Reframing the Debate over Performance-Enhancing Drugs: The Reasonable Athlete Argument

IF 1.6 Q2 ETHICS Sport Ethics and Philosophy Pub Date : 2023-10-09 DOI:10.1080/17511321.2023.2266581
Matthew C. Altman
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The reasonable athlete argument solves both sets of problems: it justifies a ban on some performance-enhancing drugs based on health and fairness, while avoiding paternalism, and it also establishes a non-arbitrary standard to determine which drugs ought to be allowed. First, if unsafe PEDs were allowed, some athletes would refuse to take them out of concern for their health. This is a reasonable decision even though it would put them at a competitive disadvantage against athletes who choose to use unsafe PEDs. It would be unfair for clean athletes to suffer a competitive disadvantage for acting reasonably. Therefore, PEDs that pose significant health risks should be prohibited for all athletes. Second, it would be unreasonable for athletes to refuse, on principle, relatively safe and effective PEDs, so a blanket prohibition is also unjustified. Which drugs and which doses to allow should be determined not by athletes’ actual choices but by the hypothetical choices of the reasonable athlete. The resulting sport-specific drug policy would carve a justifiable middle path between complete prohibition and complete permission.KEYWORDS: Performance-enhancing drugsdopingfairnesscoercionsteroids AcknowledgmentsI am grateful to Cynthia Coe and Lou Matz for helpful comments on earlier drafts. The two reviewers for Sport, Ethics and Philosophy also provided valuable suggestions as I revised the article for publication.Disclosure StatementNo potential conflict of interest was reported by the author(s).Notes1. Some philosophers have questioned whether elite athletes are in fact fully free. For example, Murray (Citation1983), Fraleigh (Citation1985), and Holowchak (Citation2000) claim that they are coerced—forced to choose either to harm themselves, lower expectations, or quit the sport; and pressured by team owners and fans—and are thus not in control of their choices regarding PEDs. Brown (Citation1985a) and Veber (Citation2014) challenge that idea, claiming that the athlete’s situation is not coercive, or coercive enough, for them to be in need of protection against their own decisions. Saying that someone must do something dangerous to compete at the highest levels, such as the McTwist maneuver in skateboarding, is not coercive, and neither is the pressure to use PEDs (Veber Citation2014). Simon takes a middle view: although athletes are not coerced (Simon Citation1985, 8–10; Simon, Torres, and Hager Citation2015, 90–92), they are given an ‘unethically constrained choice’ either to risk harm in order to compete, to be noncompetitive, or to quit the sport (Simon, Torres, and Hager Citation2015, 92–95). Loland (Citation2009) agrees that, ‘in a situation with mature and rational athletes who can make free and informed choices of the use of technology, the argument about athletes’ vulnerability and exploitation seems without merit’. So, it seems like Loland wants them to choose for themselves. ‘However’, he adds, ‘such a scenario is unlikely to arise. Athletic performances are the result of many years and even decades of hard training from a young age, and few athletes have the necessary knowledge to make their own choices along the way’ (171). Apparently, elite athletes are so intellectually and morally stunted that they cannot be allowed to make important decisions for themselves, even if it only affects them.There is some truth in what Loland says. Most elite athletes begin training as children, so the norms of their sport are inculcated early on. Gymnasts, tennis players, swimmers, and many others are told by their parents and coaches at a young age that they should take whatever advantage they can to be more competitive and get ahead. This training undoubtedly affects an athlete’s decision-making, such that the choices they make as adults are not coerced but are not simply autonomous either. This raises the larger question of whether circumstantial moral luck undermines our capacity to be free, which is beyond the scope of this paper.2. The prevalence of doping in the elite athlete population is estimated to be as high as 57 percent, even with existing bans (Ulrich et al. Citation2018).3. Sean McKeever (Citation2017) calls this a ‘bad choice’ in his argument against PEDs. McKeever’s argument is similar to mine, although he focuses on the goods of the sport that the clean athlete is forced to forego—‘competitive success’ and ‘public admiration’ – which he says is unfair. According to my argument, clean athletes are being unfairly penalized by acting reasonably in protecting their health. My position emphasizes the choice itself and the harms to be avoided rather than the resulting distribution of ‘victory and laurels’.4. Contrary to Murray (Citation1983), Fraleigh (Citation1985), and Holowchak (Citation2000), I am not claiming that athletes would be harmed because, in a sport that allows doping, they would be coerced into using PEDs. My approach is the obverse of this argument. 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Abstract

