Current anti-doping policy: a critical appraisal

Abstract

Background: Current anti-doping in competitive sports is advocated for reasons of fair-play and concern for the athlete's health. With the inception of the World Anti Doping Agency (WADA), anti-doping effort has been considerably intensified. Resources invested in anti-doping are rising steeply and increasingly involve public funding. Most of the effort concerns elite athletes with much less impact on amateur sports and the general public. Discussion: We review this recent development of increasingly severe anti-doping control measures and find them based on questionable ethical grounds. The ethical foundation of the war on doping consists of largely unsubstantiated assumptions about fairness in sports and the concept of a "level playing field". Moreover, it relies on dubious claims about the protection of an athlete's health and the value of the essentialist view that sports achievements reflect natural capacities. In addition, costly antidoping efforts in elite competitive sports concern only a small fraction of the population. From a public health perspective this is problematic since the high prevalence of uncontrolled, medically unsupervised doping practiced in amateur sports and doping-like behaviour in the general population (substance use for performance enhancement outside sport) exposes greater numbers of people to potential harm. In addition, anti-doping has pushed doping and doping-like behaviour underground, thus fostering dangerous practices such as sharing needles for injection. Finally, we argue that the involvement of the medical profession in doping and anti-doping challenges the principles of non-maleficience and of privacy protection. As such, current anti-doping measures potentially introduce problems of greater impact than are solved, and place physicians working with athletes or in anti-doping settings in an ethically difficult position. In response, we argue on behalf of enhancement practices in sports within a framework of medical supervision. Summary: Current anti-doping strategy is aimed at eradication of doping in elite sports by means of all-out repression, buttressed by a warlike ideology similar to the public discourse sustaining international efforts against illicit drugs. Rather than striving for eradication of doping in sports, which appears to be an unattainable goal, a more pragmatic approach aimed at controlled use and harm reduction may be a viable alternative to cope with doping and doping-like behaviour.

An Exploration of Doping in Recreational Welsh Rugby An Ethical Analysis of Policy Responses

“…Punitive anti-doping sanctions Kayser et al, (2007) outlines that the punitive approach by the WADA and ADOs has pushed doping behaviours underground. Pushing doping underground and away from healthcare professionals increases the health risks for the users of these drugs and this is concerning when we consider the health and well-being of recreational athletes.…”

“…Whilst the current ADP is said to drive doping behaviours underground and away from healthcare professionals (Kayser et al, 2007;Evans-Brown et al, 2009), ADP plays an integral role within efforts to prevent and deter use of doping substances not just within sport but also by the general public. It is notable that the use of many substances included on the WADAs Prohibited list is not illegal.…”

“…Research shows the 40% of ADRVs are committed inadvertently (Hong et al, 2020), and further research suggests that few athletes were truly at fault when ARDVs were committed (de Hon & Bottengurg, 2017). What is more, (Whitaker et al, 2017) (Kayser et al, 2007). Finally, there are some specific substances that are difficult to detect and the use of HGH by some athletes has led to some controversies.…”

“…First, it is important to point out that some reports suggest that anti-doping tests lack efficacy and sensitivity (Ayotte, Miller & Thevis, 2017;Bowers & Bigard, 2017) and Kayser, Mauron & Miah (2007) suggest that some anti-doping tests for specific substances are inconsistent and have led to a number of false positive anti-doping tests. Not only is this problematic for anti-doping effectiveness, but it can potentially cause damage to an athlete's reputation, health and well-being.…”

“…Howman stated that anti-doping control tests must improve the quality and efficiency of its testing if it wanted to continue its fight against doping (Howman, 2011). Due to these concerns, the potential inadequacies of ADP, and the struggles to ensure doping-free sport, it can be argued that ADP ought to be revised or completely abandoned due to these inadequacies (Kayser et al, 2007).…”