Submission by Dr. John T. Ehrbar1*
1* Student of doctoral studies in sports management at the United States Sports Academy
New technologies are currently being developed that will enable medical professionals to modify genes for medicinal purposes. As the process continues to be refined, the emergence of a controversial new use for this technology has ignited some serious debate. Scientists have submitted that genetic modification could potentially be used as a method of performance enhancement in sport. There are different schools of thought on this type of performance enhancement, and researchers and theorists have argued the advantages and disadvantages of using such a technology. These arguments are discussed in the present review. Though the ethical debate on this matter is in its infancy, a general consensus is that the allowance of genetic modification for the purpose of enhancing performance in sport will most certainly create a new look, along with new concerns, for sport in the future.
Key words: ethics, gene doping, sport, performance, enhancement
Technological advancements have improved the world in many ways. Innovative use of technology has opened the door for new avenues of communication, efficient means in which to conduct business, new learning opportunities, and major advancements in the fields of science and medicine. These technological advancements, in many ways, have greatly improved society. With development of any new technology, however, there is always possibility that the technology may be used inappropriately. For this reason, it is crucial to examine ethical issues that may arise as a result of the new technology. In the ongoing pattern of change in today’s world, it is clear that through discovery and development of new technology, society will be capable of many more things in the future, which will lead to ongoing discussions on ethics and morality.
A major technological advancement in recent years is the ability to manipulate genes. Gene therapy, as it is referred to, has been developed with the intent of healing and possibly preventing disease or injury. As technology in this field continues to grow, the possibilities grow with it. For example, gene therapy could potentially be used for performance enhancement in sport. Scientists are learning increasingly more about DNA and genetic make up, and as a result, are starting to identify specific genes that may enhance athletic potential.
The idea of gene doping or genetic modification as a method of enhancement in sport is very innovative. It is also a very controversial topic, and the worldwide discussion on gene doping is continuing to grow as this technology expands. The idea of creating “super athletes,” though, is incredibly intriguing. Very little research exists on the application of genetic technology for the benefit of sport, but several pieces of research on the theoretical implications of this technology have been published. The research indicates that key ethical considerations need to be examined prior to considering implementation.
The purpose of this review is to focus on the ethical considerations of genetic modification to enhance sport. Specifically, reasons why an individual would want to utilize this type of technology are examined, including normative arguments for and against its use in sport. As technology continues to improve and expand, it is only a matter of time before this futuristic idea of genetic modification becomes a present-day reality.
For clarity purposes, it is important to identify key concepts and terms that are used in research on genetic technology. In sport, doping has traditionally been the term that describes the process of using illegal performance enhancement substances. Most sports governing bodies, as well as the World Anti-Doping Agency (WADA), have some type of written policy that identifies which substances are not acceptable for the purpose of performance enhancement in sport. Gene doping is a relatively new term that is discussed extensively in the research presented in this review. WADA (17) defines gene doping as “the non-therapeutic use of cells, genes, genetic elements, or of the modulation of gene expression, having the capacity to enhance athletic performance” (p. 7).
The two types of gene modification that are discussed in the literature are somatic therapy and germ line therapy. Somatic gene modification deals with the treatment or changing of gene cells in an adult (16). The modifications that occur as result of this type of gene therapy are restricted to only the individual and cannot be inherited by any future offspring (4). An example of somatic gene therapy, which is in violation of WADA policy, is the modification of a cell to make it produce more testosterone on a regular basis than it would in its natural state (16). Somatic gene modification is a process that can only be used on existing humans.
The second type of gene modification is more controversial and is known as germ line therapy. The biggest reason for the controversy is because this type of modification is done prior to birth and all manipulations from germ line therapy become hereditary (4, 16). The principal function of germ line modification is to counteract genetic disorder or heredity disease. For example, if a family has a history of heart disorder, it may be possible to use germ line therapy to change the genome of an unborn individual. By doing so, the risk of heart complications later in life can be reduced or even prevented.
In terms of sport, germ line therapy could also be used to alter an embryo with desired genetic characteristics to make it predisposed for physical excellence, thereby creating a so-called “super athlete.” The majority of the literature presented in this review focuses on the ethics and implications of germ line modification.
