Rethinking Enhancement in Sport

ANDY MIAH
University of Paisley, KA8 0SR, Scotland, UK

ABSTRACT: This article explores the arguments surrounding the use of

human enhancement technologies in sport, arguing for a reconceptual-
ization of the doping debate. First, it develops an overview and critique
of the legislative structures on enhancement. Subsequently, a conceptual
framework for understanding the role of technological effects in sport is
advanced. Finally, two case studies (hypoxic chambers and gene trans-
fer) receive specific attention, through which it is argued that human
enhancement technologies can enrich the practice of elite sports rather
than diminish them. In conclusion, it is argued that elite sports are at
a pivotal moment in their history as an increasing range of enhance-
ments makes less relevant the protection of the natural human through
anti-doping.

KEYWORDS: sports; enhancement; ethics; hypoxic training; gene doping

INTRODUCTION

As we improve our machines they will become more organic, more biological,
more life like, because life is the best technology for living . . . Some day the
difference between machines and biology will be hard to discern. Yet “pure”
life will still have its place . . . because of its autonomy . . . the organic and
the machine are merging. (Kelly 1994, p.165.)
Recent events in the sporting world have made explicit the moral, political,
and cultural characteristics of discussions surrounding the use of enhancement
technology in sport. Within the last 5 years, the landscape of sport technolo-
gies and policy has changed dramatically and it is reasonable to consider that
further innovations are imminent. Elite sports constitute arenas for conver-
gent technological applications where a range of applications demonstrates
the embeddedness of sports within technological structures. The prospects for
even more radical technologies to influence athletic performance grow con-
tinually as progress in nanotechnology, stem cells, and genetics gain strength.

Address for correspondence: Andy Miah, School of Media, Language and Music, University of
Paisley, Ayr Campus, KA8 0SR Scotland, United Kingdom. Voice: +44(0) 7962 716 616; fax: +44(0)
1292 886371.
e-mail: [email protected]

Ann. N.Y. Acad. Sci. 1093: 301–320 (2006). 

C 2006 New York Academy of Sciences.

doi: 10.1196/annals.1382.020

301
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This growing role of technology within sport raises questions about its future
direction, particularly how, as Kelly describes it, biology will relate to the “new
biology of machines.”
One of the more volatile debates that surrounds enhancement in sport has
been the application of gene transfer and genetic technology more generally.
In 2003, the World Anti-Doping Agency (2003) instituted a policy prohibiting
the use of “gene doping” and yet there is still considerable lack of clarity over
whether it will ever be possible to detect all kinds of genetic enhancement.
These debates have engaged the mainstream of bioethicists where controversies
relating to human enhancement abound. Sport, it would seem, has become an
exemplar case study for investigations into the ends of technology in society.
One of the pivotal questions surrounding sports is whether the approach to
doping needs radical transformation, as the age of enlightenment gives way to
an age of enhancement.
This article aims to reconstitute the debate surrounding enhancement issues
in sport. First, I outline the recent legislative context surrounding the regu-
lation of enhancement in sport, which draws attention to the political nature
of the issue and the tensions between individual liberties and social justice.
Subsequently, I develop a conceptual framework for analyzing the effects of
technology in sport, each of which reveals varying ethical connotations but,
collectively, they demonstrate the convergent role of technology in sport and
its multifarious moral value. Finally, I consider two case studies that, together,
engage the complex ethical arguments arising from the use of enhancement
but, which also both demonstrate the case for rethinking how enhancement
technologies are limited by sports authorities.

LEGISLATIVE STRUCTURES ON ENHANCEMENT

Since the early part of the 20th century, various sports organizations have
employed an anti-doping policy, though it was 1967 when the International
Olympic Committee first organized a Medical Commission whose primary
role was to address the use of doping substances. The main concern of this
committee involved the risks to health that doping entailed for athletes, which,
expectedly, was also seen to diminish the values of Olympism. In particu-
lar, the televised death of Tommie Simpson in the Tour de France in 1967
began a cultural turn in how the doped athlete was represented. His image
of a doped athlete has become characteristic of the abjection associated with
unnatural enhancements, which, I suggest, sustains part of the political will
surrounding anti-doping. In 1998, the Tour de France again was monumental
in transforming this political landscape. The images of athletes under siege by
police provoked the world of sport to rethink its approach to doping and the
World Anti-Doping Agency (WADA) was born soon after.
The current international standard for doping technologies is the World Anti-
Doping Code, which indicates that two of three conditions must be met in order
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for a technology to be considered for prohibition from sport. These consist of

