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Doping problem isn't that cut and dried

Outrage over steroids doesn't help create good policies

Sports doping has now entered the pantheon of modern monsters, along with bird flu and mold. It's another vague, creeping, futuristic ill with no clear origin or cure. We don't even know how afraid of it we should be. All we know is that we want to punish Jason Giambi and Barry Bonds for it.

We have a picture of what natural athletes should look like in our minds, and they shouldn't look like a Macy's Day Parade balloon with a human face. It's viscerally upsetting to look at photos of Giambi and Bonds, next to stories detailing their admissions of steroid use before a grand jury. They're the image of our swollen, exploding times, their grossly distended and fatly egregious necks spilling over collars that won't button properly.

But visceral outrage is not a basis for making policy. We will now proceed to hurl Giambi and Bonds into the blender of Bad People in Sports, but while that's satisfying to our mob mentality, it doesn't help anything. We have to sort out our repulsions and the other complexities of feeling provoked by Bonds and Giambi, because we have to ask some questions no one is asking about doping. Otherwise, we'll never solve it.

And we had better solve it because something far more morally challenging than steroids is coming, and it's called gene therapy. One day sooner rather than later, doctors will be able to significantly change human physiology in a lasting way. Already researchers in a Pennsylvania lab have created muscled "mighty mice" — and already they have had overtures from athletes and trainers wanting to know more about it.

We should start with this question: What do we really mean by the "performance enhancement" and where do we draw the line between noble striving and dirty immoral striving?

For example, why is it that when athletes take nutritional supplements it's considered dedicated training, but taking something synthetic is considered cheating? What's the difference between using a steroid to build muscles to hit a baseball farther — and using fiberglass poles in the pole vault? Why do we vilify one and call the other progress? Aren't they both performance enhancing? Aren't they both synthetic?

Doping is a vast, subtle, and multifaceted problem that contains thousands of substances, each of them with different implications about health, law, ethics and science. But instead of hammering out terms and definitions, we tend to discuss doping with a capital D as a large, single problem with a single answer. Too few people are willing to do thorough, difficult philosophical thinking because it's such an exhausting and sometimes ambiguous topic.

One person who's attempting to do so is Thomas Murray, president of the Hastings Center, a nonpartisan research institute that explores emerging questions in bioethics, and the chair of an ethics advisory panel for the World Anti-Doping Agency. Murray regularly forces himself to stare hard at indistinct subjects, and to split hairs no one else wants to examine. I called and asked if I was right to have some nagging questions in the periphery of my brain, or if I'm just another weak-minded moral equivocator. He responded that there are plenty of questions to be asked. "There've been many missteps in the effort to control substance abuse, and it's difficult to think clearly about it," he says.

"You have to think about each of the ways in which people are trying to enhance," adds Murray. "And the question you have to put to each of the technologies is, does this make the sport admirable or beautiful, is it neutral, or does it in fact in some ways amplify, or does it diminish the sport?"

The answer isn't always clear, at least not to me. Why are blood transfusions illegal in cycling and yet altitude training, which has a similar effect and may also be health-hazardous, is not? Caffeine was once banned as a performance enhancer. It no longer is. Why? Because scientists decided it was actually performance diminishing. Ephedra. It's an herb. It apparently killed pitcher Steve Bechler at the age of 23. A Rand Corporation study of Ephedra concluded that there's no scientific proof it enhances the performance of athletes. There is simply not enough evidence on the subject. So what do we do with it?

Is there an ethical distinction between an anabolic steroid and EPO? While a steroid has some benefit in and of itself, it enhances performance because it allows an athlete to work harder. He or she can spend more time in the weight room, lifting heavier weights, and recover faster, but the athlete still has to do the work. EPO, on the other hand, acts to enhance the creation of red blood cells whether the athlete does anything or not. Is one worse than the other?

Is our chief interest in banning a substance that it potentially distorts a game, or is our chief interest the health of athletes? Or both?

To make matters more confusing, "the scientific evidence is not crystal clear" on some so-called performance enhancers, Murray says. To this day we don't know a great deal about the side effects of steroids. "For one thing, it would be immoral to conduct a well-controlled study where you administer steroids," says Murray. "So that it makes it tough to get reliable info."

Instead, we have to rely on what Murray calls "second best methods" to study doping questions. Which means that we are judging and penalizing athletes based on these second best methods, too. And perhaps using some dicey testing methods to boot.

Which brings us to this question: Why do we reserve our harshest judgment and punishment, sometimes lifetime bans, for athletes when in most cases the athlete is just the pressured human result of a whole system of coaches, trainers, scientists and others who are creating new drugs and urging their use?

What should we do about the athlete who may have doped for awhile and then repented, and is now clean? Or the athlete who took a substance unknowingly, as Bonds apparently contends? What about athletes who play in the pharmacological gray zone, using borderline substances because they're trying to compete with aggressive cheaters? Do we prosecute athletes retroactively for substances that aren't strictly illegal but may be declared so in the future, when we don't prosecute people who drank liquor at 18 before we raised the drinking age to 21?

Athletes explore physical extremes, that's what they do. They're in the business of extracting every last particle of effort and excellence from their bodies. To talk to them about the dangers of performance enhancement is to naively employ what Murray calls "the you'll put-your-eye-out argument." It doesn't deter a 10-year-old from playing with a BB guns to tell them they could get hurt. So you think a football player who gets hit by 300-pound linemen is going to decline to take a steroid because it might injure his health? Or a downhill skier? "You want to tell someone who straps boards to his feet and goes down a mountain at 70 mph, that you might hurt yourself?" Murray says. "That's called paternalism. And for young athletes it has no moral force."

Here's another reason our anti-doping righteousness lacks moral force: We will proceed to vilify Giambi and Bonds, but we certainly bought tickets to their home run races. We've been going to the ballpark in record numbers. We crave excellence, applaud achievement, and we disparage athletes, even in Little League, who don't seem to pursue excellence remorselessly as lazy or undedicated. But when someone pulls back the curtain and reveals how these things were achieved, we're alternately confused, repulsed, or angry. In a word, we're unclear. And with gene therapy on the horizon, it's only going to get more hazy.

"It's really about the meaning we attach to sports," Murray says. "I foresee two possible future worlds for athletes. One is a future absolutely dominated by what I call the 'performance principle.' The idea that you wring every last possible fraction of performance out of an athlete by any and all means available. The alternative future and the one I still have hope for, but don't underestimate the difficulty of preserving, is one where we still find meaning in great performances as an alchemy of two factors, natural talents or abilities, and virtues."

He's not at all sure how it will turn out.