Before the rules are written: navigating moral ambiguity in performance enhancement

In 1984, a number of US cyclists used blood transfusions to boost their performance at the Los Angeles Olympic Games. The cyclists broke no rules and dominated the Games, yet were later maligned as cheaters and dopers—they had, it seemed, violated some important norm, albeit one which was neither an official rule nor otherwise easily identifiable. Their case illustrates the moral ambiguity that arises when a performance enhancement is employed in a sport that has not addressed it. This article takes up the crucial question posed by such moral ambiguity: is it ethical to enhance performance through a substance or technology when no rules exist to prohibit it? We first examine ordinary ethical obligations that athletes carry based on their status as moral agents. We conclude that such obligations provide some guidance, but cannot resolve the issue. We then examine arguments that take sport as a unique social practice that presents its own moral obligation not to use performance enhancers. We argue that these ‘spirit of sport’ arguments, developed by McNamee and Loland and Hoppeler cannot resolve the issue either. We conclude that when the rules governing sport are silent on the issue of performance enhancement the constraints on its ethical use are limited at best.     

Guidelines for Counsellors Working with People of African Ancestry in a Sport Context

The objective this article is to describe five practice guidelines for counsellors working with people of African ancestry in a sport context. The practice guidelines pertain to counsellor training, counsellor perspectives, counsellor services, counsellor ethics and counsellor research. These practice guidelines can assist counsellors working with people of African ancestry in a sport context to focus on both personal development through sport and performance enhancement in sport. This will enable athletes not just to view sport in terms of their win-lose record, but to also strive for excellence in sport by becoming better people. In becoming better people athletes can contribute to building up Africa and her people.     

The Elite Sport and Christianity Debate: Shifting Focus from Normative Values to the Conscious Disregard for Health

Scholars and theologians continue to debate whether or not God’s intended purpose of elite sport violates the creational normativity for elite sport. However, while it is important to be aware of the contradictions between elite sport and Christianity, there is a need for more deep-seated discussions about emotions and health problems in elite sport and why so many Christian athletes continue to train for their sport at the expense of their health. This paper summaries the present debate regarding elite sport and Christianity and then shifts the reader to an exploration of the normalization of emotion, and the consequence of emotional suppression on athletes health. In doing so, the author presents the disregard of health problems as a more concrete measure of how far athletes should push themselves in elite sport. The author makes recommendations for emotion education and suggests directions for future research and practice.     

Doping in sport and enhancement medicine

The reason that gives doping in sport a deeper philosophical and ethical dimension is the emergence of a new medical paradigm: enhancement medicine. The question of enhancing performance in sport has become part of a broader societal debate on human enhancement. The gradual blurriness of the boarders between therapeutic medicine and enhancement medicine constitutes the most spectacular and the most troublesome form of these modifications. In the contemporary biomedicine, the new medicines and technologies can be used not only to cure the patients but also to enhance human capacities. This evolution represents a paradigmatic change in the medical practice: it is not the mere restoration of health which is expected anymore, nor the promotion of health. What is required is the improvement of performance and the perfectibility of the human being, including in the field of sport. Competitive sport could become the main laboratory of enhancement medicine. The intersection of science and sport raises fundamental philosophical, ethical and policy issues that cannot be answered easily. The prohibition and the war on doping is not the only solution.     

Miracles in Sport: Finding the ‘Ears to Hear’ and the ‘Eyes to See’

Paralympic Games (PG), involving people with disabilities (PWD), are a manifestation of excellence in sport. They show that athletics performed by PWD counts as genuine sport. They also support a wider meaning of the term ‘health,’ understood not just like a utopian state of perfection, but like the ability to realize oneself in the projects and activities of one’s own choosing. Notwithstanding these virtues, PG—in their current form—may paradoxycally reinforce social prejudice against PWD. This is due to the fact that PG and Olympic Games (OG) are now two distinct events. In this article, I argue that PG should be integrated in the OG, just like women’s and ‘minor’ sports, because the separation of PG and OG indicates a morally arbitrary separation between people with and without disabilities. I also propose to remove the word ‘Para-lympic’ because it stigmatizes the sport performed by PWD as an appendix of ‘normal’ sport. Athletes with disabilities deserve special attention because they have special needs; but they also deserve an arena where their excellence is offered to the public, and this arena should not be different from that of normal-bodied athletes.     

