1.  INTRODUCTION

  1.1  The most important role philosophy can play in debates such as exercise this Committee is in the clarity it may bring to the terrain of the dispute. While this cannot be done entirely neutrally, for the very framing of issues betrays ones predilections, it can be done with some objectivity, at least. It is clear that the excitement and enthusiasm that attends scientific and technological breakthroughs, such as we have seen over the last decade, in the field of biotechnology has led to many extreme and sometimes incautious claims. And to be sure there are many careers that are predicated on these projections. By contrast, I want cautiously to offer some clarificatory remarks on the conceptual parameters of this debate while making it clear that my own preference is marked by a precautionary attitude towards them.

2.  ON THE IDEA OF ENHANCEMENT AND RELATED CONCEPTS

  2.1  It is easy to slip into the conflation of the two concepts "modification" and "enhancement" yet critical that they are kept distinct for logical and practical reasons. Notwithstanding this, many advocates for the increasing application of what are called human enhancing technologies wish to bring these two ideas together. The increasing valorisation of autonomy as the chief ethical value in medicine (and beyond) has supported a supposition that any modification sought by an individual is thereby to be considered an enhancement by their own lights. At least one of its extremes is to be found in elective, non-therapeutic, amputation (see Elliot, 2003). Clearly this renders the concept of enhancement empty. When disputing matters of enhancement, criteria beyond mere individual choice must be borne in mind. We might benefit from considering the broader goals of sport and society (Parens, 1998) the narrower goals of biomedicine, (Jeungst, 1998) as well as the ethics of self-improvement (Jeungst, 1998) including the dignity of human activity (Kass et al, 2005). By way of warning, Jeungst (1998) writes that "For policy makers faced with the prospect of using of enhancement as a regulatory concept it will be important to have a clear map of these uses and interpretations" (1998:29). It is clear that there is shared terrain here; instances where one point cuts across these domains of significance but it is also clear that the distinctions can direct us to where certain arguments best gain their purchase.

3.  THE THERAPY—ENHANCEMENT DISTINCTION

  3.1  One line of argument frequently suggested is that the therapy/enhancement distinction is blurred and, therefore, of no use in distinguishing permissible/desirable from impermissible/undesirable technological modifications (see, in relation to sports, Miah, 2004: 95). This argument is not as sound as it appears. The typical example given to undermine the absoluteness of the distinction is that of immunization where the levels of the immune system are boosted beyond normal functioning (itself a range, but typically used as a benchmark for biomedical accounts of health and the therapeutic ends of medicine). On such an account a body is diseased, ill or under some deleterious condition when it is functioning abnormally in relation to the class of species to which it belongs). But a distinction need not be exceptionless to be either useful or clear. The final end or purpose even of immunizing enhancement is one of prevention rather than enhancement per se. So despite the fact that an exception can be lodged on these grounds it does not follow that any and all other modifications which do not share the preventative goal are legitimized.

  3.2  Moreover, Jeungst (1997: 129-30) identifies three examples, pertinent to our present concerns, where applying the label "enhancement" is unproblematic: "interventions which take place to the top of their personal potential (like athletic training) or beyond their own birth range (like growth hormone), or to the top of the range of the reference class, or to the top of the species-typical range, or beyond (!), are all to be counted as enhancements and fall successfully further beyond the domain or responsibility of medicine or health care." It is the last point that is noteworthy here. Much of the discussion which attempts to support a more liberal approach to human enhancement technologies (both as in older attempts to liberalise steroids as much as new advocacy for genetic technologies) attempts to use the contested terrain between the two concepts to open the way to a more accepting approach of the new possibilities offered by technology whether in medicine (Resnik, 2000) or sport (eg Miah 2004; 2005, and Tamburrini, 2000; 2006). The central thrust of the challenge to that distinction concerns the identification of health care needs as distinct from other health-related desires in the face of health insurance schemes' obligation in the relation to the former but not the latter (see Buchanan et al, 2003). Or, as Jeungst (1998) puts it, the distinction can be used to define the limits of a physician's obligations. At the risk of labouring the point, acceptance of this does not entail the denial of the utility of the distinction in relation to, for example, genetic enhancement of elite athletes.

4.  WHAT FOLLOWS IF THE ATHLETE IS NOT A PATIENT?

  4.1  One interesting development of this point presents itself in the idea that the athlete is not to be viewed under the aspect of "patient". It is concluded from this that the athlete should not be "beholden to the same kinds of ethical distinction (sic) that exist within healthcare and medicine" (Miah 2004:96). This seems an important point which follows from the therapy-enhancement discussion.

