is a banned substance in the Netherlands. It is prohibited to have it in your possession, and therefore also to take it to clubs or festivals. There are controls for drugs at the door (since many people use it in clubs).
    However, once inside a party, people with a normal amount (several pills) were clear. And (and this is interesting), you could even hand in your pills at a party to have them tested and see if they were contaminated. If they weren’t, you’d get your pill back and you’d know it was safe to use.
    This makes sense from a health persepctive, since the biggest risk with these drugs was that they weren’t clean or good quality. People will use them anyway, so why not give them the option to check it to lower the risk of bad pills?

    Of course, drugs carry an inherent health risk, people can still take too many pills or mix them with other substances. This system isn’t foul proof. But maybe that’s the problem with the drugs/doping problem: we are looking for a solution that’s perfect and solves all our problem, both ethically and from a health perspective. I’m not saying doping should be allowed all together, but we should keep in mind why we don’t allow doping, and try to find a solution that better than what we have, not one that is perfect.
    For example, educating and licensing certain team doctors, and allowing them to advice or guide riders who are doping within certain protocols (making sure the riders stay anonymous) could mean riders will be more open towards their doctors.

  21. A very interesting take on the whole premise of doping. Hats off for another great read.

    I’ve had this argument with a few friends before, some of whom work in sports nutrition, and state that “the entire peloton still dopes” from first hand testimony, but that they can’t provide evidence because of client confidentiality. A nice get-out, but it always raises the proposal of ‘let them all dope’.

    I usually put forward one example of why this won’t work and there’s no level playing field (notwithstanding the long-term effects of systematic doping):

    East Germany.

    They had money, organisation, and dominated athletics and other sports for years. There was no level playing field, and down the line their athletes had some terrible problems in later life.

    If that’s not an argument of ‘not repeating the mistakes of the past’ I don’t know what is.

  22. It’s interesting to note that he didn’t cover – or not in anything I’ve read about it – blood transfusions, which are what I’ve always thought are a real moral grey area. Removing then transfusing your own blood is, so long as you don’t add anything to it, is simply a scientific technique for changing the make up of your blood, which is also what any other form of training is.

    Altitude training, scientific power training, even just riding your bike are ways of changing your biological make up away from what dna has given you into a form better suited to winning bike races and a transfusion is not much more artificial than sleeping in a oxygen tent.

    I’m not advocating for it at all – the rules say you shouldn’t and sport is nothing if you don’t follow the rules – but it is interesting that there is never a discussion around where the line in the sand has been drawn – the line which says ‘you may modify your body this far and no further.’

    • I’ve often had a similar thought.

      You can take a recovery drink after a race, but injecting it is not allowed. You are taking the same stuff, just in a more effective way. Same goes for your blood, an effective way of recovery, with nothing artificial. I agree it’s a grey area – at least in my head.

  23. I gotta do a facepalm. A double facepalm. Just at a loss for words…

    Stop cheating. That’s it. It’s so simple [simple, not easy].
    Children know they’ll get in trouble for eating cookies before dinner, so they don’t. The ones that do have sore bums or empty stomachs.
    Why should rules be changed for adults? A stomach full of cookies makes for indigestion…

    Anyone who talks about allowing EPO doesn’t deserve to ride a bike. It tells me they know nothing about reaping the infinitesimal rewards and joy hard work brings. It tells me that they are cowards – that they can’t handle the pain and want relief. And it tells me they don’t know what honor and humility are – losing because you weren’t good enough and accepting it, truly, is the mark of a sportsman.

    It doesn’t matter if it costs more to protect the purity of an idealized clean sport than it is to monitor doped up athletes. That is such a abstract premise. The point of testing is to uphold the dignity.

    Who is going to watch a food show prepared with labelled as genetically modified ingredients? How about a talent contest with lip-syncing allowed?

    Are we really going to let cycling lower itself to the likes of WWE [wrestling in America, with rampant steroid use] or tabloid newspapers for entertainment?

    Again, facepalm.

