Ethical Positions in Doping and Anti-Doping in Sport

Beliefs and Attitudes Around Performance Enhancement

Ethical rationales for anti-doping include protecting athlete health, preserving sport integrity and ensuring fair play, as well as preserving a normative theory of sport that encompasses a lengthy list of values and “the spirit of sport” (WADA, 2021). However, the beliefs and values that shape attitudes of athletes and predict their behaviours are established long before they reach the Olympics. One observation is that athletes consider performance-enhancement both normal and desirable. As a matter of fact, the United States Olympic Committee (USOC) conducted research in 2004 demonstrating that the use of dietary supplements is standard practice amongst 90% of athletes (Collins & Kalman, 2008).

More recently, Garthe and Maughan (2018) found that 40-100% of athletes, depending on various factors, use dietary supplements. Of these factors is athletic status; the more elite the athletes, the greater percentage of them who use supplements (Knapik JJ et al., 2016). These findings are significant for several reasons: supplement users “show more favourable attitudes towards doping than non-users”, and as many as 58% of sport supplements may contain WADA banned-substances (Backhouse et al., 2013; Martínez-Sanz et al., 2017). If 40-100% of athletes use dietary supplements, and an average of 12-58% of supplements are tainted with compounds that would trigger a positive test result, then the prevalence rate of doping according to test sample data could be closer to 4.8% to 58% of athletes based on tainted supplements alone.

Mounting research on supplement use illustrates that not only does the use of supplements increase the likelihood of doping by 3.5 times, but also that supplement use is one of the strongest predictors of doping (Backhouse et al., 2013; Boardley et al., 2015; Ntoumanis et al., 2014).  Think about just how significant that statement is.  Now, thi does not necessarily imply that the same motivations for using supplements are the same for cheating in sport.  In this instance, “never attribute to malice that which can be adequately explained by neglect, ignorance or incompetence” (Hanlon’s Razor). To illustrate, 53% of athletes from a 2015 study by Berdi et al. and 67% of athletes from a study by Brooling et al. (2008) would accept an unknown supplement from their coach, while only 6.3% would outright refuse. Notably, 10% of respondents did not care about the legitimacy of the supplement as long as it could boost their performance (Brooling et al., 2008).

Contrary to the normative view of anti-doping and the clean image of sport that WADA and the IOC try to instill, the fact remains that athletes are willing to ignore the possibility of testing positive if it means gaining “an advantage over their competition”(Collins & Kalman, 2008, p.36). In this sense, WADA’s normative view of anti-doping is opposed by society’s favourable normative view of performance enhancement. Professor Sigmund Loland (2015) observed that gaining an advantage (i.e. cheating) requires others to agree and adhere to the rules with minimum consensus. In the case of doping, an argument could be made that performance enhancement is the status quo, and is therefore not deviant behaviour subject to that definition of cheating.

Winning and success are highly prized and very North American ideals, which is difficult to argue with given that some of the highest paid members of society are professional athletes. Likewise, athletes must wrestle with “increasing pressures to perform” that may involve the potential gain or loss of “scholarships, jobs, endorsements” (Collins & Kalman, 2008, p.399). With so much weight on their shoulders to thrive, survive, or provide, it may just turn out that “[what] is ethical may depend on the individual athlete’s code of ethics” (Collins & Kalman, 2008, p.399). These points beg the question: are all forms of performance enhancement in sport reasonable and fair? Of course, the IOC and IF’s are signatories to the Code and must therefore abide by the standards of anti-doping

Sanctioned Doping to Reduce Harms

As mentioned previously, many sport supplements are tainted with banned substances, and in that same vein anti-doping rhetoric, rules, and legislation have the capacity to fuel black market production of PEDs of “suspect” quality (McLaren, 2016). Because of this, the danger of tainted drugs has caused some scholars to consider a harm-reduction type approach as a more effective and ethical means of addressing doping in sport. Harm reduction as it applies to doping looks something like this: abandon WADA’s unscientific “spirit of sport” justification for anti-doping; keep the athlete-health justification; and progressively deal with individual substances on a case-by-case, substance-by-substance basis with the aim to dynamically adapt the system and Prohibited List (PL) based on health outcomes (or the lack thereof).  For instance, drugs like Cannabis (a substance without obvious negative health effects) could be removed from the PL while Anabolic-Androgenic steroids would remain.  Other ways of making the system more dynamic and reflective of a true concern for athlete health would be to permit doses that enhance performance, but ban doses/blood levels that endanger health.

With the advent of the Enhanced Games (EG), a newly announced and non drug-tested competitor to the Olympic Games scheduled to launch in 2025, this hypothetical proposal of monitored drug use by athletes may finally become a reality. The EG pledges to be “the safest international sporting event in history” by mandating a “pre-competition full-system medical screening protocol” (Retrieved from https://enhanced.org/event-plan/ on May 26, 2024).  The EG has had its share of critics and concerned parties, and it remains to be seen if this system will be an improvement or a step backwards for sport.  Personally, while I see alot of sense in the harm-reduction approach and while I can’t imagine the emotional rollercoaster of what it must be like to receive a medal at an Olympic Reallocation Ceremony (which could largely be avoided by adopting the harm-reduction approach), I am fond of what sport ethics professor Mike McNamee says about the pursuit of excellence: it’s about testing limits, not removing them.

