Reframing the Debate over Performance-Enhancing Drugs: The Reasonable Athlete Argument

ABSTRACTTwo 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.KEYWORDS: Performance-enhancing drugsdopingfairnesscoercionsteroids AcknowledgmentsI am grateful to Cynthia Coe and Lou Matz for helpful comments on earlier drafts. The two reviewers for Sport, Ethics and Philosophy also provided valuable suggestions as I revised the article for publication.Disclosure StatementNo potential conflict of interest was reported by the author(s).Notes1. Some philosophers have questioned whether elite athletes are in fact fully free. For example, Murray (Citation1983), Fraleigh (Citation1985), and Holowchak (Citation2000) claim that they are coerced—forced to choose either to harm themselves, lower expectations, or quit the sport; and pressured by team owners and fans—and are thus not in control of their choices regarding PEDs. Brown (Citation1985a) and Veber (Citation2014) challenge that idea, claiming that the athlete’s situation is not coercive, or coercive enough, for them to be in need of protection against their own decisions. Saying that someone must do something dangerous to compete at the highest levels, such as the McTwist maneuver in skateboarding, is not coercive, and neither is the pressure to use PEDs (Veber Citation2014). Simon takes a middle view: although athletes are not coerced (Simon Citation1985, 8–10; Simon, Torres, and Hager Citation2015, 90–92), they are given an ‘unethically constrained choice’ either to risk harm in order to compete, to be noncompetitive, or to quit the sport (Simon, Torres, and Hager Citation2015, 92–95). Loland (Citation2009) agrees that, ‘in a situation with mature and rational athletes who can make free and informed choices of the use of technology, the argument about athletes’ vulnerability and exploitation seems without merit’. So, it seems like Loland wants them to choose for themselves. ‘However’, he adds, ‘such a scenario is unlikely to arise. Athletic performances are the result of many years and even decades of hard training from a young age, and few athletes have the necessary knowledge to make their own choices along the way’ (171). Apparently, elite athletes are so intellectually and morally stunted that they cannot be allowed to make important decisions for themselves, even if it only affects them.There is some truth in what Loland says. Most elite athletes begin training as children, so the norms of their sport are inculcated early on. Gymnasts, tennis players, swimmers, and many others are told by their parents and coaches at a young age that they should take whatever advantage they can to be more competitive and get ahead. This training undoubtedly affects an athlete’s decision-making, such that the choices they make as adults are not coerced but are not simply autonomous either. This raises the larger question of whether circumstantial moral luck undermines our capacity to be free, which is beyond the scope of this paper.2. The prevalence of doping in the elite athlete population is estimated to be as high as 57 percent, even with existing bans (Ulrich et al. Citation2018).3. Sean McKeever (Citation2017) calls this a ‘bad choice’ in his argument against PEDs. McKeever’s argument is similar to mine, although he focuses on the goods of the sport that the clean athlete is forced to forego—‘competitive success’ and ‘public admiration’ – which he says is unfair. According to my argument, clean athletes are being unfairly penalized by acting reasonably in protecting their health. My position emphasizes the choice itself and the harms to be avoided rather than the resulting distribution of ‘victory and laurels’.4. Contrary to Murray (Citation1983), Fraleigh (Citation1985), and Holowchak (Citation2000), I am not claiming that athletes would be harmed because, in a sport that allows doping, they would be coerced into using PEDs. My approach is the obverse of this argument. While their argument rests on the wrongness of a self-harming decision that is not fully free, my argument rests on the wrongness of the unfairness that results from a free act of self-protection.5. The moral question that I am addressing here is separate from the practical question of how to enforce rules against PEDs. Russell and Browne (Citation2018) seem singularly focused on the latter issue. But before we address that, we must first have a principled method of figuring out which rules to adopt, which is what the reasonable athlete argument attempts to provide.