the following:
1. Is the technology harmful to health?
2. Is it performance enhancing?
3. Is it against the “spirit of sport?”
It is widely recognized that determining whether these conditions are en-
gaged is not simple and requires some form of discursive process to resolve.
However, this process does not apply to all forms of enhancement technology,
which are not considered in relation to the Code. For instance, when a new
design element of a tennis racquet is introduced—such as the use of piezo-
electric dampening technology—the anti-doping code is not engaged. Rather,
the specific sport’s federation will consult its own guidelines on technical
specifications to determine whether the innovation is acceptable.
Since its beginning, WADA’s role has been to harmonize policy and it has
gradually worked toward independence from the International Olympic Com-
mittee at a time when the International Olympic Committee was under scrutiny
for allegations of corruption. During this time, it has succeeded in working with
UNESCO to develop a Convention on doping and its relocation to Montreal
has been accompanied by renewed efforts from a range of countries whose
recent actions suggest greater, rather than less controls over athletes’ actions.
In particular, President George W. Bush has included references to the “war
on drugs” within his two most recent State of the Union addresses (2004 and
2005). Also, over the last 3 years, a series of congressional hearings have taken
place in relation to doping within baseball, which aim to address the prevalence
of substance use within youth culture. Yet, also during this time, critics have
alluded to a need for more careful consideration on how best to tackle the use of
performance-enhancing substances in sport. At a time when the United States
is beginning to introduce anti-doping tests within a number of high schools, it
is pertinent that the American Academy of Pediatrics (AAP 2005) published
a statement questioning the effectiveness of such tests as a deterrent.
Other activities within the United States have also been relevant for raising
the political profile of sports enhancement issues. For instance, during 2002 the
U.S. President’s Council on Bioethics received two sessions, which discussed
enhancement in sport (2002a, 2002b). Also, the leading bioethics institute,
The Hastings Center, has undertaken continual research in this area since the
1980s (Murray 1983, 1984, 1986a, 1986b; Parens 1998). Projects taking place
at the Hastings Center during these years have been pioneering in terms of
sport’s commitment to funding ethical research. In 2006, Murray was also
appointed as Chair of the new WADA Ethical Issues Review Panel, which,
also in 2006, made its first substantive intervention by concluding that the
use of hypoxic environments (also known as altitude chambers) should be
deemed an infraction of the WADA Code because they violate the “spirit of
sport.”
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Other, recent historical moments have been critical in shaping the current
political landscape of anti-doping. In 2003, the now infamous Bay Area Lab-
oratory Co-Operative (BALCO) affair reminded anti-doping authorities that
designer substances are completely unknown and it will be near impossible
developing direct tests for them in advance. Indeed, the challenge of proving
positive doping cases has been one of the major obstacles for anti-doping au-
thorities. This challenge has also recently given rise to changes in the law,
where the emergence of a nonanalytical positive—a doping infraction with-
out the need for a urine or blood test—means that athletes now face possible
disqualification (and sometimes prosecution) based on evidence other than
unequivocal facts. These circumstances are also accompanied by an emerging
willingness to criminalize doping infractions and to discuss doping as under-
pinned by an international criminal drug mafia (see Donati 2005). These terms
reshape what is at stake in the issue of doping, transforming a matter related
to fairness and ethics in sport to a moral panic over drug use. An additional
facet to this debate is also greater willingness to recognize the broader use of
illicit substances, which are typically associated with sports performance. The
AAP notes that many users are not elite athletes at all, but young people who
are preoccupied with body image.
This final point alludes to the relevance of broader cultural studies of body
modifications when considering the use of enhancement technologies in sport.
While it is tempting to believe that the rationale for any athlete’s use is merely
to gain an edge over other competitors, other values are at stake. Yet, related
studies of the cultural context of performance enhancement are often over-
looked in the debate about the ethics of sporting performance (Denham 1999a,
1999b). 1 For instance, while there is considerable reference to how the media
characterize the doping debate, very rarely is this media presentation taken
into account in policy discussions. Thus, one could be skeptical of the claim
that society broadly is unhappy about enhanced athletes. Rather, one might
more adequately claim that the media discourses surrounding the doped ath-
lete generate a justification for a culture of anti-doping (Magdalinski 2000).
The recent discussions on the ethics of hypoxic chambers in elite sport
demonstrate how technology gives rise to a mixed reception and that the eth-
ical stance taken by athletes or lay spectators or sports fans is malleable. In
short, there is no ethical view “out there” that can, without qualification, justify
the current approach to evaluating the role of technology in sport. However,
concerns about doping in sport also reveal a rhetoric of “dehumanization”
(Hoberman 1992) in sport, where technology might reduce the athlete’s role
in performance and, in so doing, diminish the value of competition. This view
of dehumanization also emerges from a “mechanization” thesis that describes
the scientification of sport as bringing about feelings of alienation—the man-
ufacturing of athletes, for instance. Such an evaluation of contemporary, elite
1 In 2006, WADA opened a tender for social science studies of doping.
MIAH: RETHINKING ENHANCEMENT IN SPORT 305

sports, describes the athlete as a product of a scientific or technological process,

