Genetic Enhancement in Sports

As the field of gene therapy progresses and its promise to become a widely available therapy progresses as well, so too does the potential for misapplication by professional and amateur athletes. For instance, erythropoietin, a protein hormone commonly used medically to increase hematocrit levels in patients with chronic renal disease, might be genetically engineered and used to increase endurance capabilities in athletes. Other examples include protein insulin-like and mechano growth factors, two important genes associated with muscle repair mechanisms used medically to treat muscle-wasting diseases. These two genes might be genetically engineered to boost muscle mass.

The World Anti-Doping Association (WADA) and the International Olympic Committee have both adopted a proactive attitude toward the issue of doping in sports. They have prospectively banned gene doping (or the non-therapeutic use of genetic technologies that have the capacity to enhance athletic performance) in the World Anti-Doping Code. The Code represents the first and most important document to harmonize international regulations and establish rules and policies concerning anti-doping in sports worldwide.

The notion of enhancement is the raison d'etre of doping in sports. The fundamental rationale supporting anti-doping policies is the preservation of what is intrinsically valuable about sports, that is, equality, fairness, integrity, and competition. Indeed, these four characteristics combined form the very spirit of sports. Sport technologies (including genetic ones) represent means to realize human interests and goals. Yet, the use of genetic modification technologies might challenge what we regard as valuable to our humanness. Indeed, the broader societal implications of gene doping are what make it unique with respect to other kinds of doping.

Diverse theories on the critical interpretation of athletic performance have emerged. The non-theory attempts to conceptualize how sports can serve as an efficient means toward external goals such as prestige and profit, and accordingly accepts any kind of sport technology as long as it serves the purpose of reaching the desired objectives. Hence, the use of genetic enhancement technologies by athletes should always be allowed provided their use is aimed at fulfilling such external goals. For the thin theory, the goal of sports is to challenge the performance potential of the human body in objective terms. Under this view, performance enhancement technologies are acceptable as long as there is equal access to them by all athletes. In contrast, the thick theory rejects any technology that does not seem to promote human values such as human self-development and flourishing, contribute to the value of sports, and respect for the individual athlete. This third theory calls for careful regulation on the use of technology in sports and accepts only technology that requires the athlete's effort and skills, under the condition of equality of opportunity; and finally, with the caveat that there are no unnecessary risks for harm. Consequently, the thick theory rejects the non-medical use of genetic enhancement technologies in sports.

Those who are in favor of enhancing human capacities and traits claim that enhancement is a worthy ideal, as evidenced by the general social commitment to education, medicine and welfare. For them, if the goal of genetic enhancement is the same as the (laudable) goal of overall or general (generic) enhancement, then the means of enhancement does not matter morally. Hence, using genetic technologies to enhance athletic performance represents only one end of the continuum, and constitutes an eloquent example of how the human being thrives to transcend biological limitations.

However, unregulated, unequal access to genetic enhancement in general, and in sports in particular, would create great risks for society, to say nothing of how it would exacerbate existing social divisions and inequalities. The use of these technologies in sports will not only diminish important societal values (e.g., equality of opportunity) but also those values we hold dear in sports. In the imposition of constraints on genetic enhancement in the realm of sports, a line must be drawn between acceptable forms of therapy and enhancement. I propose as an ethical guiding principle to limit the acceptance of genetic technologies to those that are solely for therapeutic purposes or that are medically prescribed. In addition, all genetic technologies that are performed in athletes with the sole intent of enhancement should be considered a doping violation.

Still, several questions remain regarding the prospect of gene doping. Should some gene-therapies, whose main purpose is to cure diseases and ailments but also have a secondary potential to improve athletic performance, be considered enhancements (and therefore "doping") as defined by WADA? How should a coherent ethical policy about the use of genetic technologies in sports, which could eventually serve as a model for other areas of genetic enhancement, be developed? What are the resulting effects of accepting or rejecting gene therapy on the acceptance (or rejection) of human enhancement in other areas? How should gene doping, given the special nature intrinsic to genetic information and the significant invasive nature of certain testing procedures, be detected?

Rosario Isasi, J.D., M.P.H., is an attorney specializing in health and human rights, particularly with regard to the new human genetic technologies. She is currently a Postdoctoral Fellow for the Centre de Recherche en Droit Public, Universite de Montreal. Isasi is an Affiliated Scholar with the Institute on Biotechnology and the Human Future.

Main Arguments Against the Use of Doping in Sports:

-   Coercion (lack of autonomy, violates ethical principle of respect for persons)
-   Perversion of the spirit of sports (against its nature and societal values)
-   Rule breaking (cheating, unfairness)
-   Harm (to users, clean athletes, society and sport)

International Policies:

1.   World Anti-Doping Agency. "World Anti-Doping Code," Montreal (2005).
2.   World Anti-Doping Agency. "The 2005 Prohibited List - International Standards,"
      Montreal (2005).
3.   Council of Europe. Anti-Doping Convention, Strasbourg (1989).
4.   Council of Europe. Additional Protocol to the Anti-Doping Convention, Warsaw, (2002).
5.   UNESCO. International Convention Against Doping in Sport, Paris (2005).
6.   The Copenhagen Declaration on Anti-Doping in Sport. World Conference on Doping in
      Sport, Copenhagen (2003).