The future of athletic enhancement

Queen’s Prof weighs the ethical implications of genetic doping and sports

Miami Dolphins receiver David Boston relies on intensive training and supplements for his muscle mass, which gene therapy could theoretically increase by 30 to 40 per cent.
Miami Dolphins receiver David Boston relies on intensive training and supplements for his muscle mass, which gene therapy could theoretically increase by 30 to 40 per cent.
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Imagine a performance-enhancing technology whereby a single injection of a modified virus that could not only alter your genes to make you jump higher or run faster, but would also be virtually undetectable.

Imagine a similar technology that could pass the modifications on to your children, or a genetic screening process that would help you decide whether to put them in Little League or swimming lessons.

The technology has existed for about a decade, but according to Dr. Tracy Trothen of the Queen’s Theology Department, ethicists are only now beginning to come to grips with its implications.

Trothen recently conducted a seminar on the ethics of gene therapy to enhance athletic performance and addressed some of the many tensions and difficulties the new technology brings with it.

According to Trothen, the very way we talk about this issue presents a problem.

“The use of terms such as ‘therapy’ and ‘doping’ very much frames the assumptions behind it, and we have to learn to identify the terms used as loaded and question them right at the start,” Trothen told the Journal.

Governing bodies like the International Olympic Committee (IOC) and the World Anti-Doping Agency (WADA) have already cried foul at this technology, calling it gene doping, lending a pejorative nature to the processes which links them to the use of performance-enhancing drugs.

Calling it gene therapy, however, emphasizes the therapeutic effects of such enhancement and evokes images of health and regeneration, significantly altering one’s perception.

Any decision on what to call these processes hinges on an assumption one must make about whether it is abnormal or unnatural to genetically enhance a human being for a particular purpose, Trothen added. As she explains in her paper on the same topic, the line between natural and artificial is “impossible to draw clearly.”

“In the world of elite athletes, what if ‘normal’ ends up being 6’0” in terms of height?” she said. “The argument could become that ... I am below normal without the gene therapy, therefore I need to have that therapy.”

There are numerous different kinds of gene therapy being developed, including somatic cell modification and germ line modification. Somatic cell modification and enhancement in theory only affects the individual who is treated, which makes it more attractive than other options.

According to Trothen’s paper, to perform the procedure, a technician must take “an ordinary adenovirus such as the common cold virus, then remove the genes within the virus that caused the disease, and replace them with genes that make the body produce the desired proteins, and you inject the virus into the human body.” This technique could be used in the administration of exogenous erythropoietin (EPO), an existing drug used by endurance athletes to increase red blood cells’ oxygen carrying capacity, Trothen writes. It could also be used to convey the gene IGF-1 (insulin-like growth factor 1), and one of its isoforms, mechano-growth factor (MGF), which “could also help athletes to increase muscle bulk, and repair muscle damage and so increase recovery time.”

This gene intervention has had dramatic effects in preliminary scientific research. In 1998, scientist H. Lee Sweeney demonstrated that it could increase muscle bulk in mice by 15 to 30 per cent even though the mice were sedentary and that “rats could increase their strength further by engaging in weight training.”

The implications of this are astounding. As one ages, the body expresses fewer genes that promote growth and thus recovers more slowly. If we were able to supplement this loss, athletic decline due to aging could be seriously slowed.

“Wayne Gretzky could be as effective on the ice at age 50 as he was at 30. The implications are staggering,” Trothen says in her paper.

Unlike steroids, however, there is no currently usable way to test for gene therapy in athletes.

“It will be virtually undetectable except by an invasive muscle biopsy, which people aren’t going to do, because of the harm that would cause,” Trothen said. “No athlete’s going to say ‘Well sure, take a slice of my muscle.’ ”

Germ line gene technology carries as-of-yet “unknown consequences to future generations” because they involve reproductive cells, Trothen said. This sort of technology would allow us to create, for instance, children who were born to be taller, giving them a better shot at playing basketball.

Gene technology could affect children in other ways, through genetic profiling and pre-selection, Trothen said. We could, theoretically, profile a young child and find that they are genetically predisposed to being good at a particular sport. They could then be trained and treated intensively from a young age, focusing on the sport at which they are most likely to excel.

“It raises the whole question of consent,” Trothen said. “It’s commonly recognized that children below the age of 16 can’t give consent in the way that adults can, so potentially they could be funnelled into that kind of training.”

This kind of determinism and pressure on children is a forbidding thought in a world where out-of-control parents push their children far too hard in the pursuit of grandiose athletic dreams, she said.