somehow automated in performance.
Elsewhere, I have argued that the “dehumanization” thesis about sport and
technological progress is neither accurate nor critical, but is a historical con-
sequence of disenchantment with grand, technological progress (Miah 2004).
Thus, one might describe a sense of anxiety over tampering with biology on a
global scale. Yet, even in these cases, it is unclear why such tampering should
matter morally. A further example that raises questions about whether there is
a broad social concern about enhancement technologies is cosmetic surgery
(or more broadly body modification). Very little is known about whether ath-
letes would use elective reconstructive surgery for sports performance. While
one might consider aesthetic interventions given the importance of gaining
sponsorship within the sports world, one might also envisage other surgical
procedures that could enhance the body. Indeed, there is some evidence of ath-
letes undertaking risky, experimental surgical procedures when injured, hoping
that their ability will be restored. In particular the so-called “Tommy Johns”
surgery to rehabilitate the shoulder of baseball pitchers has shown anecdotal
evidence that the recovered athlete is even stronger after the intervention. A
related case that has been discussed widely is LASIK eye surgery to attain
perfect vision, which was used by the champion golfer Tiger Woods. Such
enhancements are not prohibited by sports governing bodies, which further
emphasize how blurred the boundaries are between legitimate and illegitimate
enhancements. These examples also raise questions about the appropriateness
and capacity of sporting authorities to legislate in respect of personal biological
modifications.

CONVERGENT TECHNOLOGICAL SYSTEMS IN SPORT

The suggestion that sport enhancement issues are converging with broader
medical enhancement debates is reflected in the activities of key legislative
agencies and advisory committees. The current U.S. President’s Council on
Bioethics (2003) has focused considerably on “enhancement” or, perhaps more
accurately, emerging technology issues. Its landmark publication Beyond Ther-
apy engages with some of the issues faced by the world of sport in the context of
enhancements. Alternatively, the Australian Law Reform Commission (2003)
published an extensive document on the use of genetic information within a
range of social contexts, one of which includes sport. More recently, the UK
Government Select Committee for Science and Technology launched a public
inquiry into the use of Human Enhancement Technologies in Sport (Science
and Technology Select Committee 2006). To this extent, it is useful to employ
our convergent metaphor in the analysis of converging legislation surrounding
human enhancement technologies. Nevertheless, of critical value is to un-
derstand how a range of technological systems affects social practices. The
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following section outlines various forms of technology within sport, which es-
tablishes a critical response to how technology is framed by sports authorities
as a diminishing influence.

Making Sport Possible

An initial category of effect for technology involves the constitutive func-

tion of technology within sports. The category raises questions about the pol-
itics of defining technology, since it reminds us that sports have always been
technological and the moral evaluation of this relationship shifts over time.
Technology (primitive or sophisticated, premodern or post, recent or ancient)
is unequivocally a necessary characteristic of many sports without which they
would not be possible. It is thus, no surprise to notice that, as the technology
evolves, so too do the sports. In Formula One motor racing, it is possible to
see this most clearly where advances in motor engineering vastly affect the
outcome and demands upon a driver and race team. In such a performance-
driven sport, the technology has often been argued as being the determining
factor of success, where the driver plays merely a secondary role (Aveni 1976).
Yet, such a view would be naı̈ve or, at least, incomplete since even those who
reject the most recent advances in technology that they consider to have re-
duced the skills required to be a driver, no such views would argue for a return
to cars from the earlier parts of the 20th century. To this extent, one might
describe that the relationship between technology and sports has an optimal
limit beyond which something critical about the sports particular character is
compromised. One important conclusion that must be drawn from this is to
realize that technologies are not antithetical to sports and that it can only be
the way in which they develop—rather than their very existence in sport—that
raises ethical problems.

Safety and Harm

One of the central aims of technological change in sport has been to im-
prove safety and reduce the risk of harm. Many rule changes within sports can
be viewed as technologies of knowledge that aim to restructure the range of
technological interactions—such as the foot against the floor or a shoulder’s
movement when swinging a racket. Other examples include the redesigning
of the javelin in the 1980s, when athletes were throwing dangerously close to
the spectators. The only reasonable solution to this impending problem was
to change the specifications of the javelin so that the athletes could not throw
it as far. This resulted in a change in the kinds of athlete that were success-
ful as javelin throwers, from the strongest to the technically proficient. Other
examples include:
MIAH: RETHINKING ENHANCEMENT IN SPORT 307

1. Improved floor surfaces within sports halls to reduce shock to athletes

when landing or bounding (Bjerklie 1993).
2. Introduction of plastic helmets in American Football to reduce head injury
(Gelberg 1995).
3. More sophisticated shoe design for more support to foot during athletic
events.
4. Increased wicking qualities in clothing to protect climber or mountaineer
from the cold and rain.
5. Spring board surface in diving to prevent slip and increase resiliency of
board tips to reduce injury (Bjerklie 1993).
6. Sturdier epee and foil in fencing, as well, Kevlar jackets for more pro-
tection but with no loss to movement (Tenner 1996).
7. Navigational equipment in sailing (Inizan 1994; Tenner 1996).
8. Carbon composite Poles in Pole Vaulting and enhanced safety pits, al-
lowed more daring contest and higher vaults (Bjerklie 1993).
These examples identify the imperative for sports federations or governing
bodies of sport to strive for their practices to be less dangerous for the com-
petitors by introducing new technological measures. Their ethical justification
derives from an interest in athlete safety and, generally, allowing the athlete to
perform at an optimal level without placing undue stress on the body. How-
ever, these examples are controversial since their implementation can change
the kind of test that is constituted by the competition.