    • This is kind of a minor (though not entirely irrelevant) point, but I actually don’t think it is fair to say that those who have used EPO (or cortisone or testosterone or whatever) are just looking for a shortcut or for a way out of doing the hard work that would otherwise be required.

      Certainly, there are cases that resemble this. But the fact is that much of what is available in terms of PEDs does not really reduce the work required of the athlete. I doubt that many people at the highest levels take things as a shortcut so they don’t have to go train in bad weather or they don’t like the pain or whatever. At least there is no reason to presume this is the case, in part because anyone at the higher levels of the sport has to be doing a ton of training to just finish races, PEDs or not. Even more importantly, many PEDs actually enable athletes to train more and harder than they otherwise would. Use EPO to allow you to go longer, cortisone for recovery, etc. These are not ways of simply avoiding work and looking for shortcuts, but for allowing your body to go beyond its natural (whatever that word means…) limits and then do more work than would otherwise be possible.

      The reason I bring this up is because it is important to keep in mind the complexities of the issue so we don’t get too caught up in making simplistic judgments about why people dope or why we should ban certain substances.

      As a side note, a similar point against simplistic arguments was already raised above- that there is something (at least seemingly) arbitrary in the distinction between banned substances/practices and allowed ones. There isn’t necessarily anything that absolutely separates sleeping in an altitude tent from taking EPO into different categories- both are expensive and can have similar results and risks. I think it is important to acknowledge this while remembering that we don’t necessarily need such a clear line of demarcation to decide to ban something. The banning is a binary judgment, but the reasoning that leads to it need not rely on binary categories.

      • I was referring to people talking about allowing EPO, not current/past users. To expand that point though, I’m certain that some pros don’t want spend their free time cooped up in a hotel room with an IV drip when they could instead explore the local community as a perk to their travels.

        This is more systemic, but why would a pro need to train harder and longer than what their gifted body can handle? Push the limit? Ego? Because someone else is on PEDs? Securing contract? What is the driver for going above and beyond? Are these reasons legitimate enough to absolve their actions? Mr. Barry may have never met Dede Demet without being up in the pro ranks, but should even love be an excuse? Yes, human decision making is extremely complex – but the end result is the same. The solutions should not be focused on avoiding these negative results, but on encouraging positive decisions.

        I think money and peer pressure are two huge factors. Pros don’t make enough to retire and are constantly competing for spots on the roster. A lot of them do not have professional skills outside pedaling a bike, so their job prospects are thin post-PRO. It’s a limited time cash buffet with jerks bringing their own tupperware. What is the natural response?

        Maybe a structured pension plan will ease their fears, I dunno. Yes, pension to ease PED use. Sounds ridiculous, but ask any employee without a good pension plan compared to one with. The inclination to strive and collect is a lot higher [ie. more dog eat dog].

  24. Yes, I agree with Anon, cycling is not wrestling.
    No, to cheating.
    We are wiping away any individual effort.
    As Tyler Hamilton mentiond, in some races they were “breathing through their noses,” meaning there was very little effort required when they were on a drug program.
    This is not sport.

  25. Allowing doping is a bad sign to the young and amateurs, who can’t afford medical assistance. I’m in big favor of more frequent tests (every rider, every race + out of comp) and less strict limits & rules, so we can make cheating harder and at the same time eliminate false positives like the Bassons case.

  26. What is sport? If we are mostly interested in a spectacle, then limited use of ‘doping’ might actually improve athlete health (the ‘hormone re-balancing that was so popular in the 80s) in some limited areas. If it is some kind of noble pursuit, with a moral dimension, then we will want to ban doping. Our conception of sport – as fans – might be quite different to that of the riders. It’s their job, after all. As Rudi Altig said, in reference to both doping and the amateur ideal: “We are not sportsmen, we are professional cyclists.”

  27. Legalise PEDs its a race to the bottom. you can count me out and I will take up gardening or perhaps wander down the local school and see the phenominal 11yr old win the 100m race.

