The medicalization of sports is nothing new; drugs such as EPO that treat anemia in cancer patients and significantly boost red blood cell counts have been common place in distance events since the early 90’s and the desire to be faster, higher and stronger seems well entrenched in the human psyche. However inadequate the science, politics and organisation of implementing current anti-doping efforts are perceived to be, a full revolution will likely be needed in the coming years if the system is not to collapse completely.
Advances in medicine are such that an era of gene doping is likely imminent, if not already underway. Medicines and therapies that genetically instruct the body to produce more EPO are already in testing – ranging from ingestible pills to gene therapy. If such methods avoid the common drug testing routine of looking for foreign substances in blood and urine, then whole new scientific paradigms will need to be employed by the testers, and probably at great cost.
It is likely that wearables or ingestible technologies could evolve to become a more reliable and constant real-time test for conventional drugs and doping techniques, and allied to big data and predictive analytics indicate a range of predicted performances given certain parameters. Beyond this, could genetic passports – similar to, but more advanced than today’s biological passports – be needed?
Some advances will even lead to some questioning what exactly constitutes doping – ‘…electroactive polymers (EAPs) bend and stretch like real muscle fiber in response to an electrical charge; clothing woven with EAPs might augment an athlete’s muscle power,’ says Yoseph Bar-Cohen, a physicist at NASA’s Jet Propulsion Lab[i].
Beyond gene doping lies the possibility of shifting the playing field before a baby is even born. Embryo selection and IVF could enable us to eliminate many genetic diseases, extend healthy lifespans, and enhance people’s overall well-being in the coming decades. Indeed, some have predicted that by 2040, the majority of babies will be created rather than conceived[ii]. Even if the prediction of a majority falls flat, it would seem likely that a future Olympic champion will have had the benefit of superior gene-selection and enhancement without ever having the need to dope in the conventional sense, yet benefit from many of the characteristics that various doping products create.
This creates fundamental questions for sport going forward; what will it mean to be an athlete, what constitutes doping, how do you level a playing field for athletes that is increasingly uneven (assuming these techniques cost a lot of money) and how do you monitor and verify such advancements? Will we be happy, on a philosophical level, to watch the spectacle of sport devolve further into a medical arms-race?
There can be little doubt that the type of medicines, techniques and procedures mentioned will provide a net benefit to humanity and to wellbeing, but the unintended (and in some cases very much intended) side effects will completely rewrite the rules governing a $145 billion global industry[iii].