UNPACKING THE CLAIMS
Fost, MD, MPH, is professor of pediatrics and bioethics, director
of the Program in Medical Ethics, head of the Child Protection
Team and works as a general pediatrician at the University of
such as, "Using anabolic steroids for performance enhancement
in sports is immoral," or "Iraq has weapons of mass
destruction," seem to be so clearly true that reliable
evidence (in the latter case), or coherent arguments (in the
former) aren't considered necessary to justify coercive action.
long campaign to demonize and prohibit the use of anabolic steroids
in sports -- in the press, by the Congress, and by the offices
of the leaders of sports -- has been so strident and one-sided
that a literate person would have little reason to suspect there
is another side to the story.
it is the business of ethics to present justifications for actions,
and the claims that have been made for prohibiting the use of
anabolic steroids by competent adults appear to be incoherent,
disingenuous, hypocritical, and based on bad facts. Let's look
at the common claims.
Steroids result in unfair competition.
Anabolic steroids clearly do enhance performance for many athletes,
but there is no coherent argument to support the view that enhancing
performance is unfair. If it were, we should ban coaching and
training. Competition can be unfair if there is unequal access
to such enhancements, but equal access can be achieved more
predictably by deregulation than by prohibition. It is hypocritical
for leaders in major league baseball to trumpet their concern
about fair competition in a league that allows one team (the
Yankees) to have a payroll 3 times larger than most of its competitors.
egregious example of this hypocrisy was the juxtaposition in
the 1988 Olympics of Ben Johnson and Janet Evans. Johnson broke
the world record for the 100-meter dash and not only had his
gold medal taken away but became the permanent poster child
for the immorality of steroids, which, though illegal, were
available to virtually anyone who wanted them. Evans, after
winning her medal in swimming, bragged about the key role of
her greasy swimsuit, which the Americans had kept secret from
their competitors, and went on a prolonged lecture tour as "America's
Steroids are coercive: if your opponents use them, you have
"Coercion," according to my dictionary, has to do
with the use or threat of force, or the threat of depriving
someone of something he or she is entitled to. No one in American
sports is forced to use steroids. Nor is anyone entitled to
be a professional athlete. It's an opportunity, often involving
high risks, which everyone is free to walk away from.
is it the case that you have to use steroids to succeed at the
highest level. In the first year that Major League Baseball
required anonymous testing, solely to determine the incidence
of steroid use as a guide to development of policy, fewer than
6 percent of the players had positive tests.
Steroids cause life-threatening harms.
Good ethics starts with good facts, and the claims on this point
are, to understate the case, seriously overstated. Articles
abound in the mass media on the life-threatening risks of anabolic
steroids: cancer, heart disease, stroke, and so on. What is
missing are peer-reviewed articles in scientific journals to
support the claims. Quick: name an athlete who died, or was
diagnosed, with steroid-related cancer, heart disease, or stroke.
Cases are so hard to find that the prohibitionists have to make
them up. So Lyle Alzado, the NFL all-star, is presented on the
front page of the New York Times and the cover of Sports Illustrated
because of an alleged steroid-related brain tumor. What is missing
is a single article, or evidence, or even a quote from any authority
on the topic to support any connection between steroids and
course, even if steroids did have these dire effects, it wouldn't
follow that a competent adult should be prohibited from assuming
those risks in exchange for the possible benefits. We allow
adults to do things that are far riskier than even the most
extreme claims about steroids, such as race car driving, and
even playing football. There are far more deaths reported from
the sport itself than from steroids. Why are the paternalists
not using these data to ban the sport? The claim by the leader
of the National Hockey League that they test for steroids because
they're concerned about the health and safety of the players
is, well, hysterical.
Steroids are unnatural, and undermine the essence of sport.
This claim seems predicated on the notion that there is some
essence of sports. Sports are games, invented by humans, with
arbitrary rules that are constantly changing. Since the beginning
of recorded history, athletes have used an infinite variety
of unnatural assists to enhance performance, from springy shoes
to greasy swimsuits, bamboo poles to better bats, and endless
chemicals from carb-filled diets to Gatorade drinks. Should
vaulting poles be banned because they undermine the essence
of the high jump? Why is there not a ban on training in high
altitudes, or sleeping in a hypobaric chamber, for the purpose
of raising hemoglobin to unnatural levels?
Steroids undermine the integrity of records.
Of all the proposed punishments for Rafael Palmeiro, the Baltimore
Oriole slugger who was reported to have tested positive for
steroids shortly after he testified under oath to a Senate committee
that he had never used them, the favorite seemed to be to abolish
his home run records. The implicit concern is that Babe Ruth
or Roger Maris is being unfairly deprived of his place in history.
But steroids are only one of many reasons why the old records
keep falling. The fences are shorter, the pitching mound is
lower, the ball is reputedly livelier, the strike zone keeps
changing, and so on. The left field fence in Jacobs Field is
more than 100 feet closer than it was in Municipal Stadium when
it opened in the 1930s, so let's have some asterisks for home
runs at "The Jake" and every other stadium with shortened
Fans will lose interest.
It isn't clear what the moral issue is here, other than the
possible dishonesty of the claim. It's pretty clear that the
biggest draws in the sport over the past 10 years have been
Barry Bonds, Sammy Sosa, and Mark McGwire, all suspected of
steroid use and, in McGwire's case, a confessed user of the
now-banned androstenedione. Chicks and guys love the long ball,
and the steroid era has been accompanied by record-setting attendance.
It's bad role modeling for kids.
I'm against steroid use by children and favor harsh penalties
for suppliers, but I'm more concerned about tobacco and alcohol
use, which account for approximately 500 000 more deaths per
year than steroids, most traceable to behaviors that begin in
childhood. Baseball is presided over by the former owner of
the Milwaukee Brewers, who play in Miller Park, where beer is
consumed in prodigious quantities. President Bush and various
senators are outraged at the message sent by steroid use, but
have little or nothing to say about athletes arrested for drunk
driving with little punishment from the leagues, or the larger
number found guilty of sexual assault and battery. What message
does that send to the kids? And battery is not confined to off-hours
behavior. Professional hockey promotes illegal violence and
infliction of injury, and it is taught in the junior leagues.
Professional football glorifies hurting your opponents.
aren't good for kids, but there's something fishy going on when
the number of articles and congressional hearings about protecting
our children are inversely proportional to the seriousness of
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Norman Fost, you are a nihilist and a disgrace. Do you not
see how intense competition, without any ethical standards
and sense of proportion, escalates into something totally
destructive for all involved including innocent bystanders?
And you are a professor of Medical Ethics?
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