Deskilling and Reskilling

Technological innovations can alter the way that sports are played. They
can change the conditions of training that are required to be successful at a
particular skill, and can even make it easier to perform the required skills.
Examples of such technologies include:
1. U-groove golf clubs that allowed greater accuracy on stroke (Gardner
1989).
2. Depth finders in fishing to make it easier to locate large schools of fish
to enhance prospects of catching (Hummel and Foster 1986).
3. Superman cycling position that allowed more streamlined position for
greater speed (Fotheringham 1996).
4. Breathable clothing material used to regulate body temperature in ex-
treme climates (Miah 2000a).
The PGA’s reasons for disallowing the “square” or “U-grooved” irons from
golf in 1990 reflect how technology can alter the kinds of skill required of an
athlete (Gardner 1989). Gardner describes how tour players considered that
the clubs gave the golfer an advantage by creating a higher spin rate, which
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translated into better ball control. Some tour professionals had been opposed to
their use because of a concern that they “devalue true golf skill and consolidate
their talent” (p. 69). Similarly, Hummel and Foster (1986) recognized that the
“spinning reel” in fishing “virtually eliminated backlash in casting and thus
the necessity of an ‘educated thumb’ to act as a drag on line being cast” (p. 46).
Thus, the innovation was considered to have democratized the skills of the sport
and had devalued or deskilled the activity. While these devices would seem
quite useful for a novice who may require assistance to engage in the activity
in a meaningful way, their application to competitive sports is implied—yet, it
is unclear that such things are beneficial within elite competition.
Additionally, it is not representative to argue that these technologies nec-
essarily deskill a sport. It may also be argued that technological changes in
sports “reskill” an activity. In explanation of “reskilling” one may consider
the controversial “superman” cycling position introduced by Graeme Obree
in 1995. The position entailed the arms of the cyclist being placed in front
of the face and the seating post being unusually high, thus making the posi-
tion more aerodynamic. Thus, while the skill had not been made any easier,
it had altered the bicycle such that it did not resemble conventional cycling
positions (it had been reskilled and it made it possible to achieve more without
any greater physical capability). Interestingly, the International Cycling Union
(ICU), made this very argument when legislating against the use of the posi-
tion. In concluding their stance on the “superman” position, the ICU argued
that the technical developments had “obscured the physical demands made
by cycling, and had made it harder for the man on the street to identify with
elite cyclists” (Verbruggen cited in Fotheringham 1996, p. 23). Despite such
claims, it might be wondered how the ICU justify the acceptance of methods of
design and construction of bicycles that are more comparable to the design of
an aircraft than an “everyday” bicycle. It would seem possible to argue that, on
similar grounds, the use of such materials also makes the bicycle unacceptably
different from a preconceived notion of what is a bicycle.

Dehumanizing and Superhumanizing

The cycling example raises a more complicated question about whether an

athlete can claim responsibility for any performance achievement and puts
into question whether the human athlete or the technology has achieved the
performance. However, to answer such a question requires being able to make
clear distinctions between each. This category presumes that something clear
can be said about humanness that is lessened or removed by the use of some
technology. This categorization might be criticized for bringing together two
quite different claims about a technology, which are not at all oppositional.
Indeed, the elite athlete might both be dehumanized and superhumanized by a
technology.
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Nevertheless, the purpose of this categorization is to demonstrate ideas about

the moral implications of technology so as to identify the kinds of argument
that are being made about the effects of technology. In this sense, dehuman-
ization is justified inasmuch as researchers of technology have made such
claims. Some examples that have been (and might be) seen as reflective of
dehumanizing/superhumanizing technologies are as follows.
• Doping and drug taking (Fraleigh 1984; Hoberman 1992).
• Genetic enhancement (Miah 2000b, 2004; Munthe 2000).
• Springboard in diving allowed divers to gain more height on dive (Bjerklie
1993).
• Fiberglass archery bows, more resilience and more consistency (Bjerklie
1993).
• Plastic/metal composite discus allows longer throw.
• Barbells are now stronger with some flexibility to allow the lifter to use
more technique when lifting and drop bar at end of lift to save strength
(Bjerklie 1993).
• Kevlar and carbon fiber kayaks are lighter, more sturdy and easier to
maneuver.
While various authors discuss how these technologies alter what it means to
be human, adding content to such claims is more problematic as identifying
the salient characteristics of humanness that are removed or lessened by such
technology is not easy. Nevertheless, if one is to place any credit at all in these,
at least, intuitions about technology, then it is worth considering the possibility
that they are not consistent with the characteristics of humanness. If one is
not convinced that these technologies do, in fact, dilute human qualities, then
it can be useful to discuss whether any kind of technology could be a threat
to humanness. Would, for example, a human that is largely a mechanoid be a
challenge to humanness? If not, then is a robotic human, one whose mental
capacities are formed by some artificially intelligent computer, a threat to
humanity? If such beings can be seen as a challenge to humanness, then there
might be some grounds for concern. Where this line is drawn is less important
than the possibility that it could be crossed, which I suggest, is often the basis
on which anti-doping policy is justified (i.e., there is an imperative to draw a
line somewhere).

