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1. Introduction
The doping problem in sport has yet to be solved. One must continue to assume that controls do not identify all athletes who use performance-enhancing drugs.[1] As a result, a general suspicion has arisen that some of the most outstanding achievements in sport may have been achieved by doping. For this reason, several authors have claimed that controlled use of performance-enhancing drugs in sport should be permitted.[2-5] If that were to happen, the central argument against doping, i.e. the fairness argument, would immediately be rendered irrelevant (assuming that all athletes used performance-enhancing drugs within the permitted boundaries), and a ban on doping would be more difficult to justify. This review investigates whether a ban on doping should be included in the rules of sport and discusses the possible consequences of the legalization of performance-enhancing drugs under medical supervision.
2. What Does Legalization of Performance-Enhancing Drugs under Medical Supervision Mean?
Any legalization of performance-enhancing drugs in sport, if it were to occur, would need to be subject to limitations. This is not disputed by either opponents or supporters,[2,3,6] for complete legalization would also sanction actions that introduced risks and possibly irreversible damage to an athlete's health. That would certainly be unacceptable, even if the athlete were willing to accept the risks and damaging effects, because it is inconsistent with the favourable health requirements of sport. In extreme cases, the medically-induced, transient success achieved by doping would be paid for with definite and permanent damage to health or even loss of life. This is considered to be too high a price to pay in sport, even in a society that permits self-destructive behaviour. Thus, even if performance-enhancing drugs were to be legalized in sport, some possible doping activities would remain banned. Only those doping actions, which were considered to involve acceptable risks, would be permitted.
How the appropriate limits of the use of performance-enhancing drugs can be determined is by no means self-evident and requires further investigation. The current lack of knowledge means deciding which doping activities lead to which unwanted effects is often difficult to determine, particularly with regard to the long-term perspective. This lack of knowledge is particularly problematic in relation to new substances. Theoretical considerations alone suggest that adverse effects should be...