Two 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. (shrink)