Intended for healthcare professionals

Head To Head

Should athletes be allowed to use performance enhancing drugs?

BMJ 2013; 347 doi: (Published 22 October 2013) Cite this as: BMJ 2013;347:f6150
  1. Julian Savulescu, Uehiro chair in practical ethics1,
  2. Leon Creaney, consultant in sport and exercise medicine 2,
  3. Anna Vondy, ST6 emergency medicine3
  1. 1University of Oxford, Oxford, UK
  2. 2Trauma and Orthopaedics, University Hospital Birmingham, Birmingham, UK
  3. 3Emergency Department, Royal Liverpool University Hospital, Merseyside, UK
  1. Correspondence to: J Savulescu julian.savulescu{at}, L Creaney leon.creaney{at}

Stories about illegal doping in sport are a regular occurrence. Julian Savulescu argues that rather than banning performance enhancing drugs we should regulate their use, but Leon Creaney and Anna Vondy say this would lead to escalating use and call for tougher enforcement

Yes— Julian Savulescu

The zero tolerance ban on doping has failed. The second fastest runner ever, the American Tyson Gay, recently tested positive for a banned substance, along with Jamaican sprinters Asafa Powell and Sherone Simpson. There is evidence of widespread doping across many sports including athletics, tennis, and cycling.1 Recent evidence from Germany suggests doping is rife in football.2 Despite apparent advances in the “war on doping,” our success in detecting drug misuse is limited. In 2000, the first tests for erythropoietin were introduced.3 Yet in 2012, the US Anti-Doping Agency expert Larry Bowers said that a negative test cannot be equated with the absence of doping.4

According to Hermann and Henneberg, “Using typical values of detectability . . . the probability of detecting a cheater who uses doping methods every week is only 2.9% per test.”5 It is time for a different approach.

Human nature

It appears we reached the limits of human performance in sprinting about 15 years ago. Starting with Ben Johnson in 1988, only 10 men have ever run under 9.8 sec. Only two (including Usain Bolt) are currently untainted by doping.

To keep improving, to keep beating records, to continue to train at the peak of fitness, to recover from the injury that modern training inevitably inflicts, athletes need enhanced physiology. We have exhausted human potential. But to be human is to be better, and doping is not going to go away.

Regulation could improve safety

The strongest argument against doping is safety. Since there have been no scientific tests of the effects of doping …

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