A philosophical response to the critics of anti-doping

Andrew Bloodworth
School of Sport and Exercise Sciences,
College of Engineering, Swansea University


Thomas H. Murray
Good Sport: Why Our Games Matter – and How Doping Undermines Them
195 pages, hardcover.
Oxford: Oxford University Press 2018
ISBN 978-0-19-068798-4

In Good Sport, Thomas Murray offers a defence of anti-doping policy. More specifically, Murray defends the role of the prohibited list in preserving values that should remain central to sport. Murray’s defence does not rest on the protection of athlete health. It rests on an account of the values of sport doping threatens. In this short review, I offer an outline of the key themes in Murray’s book, and some preliminary critical remarks. The book, as Murray notes in the concluding chapter, takes a bottom up approach. Murray introduces a range of examples and ideas that indicate how we understand sport and the values central to it. He then moves to more general claims regarding the significance of this analysis for anti-doping policy. 

The book successfully maintains the delicate balance required of any applied piece of ethics and philosophy. It demonstrates a careful understanding and engagement with the problems facing sport and sport policy makers with regard to doping. This understanding is coupled with a rigorous philosophical defence of anti-doping policy and a prohibited list. This approach has many merits, and results in a thoroughly readable, flowing style. The problems facing policymakers are described clearly. An example being the excellent description of classification in disability sport, its purpose and the problems it faces, both practical and conceptual. No doubt Murray’s expertise in applied philosophy, ethics and experience on governing body ethics committees has helped facilitate this grounded approach.  

The main argument that Good Sport offers is introduced and defended early on. This argument then reappears as a particular way in which to seek to resolve, or at least think about the problems presented. In short, Murray argues that it is perfectly reasonable to oppose the use of certain drugs methods and technologies in sport, as they threaten the values that should be central to sport. Sport should test our natural talent and our dedication. It concerns our natural abilities and our efforts to either overcome our physical limitations or to supplement those physical gifts that many elite athletes appear to have. Murray’s defence works through a range of objections to this line of argument. He responds to the suggestion that it would be fairer to equalise for this natural talent, and that doping might provide an opportunity for such equalisation. Murray questions whether doping methods could be used with the necessary precision to achieve such equalisation. A similar point is made in the context of the limitations of Therapeutic Use Exemptions by Jon Pike (2018). Murray also argues that justice need not require complete equality of all human attributes.

Finally, and most importantly, Murray considers the sort of sporting performances that we admire. Sport is a special sort of test in which we admire performances that represent rare physical prowess. Importantly, it is argued that our admiration would be significantly reduced, or indeed not exist at all, were we to be made aware that such physical gifts were not the result of natural talent or very hard work, but the athlete having taken some form of technological or medical short cut. In this way Murray articulates an intuition that many of us might have relayed at some point. Certainly, in interviews we conducted with talented young athletes some time ago (Bloodworth and McNamee, 2010), the claim that doping was an unethical short cut, and that using performance-enhancing drugs would result in a great deal of guilt on the part of the athlete was commonplace. Of course, those who dope and achieve success are not likely to be passive and lazy. The likelihood is that these athletes too work tremendously hard. At times Murray might have made this clearer. Yet this is not a concern for his overall thesis. The effects of doping substances and methods allow an improvement in performance, or are aimed at an improvement in performance, that cannot be attributed just to the hard training of the athlete, or to their natural talent.

Sport forces us to think about which ways of playing a game, or competing, that are integral to the sport and the talent and values it seeks to test, and which are not.

The distinction between treatment and enhancement has been an area of focus for those opposed to anti-doping policy. Rejecting the claim that we can make a moral distinction between the two leaves anti-doping policy in a precarious position. If we can’t distinguish morally between the use of such substances for treatment and use for enhancement purposes, the grounds for banning steroids and growth hormone seems problematic (see Morgan, 2009). Murray acknowledges the complexity of this issue in a manner that gets right to the heart of it, without extensive discussion of philosophical work in the area. Murray discusses the difficulty in line drawing here. He discusses the use of steroids to recover from an injury, and how difficult it might be to distinguish between this and steroid use to help recover from a very hard training session, with the attendant muscle damage that arises from this. Murray still thinks that it is important to retain such a distinction. There is no appeal here to particular conceptions of health or disease. Murray’s overall attempts to defend anti-doping are, as he argues later, dependent upon an understanding of the context in which methods and substances are used and the impact upon the value and meaning of sport. It’s not the drug itself that Murray objects to, and in his discussion of the legitimacy of therapeutic use exemptions Murray makes this clear. It’s how the use of such medical technology might threaten or damage those values that we admire in our elite sports people. Sport would no longer represent the test of athlete virtue reflected in their dedication and training, coupled with their natural talent.

