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Abstract

This research paper explores the relationship between bioethics and sport ethics, which changed dramatically in the early 2000 when the genetics era generated a series of new questions about the ends of sport and how they would interface more widely with a range of bioethical principles. Focused largely on the nontherapeutic application of genetics to persons, the entry situates these debates within the context of discussions about the use of human enhancement and wider debates about transhumanism. It argues that concerns about the ethics of performance enhancement in sport have become more closely aligned with wider public health concerns, where doping should be seen as more than just a problem for elite sport. It also examines the overlap between technologies, which have further expanded the ﬁeld of bioethics into such areas as disability studies, where the case of Oscar Pistorius – as the ﬁrst prosthetically enabled Paralympian to compete within the Olympic Games – has been a prominent example of the overlap between biotechnology and biomechanical prosthesis.

Introduction

The applied ethical traditions of bioethics and sport ethics grew up in the 1970s, but largely without reference to one another. The foundation of the Philosophic Society for the Study of Sport (now the International Association for the Philosophy of Sport) by Paul Weiss in 1972 generated interest particularly around the ethical issues related to doping, which became a prominent topic throughout the 1980s. In part, this may be attributed to a number of high-proﬁle cases of athletes being caught using doping methods or substances, as in the case of Canada’s sprinter Ben Johnson, which revealed a culture of doping that was rife in athletics.

The social concern about the prominence of doping in sport, as a threat to crucial values and the image of sport, were important catalysts for debates about the ethics of doping among sport philosophers, where scholars interrogated the prima facie assumption that doping was wrong by drawing attention to the peculiar practices of sports, which operate with rules that are different from those that are implemented within society at large. Yet, even here, where the topic involved the application of medical substances to, arguably, nonmedical use, the points of connection between sport ethicists and bioethicists were few and far between. Sports ethicists – who came largely from kinesiology and physical education departments, with some roots in the philosophy of education or phenomenology, focused on the concepts of cheating, fair play, the body, and justice, arguing that sport provides unique examples where these ideas do not ﬁt with traditional interpretations.

Meanwhile, bioethicists focused on the ethics of science and medicine to approach the same subject. Around this early period, bioethics emerged as a distinct area of inquiry from medical ethics, with such institutions as The Hastings Center establishing new territory and expanding the remit of ethicists within scientiﬁc and medical research and practice. Indeed, The Hasting Center was a crucial point of interface within the history of bioethics and sport. In 1983, Thomas Murray, who would later become a key ﬁgure in the World Anti-Doping Agency’s ethical issues review panel, the US Anti-Doping Agency work, and President of The Hastings Center, described the “coercive power of drugs in sport,” arguing that “the use of performance enhancing drugs is ethically undesirable because it is coercive, has signiﬁcant potential for harm, and advances no social value” (Murray 1983, p. 30).

Soon after, Norman Fost (1986) developed his “skeptical view” on banning drugs from sport, but again, operating largely outside of the philosophy of sport community. Around this period, Murray was also more broadly active in articulating a number of other bioethical tensions within sports practice, such as the divided loyalties of an athletic team physician, who is under an ethical obligation to ensure the health of players is protected, while also will ﬁnd themselves expected to make players ﬁt for competition as effectively as possible, to attend to commercial pressures.

In the 1990s, sport was a key agenda item in The Hastings Center’s project on the “Prospect of Technologies Aimed at the Enhancement of Human Capacities” (Parens 1998). In this text, frequent Bibliography : to sport help to elucidate what it is about enhancement that people ﬁnd so alarming and which may reveal an inconsistency in moral reasoning about what sorts of things people ought to value. Discussions describe how enhancement can undermine the appreciation of human excellence or the intrinsic value of our practices, by short-circuiting the process one would typically be required to undertake when progressing from novice to expert. On this basis, scholars have described performance enhancement as cheating in at least two senses – cheating other competitors with whom a tacit contract to maintain certain rules had been made and cheating the activity, or undermining its value. Some authors even argued that sports doping contributes to human suffering by leaving our cultural pursuits more impoverished, thus extending the harm argument against the practice to broader social-psychological parameters. On such a view, sport is characterized as having value partly because it is subject to a particular kind of valued uncertainty, which is threatened by enhancement technologies since they reduce chance to bring about more predictable results.

