PubMed · 8799588
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J A Lombardo. 1996. Drug control programmes.. https://doi.org/10.1136/bjsm.30.2.82
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Sport authorities continue to confront a variety of perplexing issues as they attempt to address effectively and efficiently the problems posed by doping. The emergence of the phenomena of blood doping and the administration of erythropoietin have added to the challenges faced by doping control authorities. Some sport organizations have introduced blood tests in an attempt to deal with these issues despite the absence of any effective test for the detection of the administration of homologous blood products or eythropoietin. A number of ethical issues are raised by such developments. Even in the presence of an effective test it is suggested that the decision to implement a specific testing approach can be reached by considering the wishes of a hypothetical "Fair Competitor" and an analysis of the costs involved. In this respect the Fair Competitor assumes in the sport community the role that the "reasonable person" occupies in law, permitting an analysis of a proposed course of action. In making any decision regarding the implementation of any test, a Fair Competitor would be guided by considerations of the postulated advantage and incidence of a doping technique, the likelihood of false positive and negative results, the risk of unwanted consequences of a testing process, and a concern that a specific test not accelerate the likelihood of the use of other doping methods. This approach is applied to a consideration of the appropriateness of blood testing in sport. It is concluded, using such an analysis, that in their present state of development, blood tests should not be implemented. It is recognized that certain sport authorities currently use blood tests to exclude competitors whose blood values exceed certain predetermined levels on the grounds of concerns regarding health and safety. Screening of this kind is beyond the purview of this discussion.
The International Olympic Committee (IOC) published the first list of doping classes in 1967. Since that time, there have been significant problems associated with doping control in sport. Sport is a high profile, internationally recognised activity. However, operational inconsistencies exist between countries and between sports federations. Endogenous substances, such as testosterone, human growth hormone (hGH) and erythropoietin (Epo) present particular problems in determining what constitutes 'normal' levels in athletes. In addition, there is no reliable method available for the detection of hGH and Epo through urine testing. Athletes continue to test positive for banned drugs that are available over-the-counter despite their having been taken inadvertently, without intent to enhance performance. Marijuana use is becoming widespread in society and the impact of this in sport is becoming evident. Doping control, through the IOC list, must continue as a primary objective for the IOC and the sports federations. Constant vigilance and a continued willingness to respond rapidly to change is a prerequisite for such a list. The IOC appears to recognise this need. There are, however, more fundamental issues to be considered. The concept of doping control must be supported by high quality research, effective education and international collaboration. More research is needed into the factors which induce an athlete to take drugs and into the effect, if any, that education on drugs is having on competitors. The most important area for change is the overriding need for international collaboration between the IOC, governments and sports federations. This applies to uniformity in the rules and regulations, consistency in the application and level of sanctions and cooperation on the dissemination of information and development of education policies.