Health, integrity, fair play, and the spirit of sport are noble causes, however they may not be truly representative of the cultural realities of organized sport. WADA testing may not even have a finger on the pulse of true doping prevalence, making one wonder are all the millions of dollars spent on their crusade worth it, particularly when, ethically speaking, that money could be spent on more important matters like housing or the opioid epidemic. The times are changing and come 2025 we can expect to see tectonic shifts in the public perception and acceptedness of PEDs. Regardless of whether the Enhanced Games are morally justified, how does one justify for example notifying an athlete that they were the rightful winner of the gold medal in their event 7 years after the Olympics they competed in (Kolliari-Turner A et al., 2021)?  The IOC calls it a win for clean sport.  Others say clean sport is a pipe-dream, and I very much doubt that the athletes receiving those belated medals feel like winners.

References and Resources

Backhouse, S. H., Whitaker, L., & Petróczi, A. (2013). Gateway to doping? Supplement use in the context of preferred competitive situations, doping attitude, beliefs, and norms. Scandinavian journal of medicine & science in sports, 23(2), 244–252. https://doi.org/10.1111/j.1600-0838.2011.01374.x

Bérdi, M., Köteles, F., Hevesi, K., Bárdos, G., & Szabo, A. (2015). Elite athletes’ attitudes towards the use of placebo-induced performance enhancement in sports. European journal of sport science, 15(4), 315–321. https://doi.org/10.1080/17461391.2014.955126

Boardley, I. D., Grix, J., & Harkin, J. (2015). Doping in team and individual sports: a qualitative investigation of moral disengagement and associated processes. Qualitative Research in Sport, Exercise and Health, 7(5), 698–717. https://doi.org/10.1080/2159676X.2014.992039

Brooling, J., Pyne, D., Fallon, K., & Fricker, P. (2008). Characterizing the Perception of the Placebo Effect in Sports Medicine. Clinical Journal of Sport Medicine, 18(5), 432-437.

Collins, R., & Kalman, D. (2008). Effect of Government Regulation on the Evolution of Sports Nutrition. In M. Greenwood, D. Kalman, & J. Antonio (Eds.), Nutritional Supplements in Sport and Exercise (pp. 12–399). Humana Press.

Event plan – enhanced games. A better version of the Olympic Games. Enhanced Games. (2024, March 22). https://enhanced.org/event-plan/

Garthe I, Maughan RJ. Athletes and Supplements: Prevalence and Perspectives. Int J Sport Nutr Exerc Metab. 2018 Mar 1;28(2):126-138. doi: 10.1123/ijsnem.2017-0429. Epub 2018 Mar 26. PMID: 29580114.

Knapik, J., Steelman, R., Hoedebecke, S., Austin, K., Farina, E., & Lieberman, H. (2016). Prevalence of Dietary Supplement Use by Athletes: Systematic Review and Meta-Analysis. Sports Medicine (Auckland, N.Z.), 46. https://doi.org/10.1007/s40279-015-0387-7

Kolliari-Turner, A., Lima, G., Hamilton, B., Pitsiladis, Y., & Guppy, F. M. (2021). Analysis of Anti-Doping Rule Violations That Have Impacted Medal Results at the Summer Olympic Games 1968–2012. Sports Medicine, 51(10), 2221–2229. https://doi.org/10.1007/s40279-021-01463-4

Loland, S. (2015). Performance enhancing biomedical technology in sport: Where are the limits. In V. Møller, I. Waddington & J. Hoberman (Eds.), Routledge handbook of drugs and sport (pp. 54-63). Routledge.

Martinez-Sanz, J., Sospedra, I., Ortiz, C., Baladía, E., Gil-Izquierdo, A., & Ortiz-Moncada, R. (2017). Intended or unintended doping? A review of the presence of doping substances in dietary supplements used in sports. Nutrients, 9 (10), 1093. PMid: 28976928.

McLaren, R. (2016). (rep.). The Independent Person Report: WADA Investigation of Sochi Allegations (p. 49). Montréal, QC: World Anti-Doping Agency.

Ntoumanis, N., Ng, J. Y., Barkoukis, V., & Backhouse, S. (2014). Personal and psychosocial predictors of doping use in physical activity settings: a meta-analysis. Sports medicine (Auckland, N.Z.), 44(11), 1603–1624. https://doi.org/10.1007/s40279-014-0240-4

World Anti-Doping Agency. (2021). World Anti-doping Code 2021. https://www.wada-ama.org/en/resources/world-anti-doping-program/world-anti-doping-code

Solly is the head coach of the Nanaimo Kettlebell Club and has been training clients for over 15 years. He has twice been on Team Canada as both an athlete and coach, and has continues to operate the longest running kettlebell sport event in Canada.