The relationship between bioethics and sport ethics improved dramatically in the early 2000s when the genetics era provoked a series of new questions about the ends of sport and how they would interface more widely with a range of bioethical issues, focused largely on the nontherapeutic application of genetics to persons. These possibilities were reinforced by research, which suggested the possibility of characterizing performance genes, which would later give rise to speciﬁc genetic tests that claimed to identify propensity for speciﬁc capabilities in sport. In this sense, the crucial period in which bioethics and sport were brought together occurred at the beginning of the new millennium, and this period frames this entry on the relationship between bioethics and sport. These 15 years also reinforced the global nature of the problem of doping in sport and the need for sports industries to draw on bioethical investigations to achieve a more rigorous analysis of the ethics of doping. Around this time, the ethics of performance enhancement in sport became more closely aligned with wider public health concerns, where doping was seen as more than just an elite sport problem; it was also something people do to achieve a certain kind of physical ideal and identity, whether or not they played sport.

On this basis, there is value in focusing an analysis of the global bioethical issues related to sport on this period, during which a series of key concerns were identiﬁed by a range of scholars on both sides of the ethical terrain. From here, one may advance a framework for examining bioethical issues related to sport and ensure that analyses are future focused and engaged with other key trajectories that are shaping the range of bioethical issues confronting sports. The entry proceeds by exploring the common ethical ground between sport and bioethics, before looking more closely at genetics, as a lens through which a number of global bioethics issues can be identiﬁed. Arguably, questions around genetics underpin all future ethical issues faced by sports, particularly as it concerns bioethical questions, involving the tampering of an athlete’s biology through technological means and the possibility that this may have consequences for subsequent generations.

Sport In Bioethics

Over the last 15 years, bioethicists have made reference to sports within arguments about the teleology of science and medicine, particularly when inquiring into the proper role of medical practice, as a vehicle for promoting health and alleviating suffering that results from ill health, injury, or disease. For example, Chadwick (1987) uses sport as a basis for questioning the limits of health care, asking whether athletes – who take greater risks with their health than may be said of the general public – should be entitled to the same level of care as low risk-takers. In this sense, sport is discussed as an instance where one might locate limits to the role of medicine and, perhaps as a result, identify what might be the deﬁning parameters of medical interest and responsibility. This is a problem of wider interests to bioethicists, who are confronted with expanding demands in health care.

Closely allied to this is how sport is discussed within bioethics as an example of unethical medical intervention, where, for example, genetic modiﬁcation in sport would not be acceptable, since sport is too trivial an activity to require the use of such important and expensive technology, or that sporting modiﬁcations would lead to sameness and make sport uninteresting, since sport is the kind of activity that relies on creating differences. Alternatively, Ledley (1994) uses sport as an example of unethical genetic modiﬁcation, arguing that its use would not satisfy Rawls’ conditions of fairness, as it would further “inequalities in opportunity without a tangible prospect of beneﬁting those who remain at a disadvantage of furthering a state of equal basic liberties” (p. 161). Further examples of how bioethicists have drawn on sport are found in Juengst’s (1998) articulation of intrinsic value in sport, which is complimented by sport philosopher Morgan’s (1994) application of Alistair Mac Intyre’s articulations of sport ethics, where the practice of sport is deﬁned by the distinction between internal and external goods. Where technology seems to undermine the internal goods, by collapsing the distinction between the novice and the expert, this is where one may question the value of innovation, whether it is substances, methods, equipment, or knowledge.