Increase Participation and Spectatorship

One of the major interests of a sport governing body is to maximize the

breadth of inclusion within the given sport. This ambition often translates into
the development of technology that can allow a sport to become more accessible
to prospective participants. The example is slightly different from developing
technologies to make the sport easier, as the main aim here is the maintenance
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of standards, with the broadening of participation. Alternatively, equipment

is often developed that can even exclude particular kinds of individual from
participation. For example, the sophistication of technology demands a level of
finance that is beyond many individuals. Examples of such technology include
the following:
1. Artificial turf for field sports (Tenner 1996).
2. U-grooved golf clubs (Gardner 1989).
3. Carbon composite tennis racquets and mass production of other kinds of
equipment (Brody 2000).
4. The carving ski (alpine) that makes it easier to learn skiing.
5. Different-sized tennis balls (Miah 2000c).
6. Varying speeds of squash ball for different levels of competence.
The benefits of such technology are not complex. The ability to reach a
wider audience can seem a worthwhile ambition. However, the ends of such
ambitions can be problematic for the sport. For example, in sports, such as
climbing or skiing, there exist limited natural resources, the overuse of which
could seriously damage the environment and lessen the aesthetic experience
of the performance. If mountains were overrun with climbers and skiers, they
could lose their tranquil characteristics, which would seem to entirely contra-
dict what is valuable about these activities. Along these lines, it is not at all clear
how big would be big enough for sports. While the ambition for widening par-
ticipation is admirable, its justification tends to be more financial than moral.
Yet, the exploitation of a sport simply to widen participation and generate more
financial resources seems ambiguously beneficial.
These varied examples provide some basis for understanding the complexity
and effect of technologies in sport and the range of values that are engaged when
considering the ethical implications of any proposed technological innovation.
In addition to these effects, one must also recognize that there are further
concerns about the unknown consequences of new technologies. Indeed, it is
crucial to recognize how anti-doping authorities develop policy on the basis of
lacking scientific evidence that can demonstrate safety.

Alternate Conceptualizations

Within this brief conceptualization there is the degree of overlap among

the different technological effects. For example, the improvement of floor sur-
faces within sports halls that can significantly reduce injury and which would
thus, fit within the safety category, also reskills the activities. As such, the
categorization vastly simplifies any single example of technology within sport
and, therefore, does not suitably characterize it. Consequently, it is tempting
to draw some further categorization about them in an effort to find some con-
ceptual framework that demarcates technologies from nontechnologies. Thus,
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one might separate them into such categories as body, external, internal, envi-
ronment, or something similar. However, this categorization would not yield
any further critical edge to the main task, which is to demonstrate the broader
performative role of technology as a way of reconceptualizing the role and
ethics of enhancement within sport. It is not reasonable to expect that the
categorization alone will yield answers to which ones are acceptable or not.
Instead, the reason for undertaking this conceptualization is to reveal the
range of technological effects that arise within sport and to demonstrate
the range of moral narratives that they provoke. In short, the present ap-
proach to enhancement technology within the structures of sports admin-
istration, where, for instance, the performance-enhancing capacities of the
Speedo FastSkin swimming suit are completely separate from debates over
the ethics of blood doping creates a limited environment for ethical debate.
Rather than an anti-doping policy, a “performance policy” (Miah 2005a) is
necessary to develop so that this broader range of ethical discussions can take
place.
The final substantive sections of this article will explore two case studies of
human enhancement technology in sport. I have already mentioned the recent
discussions surrounding the use of hypoxic chambers within elite sports. It is
useful to focus on this technology as a specific case study, because it is an
instance of technological enhancement whose ethical status remains in great
doubt and because it does not easily fall within a specific kind of categoriza-
tion. Subsequently, I will discuss the emergence of gene doping within sport,
outlining some of the crucial ethical problems it provokes.

