Doping Athletes

The use of performance-enhancing drugs by professional athletes not only leads to serious challenges in maintaining a level playing field in competitive sports but also raises broader ethical issues and concerns.

Some of these concerns were highlighted in 2015 when the former world number one tennis star Maria Sharapova was banned from competitive play for two years by the International Tennis Federation (ITF) after she tested positive for the banned substance meldonium. The Court of Arbitration for Sport subsequently reduced her sentence to 15 months. Meldonium, an over-the-counter Latvian drug known to dilate blood vessels and increase the flow of blood, may contribute to improving an athlete’s physical endurance.

Her case was made more complicated by her claim that she was taking the drug for health reasons, a claim viewed with skepticism among other athletes and ultimately rejected by the Independent Tribunal appointed by the ITF to review the case. Former British Olympic sprinter and world championship bronze medalist Craig Pickering described the real pressure that top athletes can face:

“I would bet my life savings that Sharapova was taking this medication because of its purported performance enhancing effects… Athletes are always going to push the boundaries in order to have a chance at success. That is what happens when you introduce competition.”

In competitive athletics, the supposition is that competitors are beginning on a par with each other, which means that no one has an “unfair” or “unjust” advantage over another going into the competition. At the starting line, they arrive as equals in the sense that they arrive with whatever they were endowed with at birth, and whatever they may have managed to become through practice, hard work, and discipline.

Cheating through doping involves an attempt to step outside these rules and suppositions, and play a different game, one that circumvents or removes the “on a par” assumption without revealing the fact. In this sense, cheating through doping is wrong because it is a form of lying, a form of presenting one’s initial endowment as if it were “natural,” and the result of athletic discipline, even though it really may not be so at all.

Several of Sharapova’s opponents expressed frustration at what they took to be a further injustice, namely, that in April 2017, she was given a wild card re-entry into World Tennis Association (WTA) tournament play in Germany. They insisted that she should, at a minimum, have to work her way back up from whatever her ranking had declined to after more than a year of tournament inactivity. Others, such as fellow player Eugenie Bouchard, perceived the doping transgression as even more serious, and argued that Sharapova should be banned from playing for life:

“She’s a cheater and so to me… I don’t think a cheater in any sport should be allowed to play that sport again. It’s so unfair to all the other players who do it the right way and are true. So, I think from the WTA it sends the wrong message to young kids—cheat and we’ll welcome you back with open arms.”

Some commentators have noted how event organizers typically like to include big name draws like Sharapova in their line ups, and former number one player Caroline Wozniacki opined that, “obviously the rules are twisted and turned in favor of who wants to do what.” Others have expressed concerns about corporate sponsors and advertisers continuing to promote high profile sports personalities after they have been suspended for doping, individuals who may already be among the wealthiest athletes in the world. It seems fair to conclude that doping constitutes a form of cheating not only of one’s competitors, but also one’s fans, oneself, and the integrity of the sporting activity itself.

Through an honest pursuit of the athletic crown, meanwhile, we encounter the possibility of transcending who we are in limited, but important ways. The self-directed training and preparation of the athlete helps develop and hone a host of important personal qualities: strength, coordination, endurance, drive, agility, discipline, quickness, vigilance, cleverness, vision, and daring. This draws us towards an authentic perfecting of our bodies, our character and ourselves — an inwardly-directed order and discipline that arises from deep within — and forms us in such a way that we reach beyond where we ever thought we could reach, and through that personal stretching and growth, come to experience a true measure of human fulfillment. That’s something that doping athletes sadly cheat themselves from fully experiencing.

Featured image by Justin Smith from UK – Maria Sharapova – Wimbledon 2009, CC BY-SA 2.0,

COMING UP: The Ethics of New Age Medicine

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Patients who face serious illnesses are sometimes attracted to alternative medicines, also referred to as “holistic” or “new-age” medicines. These can include treatments like homeopathy, hypnosis, “energy therapies” like Reiki, acupuncture, and herbal remedies, to name just a few.