Another crucial moment in the drawing together of bioethics and sport is through the wider debates around trans humanism and the use of technology to make people better than well. Transhumanism is a philosophical approach that is directed toward speciﬁc kinds of technology, frequently involving discussions about emerging sciences such as cryonics, nanotechnology, or artiﬁcial intelligence. It is broadly understood as a philosophy that locates at its heart the conviction that improving the human species through technology is valuable and various proponents of transhumanism have found themselves engaged with bioethicists, debating the merit of a technologically enhanced future. Outside of sport, transhumanism has engaged bioethicists, particularly those who seek to close down conversations about the use of medical and scientiﬁc resources for anything other than nontherapeutic purposes. The application of transhumanist thought to sport has also been a point of intersection between bioethics and sport.

Other conversations that became subsumed into this posthuman future for sport included the use of laser eye surgery by golfer Tiger Woods, the development of Tommy John’s surgery for baseball players, and the wider utilization of prosthetic devices that are increasingly rivaling the athletic capacities of their biological counterparts. From 2006–2012, there was extensive debate around the Paralympian Oscar Pistorius, who campaigned to be allowed to compete in the Beijing 2008 Olympic Games, not just the Paralympic Games. In this area, bioethics contributions expanded further to include specialists in disability studies (Wolbring 2008). Such ideas were part of a wider debate about a world where technology is changing what it means to be able bodied to such an extent that one may conclude that everybody may be understood as disabled and in need of enhancement. As a bilateral below-the-knee amputee, Pistorius’ 2007 campaign to compete in the Olympics – rather than just the Paralympics – was facilitated by the Cheetah legs he wears when sprinting. This innovation, and Pistorius’ capacity to make it a part of his body, speaks to the way in which traditional therapeutic interventions give rise to debates about what it means to be human and how one might judge differences between people. Pistorius claimed that he is enabled rather than disabled and he should be entitled to compete alongside so-called “able-bodied” athletes. The cases also created alarm for the manner in which they suggested a future wherein healthy people might choose to amputate limbs in order to enjoy the beneﬁts of more able prosthetics, a position which does not sit neatly with the ethics of medical intervention.

Thus, the focus on human enhancement within the bioethics and sport literature is underpinned by long-established tensions about what kinds of lives are worth living and what kinds of practices are possible to undertake in an ethically sound manner. If one takes an evolutionary perspective on our development of biotechnology, then one might consider enhancing evolution to be justiﬁed and valuable, and likely to ensure our ongoing ﬂourishing as a species. Alternatively, if one considers that our cognitive capabilities has led to our ability to disrupt evolution in a way that compromises fundamental principles that have ensured our survivability to date, then there are crucial considerations to be made before taking enhancement any further. For bioethics, questions about the proper role of medicine, the responsibilities of the health-care industries, the importance of promoting autonomy, the distinction between therapy and enhancement, and the practice of scientiﬁc research are all issues engaged by the sport case. Indeed, sport is an appealing subject to focus on, since it often involves testing these boundaries and the limits of technology. Furthermore, for sports, the human enhancement case helpfully focuses debate on the value of human lives in practical ways, asking us to consider what matters about the cultural practices people enjoy, what becomes of a world where people are required to undergo endless medical testing to ensure fairness and justice within society, and what may be wrong with manipulating biology.

These bioethical inquiries into sport are most extensively articulated through the subject of genetic technology which, since the turn of the millennium has mobilized bioethicists and sport ethicists, each of whom have sought to understand what may be valuable or alarming about a world where humans have the capacity to modify themselves genetically.

Genetics And Sport: A Unifying Subject

In 1998, New Scientist magazine published an article referencing research by Montgomery et al. (1998) that suggested the existence of performance genes, which may be possible to isolate – and perhaps modify – to promote speciﬁc athletic capacities. The article came at the beginning of the public hype of the Human Genome Project, which spawned countless debates about what brave new world would ensue from an era of human genome sequencing and possible modiﬁcation. By 2001, the International Olympic Committee had convened a working group looking at the possible abuse of gene therapy in sport, and in 2002, the World Anti-Doping Agency held a landmark meeting on gene doping, which was a crucial catalyst in the drawing together of expertise in sport ethics and bioethics.

