Sports physicians are continuously confronted with new biotechnological innovations. This applies not only to doping in sports, but to all kinds of so-called enhancement methods. One fundamental problem regarding the sports physician's self-image consists in a blurred distinction between therapeutic treatment and non-therapeutic performance enhancement. After a brief inventory of the sports physician's work environment I reject as insufficient the attempts to resolve the conflict of the sports physician by making it a classificatory problem. Followed by a critical assessment of (...) some ideas from the US President's Council on Bioethics, the formulation of ethical codes and attempts regarding a moral topography, it is argued that the sports physician's conflict cannot be resolved by the distinction between therapy and enhancement. Instead, we also have to consider the possibility that the therapy-based paradigm of medicine cannot do justice to the challenges of the continuously increasing technical manipulability of the human body and even our cognitive functions as well. At the same time we should not adhere to transhumanist ideas, because non-therapeutic interventions require clear criteria. Based on assistive technologies an alternative framework can be sketched that allows for the integration of therapeutic and non-therapeutic purposes. After a thorough definition of standards and criteria, the role of the sports physician might be defined as that of an assistant for enhancement. Yet the process of defining such an alternative framework is a societal and political task that cannot be accomplished by the sports physicians themselves. Until these questions are answered sports physicians continue to find themselves in a structural dilemma that they partially can come to terms with through personal integrity. (shrink)

Governing bodies such as the World Anti-Doping Agency (WADA) and the National Collegiate Athletic Association (NCAA) make decisions about which drugs to prohibit athletes from using and the dosage...

We ask why pharmacological cognitive enhancement (PCE) is generally deemed morally unacceptable by lay people. Our approach to this question has two core elements. First, we employ an interdisciplinary perspective, using philosophical rationales as base for generating psychological models. Second, by testing these models we investigate how different normative judgments on PCE are related to each other. Based on an analysis of the relevant philosophical literature, we derive two psychological models that can potentially explain the judgment that PCE is unacceptable: (...) the “Unfairness-Undeservingness Model” and the “Hollowness-Undeservingness Model.” The Unfairness-Undeservingness Model holds that people judge PCE to be unacceptable because they take it to produce unfairness and to undermine the degree to which PCE-users deserve reward. The Hollowness-Undeservingness Model assumes that people judge PCE to be unacceptable because they find achievements realized while using PCE hollow and undeserved. We empirically test both models against each other using a regression-based approach. When trying to predict judgments regarding the unacceptability of PCE using judgments regarding unfairness, hollowness, and undeservingness, we found that unfairness judgments were the only significant predictor of the perceived unacceptability of PCE, explaining about 36% of variance. As neither hollowness nor undeservingness had explanatory power above and beyond unfairness, the Unfairness-Undeservingness Model proved superior to the Hollowness-Undeservingness Model. This finding also has implications for the Unfairness-Undeservingness Model itself: either a more parsimonious single-factor “Fairness Model” should replace the Unfairness-Undeservingness-Model or fairness fully mediates the relationship between undeservingness and unacceptability. Both explanations imply that participants deemed PCE unacceptable because they judged it to be unfair. We conclude that concerns about unfairness play a crucial role in the subjective unacceptability of PCE and discuss the implications of our approach for the further investigation of the psychology of PCE. (shrink)

Sport doping is not a recent phenomenon. Athletes have used many forms of performance enhancements going back to antiquity. Within the sport philosophy literature, sport doping is entangled in a multitude of ethical discourses, some denouncing, and some supporting, doping in sport. Our aim is to use a systematic approach to classify ethical discourses put forward by scholars focused on doping. To take stock of these ethical discourses, and to advance the sport philosophy literature on doping, this paper provides an (...) empirical account of the types of arguments used in the peer-reviewed sport philosophy literature. This empirical account is intended to provide a map of the ethical discourses in circulation, to highlight the most common arguments, and to show where other types of arguments are absent or less well developed. To map the ethical discourses, the authors use an ethical discourse typology from a university-based ethical reasoning program. (shrink)

Despite the promise to boost human potential and wellbeing, enhancement drugs face recurring ethical scrutiny. The present studies examined attitudes toward cognitive enhancement in order to learn more about these ethical concerns, who has them, and the circumstances in which they arise. Fairness-based concerns underlay opposition to competitive use—even though enhancement drugs were described as legal, accessible and affordable. Moral values also influenced how subsequent rewards were causally explained: Opposition to competitive use reduced the causal contribution of the enhanced winner’s (...) skill, particularly among fairness-minded individuals. In a follow-up study, we asked: Would the normalization of enhancement practices alleviate concerns about their unfairness? Indeed, proliferation of competitive cognitive enhancement eradicated fairness-based concerns, and boosted the perceived causal role of the winner’s skill. In contrast, purity-based concerns emerged in both recreational and competitive contexts, and were not assuaged by normalization. (shrink)

