Regulating human enhancement: extending anti-doping policy beyond sport?

Bengt Kayser, Professor, ISSUL, University of Lausanne, Switzerland

Humankind is witnessing a scientific revolution arguably of Kuhnian paradigmatic proportions. Bio-medical and engineering invention rapidly advance and unleash important potential beyond therapeutic use. These developments come with important ethical questions concerning equity, equality, and need. Sports was and is a human activity in which performance enhancement is essential. The Olympic motto is exemplary in this regard: higher, faster, stronger. Athletes adopt behaviour that helps them performing better in their sport by means of training schemes, nutrition, supplements, psychology, and technology. Most pharmacological means and some technologies are not permitted because considered doping.

Since the inception of the World Anti Doping Agency early century, anti-doping  efforts in elite sport have led to a gradual shift towards vilification of doping behaviour. This in turn led to increasingly strong repression by means of surveillance and punishment. Pressed by WADA and the IOC, increasingly specific national punitive anti-doping legislation was introduced, in several countries in the form of criminal law, something now explicitly asked for by WADA.

In several countries this legislation also applies outside elite competitive sport. In Belgium and in Denmark non-competitive fitness clients are subject to unannounced urine sampling and risk sanctions when traces of forbidden substances are found. Anti-doping surveillance is now also extended to amateur sport such as popular grand fondo cycling races in the USA. Compulsory urine controls for students were introduced in several schools in the USA. Such extensions of anti-doping outside competitive professional sport, for example in fitness centres, can result in increased harm since it pushes the behaviour underground, something accompanied by more risky behaviour. Akin to the consequences of the ‘war on drugs’, a ‘war on doping’, anchored in international conventions obliging national governments to combat doping in and outside elite sport, may thus lead to greater societal harm than it prevents.

This leads to the question on how much of the present harm of doping – for the athlete and the wider society – might be related to anti-doping policy rather than to the use of the performance-enhancing methods or substances as such. The prospect of a blanket extension of sport’s anti-doping policies to wider society would seem a bad idea. Based on the experience with illicit drugs, for which experimenting with alternative policies with harm reduction strategies have come of age and proven their societal benefits, a pragmatic non-essentialist approach of enhancement behaviour in general society applying principles of harm reduction would seem a more viable approach. Whether this would eventually lead to similar changes within competitive sport remains an open question.