An Alternative Solution to Lifting the Ban on Doping: Breaking the Payoff Matrix of Professional Sport by Shifting Liability Away from Athletes

The persistence of doping in professional sports—either by individuals on an isolated basis and by whole teams as part of a systematic doping programme—means that professional sport today is rarely if ever untainted. There are financial incentives in place that incentivise doping and there are data that show that doping is often a systematic, organised enterprise (either at team-level, or at state-level). The main question to be answered today in professional sports is whether doping’s repressive anti-doping policies do not have greater negative consequences for society. Whilst some have suggested legitimising safe doping under medical control, in this paper, I argue that doing so will do little to prevent clandestine use of dangerous performance-enhancing substances, and suggest an alternative solution to lifting the ban on doping, i.e. starting from extending liability for doping in sport beyond athletes to those holding power and authority over athletes, to changing winning incentives for doping, to making sport sustainable in the longer time by devising ways of providing athletes with a steady income which is not linked to record breaking or sponsorships.     

Performance-Enhancing Drugs,Sport, and the Ideal of Natural Athletic Performance

The use of certain performance-enhancing drugs (PED) is banned in sport. I discuss critically standard justifications of the ban based on arguments from two widely used criteria: fairness and harms to health. I argue that these arguments on their own are inadequate, and only make sense within a normative understanding of athletic performance and the value of sport. In the discourse over PED, the distinction between “natural” and “artificial” performance has exerted significant impact. I examine whether the distinction makes sense from a moral point of view. I propose an understanding of “natural” athletic performance by combining biological knowledge of training with an interpretation of the normative structure of sport. I conclude that this understanding can serve as moral justification of the PED ban and enable critical and analytically based line drawing between acceptable and nonacceptable performance-enhancing means in sport.     

The relationship between intrinsic and extrinsic religiosity and competitive anxiety

ABSTRACT

The present study examined the relationship between religiosity and competitive anxiety in college athletes and whether there were differences in competitive anxiety for intrinsically religious and extrinsically religious individuals. College athletes (N?=?95) from three separate sports from the NCAA completed a questionnaire that included the Age-Universal I/E Scale, the Competitive State Anxiety Inventory-2 Revised, open-ended questions on habits related to religion, and demographic items. Results revealed no significant relationship between intrinsic and extrinsic religiosity and competitive anxiety. Extrinsically religious athletes had higher somatic anxiety than intrinsically religious athletes. The majority of participants (77%) reported praying before games primarily for comfort. Athletes turn to religion to calm their nerves but it is important to understand that their approach to religion may relate to increased anxiety. This information is useful for sport practitioners and coaches as they seek to help their athletes seek an intrinsic approach to religion in sport.     

Que(e)rying the Clinic before AIDS: Practicing Self-help and Transversality in the 1970s

In this paper, I offer a treatment of “the clinic” in which the clinic—as concept and space—is que(e)ried, that is, both questioned and made queer. I present two historical case studies that queer clinical thought and practices in the period before AIDS and before the full-blown arrival of queer theory on the western theoretical landscape. These two cases—the practice of self-help developed in the women’s health movement in the United States and the practice of tranversality developed out of and beyond the Institutional Psychiatry movement in France—challenge the practice of medicine in the prehistory of both AIDS and queer theory, yet, they are not generally seen as precursors, or related in any way, to AIDS activism. In a sense, then, I also want to question and make queer the history of AIDS as we conventionally know it today by extending that history backwards and outwards to earlier queer critical and clinical practices like self-help and transversality.     

The rebalancing act: Injured varsity women athletes’ experiences of global and sport psychological well-being

ObjectivesThe purpose of this study was to explore how seriously injured women athletes perceive and experience global and sport psychological well-being (PWB) during sport injury recovery.MethodAdopting an interpretivist constructionist approach, we conducted one semi-structured interview with twelve participants (12 interviews total), aged 18–23. All participants were currently seriously injured, with a range of six months out of sport. Through a reflexive thematic analysis (Braun & Clarke, 2019) we analyzed patterns within the data related to how injured athletes perceived and experienced global and sport specific PWB during sport injury recovery.ResultsFour overarching themes were developed: (1) my life is chaos and out of control, (2) pressures shaping response to sport injury, (3) maybe I can: adaptation from the disruption of sport injury, and (4) sport injury growth (SIG). Participants experienced an initial disruption of sport PWB and global PWB, however once they were able to adapt, they could rebalance their PWBs. Once rebalanced, participants reappraised the injury experience to be an opportunity for psychological growth and development, leading to the possibility of SIG. Findings suggest that sport injury can initially hinder one’s PWB, however once one can rebalance their PWB sport injury is perceived as a positive event that can lead to SIG.ConclusionThese findings reveal that it is important to consider the role of PWB during sport injury, as it has been identified that there are disruptions to one’s PWB. These findings help further our understanding of injured athletes’ experiences of PWB during sport injury and how athletes could be better supported to protect their PWB and mental health during recovery.     

