BIOETHICS

A Shot In the Rear

Why Are We Really Against Steroids?

Professional and amateur sports are awash in steroids and have been for many years. It seems self-evident that this is a problem. The amount of media and political attention paid to steroids and other pharmacologic forms of enhancement in sports might even suggest that it is one of the greatest moral problems the world faces.

Someday we may get drugs that do what steroids do without any real risk of harm to the user. Would we still want them banned?

Admittedly, putting the challenge of dealing with steroids on the same moral plane as battling poverty is a bit of a stretch. Still, a lot of people all over the world are clamoring for those in charge to get steroids out of sports. That is what makes the recent publication of a number of articles and books challenging the idea that performance enhancement if morally wrong so interesting. While it may seem obvious that athletes using steroids to build strength or gain endurance is wrong, could those intuitions be mistaken?

In one sense they cannot. Steroids are dangerous and there is a real need to protect children who admire athletes from taking serious risks with their health in imitating what their idols do. But put the safety issue aside. Someday we may get drugs that do what steroids do without any real risk of harm to the user. Would we still want them banned?

John Harris, a British bioethicist, is a useful example of someone who is not at all sure that a bit of the “juice” is such a bad thing in athletic competition. In his Enhancing Evolution (2007), he argues that performance enhancement is not only ethically acceptable, but that sometimes it may be morally obligatory.

Harris sees a legitimate role for the use of drugs and genetic engineering to improve performance in sport. But sports are not his main target. He sees a future in which parents happily and willingly use genetic and reproductive technologies to design their children with more capacities and abilities than they otherwise would have had. His main argument in the book is that there are no convincing arguments against performance enhancement and plenty that support it.

Can Harris’s positive view of enhancement be used to as an antidote to the wave of anti-steroid mania tearing through the sports and editorial pages? In Harris’s sports world, the genetically engineered, chemically enhanced, and optimally trained ought serve as our heroes. They will give us performances to remember. And that is the point of sport. Or is it?

Harris’s eloquent defense of performance enhancement as entirely ethical stands in stark contrast to the efforts of sports authorities and prosecutors all over the world to vigorously chase down and defrock of honors athletes who have used steroids and other performance enhancing substances. Are the prosecutions really persecutions? Should performance enhancement simply be accepted as a part of sport? Are those who want seconds shaved off of the time it takes to run a mile or who want to see baseball sluggers smash seventy or more home runs in a single season really all that interested in whether these records are achieved by those who use no drugs in achieving these record performances? The international brouhaha over drug use to improve performance gives some evidence that the road to better living through biochemical engineering may be laced with more ethical potholes than are dreamt of in Harris’s philosophy.

Consider first just a tiny bit of the mess that efforts at drug-based performance enhancement have produced in contemporary sports. The world of cycling is just about kaput as a result of drug allegations and revelations. Marion Jones, the dazzling Olympic sprinter who won three gold medals and two bronzes at the games in Sydney, Australia, has confessed in a U.S. Federal courtroom to using steroids and jail awaits. Her tearful admission came after years of angry denials that she had ever gone near performance enhancing drugs.

Baseball’s all-time homerun hitter, Barry Bonds, faces federal charges for lying about steroid use as part of a larger investigation of an illegal steroids lab, the BALCO company of Burlingame, California. The BALCO probe has turned up the names of many high-profile professional athletes from around the world, as BALCO steroids customers include baseball players, track and field stars, football players, cyclists, and boxers. Baseball had never formally banned steroids and no testing was done to find those who had used them. But Bonds realizes that baseball fans would dismiss his achievements as the product of a chemically enhanced body were he to admit what is obvious from changes in his body over the years —that he used steroids and other performance enhancing drugs.

Roger Clemens, perhaps the preeminent pitcher in the history of baseball, a seven-time Cy Young Award winner—a prize given each year to the best pitcher in baseball—spent a dreary four hours in front of the House Oversight Committee jousting with its chair, Henry Waxman. While there he failed to persuade anyone except a few star-struck, fawning conservative representatives that he had not gotten steroid injections from his personal trainer when he played for the New York Yankees.

Afterall didn’t Jones, Bonds, Clemens, and others give us remarkable and memorable performances?

Clemens’s best friends on the team, Andy Pettitte and Chuck Knoblauch, have admitted using. So did Clemens’ wife! She said she had the trainer shoot her up in preparing for a swimsuit photo-shoot. These admissions make it a feat of epistemological legerdemain to believe that Roger knew what those closest to him were doing but that he did not know he was getting steroids injected into his rump when his trainer inserted a needle there.

An additional problem for crediting Clemens denials that he ever used steroids is that his own career performance statistics contradict him. He was at his most productive late in his career at a time in his life when nearly every other pitcher has begun to lose their speed and stamina. Admitting a flow of steroids through his body would make not only a mockery of his denials but also of the virtuous character he seeks to claim for himself in explaining how he could improve his abilities at a time when nearly every other pitcher in the history of baseball was seeing theirs wane.