One of the key determinants of this uniﬁcation was the realization that athletes might use genetic technologies to enhance their performances and, as a result, undermine the aspirations of the antidoping industry, which, by then, had become a worldwide pseudo-political movement. However, it is also reasonable to claim that genetic scientists were equally concerned about the misuse of genetic research that this would entail and its impact on the public perception of a science that was already controversial and communicating poorly with the public. The prominence of world-renowned genetic scientist Ted Friedmann, who was named the President of the American Society of Gene Therapy in 2005 and who became a key ﬁgure as Chair of WADA’s Gene Doping Expert Group, is indicative of this closer relationship between science and sport. Along with the prominent work of Lee Sweeney – also a member of WADA’s group – whose research into IGF-1 would engage the world’s media on its possible application to sport, the context for bringing bioethicists together with sport ethicists was ripe.

This focus was reinforced by the interventions of numerous bioethicists, whose foray into sport ethics issues – largely through discussions about genetic modiﬁcation – brought greater prominence to the issues and the relationships across practice ethics. The work of Michael Sandel, Bill Joy, Ronald Green, Andy Miah, Thomas Murray, Julian Savulescu, Soren Holm, John Harris, and later Michael McNamee, Claudio Tamburrini, Gregor Wolbring, Bengt Kayser, and Alexandre Mauron, went some way to bringing sport into the frame of interest within bioethics. It is as if the genetic enhancement topic became a catalyst for, especially, controversial bioethicists or philosophers to become engaged by the applications to sport, and the policy context within the sports industry was quickly being agitated by these prospects. The consequence of these discussions was the establishment of a new community of bioethical perspectives on the enhancement debate in sport.

By 2003, WADA had included a provision within its World Anti-Doping Code to ensure that gene doping was prohibited, before anyone had any idea about whether it was even possible. At the same time, various anti-doping authorities began to invest into genetics as a basis for nextgeneration doping detection, while also investing funds into bioethics work to establish the foundation for prohibiting its use, mostly focused on the doping-like applications of genetics, rather than the bigger implications that might ensue from germ line engineering. Moreover, some nations were beginning to experiment with genetic technologies, hoping for them to yield more effective ways of identifying talent, but even these applications of genetics were beginning to generate controversy, and so, nearly as quickly as they came about, a culture of silence ensued about such use.

These inquiries gained further political momentum via Francis Fukuyama’s varied contributions within the biopolitical sphere, along with the broader works of the US President’s Council on Bioethics, the latter of which considered the sport case as part of broader debates on the prospect of human enhancements. Fukuyama’s contribution to these discussions developed his End of History thesis from the mid-1980s, drawing attention to its failure to come to terms with the teleology of scientiﬁc development. Here, he argues that, because humanity has not yet seen the end game of the scientiﬁc method, one cannot fully account for the disruption to fundamental, normative structures within society that this will cause. In 2002, Fukuyama’s “Our Posthuman Future” articulated this imminent demise whereby the commercialization of lifestyle biotechnological modiﬁcations to humans would compromise a proposed human dignity that, for now, holds societies together. A good example of this may be the perception that the world is predicated on some sense of the distribution of goods through merit and where enhancements could completely collapse this normative structure. In this same period, Fukuyama’s work on the US President’s Council on Bioethics detailed how elite sports cultures would be among the ﬁrst – if not the ﬁrst – physical cultures to feel the impact of this scientiﬁc revolution. In short, athletes’ bodies were already marked for an imminent overhaul via biotechnology. These details function as a prologue to explaining how elite sports became the subject of extensive bioethical interest and debate, and as a result, they frame this entry’s articulation of a global bioethical framework around sport.

As mentioned earlier, a number of bioethical issues have been discussed through genetic technology, which, together, elucidates a bioethical framework for sport. For example, consider the story that concerned ﬁve British footballers, who planned to store the stem cells of their children to protect themselves (and their children), should they become injured during competition. In this situation, a number of complex issues arise that reﬂect the cultural context within which genetic technology has developed. First, the footballers’ intentions imply an acceptance of the legitimacy to harvest stem cells, which is not something that is universally shared. Second, the fathers presume an entitlement to utilize the cells of their children for their own means, rather than consider that these cells belong only to the child or, perhaps also to the mother. Third, the possibility of undertaking such a decision exists in a country where the industry of commercial stem cell storage exists, which is a possibility that is not available to all nations.