  28. I was thinking also that Savulescu’s arguments concerns elite sport but really what is elite? In cycling there are races with ProTour teams and ProConti teams together; then races with ProConti and Conti teams; then races with Conti teams with amateur riders. So where do you draw the line? This is true in a lot of sports, particularly “olympic” sports, where elite athletes in fact have the same status as all sportsmen in their federation and various level intermingle in some competitions.

  29. These people may know plenty about ETHICS but quite often know little or nothing about SPORT. Being married to a sports-philosopher exposes me (for better or worse) to a lot of these arguments. Should we toss out rules just because they are difficult to enforce? SPORT is made up of artificial impediments, otherwise LeTour could much more easily be accomplished using a motorcycle – something I think pretty much everyone would object to…so why should the rules against using drugs be different?

  30. Wonder what would happen if it was compulsory for those racing in the Grand Tours , had to present to the Tour Doctor and swallow a ” Daily Pill ” provided to them , then and there ?

    First off , most of the Sponsors would be so outraged they would quit , then the racers would complain that their health was being compromised !

    Yet , at present , this is exactly what most of the Racers are reported to be doing !

    Seems it is OK for PIED Products to be used as long as it is illicit ?

    2015 and the New WADA Protocols , cannot arrive quick enough .

    IOC seem intent on reviewing WADA so as to keep PIED Products from besmirching their reputation , see my letter to Jacques Rogge on http://www.Parrabuddy.blogspot.com ,

  31. Cyclingtips had a good interview with former pro Trent Lowe last week. In one part he (Lowe) talked about the current workloads for professional cyclists being unrealistic and pushing many towards doping.

    “In my opinion, the workload is still to great, and riders may almost feel forced into a position where they have to dope or risk loosing their contracts. The races are too long, too hard, too frequent and the seasons are too arduous on the whole. This is not to say that it cannot be done without doping, as I did so for some years, but I seem to have paid a big price on my health for some time to follow. Unfortunately, the globalization of the sport has created this scenario of long seasons and workloads on the riders. Teams want value and results.”

    http://www.cyclingtips.com.au/2013/02/trent-lowe-life-after-cycling/

  32. Tolerating any level of legal PED usage is akin to allowing a certain level of crime in society. It’s like the Government saying, “shoplifting is now legal because so many people do it”. Some things are just wrong, and dosing yourself up on some synthetic substance to lift your performance above your competitors is one of those things. I can’t believe apparently intellectual people are debating the ethics of this practice.

  33. Simply put – doping needs to be banned because it is a race to the bottom.

    Besides the health risks, it becomes who has the best doping program, not who is the best racer. There will be future PEDs without the health risks, and there will be fine lines drawn over what is legal and what is banned. Cycling shouldn’t be an arms race, so I hope that WADA, IOC, and UCI get the appropriate handle on the implications.

    I have a 15 year old Cat 3. He won’t ever be pro, but he shouldn’t have to risk his health to be competitive and enjoy racing. And we’ve already seen amateurs doping. One could say that amateurs or juniors shouldn’t be using carbon wheels and 14 lb bikes, but that cat is out of the bag, and pricing supports the tech for the pros.

  34. There is debate because its complex.
    Saying no to PED’s is pretty simple – administering that decision is not.
    For instance: there is a whole range of things that an athlete can use to enhance their performance. On one end of that are basics like food. On the other end, highly specialised pharmaceuticals. Somewhere along that spectrum we draw a line (based on philosophy mostly, but also pragmatism, health & safety etc) that anything to the right of here is out and anything to the left is in. Moreover, this line has moved over the years. Remember when vitamin injections were allowed? IV fluids for recovery? Things that were ok are now not…..What about all the issues that cortisone cream seems to create? Of course it can show up as evidence of cheating – but it also treats sores and infections. Athletes are human, they need medical help too sometimes.
    Where do you draw the line on diet supplements, sports drink mix? Some sports drinks contain magnesium – is it ok to use IV magnesium? Only the delivery method is different. Saying that “we ban PED” is easy, enacting it is hard.

    I don’t support cheating and I worry for the health of people who abuse any product in order to win but its not a simple, yes/no issue. To say so is naive.