The World Anti-Doping Agency was created in 1999 with the goal of making elite competitive sports free of doping practices. Since then, it has grown into a powerful organization that oversees national anti-doping institutions and a majority of international sports federations. Anti-doping regulations means that the use of performance enhancement drugs or methods is prohibited in elite sports competition, and athletes who do not comply are sanctioned through a ban from competition and loss of titles and prizes link to them. (...) The recent discovery of a systematic doping scheme in Russia has shown that the regulations currently in place have failed to offer the 'clean' environment promised to athletes and the public. While there is an understandable call to reform WADA's practices to further the anti-doping fight, I suggest that the purpose of WADA itself should also be reconsidered. In taking a step back from the current controversy and urge for stricter regulations, this thesis will first ask if performance enhancement in sports should really be understood as unethical and undesirable. Favouring a interdisciplinary approach to this problematic, I will take a look at the scholarly debate on doping and critically analyze arguments from both positions including theoretical ideas on doping itself and practical concerns about WADA's current measures to prevent doping. This overview, while it does provide an unequivocal answer about the ethicality of doping, will show a wide range of counterarguments to the prevailing anti-doping stance, and raise numerous concerns about the current system. In doing so, it indicates the need for a larger, inclusive of all stakeholders, deliberation on the anti-doping position, a position which remains so far mostly uncontested outside of academia. In the second part of my thesis, this rejection of a by-default anti stance to doping in sports will then lead me to explore whether there is a more suited alternative to dealing with issue of doping in elite sports than the current zero tolerance approach. Finally, I conclude that a harm reduction approach provides a suitable answer to both moral concerns and issues of feasibility, even though it may be difficult to incorporate into WADA given the number of stakeholders involved. Still, the identification of this alternative, conjointly with the Russian scandal, serves to justify why there should be further deliberation about WADA and the anti-doping movement that goes beyond accepting the status quo and the Agency's idealist notion of achieving completely doping-free sports. (shrink)

In this article, we critically discuss different versions of the fairness objection to the legalisation of neuro-doping. According to this objection, legalising neuro-doping will result in some enjoying an unfair advantage over others. Basically, we assess four versions. These focus on: 1) the unequal opportunities of winning for athletes who use neuro-doping and for those who do not; 2) the unfair advantages specifically for wealthy athletes; 3) the unfairness of athletic advantages not derived from athletes’ own training ; and 4) (...) the unfair health care costs imposed on everyone as a result of athletes’ use of neuro-doping. We conclude that none of these versions offer a convincing principled fairness-based objection to legalising neuro-doping. (shrink)

Despite the numerous instances of PED use in professional sports, there continues to be a strong negative moral response to those athletes who dope. My goal is to offer a diagnosis of this response. I will argue that we do not experience such disdain because these athletes have broken some constitutive rule of sport, but because they have lied about who they are. In violating the constraints of their own public narratives, they make both themselves and their choices unintelligible. This (...) worry becomes especially profound as we care greatly about who our athletes are. Using cases from both athletics and US politics, I argue that certain kinds of lies so violate our understanding of who a person is that we can no longer recognize them as the person we took them to be. Fundamentally, I believe that PED users have lied about something central to their public narratives. I develop this view through an examination of narrative identity, primarily focusing on J. David Velleman’s work on agency and self-constitution. I do not claim that the athlete using steroids is nonidentical to who she would be in the absence of steroid use, but that through use of PEDs, she has misled us about an important component of her pubic narrative and this is difficult for us to reconcile. Ultimately, this has implications for sport as well as other other aspects of human social life. (shrink)

The 2018 eligibility regulation for female competitors with differences of sexual development (DSD) issued by World Athletics requires competitors with DSD with blood testosterone levels at or above 5 nmol/L and sufficient androgen sensitivity to be excluded from competition in certain events unless they reduce the level of testosterone in their blood. This paper formalises and then critically assesses the fairness-based argument offered in support of this regulation by the federation. It argues that it is unclear how the biological advantage (...) singled out by the regulation as an appropriate target for diminishment, is relevantly different from other biological advantages that athletes may enjoy, and specifically that Sigmund Loland’s recent attempt to drive a wedge between heightened levels of blood testosterone and other biological advantages fails. The paper also suggests that even if heightened blood testosterone levels do differ relevantly from other types of biological advantage, the regulation is further challenged by studies indicating that athletes with blood testosterone at the high end of the normal range have a competitive advantage over athletes with blood testosterone levels at the low end of it. Finally, the paper contends that the premises of the fairness-based argument do not unequivocally support the conclusion that DSD athletes with heightened levels of testosterone should diminish those levels, since, just as powerfully, they support allowing athletes with normal levels of testosterone to use performance-enhancing drugs in the name of fairness. (shrink)

Going beyond the biological and physiological limitations imposed on us by the human body is something which the human race has strived to do throughout its history. There is something about our human nature that compels us to strive for improvement and enhancement in our physical and mental performance, and to stretch ever further the boundaries of human accomplishment. Nowhere can a stronger desire for enhanced performance be found than in the realm of competitive sport and, it is certainly arguable (...) that, there are very few sports that can rival the competitiveness, endurance and physical exertion involved in the sport of boxing. Transhumanism is borne of this desire for continuous improvement and the refusal to resign ourselves to the restrictions placed on us by our natural biological constitution and environment, enhancing human capabilities and capacities by way of new and emergent technologies. With regard to sport, transhumanism could provide us with the ability to train longer, run, swim or cycle faster, jump higher, throw further and, in the case of boxing, punch harder. However, it is not restricted or confined to the enhancement of our physical powers, but could equally-well serve to improve our psychological capacities and alter the way in which we perceive and experience the world. In this way transhumanism could be employed to change the content of experience. (shrink)

Cognitive neuroenhancement involves the use of medical interventions to improve normal cognitive functioning such as memory, focus, concentration, or willpower. In this paper I give a Kantian argument defending the use of CNE in science, scholarly research, and creative fields. Kant’s universal law formulation of the categorical imperative shows why enhancement is morally wrong in the familiar contexts of sports or competitive games. This argument, however, does not apply to the use of CNE in higher education, scholarly or scientific research, (...) or creative endeavors such as visual art, fiction or poetry, or musical composition. This is because performance in these areas is embedded within practices that differ in morally significant ways from competitive practices. This important difference provides good reason to think that there is nothing morally wrong with the use of CNE in these areas. My approach is not simply to assume a full-fledged Kantian ethical theory and apply it straight away to the enhancement issue but to establish a reflective equilibrium between our moral intuitions, moral principles that support those intuitions, and the nature of the practices involved. (shrink)