  4.2  There are three points to be made in response to this assertion. First, note that it is assumed that the distinction between therapy and enhancement because it arises in healthcare and medicine cannot meaningfully be applied beyond those spheres. No account is given why this should be the case. Secondly, no argument is given as to what would take the place of the distinction in helping us demarcate acceptable from unacceptable enhancement. Thirdly, the use of prosthetics in elite disability sport provides a challenging case for our presuppositions regarding the proper use of technology in Paralympic sport and by extension to Olympic sport also. While there was considerable disquiet in parts of the athletic community in the early 1990s when Carl Lewis had his shoe manufacturer ergonomically design his own specific sprinting shoe, there seems to be ready acceptance of individually designed prostheses in elite disability sport. This issue merits further exploration.

  4.3  Three sorts of questions regarding the nature of excellent performance might profitably be raised here:

(i)  How desirable is the fact that excellent performance may be dependent upon the technology?;

(ii)  What further inequities are introduced by the new technologies at hand which will further exacerbate access to extremely unevenly distributed performance support and systems?; and

(iii)  Why should elite disability athletes not be seen under the double aspect of a patient and elite sportsperson?

  4.4  It is far from obvious then why the distinction cannot be useful in both Olympic and Paralympic arenas. Indeed, the "therapeutic use exemption" by WADA is an attempt to recognise that athletes have basic healthcare needs as well as those less basic, instrumental, needs that attend them in virtue of their chosen sporting ends. Where an athlete has a healthcare need that cannot otherwise be attended to by methods that do not have a performance enhancing effect they may use therapies that co-incidentally enhance performance. Why, it has been often asked, so many elite athletes suffer from asthma and are in receipt of medication that has enhancing effects is something of a moot point. More generally, however, what they committee must be vigilant towards is the excessive technologization of performance in all sports while recognising the necessary role that technology plays in elite sports.

  4.5  Perhaps the greatest challenge with respect to human enhancement technology is present in recent discussions of Transhumanism and the integration of technology and biology to transform and transcend human nature (McNamee, 2006; McNamee and Edwards, 2006). A few individuals are already experimenting with direct forms of human-computer interface. This is a serious challenge to the idea of humanness and species integrity. What ramifications this new Prometheanism may have in the less Government-regulated sphere of elite sports, where boundary-testing may be the norm, is a worrying thought (McNamee, 2007a).

  4.6  Of course discussions such as these cannot trade long on generalities. By contrast, they must proceed to the more precise terrain of why this or that enhancement should be considered a good or bad thing in relation to this or that sport or sportsperson. I shall remain, however, in my remarks here at a very general level.

5.  THE GOALS OF SOCIETY AND THE GOALS OF SPORT

  5.1  It is easy to be both sanctimonious and/or soporific about the values of and in sports. It should be clear that when we refer to elite sports we are not talking about the same social practice as Sunday morning football or midweek netball (or Friday night darts for that matter). Elite sports are Janus faced: they are simultaneously both play and display (McNamee, 1995). The internal satisfaction and external rewards are present from the beginnings of elite sport so that while the achievement of considerable esteem, glory, honour, and of course wealth has always attended elite sport it is nevertheless true these even goods are undermined when we consider unacceptable means brought to secure them. And it is undeniably true that we watch and admire elite sportspersons, canonically in the case of the Olympic games, for the excellence that the athletes embody or personify not merely what they do but that stand for or signify: commitment, channelled concentration, controlled aggression and power, courage in the face of suffering, dedication, strategic intensity, tenacity, and so on.

  5.2  It has been argued (Tännsjö, 2000) that this admiration is fascistoid: that it necessarily entails our contempt for the herd. While this view has attracted much criticism (see for example: Persson, 2005) it points to an issue that is worthy of consideration. What is the basis of our admiration for Olympic athletes in the broadest sense, and how is technology implicated in that stance? There are, of course, many answers to this question and I propose to offer only two that are salient to the present discussion.

  5.3  First, no one can doubt that Olympic athletes strive for excellence. They seek, in testing nerve and sinew, to perform to the limits of their potential and even to define the standards of excellence that others must achieve if they wish to achieve the glory, honour, fame (and in more limited cases than one may imagine) and significant wealth that attends to the achievement of excellence. The account of excellence has, however, to be one of both means and ends. Sports are partly defined by rules and rule-governed conduct which prescribes and proscribes both what is to count as success and how it may and may not be achieved. It follows from this that the means matter, logically and morally speaking. While technical means are sought for the most efficient securing of the ends of success, the very idea of "the most efficient means to the ends of sport" is ruled out by their very nature (Suits, 2005). The most certain way of scoring a knockout might appear to be to bring a machete into the boxing ring; the most secure way of scoring a goal may lead one to conceive of an apparently invincible tactic of carrying it over the goal line in an armoured vehicle. Of course these are proscribed by the rules (but not explicitly to the best of my knowledge) though perhaps more importantly, they simply would not count as a "knockout" or "goal" in the eyes of the relevant sporting communities, nor beyond.

