‘Steroids Aren’t Cool’:
Criminalising Enhancement & the Politics of Healthcare Ethics

This paper explores the relationship between medical ethics and sports medicine by considering recent conversations in the USA on the doping dilemma. Specifically, the Congressional hearings on Baseball opened with the Chairman Tom Davis calling for a need to help ‘kids understand that steroids aren’t cool’ (Davis, 2005). His words allude to a general transformation of social values and attitudes towards body modification. Indeed, they resonate with wider governmental concern over the prevalence of enhancement interventions (The President’s Council on Bioethics, 2003; Elliott, 2003). Yet, these sentiments are confused by Davis’ subsequent claim that the ‘new [drug] testing program…gets that job done’. His statement fails to recognise that testing is a quite different task compared with changing social values (American Academy of Pediatrics, 2005). In short, young people use steroids for a wider range of reasons other than a competitive edge in sport. The AAP is part of an emerging discourse that treats the doping dilemma as a broader public health issue. This frame raises a number of questions about how the relationship between ethics in sports medicine and medical ethics. Indeed, the last 5 years has shown an increased interest within the medical ethics literature to consider enhancement in sport. I suggest that it is only a matter of time before greater limits are placed on the practice of sports medicine. Indeed, the ensuing controversy surrounding hypoxic chambers is some indication of this. In connection with this emerging public health care discourse, I present a second strand of recent debates on doping, which indicate an increasing sympathy for seeking criminal sanctions for positive doping cases (Donati, 2005). To explain this, I discuss the relationship between the regulation of medical products and their use in sport. I also draw attention to various legal developments that reinforce my claim and warn of a future where doped athletes face criminal prosecution. Finally, I argue for a critical educational framework within anti-doping. Davis’ reductionism exposes the absence of a developed science communication and public engagement methodology within sports medicine and science. In conclusion, I urge caution over the criminalizing of performance enhancement in sport and propose a critical healthcare approach to understanding the doping phenomenon in its wider socio-cultural context. Within such a framework, the relationship between sports medicine and medical ethics should be different from convention medical ethics practices, but nevertheless characterised by models of best practice that derive from professional bodies.

References

American Academy of Pediatrics (2005). Guidelines for Pediatricians: Performance-Enhancing Substances. Sport Shorts. 12.

Davis, T. (2005). Opening Statement Committee on Government Reform: session on Restoring Faith in America's Pastime: Evaluating Major League Baseball's Efforts to Eradicate Steroid Use. Washington, D.C

Donati, A. (2005). Criminality in the International Doping Trade, World Anti-Doping Agency.

Elliott, C. (2003). Better Than Well: American Medicine Meets the American Dream. New York and London, W.W. Norton & Company.

The President's Council on Bioethics (2003). Beyond Therapy: Biotechnology and the Pursuit of Happiness.