www.thelancet.com Medicine and Sport Vol 366 December 2005 S21 The rules of sport deﬁne a level playing ﬁeld on which
athletes compete. Antidoping policies exist, in theory, to
encourage fair play. However, we believe they are unfounded, dangerous, and excessively costly. The need for rules in sports cannot be dismissed. But
the anchoring of today’s antidoping regulations in the
notion of fair play is misguided, since other factors that
affect performance—eg, biological and environmental
factors—are unchecked. Getting help from one’s genes—
by being blessed with a performance-enhancing genetic
predisposition—is acceptable. Use of drugs is not. Yet
both types of advantage are undeserved. Prevailing sports
ethics is unconcerned with this contradiction.
Another ethical foundation for antidoping concerns the
athlete’s health. Antidoping control is judged necessary to prevent damage from doping. However, sport is dangerous even if no drugs are taken—playing soccer comes with high risks for knee and ankle problems, for instance,
and boxing can lead to brain damage. To comprehensively
assess any increase in risk afforded by the use of drugs or
technology, every performance-enhancing method needs
to be studied. Such work cannot be done while use of
performance-enhancing drugs is illegal. We believe that
rather than drive doping underground, use of drugs
should be permitted under medical supervision.
Legalisation of the use of drugs in sport might even
have some advantages. The boundary between the therapeutic and ergogenic—ie, 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 followup to ascertain whether drugs taken by athletes are legitimate therapeutic agents or illicit.
If doping was allowed, would there be an increase in the
rate of death and...
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