REVIEW OF LITERATURE
A central theme of the research on genetic engineering is how this advance in technology can be applied for the purpose of sport. The idea of creating and engineering embryos to be future athletes seems like a topic for science fiction literature or television. Amazingly, the technology to do so is currently being developed. However, it would not make much sense to use this technology unless the benefits far outweighed the risks of such a procedure (10). Parents, though, may be willing to take certain risks when it comes to germ line modification to increase the chances of their child becoming a star athlete and subsequently ending up in a financially sound position. Parents who follow this school of thought should note a very important caveat – the fact that genetics alone do not necessarily lead to athletic success. Other factors such as ambition, diet, willpower, practice, and training are also necessary to be successful in sport (3, 10). In American culture, dreaming big and desiring the best is the norm. With this cultural mindset, the creation of “super-athletes” is not far-fetched and is a viable reason for people wanting to utilize genetic technology for the purpose of sport.
A very practical, and probably more easily accepted, reason for using genetic technology in sport is to aide injury recovery and prevention. Miah (10) suggested that gene therapy could be used to help athletes recover from injury more effectively and efficiently. Early experimental research, though limited, has provided some supporting evidence, and Cieszczyk et al. (2) agreed that gene therapy will help in treating sport-related injuries such as contusions or trauma. Implementing gene therapy in this manner for sport is more in line with the original intent of the scientific quest to prevent disease and treat illness.
A third potential benefit for genetic modification in sport is to eliminate or significantly reduce gender discrimination in sport. While discrimination will most likely be an ongoing ethical issue, it is an intriguing notion that genetic manipulation could be a step towards finding a solution. The main argument for genetic technology and its potential influence on gender discrimination in sport is that individuals whose genes are engineered for athletic superiority will be able to compete and be evaluated by athletic performance alone, thereby rendering gender a nonfactor (7). Gender, then, would no longer be a differentiator in sport, as genetic engineering would level the playing field.
With the ongoing development of so-called gene doping and cyborg technology, we will perhaps face a future where sports (as we know it) occurs in the purest form; that is, where athletes get evaluated by their athletic performance only and not by their gender and where it becomes impossible to discriminate athletes based on their body constitution and gender identity. (7, p. 259)
This thought is innovative, and with additional experimental research, could be a plausible motivation for using genetic modification techniques for the purpose of advancing sport.
Normative Arguments Against Genetic Modification in Sport
Genetic modification in sport has created large scale discussion on ethical implications. Research has been published with normative arguments that are against this relatively new technology. This section has been placed first in this review, as many of the arguments in favor of genetic modification in sport are written to refute the arguments against.
Some arguments to refuse the acceptance of the development of genetic enhancement technology in sport for practical, health, and ethical reasons have been presented. From a practical standpoint, there is not a definite ideal athletic body type (14). For example, ideal boxers are built differently than ideal hurdlers. The fact that ideal body types differ depending on the sport is problematic because germ line modification requires that genetic choices be made prior to birth. Parents would, in effect, have to guess as to what sport the child may be interested in later in life. If a child is born with the expectation to be an elite swimmer because he or she was “built that way,” it creates ethical issues regarding that individual’s right to be able to make his or her own choices. In addition, Sherwin (14) warned that genes are not destiny; there are many environmental factors that influence success and failure in sports. Therefore, gene therapy is not a foolproof method that is guaranteed to link directly to athletic success.
Genetic engineering is also a risky procedure when it comes to overall health. Preliminary tests on gene modification have proven to be unpredictable, and there is still a lack of certainty as to how a body would respond to gene therapy (3, 4). In fact, testing in this field has resulted in unfortunate tragedy in some cases. A prime example of this is the case of Jesse Gelsinger, an 18 year old student who was a subject for clinical research on gene therapy. His body did not respond well to the therapy, and as a result he died within 96 hours of the treatment (2). Not all clinical trials have ended in this tragic manner, but safety is still a cause for concern.