  35. Here’s my beef/take concerning PEDs.

    I think that in the future PEDs used as a recovery agent will have a place in sport, not only cycling. Contrary to popular belief, most PEDs such as steroids are not a magic bullet. In the documentary Bigger, Stronger, Faster, they make the point that the people on steroids are not the lazy guy looking for the easy way out, the people on steroids are the hardest workers on the team. Taking steroids helps with the recovery process, which is why some people take steroids when they are sick. By taking steroids, you can do your hardest hill repeat three times a week instead of only one time a week. They don’t magically make you some super man. Now obviously EPO is a different story.

    But here is my main problem with the anti steroid argument. A lot of this stems from my research in graduate school. I worked in a lab that tested recovery drinks, mainly comparing drinks containing protein and carbs to drinks with just carbs. To simplify it, we put people on a bike, gave them the different drinks, and saw which drink led to better performance. You have so many companies telling you their product will lead to increased performance compared to the other guys, you have Bijou and Secret Drink touting how great your recovery can be if you use their products. And do they work? Yeah, kind of. But you know what does work? Steroids. I’m not here saying a bottle of Secret Drink mix and a glass of beet juice is the same thing as a vial of steroids, but I don’t think they are as different as people would like to think.

    Looking at steroid use and comparing it to non drug cycling performance, what would the old school cyclists think of the TT bikes tested in wind tunnels? Does a guy on Sky who has a personal coach, nutritionist, performance analyst, wind tunnel testing etc. have an advantage over a guy riding for United Health Care? I’d venture to say he does. Again, I am not saying these things are the same as EPO or steroids, but there are people who have”advantages” that are not just innate and natural. I do believe there is a place for the controlled use of some things we consider PEDs in sport.

  36. This guy has been getting a lot of press in light of the USADA decision. But as an ethicist he is way off the mark. You only need to go back to the Kantian maxim to realise this won’t work. But ethics is about a moral value system within an agreed series of beliefs – and apply to all. Cycling is not just pros, it includes all of us from children to retirees. If you draw an arbitrary line in the sand it must be consistent for all. You cannot allow the elite of the sport to operate in an environment – or be regulated in a way different to that of the rest of the cycling population…
    That he his gaining media coverage because he has ‘ethicist’ a d ‘Oxford’ after is name is a shame.

      • f “child” on this page is how i started looking to shape my response. here goes;

        you do not need a doctrate to know that outside of naturally genetically engineered children (eg T Phinney) it is not wise to apply such “an anything goes” maxim to all of life. i still struggle with how everyone glosses over the (HGH) development of messi – its as if the ends now justify the means in getting him to be the greatest player on the planet. in reality – messi vs armstrong – it’s just a question of dates as far as the unnatural pharmacology goes.

        i think it is right to do our best to keep all sport clean. it will never be given, but there is certainly more merit in trying. anything else, well, just isn’t sporting….

  37. Hell no! It would be a disaster for amateur sport.
    I mean if it’s legal, then it’s legal for everyone.
    I want to be (relatively) competitive, but not by taking PEDs. I don’t want, but I could’t afford either.

  38. Judging by the length of comments above, everyone’s got a lot to say on this topic. Historically, cycling and doping are common bed-fellows. For the Hard-men of the past, they did anything to arrive at the finish line. In the words of J. Anquetil, when talking about his Bourdeaux-Paris win within 24 hrs of his riding Les Grand Prix des Nations: “You think I won on sugar water alone?”

    Given the nature of competitive cycling, perhaps it is impossible to take doping–in some form or another–out of the equation entirely.

    • In some ways all the hand wringing going on now about taking doping out out of sport is bogus since too many people have too much to lose if sport is clean: WADA wouldn’t exist and their officials wouldn’t be powerful voices in sport, the UCI and other sports governing bodies are reduced to just printing out licences and operating a points spreadsheet and journalists who have made their names as doping experts wouldn’t have work. And of course one of the dirty little secrets is that dope busts sell magazines and newspapers, drive traffic to websites and all action attacking all the time racing is good for tv audiences.

