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Performance-enhancing drugs, coercion, and the harm principle

This is an excerpt from Ethics in Sport-4th Edition by William J. Morgan.

By Robert L. Simon

One argument frequently advanced against the use of such performance-enhancing drugs as steroids is based on our second criterion of harm to the user. Since use of such drugs is harmful to the user, it ought to be prohibited.

However, if we accept the “harm principle,” which is defended by such writers as J.S. Mill, paternalistic interference with the freedom of others is ruled out. According to the harm principle, we are entitled to interfere with the behavior of competent, consenting adults only to prevent harm to others. After all, if athletes prefer the gains that the use of drugs provide along with possible side effects to the alternative of less risk but worse performance, external interference with their freedom of choice seems unwarranted.

However, at least two possible justifications of paternalistic interference are compatible with the harm principle. First, we can argue that athletes do not give informed consent to the use of performance-enhancing drugs. Second, we can argue that the use of drugs by some athletes does harm other competitors. Let us consider each response in turn.

Informed Consent

Do athletes freely choose to use such performance-enhancing drugs as anabolic steroids? Consider, for example, professional athletes whose livelihood may depend on the quality of their performance. Athletes whose performance does not remain at peak levels may not be employed for very long. As Carolyn Thomas (6: p. 198) maintains, “the onus is on the athlete to . . . consent to things that he or she would not otherwise consent to. . . . Coercion, however, makes the athlete vulnerable. It also takes away the athlete’s ability to act and choose freely with regard to informed consent.” Since pressures on top amateur athletes in national and world-class competition may be at least as great as pressures on professionals, a comparable argument can be extended to cover them as well.

However, while this point is not without some force, we need to be careful about applying the notion of coercion too loosely. After all, no one is forced to try to become a top athlete. The reason for saying top athletes are “coerced” is that if they don’t use performance-enhancing drugs, they may not get what they want. But they still have the choice of settling for less. Indeed, to take another position is to virtually deny the competence of top athletes to give consent in a variety of sports related areas including adoption of training regimens and scheduling. Are we to say, for example, that coaches coerce athletes into training and professors coerce students into doing work for their courses? Just as students can choose not to take a college degree, so too can athletes revise their goals. It is also to suggest that any individual who strives for great reward is not competent to give consent, since the fear of losing such a reward amounts to a coercive pressure.

While the issue of coercion and the distinction between threats and offers is highly complex, I would suggest that talk of coercion is problematic as long as the athlete has an acceptable alternative to continued participation in highly competitive sport. While coercion may indeed be a real problem in special cases, the burden of proof would seem to be on those who deny that top athletes generally are in a position to consent to practices affecting performance.

Harm to Others

This rejoinder might be satisfactory, critics will object, if athletes made their choices in total isolation. The competitive realities are different, however. If some athletes use drugs, others—who on their own might refrain from becoming users—are “forced” to indulge just to remain competitive. As Manhattan track coach Fred Dwyer (3: p. 25) points out, “The result is that athletes—none of whom understandingly, are willing to settle for second place—feel that ‘if my opponent is going to get for himself that little extra, then I’m a fool not to.’” Athletes may feel trapped into using drugs in order to stay competitive. According to this argument, then, the user of performance-enhancing drugs is harming others by coercing them into becoming users as well.

While the competitive pressures to use performance-enhancing drugs undoubtedly are real, it is far from clear that they are unfair or improperly imposed. Suppose, for example, that some athletes embark on an especially heavy program of weight training. Are they coercing other athletes into training just as hard in order to compete? If not, why are those athletes who use steroids “coercing” others into going along?³ Thus, if performance-enhancing drugs were available to all, no one would cheat by using them; for all would have the same opportunity and, so it would be argued, no one would be forced into drug use any more than top athletes are forced to embark on rigorous training programs.

Perhaps what bothers us about the use of drugs is that the user may be endangering his or her health. But why isn’t the choice about whether the risk is worth the gain left to the individual athlete to make? After all, we don’t always prohibit new training techniques just because they carry along with them some risk to health. Perhaps the stress generated by a particularly arduous training routine is more dangerous to some athletes than the possible side effects of drugs are to others?

Arguably, the charge that drug users create unfair pressures on other competitors begs the very question at issue. That is, it presupposes that such pressures are morally suspect in ways that other competitive pressures are not, when the very point at issue is whether that is the case. What is needed is some principled basis for asserting that certain competitive pressures—those generated by the use of performance enhancing drugs—are illegitimately imposed while other competitive pressures—such as those generated by hard training—are legitimate and proper. It will not do to point out that the former pressures are generated by drug use. What is needed is an explanation of why the use of performance-enhancing drugs should be prohibited in the first place.

While such arguments, which describe a position we might call a libertarianism of sports, raise important issues, they may seem to be open to clear counter-example when applied in nonathletic contexts. Suppose for example that your co-workers choose to put in many extra hours on the job. That may put pressure on you to work overtime as well, if only to show your employer that you are just as dedicated as your colleagues. But now, suppose your fellow workers start taking dangerous stimulants to enable them to put even more hours into their jobs. Your employer then asks why you are working less than they are. You reply that you can keep up the pace only by taking dangerous drugs. Is the employer’s reply, “Well, no one is forcing you to stay on the job, but if you do you had better put in as many hours as the others” really acceptable?

However, even here, intuitions are not a particularly reliable guide to principle. Suppose you have other less stressful alternatives for employment and that the extra hours the others originally work without aid of drugs generate far more harmful stress than the risk generated by the use of the stimulant? Perhaps in that case your employer is not speaking impermissibly in telling you to work harder. If not, just why does the situation change when the harmful effects are generated by drugs rather than stress? Alternatively, if we think there should be limits both on the stress generated by pressures from overtime and the risks created by drug use, why not treat similar risks alike, regardless of source? Similarly, in the context of sport, if our goal is to lower risk, it is far from clear that the risks imposed by performance-enhancing drugs are so great as to warrant total prohibition, while the sometimes equal risks imposed by severe training regimens are left untouched.

Harm and the Protection of the Young

Even if athletes at top levels of competition can give informed consent to the use of performance-enhancing drugs, and even if users do not place unfair or coercive competitive pressures on others, the harm principle may still support prohibition.

Consider, for example, the influence of the behavior of star athletes on youngsters. Might not impressionable boys and girls below the age of consent be driven to use performance-enhancing drugs in an effort to emulate top stars? Might not high school athletes turn to performance-enhancing drugs to please coaches, parents, and fans?

Unfortunately, consideration of such remote effects of drug use is far from conclusive. After all, other training techniques such as strict weight programs also may be dangerous if adopted by young athletes who are too physically immature to take the stress such programs generate. Again, what is needed is not simply a statement that a practice imposes some risk on others. Also needed is a justification for saying the risk is improperly imposed. Why restrict the freedom of top athletes rather than increase the responsibility for supervision of youngsters assigned to coaches, teachers, and parents? After all, we don’t restrict the freedom of adults in numerous other areas where they may set bad examples for the young.

More Excerpts From Ethics in Sport 4th Edition

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