THE ETHICS OF HYPOXIC TRAINING

Unlike many forms of doping, the use of hypoxic chambers within sports
does not involve synthetic substances that can easily be characterized as arti-
ficial or unnatural. Moreover, it cannot easily be aligned with the antisocial
connotations of drug abuse, which are so effective at garnering political sport.
At most, the arguments surrounding its use involve its effect as a form of
cheating or as a health risk. Yet, for some time now it has not been possible to
describe the use of such chambers as a form of cheating since they have been
legal. Moreover, a number of high profile athletes have used them extensively
without any moral outrage reported.
The science of hypoxia involves changes in the partial pressure of oxygen
within an environment, which increases the body’s hematocrit level. These
changes reduce the partial pressure of oxygen in the pulmonary capillaries,
which leads to an increased need to breathe. In turn, the body senses the
changes and increases the production of red blood cells, which are rich in
oxygen carrying protein (hemoglobin). This enhanced production leads to a
greater aerobic potential for the individual.
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In the same way that I allude to the importance of Tommie Simpson’s tele-
vised death, one might also draw attention to the visual presence of hypoxic
chambers. It was not so long ago that the pop singer Michael Jackson was pho-
tographed within such a chamber. Such a context easily frames this technology
as something alien to “normal” human practices. Indeed, the characteristics of
the technology tend to have required obstructive practices for athletes who will
need to spend extensive time in these isolated booths. Such spaces conjure up
images of athletes as rats in laboratories simply growing stronger almost by
magic (Stivers 2001). Such images forces one to question whether the WADA
Code seeks to protect an athletically moral way of life more than an ethical
practice. Hypoxic training has also been particularly interesting because it
seems to have divided the scientific community and its support for WADA’s
work.
Yet, the more intriguing characteristics of this issue relate to the ethical de-
bate that has ensued. During 2006, the ethical status of hypoxic chambers was
put to the recently formed Ethical Issues Review Panel in WADA, which is
chaired by Thomas H. Murray. The Panel’s report raises a number of specific
arguments as critical to the ethical status of hypoxic training, beginning its
discussion paper by asking what it is about sport that people find honorable,
admirable, and beautiful. Their position concludes that hypoxic training is a
violation of the “spirit of sport” (WADA Code) insofar as it does not require the
“virtuous perfection of natural talents” matters to sport. In short, their view
was that the use of such chambers was “passive” requiring no skill, knowl-
edge, or effort on the part of the athlete. They state: “my responsibility for
my performance is diminished by technologies that operate upon me, indepen-
dent of any effort on my part.” As was mentioned earlier, the “spirit of sport”
concerns constitute only one element of the process by which a technology
might be deemed a doping technology. Yet, in this case, it was the first major
case where the ethical perspective was seen as being potentially decisive to the
overall outcome, since the health risks surrounding hypoxia were unproven.
The final outcome of this inquiry made in September 2006 was that the hy-
poxic chambers should remain legal, which seems satisfactory to a number of
commentators who challenged the proposal to prohibit their use (Levine 2006).
However, an exploration of its reasoning elaborates on how categories of effect
are articulated in moral language within discussions surrounding performance
enhancement in sport.

The Nonvirtuous Perfection of Natural Talents

The Panel’s view indicates that only virtuous nurturing of natural talents is
valued in sports. To this extent, they note that an athlete who benefits from
the knowledge of an excellent coach, engages with some form of relationship
that implies their interacting. Yet, is such a view a reasonable articulation
MIAH: RETHINKING ENHANCEMENT IN SPORT 313

of the athlete–coach relationship? The athlete will not have undertaken any
virtuous sacrifice to access such knowledge. To illustrate this, let us compare
two athletes, one who has an international coach and another who has a regional
coach. While each of these athletes might engage with some process of learning
to gain insights into training and so on, the crucial point seems to be whether the
difference in what they gain is attributable to the athlete’s virtuous perfection
of natural talents. I suggest it does not and, for this reason the argument from
virtuous perfection would require that all athletes are similarly privileged in the
expertise of their entourage. In anticipation that this would not be a sufficient
rejection of the position, I also suggest that the mere conscientious following
of advice and accepting it, does not, in my view constitute or imply virtue.
Indeed, as is often the case in the world of sport, an athlete will follow the
advice of the coach, doing precisely what they are told to do. Moreover, they
will continue with such behavior providing that performance improves. If it
fails to improve, then the athlete may switch coaches with nearly no care about
the virtuous relationship they will have cultivated. The role of virtuous action
here is unclear but doubtful. Nevertheless, if virtue were present here, one
would not expect the dismissal of a coach merely due to failure to deliver
results. Yet, this is the established ethos of sports practices. To this extent, it
is false to suggest that the spirit of sport necessitates that only virtuous action
is valued. Consequently, one can accept without controversy that nonvirtuous
action—actions lacking virtuous content, rather than unvirtuous acts, such as
cheating—can also have value in sport. By proposing a virtue theoretical view
of ethics, it neglects other ways in which people value sport—for instance the
value of witnessing misbehavior on a playing field.
Further examples challenge the importance of virtuous perfection as a lim-
iting ethical criterion. The Panel mentions that use of “improved running
shoes. . .requires interactions between the athlete and the technology; the hu-
man athlete utilizes, masters and controls the technology, not the other way
round” (Ethical Issues Review Panel, World Anti-Doping Agency 2006). It
seems unusual that one would talk about new running shoes as having been
mastered by the skills of athletes. It is more likely that good performance tech-
nology is “seamless” for athletes; it appears as an extension of one’s body that
demonstrates its synergy with sporting actions by evidence that it is making
the body perform better. Consider the use of piezoelectric technology within
skis. In this case, it is, again, a stretch of the word virtue to suggest athletes
become better by any special moral commitment. More likely, the accomplish-
ment or enhancement in performance will arise quite easily. If the response
to this argument is that knowledge of one’s body is itself a form of virtuous
perfection, then this seems a strange conceptualization of the word “virtue,”
which should imply some attribute of moral character.
While this response to the Ethics Panel position does not reject the claim
that “the means” are ethically relevant in sport, it does not accept the notion
that only virtuous means are valued. The Panel concludes that the crucial test
314 ANNALS NEW YORK ACADEMY OF SCIENCES

will be “whether it supports or detracts from sport as the expression of natural

talents and their virtuous perfection” but neither might be affected by the
introduction of a particular performance-enhancing technology. Requiring that
any enhancement be earned through virtuous action is too great a requirement,
which should not be interpreted as too high an ideal. Nonvirtuous action does
not mean that it lacks value.

