The following are remarks made by Richard W. Pound at the annual meeting of the American Association for the Advancement of Science in Seattle on February 16.
To begin, I want to thank the AAAS for putting this Symposium together and for giving an admitted non-scientist the chance to participate in the consideration of a series of important policy issues. It is a great pleasure for me to be here with so many eminent scientists and scholars.
Since I have the honour of speaking first, let me take the opportunity to define the question, to identify some of the matters that may have an impact on it, and to suggest some approaches that may enable us to accommodate both the advances in science and the ethical foundations on which sport is based.
The shared vision of sport is that of an activity that involves physical exertion and skill, in which individuals or teams compete against each other for entertainment – for fun. It is a humanistic endeavour, intended to see how far the natural abilities of the athlete, honed by practice and perfection of the related skills, can be advanced. It is governed by rules that, however artificial or arbitrary they may be, are freely accepted by the participants. Why a race is 100 or 200 or 1,500 metres does not really matter. Nor does the weight of a shot or a discuss, the number of members on a team, or specifications regarding equipment. Those are the agreed-upon rules. Period. Sport involves even more freedom of choice than participation in society. If you do not agree with the rules in sport, you are entirely free to opt-out, unlike your ability to opt-out of the legal framework of society. But if you do participate, you must accept the rules. You are not entitled to use a 10-pound shot instead of the 16-pound shot used by your fellow competitors. You are not entitled to start the race before the other competitors, just because you may be a bit slower than they are. This is not a complicated calculus.
There are mechanisms to change, adapt or evolve the rules. The process is essentially democratic and may operate on a local, national or international basis, depending on the nature of the organization or the particular rule. Those who make such decisions are generally, or represent, those with the most knowledge of the issues surrounding the subject matter of any change. The sport system in the world has been quite effective in adapting to a broad range of social, health and human rights issues over the past century or so, as sport has become an integral part of modern society. The governance models, founded on principle and pragmatism, provide a framework applicable at any level.
Now, the theory of all this is fine and is not difficult to understand. If you will permit me some Rumsfeldian rhetoric, Is the system perfect? No, it is not. Are there people in sport operating outside the system? Yes, there are. Are we on top of all the problems? No. There are things we know and things we do not know, things we know we don’t know and things we know we don’t know we don’t know. [I am sure that will be clear to everyone.]
There are regular infractions of the rules of play on the field. These are dealt with under the rules with appropriate sanctions, disallowed goals, penalties, suspensions, ejections from the competition. These are relatively simple to enforce, provided the officials charged with such enforcement are competent and impartial. We have all seen that at least as many of the problems in sport result from inept or corrupt officiating as from infractions on the field of play. But this is a sport problem that sports authorities must solve.
More germane to today’s considerations is the use of performance-enhancing drugs or procedures, activities that involve the athlete, of course, but which also require the complicit activity of coaches, trainers, scientists, medical doctors and others.
The context here is important. There are sport rules that prohibit the use of such substances or methods, including gene transfer therapy. These rules are just as much part of the sport as those regulating on-the-field activity. Each substance or procedure has been added to the list against a combined matrix of performance-enhancement, danger to health and the spirit of sport. I am not here to say that there is unanimity of scientific opinion on each substance or method, but the list is re-assessed each year by a panel of respected scientists and clinicians and adapted from time to time, as new discoveries (for and against) are made and evaluated. But, again, the list is the list, whether you may agree with the inclusion of a particular item or not. If you breach the rule, you are subject to the sanctions provided in the rules.
The difficulty for the sports authorities in all this is that the practice (referred to as doping) is, by its nature, entirely clandestine. The ingestion of the substances or the application of the method is done in secret, precisely because it is prohibited. Much of the research is also clandestine. There is, therefore, a paucity of scientific data, which, along with a lack of funds for most sport organizations, has inhibited the ability to devise reliable tests to detect such usage. Don Catlin will be speaking in a few minutes and will provide you with some fascinating insights into his work as a modern Sherlock Holmes and his many successes, even with the additional challenges resulting from underground use and experimentation with some of the drugs.
But, while the ability to detect is important and must continually be improved through further research, far more important is the fact that sport, which is supposed to be fun, is surrounded by people and organizations whose sole objective is to find some way to cheat, to rob an athlete who has played within the rules of what should have been his or her result. These people deliberately set out to destroy the ethical basis of sport and to ruin the lives of the athletes under their care or control, forcing them into a conspiracy of subterfuge and lies, living with the constant fear of discovery and disgrace and exposing them to the side effects of what they are taking. There is no accident about the ingestion of THG, of EPO, of stanozolol, or of blood transfusions. This is the central element of a plan to cheat.
