The Pennsylvania State University The Graduate School College of Health and Human Development FROM SCIENCE TO SPORT: A CROSS DISCIPLINARY EXAMINATION OF THE JUSTIFICATION FOR DOPING BANS A Dissertation in Kinesiology by John Gleaves 2011 John Gleaves Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy August 2011 The dissertation of John Gleaves was reviewed and approved* by the following: R. Scott Kretchmar Professor of Kinesiology Dissertation Advisor Chair of Committee Mark Dyreson Professor of Kinesiology Jim Pawelczyk Associate Professor of Kinesiology John Christman Professor of Philosophy Thomas Hunt Assistant Professor of Kinesiology University of Texas, Austin Special Member Karl M. Newell Professor of Kinesiology Head of the Department of Kinesiology *Signatures are on file in the Graduate School iii ABSTRACT In this dissertation, I will use a cross-disciplinary approach to evaluate the ethics of doping and performance enhancement in sport. I believe such an approach will help remove many myths and assumptions about the ethics of performance-enhancing substances (PESs) that have long stalled the debate. These myths emerged due largely to scholars misunderstanding or remaining unaware of research that existed beyond their individual ―silos‖ of expertise. Subsequently, one central question regarding the ethics of PESs remains unsatisfactorily answered: are sporting organizations justified to prohibit athletes from using PESs? This question will be at the center of my dissertation. Yet I will not offer any final conclusions about the permissibility of drugs in sport, either. Indeed, I do not believe there are any. What I will claim, instead, is that sporting communities have no necessary grounds for rejecting PESs. Yet contingent reasons may exist justifying their decision to prohibit or regulate athletes‘ PES use. In order to provide appropriate context for my later claims, my first two chapters will examine the historical development of the doping attitudes from their nascent stages to the death of Knud Enemark Jensen at the 1960 Rome Olympic Games. These chapters provide the necessary context for the modern PES debate by showing how significant cultural movements such as the fascination with doping horses for gambling, muscular Christianity, temperance movements, amateurism, and notions of public health helped shape today‘s anti-doping attitudes. Following, my third chapter will turn to modern PESs and the science behind them. This chapter will help establish certain facts about performance enhancement such as performance gains, mechanisms of action and health risks which are important in ethical decision making. These scientifically grounded conclusions will help dismiss many myths as well as shape subsequent evaluations of the arguments for and against prohibiting PESs. This evaluation will iv come in my fourth chapter, where I will thematically and critically review past literature discussing the ethics of banning PESs in sports. This review will show that little consensus exists regarding the justification for prohibiting PESs and new efforts towards understanding the ethics of PESs may be justified. In my final two chapters, I will use the cross-disciplinary evidence developed in the first half of my dissertation to establish new ways of viewing the PES debate. The first step, which I will address in chapter five, involves viewing the debate as two separate questions: what are the acceptable means for ―performance enhancement‖ and why should sports ban ―doping.‖ In my sixth chapter, I use the cross-disciplinary information to inform a more rational evaluation of PESs, arguing that performance enhancing substances may either improve or harm well- established sporting tests. This, I will argue, renders any ipso facto rejection of enhancement unwarranted if not also irrational. I end with an epilogue that cautions against hastily altering the pharmacological landscape as certain issues still remain at work. Despite such issues, I acknowledge that specific PESs may potentially improve certain sports by opening new avenues for enjoyment. Thus I do not conclude that all PESs are necessarily wrong, but that sporting organizations can justifiably choose to ban or regulate athletes‘ use of such technologies principally for reasons not typically advanced in the current PES literature. v TABLE OF CONTENTS Prologue ................................................................................................................................... 1 Chapter 1 ―Not for the Good of Sport:‖ The Rise of Anti-Doping Attitudes in Horse Racing, 1890-1911 ........................................................................................................... 7 Introduction ...................................................................................................................... 7 The Initial Rejection ......................................................................................................... 10 A Background Lesson ...................................................................................................... 16 Cracking Down on the ―Evils of Doping‖ ....................................................................... 20 Alone in its Efforts ........................................................................................................... 22 Another Victorian Compromise ....................................................................................... 24 Conclusion ....................................................................................................................... 27 Endnotes ........................................................................................................................... 30 Chapter 2 An Intellectual History of the Discourse on Performance Enhancement and Doping, 1889-1960 .......................................................................................................... 35 Introduction ...................................................................................................................... 35 Amateurism, Muscular Christianity, and an Emerging Anti-Doping Philosophy ........... 39 Drugs of Mass Destruction? Debates Over Doping, Public Health and the Science of Performance Enhancement ....................................................................................... 57 Conclusion ....................................................................................................................... 64 Endnotes ........................................................................................................................... 66 Chapter 3 The Science Behind Modern Performance Enhancement and Performance Enhancing Drugs .............................................................................................................. 73 Introduction ...................................................................................................................... 73 Increased Endurance through Oxygen Transport ............................................................. 76 Recombinant Human Erythropoietin (rhEPO) ......................................................... 77 Blood Transfusion .................................................................................................... 79 Altitude and Simulated Altitude ............................................................................... 81 Contextualizing Oxygen Transport .......................................................................... 82 Decreased Fatigue and Increased Focus: Stimulants ....................................................... 84 Caffeine .................................................................................................................... 85 Indirect Central Nervous System Stimulants ........................................................... 86 Modafinil .................................................................................................................. 87 Contextualizing Stimulants ...................................................................................... 88 Increased Muscle Strength: Anabolic-Androgenic Steroids, Testosterone, and Human Growth Hormone ......................................................................................... 89 Anabolic-Androgenic Steroids ................................................................................. 89 Human Growth Hormone ......................................................................................... 93 Creatine .................................................................................................................... 95 Anabolic β -agonists ................................................................................................. 96 Inhaled β2 Agonists .................................................................................................. 98 vi Contextualizing Strength Enhancers ........................................................................ 99 Psychological Enhancers: Beta-blockers and Alcohol ..................................................... 100 β-Antagonists ........................................................................................................... 101 Alcohol ..................................................................................................................... 102 Contextualizing Psychological Enhancement .......................................................... 103 Conclusion ......................................................................................................................