      For all the stuff about truth commission and all that it’s not and never will be about getting cycling clean, it’s about finding the acceptable level of dirt that everyone can live with.

      As cycling was really the first big professional sport to take anti-doping seriously it’s also the first sport to have to grapple with the reality of those efforts and perhaps start dealing with the pragmatic consequences.

      The dirt level is too high right now and harming the sport, but we should be under no illusions that a clean sport – or indeed clean sports plural – is the aim of anyone with the power to do anything about it.

      Governing bodies and WADA need a few people busted each year to keep them powerful and relevant – look at the ATP who never catch anyone – no serious sports fan believes this is because tennis is clean…

  39. Simple answer. NO drugs.
    There is NO logical or moral arguement for allowing doping – where do you draw the line, even then the past and present mindset would mean that the line would be crossed. Such a move would also encourage the belief by those involved that this was a normal, acceptable and required practice, when in reality it is not.
    The only solution is to start from a base line of NO DOPING, then catch and punish those who do not play by the rules.

  40. Some great discussions above.

    Worth taking a look at the Christophe Bassons article in the February edition of ProCycling, which makes an interesting counterpoint to the themes touched on above. He makes the argument that sport should be about growing as a person, not showing that your better than someone else. The value of the athlete are not about winning at all costs but about excelling and developing self-esteem. The ingestion of performance-enhancing drugs is not doping. Let’s call it by its real name: cheating.

    • It’s an interesting view from Bassons. Reading it my first reaction was “no way, this is pro cycling” but then you think pro cycling only has one winner each race but lots of stories. Since a team can’t win every day, telling the story of how they tried is just as valuable.

    • I agree with Bassons, but as a society ‘we’ place a very high value on winning in our pro sports. Combine this with monetary incentives and you have a potent incentive to dope and to cheat in a variety of ways. Pro sports are not like amateur sports; pro sports are about business and money and jobs. Winning, even in cycling (even though we as fans might be more interested in the ‘stories’), is king. What if all the pro cyclists got together and agreed to lobby to change the rules so that they could dope? Actually, that’s pretty much what some/many/most of them did for 100 years (to varying degrees). This is not to say that it’s right (yes, it is clearly cheating), but it is useful to have a debate around prohibition, which for a number of drugs and in a variety of scenarios, has been less than effective.

  41. Cheating is going beyond what is allowed. Allow more and people will got to greater lengths to cheat. And this becomes increasingly dangerous and unhealthy. The best way to defeat the cheats is to make the risk not worth taking. Currently the bans for doping are just training holidays. The cheats tie the process up in court and keep riding. By the time the ban is sanctioned time is almost up. Doping bans need to really hurt.

    We might consider punishing teams if riders are caught. This would mean team mates would be less likely to turn a blind eye. And teams have such good medical programmes these days they should be able to regulate riders. And contracts would then have very harsh punitive clauses for dopers.

    The biggest change we can make though is a change in culture. It is now really unacceptable to drive without a seatbelt or drunk. And if a pregnant woman picks up a glass of wine she’s likely to be tackled to the ground. These shifts in attitude need to pervade the sport. It should probably start at the top. Having the sport run by corrupt, self-serving, cheat supporting, incompetent fools isn’t doing the sport any favours.

  42. Sport: an arbitrary set of rules governing an athletic contest (my definition).

    When we participate in sport, we have incentives to compete and/or win. Some of these are intrinsic (as mentioned about Bassons, self-improvement, self-esteem) and some are extrinsic. The higher the level at which one competes, the greater the number of extrinsic incentives, I believe. Masters club racing is just about yourself, getting out to have some fun. Pro cycling involves team & career. Cheating in masters club racing is not a rampant problem, probably due to the fact that there’s no real reason to do so. Cheating at the pro level seems to be much more frequent; the stakes are much higher.