ABSTRACTTwo of the major arguments against performance-enhancing drugs (PEDs), appealing to fairness and the protection of athletes’ health, have serious flaws. First, there is no relevant moral distinction between the use of PEDs and the use of other performance enhancers that introduce unfairness and that we accept nonetheless. Second, prohibiting PEDs for athletes’ own good ignores the fact that adult athletes are constantly making tradeoffs to improve performance and pursue excellence, including sacrificing their health. We should not paternalistically impose our values on them. On the other side, arguments to allow ‘safe’ PEDs provide no normative criterion to determine the acceptable level of risk, thus begging the question. The reasonable athlete argument solves both sets of problems: it justifies a ban on some performance-enhancing drugs based on health and fairness, while avoiding paternalism, and it also establishes a non-arbitrary standard to determine which drugs ought to be allowed. First, if unsafe PEDs were allowed, some athletes would refuse to take them out of concern for their health. This is a reasonable decision even though it would put them at a competitive disadvantage against athletes who choose to use unsafe PEDs. It would be unfair for clean athletes to suffer a competitive disadvantage for acting reasonably. Therefore, PEDs that pose significant health risks should be prohibited for all athletes. Second, it would be unreasonable for athletes to refuse, on principle, relatively safe and effective PEDs, so a blanket prohibition is also unjustified. Which drugs and which doses to allow should be determined not by athletes’ actual choices but by the hypothetical choices of the reasonable athlete. The resulting sport-specific drug policy would carve a justifiable middle path between complete prohibition and complete permission.KEYWORDS: Performance-enhancing drugsdopingfairnesscoercionsteroids AcknowledgmentsI am grateful to Cynthia Coe and Lou Matz for helpful comments on earlier drafts. The two reviewers for Sport, Ethics and Philosophy also provided valuable suggestions as I revised the article for publication.Disclosure StatementNo potential conflict of interest was reported by the author(s).Notes1. Some philosophers have questioned whether elite athletes are in fact fully free. For example, Murray (Citation1983), Fraleigh (Citation1985), and Holowchak (Citation2000) claim that they are coerced—forced to choose either to harm themselves, lower expectations, or quit the sport; and pressured by team owners and fans—and are thus not in control of their choices regarding PEDs. Brown (Citation1985a) and Veber (Citation2014) challenge that idea, claiming that the athlete’s situation is not coercive, or coercive enough, for them to be in need of protection against their own decisions. Saying that someone must do something dangerous to compete at the highest levels, such as the McTwist maneuver in skateboarding, is not coercive, and neither is the pressure to use PEDs (Veber Citation2014). Simon takes a middle view: although athletes are not coerced (Simon Citation1985, 8–10; Simon, Torres, and Hager Citation2015, 90–92), they are given an ‘unethically constrained choice’ either to risk harm in order to compete, to be noncompetitive, or to quit the sport (Simon, Torres, and Hager Citation2015, 92–95). Loland (Citation2009) agrees that, ‘in a situation with mature and rational athletes who can make free and informed choices of the use of technology, the argument about athletes’ vulnerability and exploitation seems without merit’. So, it seems like Loland wants them to choose for themselves. ‘However’, he adds, ‘such a scenario is unlikely to arise. Athletic performances are the result of many years and even decades of hard training from a young age, and few athletes have the necessary knowledge to make their own choices along the way’ (171). Apparently, elite athletes are so intellectually and morally stunted that they cannot be allowed to make important decisions for themselves, even if it only affects them.There is some truth in what Loland says. Most elite athletes begin training as children, so the norms of their sport are inculcated early on. Gymnasts, tennis players, swimmers, and many others are told by their parents and coaches at a young age that they should take whatever advantage they can to be more competitive and get ahead. This training undoubtedly affects an athlete’s decision-making, such that the choices they make as adults are not coerced but are not simply autonomous either. This raises the larger question of whether circumstantial moral luck undermines our capacity to be free, which is beyond the scope of this paper.2. The prevalence of doping in the elite athlete population is estimated to be as high as 57 percent, even with existing bans (Ulrich et al. Citation2018).3. Sean McKeever (Citation2017) calls this a ‘bad choice’ in his argument against PEDs. McKeever’s argument is similar to mine, although he focuses on the goods of the sport that the clean athlete is forced to forego—‘competitive success’ and ‘public admiration’ – which he says is unfair. According to my argument, clean athletes are being unfairly penalized by acting reasonably in protecting their health. My position emphasizes the choice itself and the harms to be avoided rather than the resulting distribution of ‘victory and laurels’.4. Contrary to Murray (Citation1983), Fraleigh (Citation1985), and Holowchak (Citation2000), I am not claiming that athletes would be harmed because, in a sport that allows doping, they would be coerced into using PEDs. My approach is the obverse of this argument. While their argument rests on the wrongness of a self-harming decision that is not fully free, my argument rests on the wrongness of the unfairness that results from a free act of self-protection.5. The moral question that I am addressing here is separate from the practical question of how to enforce rules against PEDs. Russell and Browne (Citation2018) seem singularly focused on the latter issue. But before we address that, we must first have a principled method of figuring out which rules to adopt, which is what the reasonable athlete argument attempts to provide.