“How do we safeguard against it? I guess one clear route is the law,” Trothen said. “So if these technologies become available for use, approved for that kind of use, then you have to ask who has the right to access that kind of material, because we can’t ensure how that information will be used. A parent could say, ‘I want the profile of my child so I can provide the best possible health care in the future.’ It could get to be a normal part of a medical record.”

Trothen also acknowledged that there are potential benefits to the advent of genetic profiling as well.

“It could be that providing the opportunity to have sports training, access to equipment, trainers, time etc., that this is going to open up greater windows of choice for children to be who they would authentically be,” she said. “There will be parents who say, ‘I want this for my child, and this is my child, therefore I’m going to do it and you can’t prevent me from doing it.’ ”

The arguments about gene therapy promise to be similar to those about steroids, where two common arguments have emerged. One sees steroid use as cheating, and seeks to ban and eliminate their use in sports.

Another says that as we can’t stop steroid use entirely. There will always be athletes who beat the system and gain an unfair advantage, and therefore we should legalize them to level the playing field.

Trothen told the Journal the second argument raises questions about athletes’ freedom of choice.

“If we make this acceptable, or at least legal ... in a sense we’re compromising the ability of athletes to consent authentically to gene transfer technologies,” Trothen said. “The pressure will be on to use it more, because if it’s giving your peer an edge, and you’ve got to compete up against him or her in the Olympics, then you had better find something comparable ... or use the same thing.”

Trothen is adamant that athletes should not feel pressured to use technologies for which the consequences are hazy.

“The unknown health implications are a huge consequence to consider,” she said. “It’s a scary thing right now because the pressure would be on and people would use things that are not safe physically.

Physical implications aside, gene enhancement also challenges “what it means to truly engage in sport at an authentic and deep level,” Trothen added.

“The values that are invoked as essential to sport include naturalness, integrity of character, and fairness,” Trothen says in her paper. “The soft concept of fair play (the good and just game) encapsulates these values.”

However, Trothen argues, these assumptions are not entirely accurate. There is something illusory to this myth of sport, she said, adding that because it is so pervasive, it may be worth trying to preserve.

“If this is the popular perception, then we have to be careful not to destroy this image that does provide hope for a lot of people,” she said. “If we have these hero figures, we ought to know rationally that sport is not a pure meritocracy with all the training equipment and all. The line is so fuzzy. I wonder, as these technologies become more and more prevalent, if that will cause people to lose faith in their sports heroes.”

Trothen said she sees education as crucial to warding off these pitfalls, and thinks that it has to begin with youth who are aspiring athletes.

“We need a lot of intentional education around ethics that we don’t have,” she said. “The technology, I think, is far ahead of our ethical reflections and our knowledge in that area of all the issues and implications that we really have to address in a global context.

“It’s not simply good enough to say, ‘Well, it’s my right to choose, and if I want to take a calculated risk to my health that will help me win, then I should have the right to be able to do that.’ No. We need to be able to educate people at a very young age to say, ‘I think there are a whole lot bigger issues than just me and my rights, and what I do does affect other people.’”

Combining different aspects of an issue, she said, becomes crucial in helping us to understand the different approaches to issues as complex as this one.

“We have to make more interdisciplinary connections so that these measures can actually happen,” she said. “We have ethicists [here at Queen’s] in philosophy, theology and religious studies, medicine, but in sport, I don’t know that ethicists have had a huge role to date.”

Trothen also cautioned that we’re closer than we think to seeing this technology in our everyday sporting lives. The IOC and WADA have already listed gene therapy as banned, even though there are no recorded cases of it having taken place or any ways of preventing it. They can’t be certain, however, that gene doping has not taken place in sports already.

“My guess is it’s probably out there in some form—I wouldn’t be surprised,” Trothen said. Sweeney was contacted by athletes immediately on publishing his results.”

But when all is said and done, the question remains whether genetic modification actually erodes the foundations of athletic competition, Trothen noted. After all, athletic ability isn’t everything. Vince Carter has all the athletic prowess one could desire, but when he was unhappy in Toronto, his productivity plummeted.

“There will still be that factor of drive, determination, discipline, [and] we can’t replace those factors,” Trothen said. “So even if all the justice concerns were solved, all the health problems were solved, and a decision was made to proceed with these technologies, there would still be those factors of being human, being determined or not, having that drive. Whatever it is, there is that piece that puts some people past even what they ought to be able to do.”

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