Point/Counterpoint: Allow Drugs in Sports

These point/counterpoint essays are part of a live public policy debate series in New York City called Intelligence Squared U.S., which is an initiative of The Rosenkranz Foundation.

For more information and to listen to past debates, go to www.iq2US.org

Since the beginning of recorded history, competitive athletes have tried to enhance their performance in every way imaginable. Naked Greeks put on shoes. Babylonians used herbs. Kenyans trained at high altitude. American swimmers used greasy swimsuits. Marathoners loaded their bodies with carbohydrates. But none of these enhancing technologies has created the hysteria surrounding anabolic steroids and human growth hormone (HGH).

What are the claims of those who would condemn elite athletes or send them to prison for trying to maximize their performance? The simple answer is that they are breaking the rules, or in some cases, the law. But the rules depend on arguments or claims that are morally incoherent, hypocritical, or based on ice-cold wrong information.

Critics assert that athletes who use performance-enhancing drugs have an unfair advantage. But an advantage is only unfair if it is not equally available. This is usually solved by equalizing access, not by prohibition. The hypocrisy is everywhere. The same year Ben Johnson was vilified for using drugs that were by all accounts widely available, Janet Evans, the American swimmer, boasted about the greasy swimsuits that the Americans had kept secret from their competitors. Bud Selig, the commissioner of baseball, preaches about a level playing field but tolerates a system in which the Yankees spend two to four times as much as all but a few competitors.

Critics assert that steroids and HGH cause life-threatening harm, but the claims are wildly exaggerated or simply made up. Lyle Alzado, Exhibit A for the perils of steroids, died of a brain tumor, but there is not a single medical source showing any association between his tumor and steroids. We are told repeatedly that steroids cause heart disease and strokes but it is hard to identify a single elite athlete who suffered either calamity while using steroids. HGH has been given to half a million children for decades and there is little evidence of any serious harm. In fact, the major risk of these drugs is caused by the policies of driving them underground, manufactured in unknown conditions with no oversight by regulatory agencies, and no possibility of careful studies to assess the benefits and risks.

Norman Fost, M.D., M.P.H., is professor of pediatrics and bioethics at the University of Wisconsin, and director of the Bioethics Program which he founded in 1973. He has published widely on ethical and legal issues in health care, and served on numerous federal committees, including President Clinton's Health Care Task Force, and from 1994-1998 was an elected member of the Princeton University Board of Trustees.

The selective paternalism behind the ban on steroids would not be tolerated in other walks of life. More athletes have died playing professional baseball than from using steroids, and the deaths related to playing football are 10-100 times higher than those from steroids, but the games go on. We allow competent adults to take on life threatening risks from construction, police work, or joining the army, where the prospects of death are dramatically higher than even the inflated claims about steroids.

Critics assert that steroids and HGH are unnatural, but there is not an elite athlete anywhere who competes without unnatural assistance, nor is it coherent to argue that eating natural potatoes out of the ground is morally superior to carbo-loading from factory made pasta.

Critics assert that performance-enhancing drugs undermine the support of fans, but attendance at major league baseball games has never been higher than in what is widely known as the steroid era, and Barry Bonds, the perfect villain, is the greatest attraction in sports in the past decade. Mark McGwire and Sammy Sosa are widely considered to have "saved" baseball following an embarrassing strike, and McGwire admitted at the time to using androstenedione, a steroid precursor, for the explicit purpose of enhancing his performance.

Devotees bemoan the loss of credibility in new records enhanced by drugs. But contemporary records cannot be compared to previous accomplishments for many reasons unrelated to drugs. In baseball, the fences are shorter, the pitching mound is lower, the ball is said to be livelier, the strike zone has changed, and some games are played at a mile high stadium. By one calculation, if Babe Ruth played in today's stadiums, his home run total would have been closer to 1,000 than the mere 700+ achieved by Henry Aaron and Barry Bonds.

Enhancing performance is a universal goal and behavior. The most valuable service a pediatrician provides is the enhancement of the immune system of perfectly normal children. Others rely on coffee, cars, or computers to achieve life goals. If there is something immoral about any of this, sufficient to justify the witch-hunt that characterizes the current situation, the argument has yet to be made.

Norman Fost, M.D., M.P.H., is professor of pediatrics and bioethics at the University of Wisconsin, and director of the Bioethics Program which he founded in 1973. He has published widely on ethical and legal issues in health care, and served on numerous federal committees, including President Clinton's Health Care Task Force, and from 1994-1998 was an elected member of the Princeton University Board of Trustees.