    As far as the ethicist’s argument (as stated in the above article) goes, I believe it is a little wrong headed. PEDs are already allowed in the sport, it is not a question of should we or shouldn’t we. The question is, which ones. When I eat right and train properly, I am enhancing my performance. When I take iron supplements or vitamin B12 to keep my blood healthy, I am enhancing my performance (if these examples aren’t “druggy” enough, what about antibiotics to cure an ailment which is negatively performance impacting). However, the rules state that some things cross a line (EPO, motorbikes, bicycles under the weight limit) and some things are OK (power meters, team radios, altitude training). So, it is a business decision whether or not to move more things from the illegal to the legal. Part of that business is how to treat its employees (i.e. riders) and how much say its employees have in the matter. Ultimately, I think this is the lens through which this question should be viewed, not, “is this right or just for the sport?” The sport is already taken care of.

    I’d like to remind everyone that the sport is yours, not UCI’s. It is purest when it is most amateur. The ‘business of sport’ is very nearly an oxymoron. When business is involved, the decisions made are not sporting-based, but rather, they are business-based. This is fine, so long as you, as a spectator, remember this. ‘They’ can’t ruin it. ‘They’ may create a spectacle that is sufficiently different from what you think cycling should be. So what? Don’t watch; get on your own damn bike and go for a ride, race your friends, ride with a group, race with a club. You will find a bunch of somewhat like-minded individuals who, regardless of what is going on in Pro Cycling, will hardly be likely to cheat. That is sport.

  43. I don’t have a moral or ethical issue with using ‘Performance Enhancing Drugs’. I have an issue with cheating, as in gaining an unfair advantage thus ruining the event as a truly competitive spectacle. If the advantage gained is not ‘unfair’ and within the allowed rules and regulations, then it’s fine. It’s not for me to ‘morally’ say what people should or shouldn’t put in their bodies. If the law won’t judge you then neither will I. If it’s within the rules then I have no issue with it whatsoever.

  44. Professional cycling is a profession. Other professions, medical, legal etc:,,have codes of ethics. If one of the members of a “profession” breaks the code of ethics the others members may ban him/her from practicing for life. I cannot understand why “professional” cyclist cannot do this. It will then be them, the riders, who control their own behaviour not people who have external interests in unethical and corrupt practices. It would be very interesting to see a list of all banned substances in sport so that we may know what is being talked about. I do not see the U C I as representatives of a “profession”.
    Ian Tyson

    • Ian
      one very good reason is that a lifetime ban should never be considered are false positives. read here – http://velonews.competitor.com/2012/12/news/spanish-lab-suspended-from-drug-testing-after-error-leads-to-false-positive_269632 – and tell me your thoughts on what would have happened had the lab not been caught!
      secondly, and it is all related, is sanctioning. at the moment, for a first offence it is a case of one size fits all. so it doesn’t matter on your level of guilt or the product in question – 2 years ban. that is just absurd! put that in another context, as you did in your post, and apply it to most western societies – a marijunana smoker and a serial killing paedophile should be sentenced equally if found guilty – what tariff do you suggest?
      beev

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  46. has antidoping really been a complete failure?
    is failing to catch many dopers enough to say that it’s all a waste?

    I think not, not by a long shot.
    Antidoping and testing has massively changed the frequency and magnitude of doping.

    in the late 90s there were maybe 1 or 2 guys in the tour not doping and with a very significant number going to an absurd extreme. while now we have a large number completely clean and 1 or 2 going to a huge extreme.

    a bit like police monitoring motorway traffic, the fact that they don’t catch many speeding doesn’t mean that there is no benefit at all to occasionally trying to catch speeders, even if it just means that everyone is still speeding, but think they could get down to a legal speed.

    the cancer causing trial drug (GSW-105 or similar) suggests that antidoping is definitely required, even though it isn’t perfect

  47. Worth point out that the illegal trade in cigarettes disproves the case for legalisation. Cigarettes are entirely legal everywhere (obviously), yet cigarette smuggling for the purposes of tax avoidance is the single largest contraband trade going.

    PS In Conconi’s DBLAB file, the only Hct scores over 60 were Bontempi (62) and Chiappucci (60.7).

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