Murray offers an insightful analysis of the role of technological innovations in sport and how sport as a test forces those involved to articulate their views on what sorts of enhancements are ethically permissible. Sport forces us to think about which ways of playing a game, or competing, that are integral to the sport and the talent and values it seeks to test, and which are not.  Some more detail, particularly with regard to the prohibited list might have been helpful here. Morgan (2009) for example has argued that certain methods, such as the use of growth hormone or anabolic steroids, used in restricted amounts, might be better understood as treatments rather than enhancements and not a threat to sport’s key values. A more detailed response to this sort of argument, perhaps with reference to a particular aspect of the prohibited list would have been welcome. Morgan’s (2009) argument that such methods would not compromise the sort of excellences sport is designed to test is at odds with Murray’s overall thesis. Murray’s focus is very much on the means via which elite level performance is attained. As the book progresses he expresses concern over how doping impacts upon the moral agency of the athlete. Being an elite athlete requires the exercise of certain virtues. Hard, monotonous training requires the sort of sacrifice and discipline that many of us admire. We also admire the patience required to hone certain technical skills. Indeed, in the context of treatment and enhancement, sport requires the careful management of one’s own body, being sensitive to when rest is required, and when to push things. All aspects of performance, suggests Murray, that ought to be admired, not medicalised.

In the final parts of the discussion on Therapeutic Use Exemptions (TUEs) Murray notes current difficulties in applying the TUE policy. He notes the potential for exploitation and of particular difficulties if some sort of performance enhancement is anticipated or possible were access to a drug on the prohibited list to be granted on medical grounds. WADA’s policy is clear that if there is a likely anticipated performance enhancement (beyond that of restoring the athlete to normal function) the TUE shouldn’t be granted. Pike (2018) has written recently on whether this clause is too restrictive and fails to reflect the limits of medicine in predicting performance gains in individuals. An extension to this chapter to deal with some of the intricacies of the TUE policy would have been most welcome, raising as it does, a range of conceptual and ethical issues.

In the middle part of the book Murray offers a discussion of classification in sport as a way of promoting a meaningful contest. He is broadly supportive of classification according to gender, and as I have said offers a very clear section on the foundations of the problems facing disability sport. The discussion of hyperandrogenism and International Association of Athletics Federations (IAAF) rules concerning this raises some interesting questions in light of Murray’s overall focus on sport as a test of natural performance. Having described the problem facing organisations such as the IAAF, Murray doesn’t make an overall argument as to what the policy response ought to be. He doesn’t spend that much time, however, on the claim that any possible advantage enjoyed by female athletes with higher testosterone levels might be reasonably interpreted as the sort of natural advantage sport is designed to test. This line of argument is acknowledged but responded to fairly firmly with concerns over whether competition between ‘women with and without hyperandrogenism can be meaningful and interesting’ (p. 99). Murray also suggests that we need to consider questions as to the meaning and values of sport to consider what the fairest thing to do here would be. A fair approach, suggests Murray, would allow talent and dedication to prevail. As Murray acknowledges, this is a difficult area to produce a policy response, and likely important values may well be affected whatever the solution proposed. It would have been worthwhile to further probe notions of meaning and interest here. Natural talents of an athlete, again coupled with their dedication, may well at certain points in history lead to dominant players or athletes. That need not render the competition less meaningful. Indeed, in many sports we have seen athletes find meaning in competing against other dominant competitors in their classification.

As Murray states, the book is not intended as an extensively referenced, highly theoretical account of why doping threatens central sporting values. Instead, with echoes of Sandel’s Case Against Perfection, it offers a flowing defence of anti-doping values grounded in examples designed to test and develop our intuitions on certain key questions. It achieves its key aims of clearly articulating a defence of anti-doping policy and of encouraging us to engage with central questions as to what we admire in elite athletes. It will be of general interest as these questions are so central to sport and its rules and regulations today.

Copyright © Andrew Bloodworth 2018

References

Bloodworth, A.J. and McNamee, M.J. (2010) ‘Clean Olympians? Doping and anti-doping: The views of talented young British athletes.’ International journal of drug policy, 21.4: 276-282.
Morgan, W.J. (2009) ‘Athletic perfection, performance-enhancing drugs, and the treatment-enhancement distinction.’ Journal of the Philosophy of Sport, 36.2: 162-181.
Pike, J. (2018) ‘Therapeutic use exemptions and the doctrine of double effect.’ Journal of the Philosophy of Sport, 45.1: 68-82.
Sandel, M.J. (2009) The case against perfection,Harvard University Press.
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