Establishing the ethical terrain of this case is undoubtedly a job that requires a bioethical framework, as there is little from the world of sports ethics that can contribute. This is not to say that sport ethicists are ill equipped to resolve such a matter, but simply that looking toward the ethical practice of sports does not shed much light on what ought to be permitted in this case. Justifying such use of genetic material on the basis of competitive advantage seems to fail to take into account the complex chain of ownership that lies behind this choice. After all, if one concludes the blood belongs to the child, then it is difﬁcult to achieve consent to its use. Yet, there are implications for sports, should such actions be permitted. After all, if such means are considered reasonable to promote recovery from injury, then the level playing ﬁeld argument within sports may require that sports involve themselves in promoting the harvesting of cord blood, so that all athletes have a better – and equal – chance of recovering at the same pace when suffering injury. This seems an incredibly unlikely scenario, and yet, the case reminds us that what takes place outside of sport has an impact on what kinds of values sports can uphold. If stem cell harvesting is widely used outside of sport and if its use can allow an athlete to transition from recovery to, perhaps, better than well performance, then it is hard to see how sports prohibit such use. Equally, if society permits germ line genetic enhancements, which have the consequence of creating enhanced offspring, then it is unlikely that the world of sport can do much to prevent this and, by implication, prohibit such people from participating in sport on the basis of some appeal to ethics or integrity.

The example also allows us to recognize that established ethical codes of conduct are not adequately constructed to accommodate a number of novel scientiﬁc applications. This need not mean that societies devise new ethical codes to take into account such beliefs, but it might require taking into account special sensitivities that arise because of the importance people give to genes. It might also imply revising ethical protocols, such as the consent process, to account for the different ways in which people make sense of genetic information. Arguably, this is why the importance of genetic counseling has been emphasized in a clinical context, as these sensitivities give rise to new obligations for the world of sport to address.

Ethics For The Genomic Era

Understanding how best to approach these questions involves looking back on how ethical theory has changed in a post-genomic era. In the context of medicine and technology, early approaches to bioethics and medical ethics focused on developing principles that could govern good practice, which dominated the rise of bioethics in the postwar period. Their four principles – autonomy, beneﬁcence, non-maleﬁcence, and justice – have shaped the development of ethical codes within modern medicine and science. In recent times, scholars have critiqued this top-down principlism, arguing that the lived reality of ethical conduct is much more complex and that ethical codes must be informed by these circumstances. Thus, a bottom-up approach to deriving ethical guidelines has also emerged, so-called casuistry (the study of cases). Today, a method of reﬂective equilibrium has become commonplace within applied ethical settings, which relies on a combination of the two approaches, while increasingly empirical research is informing the characterization of ethical dilemmas within the medical setting.

Another bioethical controversy that surrounds the use or development of genetic science in sport is the distinction between research and application. For example, the aforementioned Lee Sweeney’s research on insulin-like growth factor 1 (IGF-1) aspires to treat muscle-wasting diseases. Yet, Sweeney’s work has also been at the forefront of the gene doping debate – much more than the research might otherwise have been – in part due to his willingness to engage publicly on how the future of his work could be utilized (Barton-Davis et al. 1998).