These approaches raise various medical and ethical concerns. An important 1998 article in the New England Journal of Medicine sums it up this way:

“What most sets alternative medicine apart, in our view, is that it has not been scientifically tested and its advocates largely deny the need for such testing. By testing, we mean the marshaling of rigorous evidence of safety and efficacy, as required by the Food and Drug Administration (FDA) for the approval of drugs and by the best peer-reviewed medical journals for the publication of research reports.”

Beyond the fact that their clinical efficacy has not earned a passing grade using ordinary methods of scientific investigation, the basic premise behind some alternative medicines can also be highly suspect, raising concerns about superstitious viewpoints or misguided forms of spirituality motivating certain therapies.

If we consider acupuncture, this technique does appear to provide benefit in certain cases of pain control. Yet similar results have been reported using “sham” needles — tapping the skin in random places with a thin metal tube. Brain scans have demonstrated that treatment with genuine needles, as opposed to the sham needles, does cause detectable changes in the brain. But, when researchers ignored acupuncturists’ recommended “meridian placement” of needles, and instead did random placement in the skin, the same brain effects were observed. Hence, it is unclear whether the results seen from acupuncture arise mostly from the well-known “placebo effect” or not. Further research should help resolve this question.

Even if the observed effects are not placebo-related, acupuncture’s non-rational justification for its purported effectiveness remains a concern. It is based on energy principles that neither science nor faith affirm. Glenn Braunstein, M.D. described it critically in the following way:

“Ch’i, the invisible nutritive energy that flows from the universe into the body at any one of 500 acupuncture points, is conducted through the 12 main meridians [channels] in (ideally) an unbroken circle. Meridians conduct either Yin energy (from the sun) or Yang energy (from the earth). All maladies are caused by disharmony or disturbances in the flow of energy.”

Clearly, then, some alternative therapies, beyond the basic issue about whether they work, raise serious spiritual concerns as well.

Another new-age therapy known as Reiki, developed in Japan in the late 1800s, claims that sickness can be caused by a disruption or imbalance in a patient’s “Reiki” or “life energy.” Reiki practitioners try to heal a patient by placing their hands in certain positions on the body in order to facilitate the flow of Reiki from the practitioner to the patient.

A 2009 document from the U.S. Conference of Catholic Bishops stresses, “In terms of caring for one’s spiritual health, there are important dangers” that can arise by turning to Reiki. The document notes that because Reiki therapy is not compatible with either Christian teaching or scientific evidence, it would be inappropriate for Catholics to put their trust in the method, because to do so would be to operate “in the realm of superstition, the no-man’s-land that is neither faith nor science.”

Scientific investigations of another new-age therapy, the popular herbal remedy known as echinacea (taken early to ward off a cold) have revealed no difference between echinacea and a placebo in controlled studies involving several hundred subjects. While some herbal remedies may be harmless and inert placebos, others may have more serious health consequences if ingested above certain dosages due to ingredients of unknown potency derived from natural substances.

Sometimes a remedy can be borrowed from Chinese, Indian or another medical tradition, but it should be chosen for its efficacy, safety, and reasonable mode of action, and not be in conflict with principles of sound medical science or Christian teaching.

Health improvements that arise from alternative remedies may be due not only to the placebo effect, but also to the fact that patients are usually given more time, attention and focused concern by alternative practitioners than by traditional physicians. This can translate into modified habits and changed lifestyles, leading to various health benefits.

Modern medicine can be legitimately faulted for downplaying this dimension, so that, in the memorable words of pediatrician Jay Perman, “Doctors tend to end up trained in silos of specialization,” in which they are taught “to make a diagnosis, prescribe a therapy, and we’re done. But we’re not done.”

The famous Greek physician Hippocrates once noted the same point: “It is more important to know what sort of person has a disease than to know what sort of disease a person has.” Today’s physicians-in-training, fortunately, are seeking to incorporate more and more of these “patient-centric” and “holistic” aspects into their own traditional medical practices to improve patient care and outcomes.