Institute of movement science and sports medicine, Faculty of Medicine
University of Geneva, Switzerland
Mankind is confronted with increasing possibilities to use the discoveries of bio-medical research in ways that bypass the ordinary framework of preventive or therapeutic medicine. Already today, there are compounds that can be used to improve our functioning without prohibitive side effects. The future will likely bring us numerous inventions, for example increasing memorization or concentration, for which the cost – benefit ratio will be judged acceptable. The concept of enhancement is coming of age and there is an urgent need to develop lines of thoughts and strategies aimed at finding workable solutions, somewhere between the extremes of total individual freedom of choice, and all-out repression of every use of technology for enhancement beyond what are considered ‘natural’ human capacities.
The recent development of a war on doping in sports, primarily based on a repressive system involving aggressive control of use of doping in elite and even amateur sports, seems at odds with the more relaxed view of enhancement strategies that prevails in society at large. Careful analysis of the development of anti-doping policy by sports institutions – but also by state legislators - has revealed serious shortcomings in the reasoning behind this war on drugs in sports. Indeed the war on doping may potentially induce more harm than it prevents when analyzed from a public health perspective because sports and its rules are no longer an exclusive concern of the sports world but increasingly have a major impact on society at large. The advocacy of the virtuous, “natural”, human in elite sports increasingly clashes with widespread public behavior integrating the enhancement use of substances and technology in daily life.
Globalization has led to increased access to technology, licit or illicit, and important black and grey markets for medication in general and doping products in particular have developed in which huge amounts of money change hands, and which are in large part controlled by criminal organizations.
At the same time the public is increasingly self-medicating. There is epidemiological evidence of improper use of pharmaceuticals, cosmetic surgery and eye surgery are mainstream, doctors are confronted with demands for prescriptions outside the therapeutic use framework, and dangerous behavior like sharing syringes for injecting anabolic steroids of dubious quality and origin are on the rise.
These developments raise questions as to the efficiency and desirability of the present repressive system and indicate problems that need to be researched, discussed and communicated, bringing together the fields of ethics, law, medicine, economics, sociology and philosophy.