There are many other genetic scientists whose work holds similar implications and this presents challenges for anti-doping policy makers. This is because the kind of developmental work that goes into medical research is highly protected until it is commercialized. Yet the capacity of the sports world to address illegal uses of such technology relies on early indications of the products that are likely to emerge on the market, to ensure it can develop robust anti-doping tests. In addition, the controversy surrounding gene doping has meant that experimental research surrounding genetics and exercise science has also met with skepticism within the policy community. As a result, the British Association for Exercise and Sport Science published a position statement arguing on behalf of genetic research in sport (Wackerhage et al. 2009). The authors assert that there are novel challenges presented by genetic science in sport, but that there should be encouragement to continue. For example, one of the difﬁculties with separating research from application is the unexpected knowledge that might derive from research, as time goes on. For example, they discuss how

…a polymorphism in the gene encoding the human bradykinin receptor B2 was shown to be associated not only with exercise-induced cardiac hypertrophy (Brull et al. 2001) but later that it also predicted coronary risk (Dhamrait et al. 2003). (ibid: 1113)

Genetic Information as an Ethical Guide Outside of sport, the use of genetic information is also taken very seriously, as its abuse may threaten the enjoyment of certain human rights. The apparent desire of employers or insurance companies to have access to genetic information, as a tool for limiting their economic risk, invites scrutiny due to its potential for discrimination. Moreover, the possibility of identifying speciﬁc genetic characteristics, coupled with the possibility of selecting in or out certain traits, may lead to considerable social pressure to undertake such decisions. Indeed, one might envisage that such choices become an integral part of what is deemed to be responsible practice in sport talent identiﬁcation.

Again, these circumstances reveal the broad societal concerns that orbit the use of genetic science in sport, while also reinforcing the importance of a bioethical approach to the sports technology problem. Genetic testing in sport has arisen in two prominent cases. The ﬁrst is outlined by the Australian Law Reform Commission (ALRC), which conducted the ﬁrst major investigation into the use of genetic information in sport. Here, they outline the case of the Professional Boxing and Combat Sports Board of Victoria, which discussed whether genetic testing could be used to help physicians advise (or better inform) the athlete about the level of risk in their competition. McCrory (2001) mentions a similar concern, explaining how “delayed cerebral oedema after minor head trauma” has been linked to “an abnormality with the CACNA1A calcium channel subunit gene” (p. 142). McCrory argues that these ﬁndings are important enough to require physicians to offer advice against participation in sports and even to require athletes to take genetic tests, where such risk exists. Moreover, the ALRC note that a “milder form of this condition can occur in players of rugby, soccer, and other sports associated with repetitive blows to the head” (section 38.29, p. 964). Yet, the Boxing Board decided against the use of such tests. A second case was of Ed Curry, basketball player for the Chicago Bulls team, who was required to undertake a genetic test after he had missed games due to an irregular heartbeat. Curry refused the test and transferred to the New York Knicks in 2005, a club that did not require him to take such a test.

The two examples highlight the complexity of maintaining bioethical principles – such as conﬁdentiality – in what are often high-proﬁle cases. Moreover, they highlight the legal uncertainty within the sports world over how to address claims from a range of parties over access to genetic information. Alongside these debates, a number of conversations have also taken place about the use of genetic information to make selection decisions on the basis of athletic potential, rather than liability of health risk. For some time, there was ambivalence about the legitimacy of such selection decisions when even the International Olympic Committee President Jacques Rogge reportedly indicated that there is nothing obviously unethical about reﬁning talent identiﬁcation techniques using genetic information.

However, the eventual realization of such testing has provoked sport leaders to revise their position on such use. This was most apparent in 2004, when the ﬁrst commercial test for a performance gene reached the market, called the ACTN3 Sports Performance Test™. It claimed to identify whether the user may be naturally geared toward sprint/power events or toward endurance sporting ability. Around the same time, Nature reported that an Australian rugby league team would experiment with genetic tests to improve their ability to train athletes and direct them toward success within competition (Dennis 2005). Soon after, WADA responded with its Stockholm Declaration, which “strongly discouraged” the use of such tests by sport organizations, especially to make selection decisions.

The use of genetic information reinforces the broader societal implications of the genetics issue in sport. Such concerns can involve extending the realm of parental autonomy, though in dramatically different ways. For prenatal selection decisions, it would involve presenting parents with decisions about what kind of embryo they bring into existence. Alternatively, in a postnatal setting, it can imply using a mouth swab to identify what sports children might excel in. The ethical and moral objections to such technology being used range from concerns about engendering an endless spiral of biotechnological competitiveness to anxieties that such selection decisions exhibit unjustiﬁed and inappropriate prejudices toward certain kind of people over others. Yet, these freedoms may also fall well within the accepted freedoms of parental liberty and so do not present such great harms as to require prohibition.

