Current anti-doping in competitive sports is advocated for reasons of fair-play and …

• Abstract
• Background
• Discussion
• Special cases
• Conclusion
• Miscellaneous
• References

Clearly, further questions need addressing to more fully explore our criticisms of current anti-doping and our proposal for alternatives. For instance, one might ask which athletes would qualify for doctor-assisted doping, whether there would be age limits or limits to performance levels. Moreover, it is necessary to explore matters of control and regulation and whether an organisation like the WADA-AMA remains the most suitable model. Sports are increasingly important for economic and political reasons. To a sizeable extent, elite sport is a self-sustaining enterprise, with significant financial returns from advertisement, media and audience revenues. As such, it could be argued that the war on doping is an internal matter of the sports community, provided that it foots the whole bill for anti-doping control. But in fact considerable public funds go into sports too, for fundamentally sound reasons such as health promotion. The increasingly expensive doping control is also paid by governmental sources, and not only by the sports enterprise itself. Moreover, the ethical foundations of sport are also a matter for public debate and, like for other ethical policies in society, there should be mechanisms ensuring accountability of policy to the broader public. For each of these reasons, the war on doping becomes a public issue as well. Hence, its consequences have to be seen from a public health perspective. We believe that current anti-doping does not adequately prevent damage from doping in sports, that it creates health problems of its own, and diverts health-care resources from more worthwhile pursuits. In addition, the role of the physician in sports and in doping control poses serious ethical dilemmas. We believe that allowing medically supervised doping rather than absolute bans would provide a sounder foundation for sports physicians to exercise their responsibility and maintain their health care obligations.