Technology, Expert Systems, and the Athlete

The Panel recognizes that technology and expert systems have improved
sports (though their report does not say how), but that the athlete’s perfor-
mance is the crucial factor that gives sport value. Yet, it is necessary to tease
out the distinction between these two concepts since their relationship, I sug-
gest, plays a crucial part of framing the moral evaluation of technological
enhancements. The concerns of the Panel in this area seem to involve claims
over responsibility for the performance. Their view might be similar to the
deskilling thesis noted earlier. The Panel presumes that the athlete is and should
remain largely responsible for his or her achievements. Moreover, the expert
systems that surround the athlete are mere supplements to this achievement.
Yet, one of the crucial factors in the negative culture of anti-doping arises
from such a separatist perspective. Instead, the athlete should be empowered
to become part of the “expert systems” surrounding technological develop-
ment in sport, making conscientious and active decisions in the process of
developing greater achievements. Indeed, many athletes are experts in sports
science, to the extent that their own educational formation involves studying
this subject. In a broader context, there might be a number of concerns with con-
flating the collective and the individual that go beyond their mere attribution of
achievement.
The appeal of making a clear distinction between the athlete and the sup-
portive system through which an athlete journeys to become elite derives from
concerns about athletes’ vulnerability to the political will of such systems. We
remain haunted by stories of the GDR (East Germany), where the political
value of sporting success gave rise to unacceptable exploitation and manipula-
tion of individual athletes. Moreover, we expect that any state-funded program
to improve athletes will have such a character. This is more broadly contex-
tualized within views about human enhancement more generally. Without a
vigilant permissive environment for human enhancements, this will remain
a prospect. As such, the burden must be on critically establishing the con-
ditions through which legitimate human enhancements could be permissible.
Yet, our model of the relationship between technology and the athlete might
benefit by analogizing it to established medical practice, where the ethical
emphasis should be on the individual’s autonomy as a guiding determinant
of acceptability. Perhaps a useful metaphor here is the driver in the seat of
MIAH: RETHINKING ENHANCEMENT IN SPORT 315

a racing car. In this case, we would not describe the driver as only partially
responsible for the performance or, at least, we might recognize her/him as
an integral part of a performance that involves a complex biotechnological
interface.

Technology in Progress

It seems remarkable that, for so many years, athletes have used hypoxic
training without it giving rise to moral outrage. In various presentations, I
have heard that athletes do not much like the form of this kind of com-
mitment. The idea of spending time locked in a room doing nothing can-
not easily be associated with the practice ethos of sports. Yet, this view of
what hypoxic training entails is also ambiguous or, at least, contingent. For
instance, there already exist rooms, which resemble regular rooms within a
home. Moreover, one could envision its construction as a space of reflection
on an athletic life or for learning essential information about the practice of
sports. The point is that a hypoxic chamber is a work in progress and that
the moral judgment of this technology on how it seems to occupy a quite dif-
ferent social space compared with the idea of athletes running in mountains
is neither accurate nor relevant. Moreover, the development of this technol-
ogy is only likely to become more “seamless” in the way that I mentioned
earlier.
The Panel rightly concludes by indicating that the spirit of sport cannot re-
quire “an absolute leveling of athletes’ circumstances.” Thus, athletes that live
at sea level cannot claim an injustice just because they might be disadvantaged
by their location. However, where positive action is required to prohibit a suf-
ficiently safe technology that could allow a more egalitarian form of equality
to emerge, then it is counterintuitive to undertake such action. For this reason,
the claim that hypoxic chambers violate the “spirit of sport” is not proven.
Moreover, I have argued how such use can quite comfortably correspond
with the nonvirtuous actions of athletes, which are also constitutive of sports
value.
In short, it is possible for a performance-enhancing technology to be of
no detriment to the spirit of sport, but simply involve a reskilling of the ac-
tivities an athlete undertakes in order to remain competitive. The intrinsic
value of sports—the skills required to bring about sporting performance—are
unaffected by hypoxic chambers. At the very most, their use will raise the
standard of sporting achievements, which is precisely what gives elite sports
their unique social value. Undertaking action that curbs such technological de-
velopment within sport compromises the broader intrinsic value of the sports
community, which themselves are undervalued within the Panel’s report. As
I mention earlier, the ideal to approach is one where technologists are seen
not merely as auxiliary to athletes, but integral to bringing about the sport
316 ANNALS NEW YORK ACADEMY OF SCIENCES

performance. While it is inevitable that circumstances arise where an athlete is

simply introduced to a new performance-enhancing technology, it is crucial to
remember that every part of that technology’s development has involved mem-
bers of the athletic community. Indeed, as is true of other technologies, it is
likely that open access to this innovation will lead to a more nuanced culture of
use.