Practical Sport Ethics As Bioethical Test Cases

A number of practical bioethical questions also emerge from such prospects, which have yet to be resolved. For example, would athletes be required to undergo genetic screening to establish their genetic proﬁles before being allowed to compete in sports? Alternatively, in what ways could sport authorities and their stakeholders have access to the information derived from genetic tests to identify doping practices? How would genetic testing inﬂuence an athlete’s enjoyment of sport? If an athlete has an unusually favorable phenotype for a given sport, would this lead to their disqualiﬁcation from competition on the basis of their having an unfair advantage?

Where genetic testing is used to identify talent, concerns over discrimination are of a different character. Here, the concern is that the testing method may not be an adequate indicator of performance potential. Indeed, the complexity of sports is such that making absolute judgments about what characteristics will ensure or even increase the probability of success is difﬁcult. For example, one may reasonably argue that extreme shortness (or extreme height) prevents an individual from performing the required skills of many sports. As such, by claiming that height is a relevant characteristic of sporting performance, one may then claim that genetic tests could be used to justify why short children are not selected in an elite training program. Yet, this conclusion is insufﬁcient, since there are many people who may welcome the chance to become an elite athlete, but for whom there is no opportunity due to the tests. Indeed, such arguments could be made in relation to a number of disabilities, for which it would be unreasonable to claim that such aspirations do not deserve support.

Thus, clearly there is a sense in which sport depends on providing opportunities for different kinds of people. Moreover, it seems preferable to adapt the structures in sport to allow the possibility of such people to pursue elite competition, rather than to endorse a system, which excludes certain kinds of people from participating. If this additional commitment requires creating greater divisions within sports, then this should be the responsibility of sport federations, since the value of sport depends on inclusivity. An additional complication in the context of sport is taking into account the life course of athletes, where participation in sport often starts at a very young age. This has a speciﬁc bearing upon the use of such testing and selection in children since a child may enjoy many years as a competitive athlete, before reaching a point where genetic factors limit competitiveness at an adult level. Consider a young basketball player who is destined to be 165 cm tall, who may enjoy being an excellent player until his peers have undergone their ﬁnal growth spurts. The value a child may accrue from these experiences is clearly sacriﬁced, were a genetic test to be used early in life reveal that his eventual height would likely limit competitiveness in adulthood.

If discussions about genetic information reﬂect the present-day use of genetic information, conversations about gene transfer in sport are its future. These debates have been dominated by the prospect of gene doping, the use of gene transfer for nontherapeutic or enhancing purposes. A range of institutions take this prospect seriously and include WADA, the American Association for the Advancement of Science, the US President’s Council on Bioethics, and the British Government (House of Commons 2007). A number of philosophical and ethical issues surround the debate on gene transfer in sport. On a philosophical level, there is a need to distinguish between types of therapy and non-therapy. For example, while the WADA Code accepts the use of gene transfer for therapeutic use, it is unclear whether the distinction between therapy and enhancement can be sustained in the long term. Thus, insofar as genetic disorders are often linked to age-related diseases – such as muscular depletion – it might be medically desirable to “enhance” people in order to maintain a reasonable level of health. Moreover, it might appear that individuals must be treated with gene transfer well before they are symptomatic, that is, when they are considered healthy. These prospects are receiving careful consideration from a range of governments around the world. As noted in the introduction, the US President’s Council on Bioethics discussed this prospect in the context of sport and identiﬁed no clear consensus on what should follow in policy terms. In addition, the British House of Commons (2007) investigation into human enhancement technologies in sport also reinforced the likely expansion of such modiﬁcations in society.