  5.4  Secondly, despite academic rejection of functionalist explanations of both religion and sport, it is undeniable that sports are modern morality plays (McNamee, 2007). The illiterate were taught Christianity in medieval Europe by these travelling theatres with their simplistic representations of God, good and evil, salvation and suffering. With the decline of organised religion as the dominant purveyor of moral norms in society, sport is the most far reaching social practice through which standards of conduct and character are displayed, disputed, negotiated, supported, tested and, of course, undermined. Thus, even where flagrant cheating exists, or where gross egoism and greed are displayed, it cannot be denied that the practices of sport at least sustain these protean moral dialogues and at best give us pictures or role models of what we and others may aim at. It is undeniable that the spaces of sport serve moral and social goals beyond themselves.

  5.5  In order to find support for a more sympathetic account of sport viz human enhancement technologies Miah (2004: 93) cites Jeungst (1998:40) to the effect that there is an ethical equivalence between the following options: creating new forms of athletic contexts or proscribing the use of technological enhancements. But this is not exactly what Jeungst (1998) argues for. It is both necessary and desirable to quote at length here for both precision and fairness of treatment. In his discussion of "enhancements as corrosive shortcuts" (1998: 39-41), Jeungst argues that some "biomedical enhancements unlike achievements, are a form of cheating. This view assumes that taking the biomedical shortcut somehow cheats or undercuts the specific social practices that would make analogous human achievement valuable in the first place. (... ) If we are to preserve the value of the social practices we count as `enhancing,' it may be in society's interest to impose a means-limit on biomedical enhancement efforts." Jeungst is properly careful here not to write off technological enhancement wholesale. Rather his concern is with social practices (such as education or sport) where the idea of achievement may be undermined or redefined by technology. With respect to attention-enhancing medication/technological products such as Ritalin, we can ask whether the enhanced performances it may bring draw in their wake contempt rather than admiration; whether the achieved grade properly marks the committed and disciplined study is designed to. He concludes that "If the grade is not serving that function then, for that student, it is a hollow accomplishment, without the intrinsic value it would otherwise have" (ibid.).

  5.6  One of the pre-eminent functions of sports institutions (such as the IOC, WADA, or indeed the National Governing Bodies such as the Football Association) is the preservation of the intimate relation between achievement and the admirable qualities that sports are supposed to foster and reward. The idea of a corrosive shortcut enabled by morally problematic means may apply in many cases. But it does not exhaust a concern with the permissive application of technology. For athletes, even in the bad old days of steroid abuse, often took these drugs to train more intensely and recover more quickly from training and performance in order to excel. Thus when Jeungst (1998: 40) writes "Either the institutions must redesign the game (eg education or sports) to find new ways to evaluate excellence that are not afforded by available enhancements, or they must prohibit the use of enhancing shortcuts." we must be clear that an entirely new catalogue of virtue and vice will have to be developed or a complete re-visioning of sports themselves in line with proposed technology. If such technology is accepted in the new definition of achievement then we will be left wondering whether it is really value neutral (as many have claimed) or rather pre-coded to transmit the values of those who have vested interests in promulgating technological conceptions of (the good) life itself. Whether what is left is recognisably human is itself a moot point.

6.  REGULATION AND THE MYTH OF SISYPHUS

  6.1  It might seem reasonable to think that the guardians of sport are involved in a struggle akin to the punishment the Gods gave Sisyphus (except that no one is claiming they committed a heinous crime). Sisyphus is condemned to roll a great rock up a hill only for it to fall down the other side as soon as he gets to the top of the hill. His strength sapping suffering thus is endless. And so it seems is the case for those who would be vigilant against the technological diminution of sports as human achievements. No sooner have they detected one corruption or usurpation than another occurs. This tragic context does not render the attempts of those who wish to preserve what is best in sport futile. Rather it enables a clear sighted vision of what is worth holding on to by careful argument and negotiation.