Aside from risk and practicality, there are other objections against the use of gene doping or genetic modification in sport. One concern is that the use of this technology could result in unexpected consequences (4). Genetic modification could alter sport as we know it in significant and permanent ways (4). The new class of humans that would result from germ line enhancement would interact with unenhanced humans in sport, thereby creating a potential disadvantage for the unenhanced. This could create a state of inequity and question the fairness of sport, as not all would have access to the technology due to price, availability, or other factors (10). It follows, then, to remain just in sport, different classes would need to be formed, similar to weight classes in boxing or wrestling (7). In this case, the two class choices would be enhanced athletes and unenhanced athletes. Whether or not this idea of classes would be accepted is yet to be seen. However, this idea of classes has a major drawback. Creating such classes would detract from the very purpose of gene doping or genetic modification, which is to gain some sort of advantage (10). Fairness is a key subject of ethical discussion in sport, and genetic manipulation for performance enhancement in sport adds a new dimension to the topic.
An additional normative argument against the use of gene doping for sport purposes revolves around the issue of privacy. If genetic modification becomes widespread and acceptable in sport, guidelines regarding privacy of personal information, especially DNA, would need to be established. Genetic engineering requires testing of genes and DNA. The information obtained from this testing would identify “all the processes occurring in the body and may be used to estimate the probability of disease, or even to define a certain type of human character” (3, p. 323). Due to the confidential nature of the information ascertained from the tests, there would be a definite need for privacy regulations. Expanding beyond sport, the lack of privacy in this matter could lead to genetic discrimination from life or health insurance companies, as information on any given individual’s genotype could be accessed (9). Putting safeguards in place to prevent this type of discrimination from occurring is a necessity. In this age of technology, the ability to collect, share, and manipulate personal information through computers has created some difficulty in maintaining privacy for individuals (13). There is valid concern about privacy that needs resolution before genetic engineering can be become an acceptable practice in sport.
Normative Arguments in Favor of Genetic Modification in Sport
Research also exists that promotes the idea of genetic modification in sport. One such argument is that genetically modified athletes would perform at higher, unimagined levels, thereby adding more excitement to sport (15). As a result, fan base and attendance at sporting events could potentially grow. Since physique would be predetermined by genetic modification, the outcomes of sport competitions in the future would be based more on psychological, moral, and intellectual strength, thereby making the competitions more pure (15). For example, as it stands today, basketball players vary in height, with the taller players typically having a major advantage. If genetic technology is used in a way so that all players are tall, the physical advantage is removed, and constitutive game skills, combined with mental toughness, will determine which competitors will win.
To counter the argument that genetic engineering could potentially cause major health issues, it has been mentioned that people have always devised ways in which to enhance or improve their physical condition (15). While genetic technology has inherent risks, other technologies were also considered risky when first introduced. For example, certain weight training techniques and special dietary regimes can be risky for individuals, yet they are still permitted as methods of performance enhancement in sport (1).
It has also been theorized that genetic technology has societal and sport-related benefits. Brown (1) suggested that there is a responsibility to use scientific knowledge to improve physical well-being. It is impossible to see into the future, though, so there is no definite way of knowing the actual benefits or harms of using genetic technology for performance enhancement (1). However, just keeping the status quo for the sole purpose of fearing risk or change does not allow for improvement (1). “We can only struggle to make things better for ourselves and our children as best we can, knowing that we will often fail in these efforts, and only dimly aware of our next steps and their uncertain direction” (1, p. 136). Brown’s arguments are crucial ones that demonstrate the need to critically evaluate change and consider improvement that result from it.
While many ethicists and theorists have labeled genetic enhancement an unfair process, there are some who disagree. Loland (8) asserted that as long as safety provisions and equal access opportunities are put in place, innovations in sport technology should be pursued as methods of bringing out athletic talent and overall human excellence. Loland’s argument assumes a state of equity. However, due to the “genetic lottery” of life, it could actually be considered unfair not to utilize genetic modification technologies (5). It is a reality that inequality exists in many facets of life. For example, life is often considered unfair for individuals who lack the resources to overcome economic or social disadvantages (7). Similarly, it could be argued that genetic differences in individuals also lead to inequality of resources or opportunities (5). Thinking along these lines, Fox (5) contended that the use of biotechnology and genetic manipulation has the potential to move us towards a more just society. Fox, like most proponents of genetic engineering, is also aware of all the ethical concerns involved and recommends a cautious approach for implementation of this new technology.
