Is It Time For a Flex Plan?
Techno-Athletes Change The Definition of Natural

By Joel Garreau
Washington Post Staff Writer
Wednesday, August 1, 2007

Some day soon -- maybe today -- we're going to have to admit it.

We have a new norm in sports. Athletes routinely are enhanced. Many of their achievements are as dependent on technology as they are on talent, dedication and spirit. The way their competitions are set up, they have little choice.

The old rules are increasingly untenable. Especially the one that goes: Enhancement is indistinguishable from cheating.

This is not just about Barry Bonds, who may break the all-time home-run record this week. Nor is it just about the Tour de France and its ejected riders. It's about Tiger Woods's laser surgery to improve his eyesight. It's also about even the legitimate Olympians. The exotic training and nutrition and astonishing genetic endowments of some render them scarcely recognizable as the same kind of human you see on the Metro.

Is it inevitable that there soon will be two kinds of leagues in baseball, basketball or football -- the Naturals and the Enhanced?

Competitive bodybuilding is far down that road, already splitting into two kinds of organizations -- the untested (anything goes) and the tested, according to Steve Downs, chairman of the World Natural Bodybuilding Federation, which emphasizes the word "natural."

Even in his league, though, the competitors are enhanced, Downs acknowledges. His magazine, Natural Bodybuilding and Fitness, is packed with ads for products like "Ripped: Body Building's Strongest Fat Burner," "AB-FX Transdermal Muscle Defining Complex" and "Maximum Strength Diuretic Xpel Extreme Muscle Defining Formula."

"There are good substances and bad ones," Downs says. Separating these is a constant debate, with no bright lines, only shifting, uncertain ones. The list of prohibited substances issued in 2007 by the World Anti-Doping Agency, the leading organization that monitors doping in sport, runs to 11 tightly packed pages.

Downs likes performance-enhancing substances that can be found in nature, as opposed to those synthesized in a lab. These include amino acids that he says help the pituitary gland secrete human growth hormone. The argument is: Taking testosterone, bad. Taking herbs that he says have been studied in Bulgaria and Australia that help the body raise its own testosterone levels: good.

Substances that come from Scottish pine tree bark: good. Similar substances synthesized in a lab: bad. These products both involved the creation of androstenedione, or "andro," a precursor that requires a chemical change in the body in order to promote testosterone production. Home-run slugger Mark McGwire was pilloried for using it in the late '90s, even though at that time it was an over-the-counter product not on Major League Baseball's list of banned substances. Andro is now banned by baseball and the Food and Drug Administration.

Downs says he retains medical consultants to consider the safety of various enhancements. But in his league he is the final arbiter of what is "natural" and what is not. His degree is in athletic management.

"What it's all about is setting limits," he says.

What about ocular implants -- artificial eyes that allow the blind to see by wiring tiny computer cameras directly into the retina? If special contact lenses specifically designed to help an athlete see the ball better are okay in sports, would athletes with safe bionic eyes be okay?

"That's a difficult one," Downs says. "There's a certain basic feeling that contact lenses would be something temporary, if somewhat performance-enhancing, beyond the normal scope.

"There's definitely some arbitrariness involved. In bodybuilding, it varies from league to league. We pride ourselves as the most strict. Yet muscle implants are not allowed. But breast enhancement is. It's not 100 percent natural. But it's more common" in the general population, he observes.

James J. Hughes sees such hair-splitting about what it means to cheat as pretty hopeless.

"In the ancient Olympics, the winners were taking all kinds of exotic medicines and herbal treatments. Eating raw bees. They were widely appreciated for that -- jumping higher, throwing the javelin farther." Hughes is a bioethicist and sociologist at Trinity College in Hartford, Conn., where he teaches health policy. He is also executive director of the Institute for Ethics and Emerging Technologies.

"This anxiety about athletes cheating with self-medication is a relatively recent phenomenon. It coincides with the professionalization of sports. To be truly superhuman in their capacities, people train 12-hour days, are hooked up to computers, have swimming gear" that costs hundreds of dollars. "That's natural -- everything else is unnatural. It's wildly inconsistent. There's a certain amount of double-think. If you have a cold, you take antihistamines to bring you up to your natural level of performance. But in sports, you would be taken out of competition," as some have.

"There's a lot of hype around the alleged harm that people do to themselves" with enhancements, Hughes says. "But in head-pounding sports, you face a lifetime of disability. In soccer, heading the ball often enough lowers your IQ. Sports can be bad for people. Why not outlaw boxing? Boxing is proven to be bad for you. It's not just that steroids are good or bad.