  6.2  By way of conclusion, and following loosely from the foregoing discussion, I offer below some questions as indicative of criteria by which we might begin to evaluate the would-be human enhancing technologies in their application to elite sports:

I.  To what extent do the proposed technologies enhance or diminish our admiration for human athletic achievement?

II.  What harms do the enhancement technologies introduce or exacerbate?

III.  Is there unfairness of access to the technologies necessary for given enhancements?

IV.  Are the enhancements coercive or paternalistic?

V.  If public monies are used to support and maintain elite athletic performance will this represent a waste of scarce resources?

VI.  In line with whose ideals and interests are athletes being technologically "enhanced" or technologically "enhancing" themselves?

VII.  Will species integrity be undermined by the proposed technological "enhancements"?

  6.3  These questions are tentatively suggested as dimensions that can help think through the desirability or permissibility of human enhancement technologies in elite sport. Clearly what is needed is a more nuanced, sport-by-sport analysis of the issues alongside critical reflections of policy makers, sports institutions and representatives of performers, tested out in arenas of public opinion supported, wherever possible by clear arguments in the public domain.

October 2006

REFERENCES

Brock, D (1998) Enhancements of Human Function. Some distinctions for policy makers. In E. Parens (ed) Enhancing human traits: ethical and social implications, Washington DC: Georgetown University Press, 48-69.

Bucanan, A, Brock, D, Daniels, N, Wikler, D (2001) From chance to choice. Genetics and Justice, Cambridge: Cambridge University Press.

Elliott, C (2003) Better than well: American medicine meets the American dream, New York: W W Newton and Co.

Jeungst, E T (1997) "Can enhancement be distinguished from prevention in genetic medicine?" The Journal of Medicine and Philosophy, 22, 2: 129-30.

Jeungst, E T (1998) "What does enhancement mean?" in E Parens op cit 29-47.

Kass, L et al (2003) Beyond therapy: biotechnology and the pursuit of happiness New York: Dana Press.

McNamee, M J (1995) Sporting practices, institutions and virtues: a restatement and a critique Journal of the Philosophy of Sport, XXII 61-83.

McNamee, M J (2006) Transhumanism, Biotechnology and Slippery Slopes

http://www.thomasmoreinstitute.org.uk/mcnamee.html

McNamee, M J and Edwards, S (2006) Transhumanism, medical technology and slippery slopes Journal of Medical Ethics 32, 9 512-8.

McNamee, M J (2007) Ethics and Sports; virtues and vices London: Routledge (in preparation).

McNamee, M J (2007a) Transhumanism, technology and the moral topography of sports medicine Sport, Ethics and Philosophy, 1, 2 (Special Issue: Medical Ethics and Sports Medicine, Guest Editor C Tamburrini, in press).

Miah, A (2004) Genetically modified athletes, London: Routledge.

Miah, A (2005) Gene doping in C Tamburrini and T Tännsjö (eds) Genetic technology and sport, London: Routledge, 42-54.

Parens, E (1998) Is better always good? The enhancement project in E Parens (ed) op cit, 1-28.

Persson, I (2005) What's wrong with admiring athletes and other people? In C Tamburrini and T Tännsjö (eds) op cit 70-81.

Resnik, D B (2000) The moral significance of the therapy-enhancement distinction in the gene therapy debate Cambridge Quarterly of Healthcare Ethics, 9, 3: 365-77.

Suits, B (2005) The Grasshopper: games, life and utopia, Toronto: Broadview Press (2nd edition).

Tamburrini, C (2000) What's wrong with doping? in T Tännsjö and C Tamburrini (eds) Values in Sport, London; Routledge, 20-16.

Tamburrini, C (2005) Educational or genetic blueprints, what's the difference? in C Tamburrini and T Tännsjö op cit, 82-90.

Tamburrini, C (2006) Are doping sanctions justified? A moral relativistic view. Sport in Society 9 (2) 199-211.

Vita More N (2006) Who are transhumans? http://www.transhumanist.biz/interviews.htm, 2000 (accessed 7 April 2006).

Williams, B A O (1995) Making sense of humanity, Cambridge: Cambridge University Press, 213-223.

BIOGRAPHICAL NOTE

Mike McNamee is the inaugural Chair of the British Philosophy of Sport Association (http://www.philosophyofsport.org.uk/) since 2002, and a former President of the International Association for the Philosophy of Sport (http://www.iaps.paisley.ac.uk/index.html).

He was co-editor of the first international collection on Ethics and Sport (1998: Routledge) and co-edits the 12 volume book series of the same title from which that book sprang (http://www.routledge.com/Sport/series_list.asp?series=1).

He is Editor of the new international journal Sport, Ethics and Philosophy (Routledge).