Ethically, the recurrent questions are about how such technology would affect equality in sport and broader notions of justice. WADA’s approach to any new technology is to identify whether it engages two of the three of its criteria: performance enhancing, risky to health, and against the spirit of sport. If two conditions are engaged, then it will consider prohibition. While the use of gene transfer remains highly experimental, it may give rise to forms of performance enhancement that are safer than current methods that rely on synthetic substances – often from an illegal black market. On this basis, there might be good reason to promote these healthier modes of human enhancement in order to diminish the illegal trade of substances that currently overshadows elite sports. Moreover, through the utilization of biomarkers and DNA passports, there might be a greater potential to monitor the detrimental health risks that an athlete could face through such modiﬁcations. These arguments are part of broader perspectives that argue on behalf of human enhancement in sport, which have gained prominence in recent years.

Conclusion

Within sports, the bioethical debate about human enhancement is conﬁgured in different ways, compared with their use more generally. While many interventions still require the approval of medical authority and, thus, are still subject to medical ethics, there are crucial differences. First, the pursuit of performance enhancements is central to the logic of elite sport competitions, where the importance of winning is paramount for many reasons. The cultural and global ediﬁce of elite sport undoubtedly places great emphasis upon the ability to demonstrably excel. As such, opportunities to enhance performance are central to the praxis of elite competitions.

Perhaps the only limiting factor for the full pursuit of transhuman enhancements is the aspiration to ensure fairness within competition, another of sport’s central values. Yet, in response, one might conclude that sport authorities should legitimize a greater number of performance modiﬁers, thus making them legal and silencing those who argue against such enhancements on the basis of fairness or concerns about cheating. Athletes engage in highly sophisticated forms of training and use various kinds of legal, transhuman technologies to adapt to and cope with different environmental demands, such as the physical stress of swinging a tennis racquet on the shoulder. Indeed, the Olympic motto reads as Citius, Altius, Fortius – Faster, Higher, Stronger – which perpetuates the transhuman values under discussion. Moreover, to the extent that it is becoming increasingly difﬁcult to achieve greater levels of performance without new technology, this is further reason to pursue such modiﬁcations. Indeed, athletes must be allowed to discover new means of performance enhancement to take sport performances to new levels. In turn, this will require the acceptance of many technologies that are considered, outside of sport, to be ethically problematic for medical professions to accept. To help sports get to this position in a safe and ethical manner, there may be a need for something like a World Pro-Doping Agency to complement the World Anti-Doping Agency, the responsibility of which is to discover and invest into developing safer forms of athletic enhancement.

The fact that there is an apparent moral community that is opposed to certain forms of performance enhancements, such as steroids or other doping technologies, does not discount the fact that sports are awash with many forms of legal enhancement. Indeed, the technological status of sports is self-evident, with many kinds of sports equipment accepted that have transformed athletic performance. Furthermore, the degree of sophistication that sport equipment describes speaks to technology that will soon become indistinguishable from the athlete’s body. Consider again what might come after the enabling technology of Oscar Pistorius’ prostheses. Conceivably, future athletes will pursue elective surgical interventions to achieve other enhancements, such as invasive leg extensions. Indeed, this already takes place outside of sports. At the very least, it is probable that injured athletes would opt for enhanced prosthesis, rather than to just seek repair to a level of normal functioning. Such athletes may then return to competitive sport, putting themselves at an advantage over their biological counterparts. In this world, both bioethics and sport ethics are key to resolving not only what is just but also what is important about the means by which people achieve certain goals and the range of people who are involved in bringing them about. Undoubtedly, the future of human enhancements in sport is characterized by the greater involvement of scientists, suggesting that future winners will be attributed much more to the athlete’s entourage. However, neither bioethics nor sport ethics has adequately shown that this will be a less engaging form of human competition, and one view of present-day sports is that it is already a competition among scientists and technologists. Furthermore, a world where the 100 m sprint is won in 5 s may attract even more television viewers than it does presently, and the increased popularity of prosthetic ally enhanced Paralympic sport may be indicative of such interests and the worth of such pursuits.

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