"How do you define who's cheating and who's not?" The dictionary defines it as "dealing dishonestly for one's own gain." But Hughes says, "It's purely a social construct. Is a fat cat who rips people off with his company a cheater? Is a welfare queen with three kids a cheater? Some think so, some don't.

"If you're living in a hyperbaric tent -- which is very expensive -- to compete with some Ethiopian, for me that's unfair competition. That's basically buying your way to success. But not all people see it that way."

There's an open question, of course -- is it worth the bother to even try to draw a line? Do fans care anymore about having sports heroes with integrity and honor and humility? Or do they just want to see amazing feats, and don't much care how they are achieved? Plenty of money is made selling tickets and television time to sports as it exists.

For Nick Bostrom, the lesson is, we should not create rules in sport regarding violations that may be undetectable and that cannot be enforced. "To do so would be to reward cheaters with unfair advantage," he says. Rules are fine as long as we can ensure openness and compliance. Bostrom is the director of the Oxford Future of Humanity Institute and a member of the philosophy faculty there.

"There is an arms race on between doping and detection. The winner will be the one who risks taking the most illicit drugs and gets away with it. The race is tothe luckiest cheaters."

He supports the idea of choosing goals. They could be "protecting athletes' health, making a sport more fun to play or watch, preserving valued traditions, setting salutary examples for the youth, or probing the limits of human performance -- with or without enhancements."

But then comes the sticky problem of how you accomplish this, as a practical matter, given our past and current failures. Bostrom comes down on the side of multiple leagues. "It is unlikely that one size will fit all. Just as we divide many sports into weight, age or sex classes, we might have different versions of the same sport that are more or less tolerant of doping."

This is wrongheaded, says Leon R. Kass, the renowned and highly literate scourge of human enhancement. He would draw the line in an entirely different place, one he says we crossed decades ago.

The avid White Sox fan acknowledges, "It is not obvious how biological enhancement differs from all these other ways they can improve their performance -- special shoes, lighter bats, better trainers."

The University of Chicago and Harvard-trained bioethicist is the former chairman and current member of the President's Council on Bioethics. In "Beyond Therapy: Biotechnology and the Pursuit of Happiness," he attacks modern sports' decades-old dilemma:

"The ironies of biotechnological enhancement of athletic performance should now be painfully clear. . . . We are choosing to become less than normally the source or the shapers of our own identity. . . . We take a pill or insert a gene that makes us into something we desire, yet only by seeming to compromise the self-directed path toward its attainment. . . .

"By using these agents to transform our bodies for the sake of better bodily performance, we mock the very excellence of our own individual embodiment that superior performance is meant to display."

Kass would take it back to the original ideals of the modern Olympics -- "the deed beautifully done, rather than a detachable performance that lives primarily as a gray statistic," as he puts it. He points to Roger Bannister, whom he knew slightly -- the breaker of the four-minute mile. "He did this by running on his lunch break with some of his friends. It was the idealization of the amateur. This was before sports became a really huge business."

How would he enforce a return to generations-old rules?

Shame.

"I think there is still a chance, at least in Major League Baseball, that the culture of the undoctored athlete could be reasserted by the players themselves, by simply shaming their teammates who are in a way betraying the game.

"What is shame? Shame is the experience that we feel when we are caught out in our actions that show the gap between what we would like to be and what we are. That's the way stigma and social shame work."

As human enhancement advances exponentially, it may seem odd that these issues showed up early on our sports pages. But it should not. Technology is usually first adopted wherever you see the most competition -- where small advances can have big consequences. That's why the other big arena in which human enhancement is being pursued most aggressively is the military.

That's why questions of what it means to be human could really explode if something dramatic were to occur in a sports venue. Suppose, for example, that in the 2008 Olympics, some athletes walk out with necks wider than their heads, and haunches like steers, and world records that normally are only broken by a tenth of a second start being broken by 20 seconds or more? Suppose these athletes pass their drug tests with flying colors, because the technologies they're employing are not drugs? Would that be a shock on the order of Sputnik, producing comparable fundamental reordering of society's priorities?

This is not to predict that such a thing will happen. It is simply to report that such technology -- known as "gene-doping" -- has existed in lab animals for years. At Johns Hopkins, in mice, it has yielded 61 percent increases in muscle mass with two treatments.

Another researcher, H. Lee Sweeney of the University of Pennsylvania, says that scarcely a day goes by that his lab doesn't get a call from an athlete or a coach interested in using gene-doping on humans.

So what are the rules?

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