I don’t know about you, but I do not want my children or my grandchildren to have to become chemical stockpiles to be successful at sport. I don’t want them in the hands of people who would do that to them. I don’t want to go a professional ball game with my grandchildren and say to them that, some day, if they take enough steroids and lie convincingly enough, they, too, might get to play the game out there. I don’t want them to train for years and to lose, by a hundredth of a second, a centimetre, a few grams, a point or two, to someone who cheated. Nor do I want that to happen to the child of a friend, a neighbour, a countryman. To anyone.
In sport, we are coming to a better understanding of how to deal with drugs. It was a genie that we allowed to get out of the bottle, before realizing the health and ethical consequences, and we have been playing catch-up ever since. The creation of the World Anti-Doping Agency (WADA) in 1999 as a joint effort between the sports movement and governments has been the most ambitious step ever taken in the fight against doping in sport.
Under its aegis, a single World Anti-Doping Code (WADC) has been adopted, to provide a single set of rules, a single list, a single set of sanctions, uniform standards of testing and analysis and a single dispute resolution mechanism that will take sport-related disputes out of the hands of the regular courts in each country (where different standards might apply) and put them into the hands of expert arbitrators. We are adding significant funding to research activities, performing more targeted out-of-competition tests and studying the best means of delivering broad-based educational programs. It is a fight that is far from won, but there has been significant progress and there are many national anti-doping agencies that are doing excellent work, including, in this country, USADA. This is the devil we know.
You will hear from Lee Sweeney in a few moments. [Please do not draw any conclusions from this juxtaposition.] I had the pleasure to participate at a conference with Lee a couple of years ago and to learn something about the work that he and others in the field of genetics are doing. It is fascinating to think what may be possible in future and to contemplate the cures to such terrible diseases as muscular dystrophy, diabetes and others. We may be at the threshold of discoveries that will be at the forefront of medicine for generations to come. I share vicariously in what must be their excitement of coming to work each day, wondering if it will be the day on which the breakthrough occurs.
But, at the same conference we attended in 2002, I also heard what I had feared. One of the first inquiries that a team of genetic researchers had received, outside the scientific circle in which it was pursuing its work, came from a coach, who wanted to know what the possible application might be to his athletes. Not as a therapeutic application, but simply for performance-enhancement.
So, here we are, at the beginning of a possible Brave New World. How close we are is a matter of speculation. As Ted Friedmann has said, the NIH Recombinant DNA Advisory Committee of the U.S. has not yet approved any proposed gene transfer studies that are not for the purpose of treating disease. But this is, despite its importance, only one agency in one country. The very kinds of scientists who developed THG may well be ready to use the new technologies for the profits to be derived from performance-enhancement. They may be in the U.S., or outside. But it is a reasonable assumption that they will exist, somewhere, and be willing to use the technology for non-therapeutic applications. And, quite possibly, without the necessary study to determine the full implications of that use.
The time to grab hold of this matter is now, in the design and enforcement of the protocols for gene transfer technology, at the laboratory level, in the rules for clinical testing and in the application of proven technology. It is far easier to prevent a problem than it is to solve it. Or, as we say in my family, an ounce of prevention is worth a pound of cure.
Seen from the outside, I hope that governments, regulatory agencies, academic institutions, professional governing bodies and the public at large will insist on the development – and the enforcement - of a policy framework to regulate the application of gene transfer technology, not just on a national, but also international, basis. This application of science may come perilously close to our humanity and its implications deserve the most careful study. Therapeutic drugs are one thing; changing the genetic make-up of people is quite another. I also hope that sport will be given a seat at the policy-making table or that, at the very least, there will be a means of getting its concerns squarely before the policy-makers.
I also hope, as the technology moves increasingly from the laboratory benches to clinical trials, that one of the regulatory requirements will be that a means of detecting the application of the technology be identified as part of that process. I am aware that a gene is a gene and that it may be impossible to detect the altered from the natural, but there may be (and probably are) indirect indicators that will provide sufficient scientific certainty to allow them to be used for testing purposes.
Science is science and knowledge is knowledge. Both are entirely neutral concepts. I have no desire to suggest that either should be limited. I believe that the advancement of knowledge, in all fields, is desirable. It is in the ethical application of that knowledge that I believe we have a particular responsibility. Understanding the power locked in the atom is an exciting scientific discovery. Using that knowledge to build an atomic bomb is more problematic, and deploying it infinitely more so. Understanding the properties of certain germs is important; using that knowledge to make applications designed for biological warfare is terrifying.
I want to keep this in perspective. Gene transfer technology may be wonderful and desirable for therapeutic purposes. It should not, however, be used on perfectly healthy athletes to enable them to cheat their competitors. Society is built on an ethical platform, as is sport. Those platforms should be sturdy enough, sufficiently defined and sufficiently enforced to deal with advances in the sciences.
I want gold medals to be given to athletes who earned them honestly, not to their secret pharmacists or gene transfer technologists.
I want athletes, not gladiators.
I want human beings, not mutants.