The list of steroid scandals goes on and on. But, as these examples make clear, using steroids and other drugs to improve athletic performance grates on the perceptions of fans, the media, sports management and many politicians. But why exactly is that so? Afterall didn’t Jones, Bonds, Clemens, and others give us remarkable and memorable performances?

One of the most interesting critics of pharmacologic enhancement in sport is Harvard political scientist Michael Sandel. Sandel has argued in a series of articles and a book, The Case Against Perfection (2007), that the causal role of human agency plays a key role in substantiating our admiration of athletic performance. In commenting on drug use in baseball he observes that,

…as the role of (drug) enhancement increases, our admiration for the new achievement fades—or, rather, our admiration for the achievement shifts from the player to his pharmacist.

Something like this explanation is at the heart of sports’ current struggle with steroids. Sandel is clearly on to something when he argues that chemically produced performance enhancement undermines our willingness to esteem the performance of the winners of the Tour de France, Roger Clemens, Barry Bonds, or Marion Jones.

This is where Harris weighs in. He does not see much merit in Sandel’s caution that chemistry corrodes admiration for athletic effort. He argues that great efforts are not always required to achieve great performance.

Moreover, in sport an athlete still has to train in order to perform well even when using steroids. Using performance enhancing drugs is not a substitute for effort. Rather, Harris argues, the drugs enhance the results of the effort.

Well, Harris is right that you don’t need to make a great effort to accomplish great things. Every once in a while someone wins the lottery or finds an old heirloom worth a lot of money in the attic and no one seems to mind that they have advanced themselves through luck, not exertion. But that is not true in sport. A lucky bounce or a gust of wind can determine the outcome, but athletes get praise for performance linked to effort, not luck. The whole point of sport is to try and reward effort even if luck plays a crucial role in the outcome. Harris’ point that small efforts can produce big rewards does not moot the point that big efforts that produce big rewards get the praise, not just the notice.

Outcomes don’t define sport—the process leading to outcomes does.

And it is true, as Harris says, that no one gets to be a great athlete simply by taking steroids or growth hormone. You get an edge or an advantage over others who are just as naturally gifted and train just as hard as you do. What Harris misses though, is that some performances are explicitly associated, by the nature of the rules governing the activity, with great effort—admittedly as a matter of history or culture—but nonetheless, it is the effort that is valued. If someone takes a pill and lifts a lot of weight it may be amazing. But it is only a weightlifter’s willingness both to train and to show extraordinary effort that makes weightlifting an athletic achievement as opposed to an exhibition.

Sport is only sport if it is measuring human abilities, as varied as those may be. Sport also links the results achieved to training, will, and effort. Outcomes don’t define sport—the process leading to outcomes does. That is why short circuiting your way to success by pills or hormones as Jones, Bonds, and Clemens did undercuts their performance since both process and outcome are required in assessing performance.

“Professional” wrestling has many fans in North America, Mexico, Asia and Europe. Its athletes can do impressive feats involving agility and strength. They are very strong certainly due to steroids. But no one seriously thinks that pro wrestling is a sport—despite having all the external accoutrements. It is a steroid-infused exhibition. Harris might say “well redefine the sport—there is nothing intrinsically sacrosanct about effort leading to performance.” Except that there is. The definition of sport is human effort based on talent and training leading to performance. This is an activity that need not be preserved but if it is to be preserved—and most baseball, track and cycling fans have an exquisite sensitivity to history—then drugs, huge shifts in equipment, and competing in venues that distort the value of effort, e.g., very high altitudes, won’t work.

So at least in sports, if not on Wall Street or in the classroom, it is how the performance is achieved and not just the performance that is valued. That link between human effort and agency and output may be contingent. But it is surely definitive of what sport is.

Sandel has one more volley to offer in defense of steroid-free sports. He argues that it is the very “giftedness” of talent that make drugs unwelcome. We appreciate that some are borne inclined to be great sprinters and others great pitchers, and drugs—not to mention genetic engineering—ruin all that.

I am not sure about this and neither is Harris. The idea that we value a performance because we admire the random luck of the lottery of life that gives some of us genes for singing, others for strength and still others for superb vision seems implausible. Why is randomness to be admired? Looking for value in the natural distribution of talents and skills is like looking for the source of free will and autonomy in the random nature of evolution or the Heisenberg uncertainty principle. Estimable value does not lurk in random luck. We can accept that luck can bring us fortune and enjoy it, but it is hard to see what role the luck of the draw in genetics has in esteeming sports performances.

The battle over performance enhancement is often fought out as if one size fits all—what makes performance enhancement acceptable in one domain, sports, will make it acceptable in all aspects of life. What the fight between Harris and Sandel reveals is that this is not so. There are reasons to believe that steroids don’t belong in sports, even putting safety concerns aside. But this does not mean that performance-enhancing drugs have no appropriate role in any areas of life and achievement. The decision about what role pharmacology and genetics ought to play depends on whether you are trying to travel to another planet, solve a difficult math problem, learn a new language, or hit a home run.

ArthurL. Caplan, PhD is a member of the Science Progress advisory board, Emanuel and Robert Hart Professor of Bioethics; Chair, Department of Medical Ethics; and Director, Center for Bioethics, University of Pennsylvania.

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