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重新讨论提高成绩的药物:合理的运动员论点
【摘要】反对使用兴奋剂的两大论点——呼吁公平和保护运动员健康——存在严重缺陷。首先,使用ped和使用其他会带来不公平的性能增强剂之间没有相关的道德区别,尽管如此,我们还是接受了。其次,为了运动员的利益而禁止使用ped忽视了一个事实,即成年运动员为了提高成绩和追求卓越而不断做出权衡,包括牺牲自己的健康。我们不应该以家长式的方式把我们的价值观强加给他们。另一方面,允许“安全”的ped的论点没有提供确定可接受风险水平的规范性标准,因此回避了这个问题。合理的运动员论点解决了这两组问题:它证明了基于健康和公平禁止一些提高成绩的药物是合理的,同时避免了家长式作风;它还建立了一个非武断的标准来确定哪些药物应该被允许使用。首先,如果允许使用不安全的ped,一些运动员会出于对健康的考虑而拒绝服用。这是一个合理的决定,即使这将使他们在与选择使用不安全的ped的运动员的竞争中处于劣势。如果清白的运动员因为行为合理而处于竞争劣势,这是不公平的。因此,所有运动员都应该禁止使用具有重大健康风险的ped。其次,运动员原则上拒绝相对安全有效的ped是不合理的,因此全面禁止也是不合理的。服用何种药物和剂量不应由运动员的实际选择决定,而应由理性运动员的假设选择决定。由此产生的针对体育运动的药物政策将在完全禁止和完全允许之间开辟一条合理的中间道路。感谢Cynthia Coe和Lou Matz对早期草稿的有益评论。在我修改文章准备发表的过程中,《体育、伦理和哲学》的两位审稿人也提供了宝贵的建议。披露声明作者未报告潜在的利益冲突。一些哲学家质疑优秀运动员是否真的完全自由。例如,Murray (Citation1983)、Fraleigh (Citation1985)和Holowchak (Citation2000)声称他们是被迫选择伤害自己、降低期望或退出这项运动的;并受到球队老板和球迷的压力,因此他们无法控制自己对ped的选择。Brown (Citation1985a)和Veber (Citation2014)对这一观点提出了质疑,他们认为运动员的情况不是强制性的,或者强制性的程度不足以让他们需要保护自己不受自己决定的影响。说一个人必须做一些危险的事情才能参加最高水平的比赛,比如滑板中的McTwist动作,这不是强制性的,使用ped的压力也不是强制性的(Veber引文2014)。西蒙持中间观点:尽管运动员没有被强迫(Simon Citation1985, 8-10;Simon, Torres, and Hager Citation2015, 90-92),他们被给予一个“不道德的约束选择”,要么冒着伤害的风险去竞争,要么不竞争,要么退出这项运动(Simon, Torres, and Hager Citation2015, 92-95)。Loland (Citation2009)同意,“在成熟和理性的运动员可以自由和知情地选择使用技术的情况下,关于运动员脆弱性和被剥削的争论似乎没有根据”。所以,洛兰德似乎想让他们自己选择。“然而,”他补充说,“这种情况不太可能出现。运动成绩是从小多年甚至几十年艰苦训练的结果,很少有运动员有必要的知识来做出自己的选择。显然,精英运动员在智力和道德上都发育不良,他们不能被允许为自己做出重要的决定,即使这只会影响到他们。罗兰说的有些道理。大多数优秀运动员从小就开始训练,所以他们的运动规范是从小灌输的。体操运动员、网球运动员、游泳运动员和许多其他运动员在很小的时候就被父母和教练告知,他们应该利用一切可能的优势来提高自己的竞争力并取得成功。这种训练无疑会影响运动员的决策,以至于他们作为成年人做出的选择既不是被强迫的,也不是简单的自主的。这就提出了一个更大的问题,即间接的道德运气是否会削弱我们获得自由的能力,这超出了本文的范围。据估计,即使有现有的禁令,精英运动员群体中使用兴奋剂的比例也高达57% (Ulrich等)。Citation2018)。3。肖恩·麦基弗(Citation2017)在反对儿科医生的观点中称这是一个“糟糕的选择”。
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