GENETICALLY MODIFIED ATHLETES

While the hypoxic chamber issue involves a claim about the “passiveness”
or less-skilled requirements of the sport, gene transfer technology in sport
is prohibited largely for its being a form of experimental science. The most
likely applications of gene transfer to sports involve manipulation to enhance
endurance capacity or muscle mass. Currently, research implicated for gene
doping includes modifications to growth factors, such as IGF-1 (Lamsam
et al. 1997; Barton-Davis et al. 1998; Martinek et al. 2000; Goldspink 2001),
PGC-1alpha (Lin et al. 2002), recombinant EPO (Svensson et al. 1997), and
the so-called ACE gene (Gayagay et al. 1998; Montgomery et al. 1998, 1999;
Brull et al. 2001).
Ethically, its application to sport is considered by officialdom as unaccept-
able since there is no protocol for such use, nor standards of efficacy or safety.
To this extent, any attempt to genetically modify athletes would currently be
seen as medical malpractice. As such, any argument in favor of gene doping
will need to address the broader question about the limits of medicine, which
will involve tackling fundamental matters of medical ethics. Specifically, an
argument will be required to justify treating healthy humans (athletes) with
medical technology.
The emergence of gene doping should mark a new paradigm for anti-doping
policy makers, because it presents a new landscape of ethical issues, political
views on enhancement and concerns. This position does not suggest genetic
exceptionalism, but speaks specifically to the moral opinions surrounding
genetics, which are rather more unresolved than one might say for doping gen-
erally. As a substantive response to the ethics of gene doping, it is doubtful that
it would dehumanize the athlete or that it would be merely passive. Moreover,
it only constitutes cheating in so far as it is against the rules. Yet, our question
involves asking what the rules should be in the first place.
Objection to genetic enhancement must wrestle with the positive contribu-
tion of technological change in medicine and the possibility that genomics
could confer a competitive advantage through therapeutic application alone,
such as through attending to athletic injuries. The moral tension arising from
the application of genetic engineering to sport reflects the crisis of authenticity
in contemporary society, specifically, the demise of the natural human and the
widespread ambivalence or anthropic bias (Bostrom 2002) over this. Fair play
MIAH: RETHINKING ENHANCEMENT IN SPORT 317

and health are secondary matters in this debate and, yet, they dominate, in part
because they lend themselves to an artificial, but sincere moral intuitionism
and paternalism that remains part of elite sporting culture.
Considerable clarification is needed on what constitutes the genetically mod-
ified athlete. Currently, sports authorities are interested only in the somatic cell
doper, who themselves consent to using gene transfer to gain an edge over a
competitor. Yet it is unclear what would happen if an individual is made to be
“better than well” (Elliott 2003) through the same kind of use in a therapeutic
context. Alternatively, are we interested in the athlete who has been born from
parents that have, themselves, been modified? Last, does the ethical debate
take into account the child born from parents who select a form of enhance-
ment for their child, or perhaps select their preferred embryo on the basis of
its propensity for elite sports competition? In 2004, the first genetic test for
performance was made commercially available. One year later, the WADA
(World Anti-Doping Agency 2005) announces in its Stockholm Declaration
on gene doping that such tests are to be discouraged.

CONCLUSION

Each of the issues and effects that have been discussed are imbued with sim-
ilar philosophical concerns about the human condition and the degree to which
enhancement technology can alter it. The ethical debate must take into account
the risks to vulnerable groups, such as children or athletes who enhance be-
cause they feel coerced and the liberties of adults who make lifestyle decisions
about body modification (Miah 2005b). Yet, it must also consider the limits
of ethical policy making within the world of sport and the relationship of this
to broader structures of ethical governance within society. When considering
what should be the strategy for anti-doping officials in relation to gene doping,
it is necessary to return to fundamental questions about the value of sport,
consider how these values might have changed, and recognize the broader
bioethical context within which decisions about medical technology are made.
This requires that elite sports organizations reevaluate established systems of
rewarding excellence, in order to promote a moral climate in sport that takes
into account inherent natural and social inequalities, which are constitutive of
sports practices.
The conceptual framework of technological effects is useful for (a) establish-
ing how ethical issues arise in the context of technological change, (b) clarifying
the interrelatedness of effects arising from any one technology, and (c) reveal-
ing that the debate surrounding enhancement as a doping infraction is only one
component of a broader relationship between sport and technology. The two
case studies that have been discussed are perhaps the most controversial ex-
amples within anti-doping debates presently. Unlike performance-enhancing
drugs, they do not encounter the same forms of resistance and, as such, the
moral evaluation of them is unclear. I have suggested that more instances of
318 ANNALS NEW YORK ACADEMY OF SCIENCES

human enhancement technologies are likely to emerge in sport, which further

stretch the capabilities of restrictive approaches to such use. As human en-
hancements become a constitutive element of broader social circumstances—
and as enhanced adults give birth to similarly enhanced children—the concept
of enhancement and of the natural human will become even more difficult
to sustain. In such a future, sports authorities might still attempt to protect a
particular way of life for an athlete, though athletes—as humans—might no
longer see either the need or the relevance.

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