Research on Sport Ethic and Policy
For years, traditional doping in sport consisted of the use of performance enhancing substances, many of which are now banned (17). The banning of such drugs has brought about new ethical issues. In fact, it has been argued that the existence of an anti-doping policy has generated a climate of cheating in sports (6). Some researchers and members of sport ethics committees believe that new policies may actually encourage athletes to attempt gene doping, because, at the present time, there are not any reliable methods of detecting the use of gene doping in individuals (6). This is a serious issue that needs to be considered and addressed by WADA and other sport governing bodies.
Following those lines, it is important to realize that gene doping is unlike any other type of doping found in sport. Miah (12) suggested that gene doping be classified differently than traditional doping, because it is so new and its effects have not been firmly established. Miah (12) challenged policy makers to consider this situation very carefully. “In a world that permits the use of gene transfer technology for therapeutic purposes, it would be inconceivable that sports authorities could prohibit such athletes from competition, just because they were genetically modified” (12, p. 155). This statement deserves consideration when establishing policies for gene doping. In terms of policy improvement, Miah (11) also stressed that policies regarding all forms of doping, including gene doping, should be presented in a more positive light. Rather than focusing policies on the negative aspects of doping, policies should be designed that define acceptable means of performance enhancement (11). This differs from current policies, which focus on substances and enhancement methods that are prohibited in sport. Presenting policy in this manner could lead athletes to choose among acceptable enhancement methods in their quests to improve performance.
Future Research on Gene Modification in Sport
There are several ethical implications of genetic technology as a means of performance enhancement in sport. Though there have been a few experiments on animals and some preliminary tests performed on a small number of humans, there is not enough data to be conclusive on the ethical issues that are present in the current philosophical and theoretical research. Future areas of research could focus more specifically on gene doping and how it is viewed by different cultures throughout the world. As more research is conducted on the scientific and ethical implications of genetic modification for use in sport, the dialogue will progress, and educated conclusions may be reached. While there will most likely never be final agreement on each of the arguments that currently exist, research can help support the decisions that will ultimately be made by policy creators and leaders of sport organizations.
Summary and Significance
Decision-makers in the field of sports management have been presented with a very complex task. There are definite risks and benefits associated with genetic modification, and those who study ethics in sport will have no shortage of opinions to consider on this topic. The research presented in this review thoroughly discussed normative arguments against and in favor of genetic modification for performance enhancement in sport. Moving forward, it is critical that policy makers and governing sport bodies stay engaged in this dialogue, despite the difficult nature of this task, so that sport can continue to grow and stay relevant long into the future.
Strength, endurance, focus, and several other traits all lead to athletic success. Since the beginning of sport, athletes, coaches, and scientists have been developing methods to improve performance in sport. With each new method has come a set of ethical questions. As this fast-paced age of technology continues, the questions seem to be getting gradually more difficult to answer. Normative issues test our values, morals, and belief systems. They demand a critical evaluation of appropriate means to advance sport. Additional research on genetic modification will produce additional questions and answers. Working through these ethical considerations, it is crucial to maintain a focus on the safety of individuals, while not losing sight of the importance of keeping sport relevant and sustainable for many years to come.
Implications for the Sport World
If genetic modification is permitted as a method of performance enhancement, elite sport will most certainly have a new look with new concerns. Though research is limited and inconclusive at this time, there is preliminary consensus that genetically engineered athletes would have some type of advantage over those who are not products of genetic technology. In elite sport, that advantage, even if it is very small, could be a difference maker in a close competition. Because physical attributes of genetically enhanced athletes will not be as necessary to develop, extra attention will need to be placed on psychological training, with an emphasis on motivation and focus. Elite sport and competition could potentially become more exciting and showcase more highly developed athletes as a result of this new technology if allowed.
As indicated by the research, a concentrated effort should be made on measuring the risks and benefits of genetic modification. This can only happen through additional study and discussion. Sports leaders and policy makers will have to settle the debate and determine what types of genetic modification, if any, are acceptable for sport. Whatever the end result may be, it is clear the sport is continuously evolving and ethical issues will continue to surface as athletes search for the latest and greatest methods of enhancing performance.
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