Enduring stress: A quantitative analysis on coping profiles and sport well-being in amateur endurance athletes

Endurance athletes experience physical and psychological stress during training and competition that can inhibit performance and promote negative health implications (i.e., lower well-being) without proper coping mechanisms (McCormick et al., 2018; Sakar & Fletcher, 2014). Additionally, these athletes that train at an amateur level have received limited attention regarding coping with stress and how it impacts well-being (McCormick et al., 2018). The purpose of this study was threefold: to (a) determine common coping profiles of trained amateur endurance athletes, (b) explore the relationship between sport well-being and these coping profiles, and (c) examine the potential roles that appraisals might play in the coping-well-being relationship. The results yielded five distinct coping profiles: Mixed Adaptive Copers (MAC), Mixed Maladaptive Copers (MMC), Engaged Copers (EC), Avoidant Copers (AC), and Social Copers (SC). Coping profiles differed across various variables including sport well-being, appraisals, and demographic factors. Overall, MAC and EC had higher levels of sport well-being. MAC viewed stressors as a challenge (i.e., opportunity) compared to EC and AC. These findings suggest the complex nature of coping in sport and that athletes should develop an assortment of coping strategies that provide different strategies for various stressful situations.     

Testing the triple-match principle among Dutch elite athletes: A day-level study on sport demands,detachment and recovery

ObjectivesDetachment, getting a physical, cognitive, and emotional break from the effortful demands of training and competition, is a recovery experience that can buffer the adverse effects of high sport demands on health and well-being. The matching hypothesis states that recovery strategies are most effective when they match particular sport demands. The main aim of this study was to investigate the matching hypothesis with respect to the relation between daily sport demands, detachment, and recovery state among elite athletes.DesignA one-week online daily diary study was conducted. Multilevel regression analyses tested within-subject associations between daily sport demands, detachment, and recovery state at bedtime, while controlling for recovery state in the morning.MethodSixty-eight elite athletes completed a daily diary survey after waking up (T1) and at bedtime (T2) across eight consecutive days.ResultsResults showed that daily physical detachment was positively related to daily physical recovery, whereas daily emotional detachment was positively related to daily cognitive recovery and emotional recovery. Moderating effects of daily detachment on the relation between daily sport demands and daily recovery state occurred more often when there was a match between specific types of sport demands, detachment, and recovery state rather than when there was less match or no match.ConclusionsFindings indicate that physical and emotional detachment are effective recovery strategies for elite athletes. Moreover, it is important that detachment matches the type of effort that has been spent to find the strongest stress-buffering effects.     

Intrinsic motivation and individual deliberate practice are reciprocally related: Evidence from a longitudinal study of adolescent team sport athletes

ObjectiveThere is limited understanding of how sport motivation is associated with deliberate practice in youth team sport athletes. Therefore, the aim of this study was to examine prospective associations between intrinsic motivation and individual deliberate practice in specializing team sport athletes.DesignLongitudinal.MethodEstonian adolescent team sport athletes (N = 163; M_age – 13.6 years at the beginning of study) completed the Sport Motivation Scale and training diary across a 12-month period.ResultsBoth individual deliberate practice and intrinsic motivation increased over the 1-year period. Greater baseline intrinsic motivation predicted subsequent individual deliberate practice and greater initial individual deliberate practice predicted greater subsequent intrinsic motivation. The bidirectional relationship between athletes intrinsic motivation and individual deliberate practice were replicated across both time lags.ConclusionThe findings have significant implications for the importance placed on intrinsic motivation as a means of increasing of individual deliberate practice as well being an important outcome variable in specializing team sport athletes.     

A conceptual model for mental health and performance of North American athletes: A mixed methods study

ObjectiveThe demands of sport create psychological and physical challenges for athletes, making it essential to understand what factors contribute to mental health and performance optimization in sport. The purpose of this mixed-methods investigation was to develop a conceptual model for mental health and performance of North American athletes.MethodForty-three experienced athletes, coaches, and sport professionals identified, sorted, and rated 113 behaviors, thoughts, and feelings that contribute to optimal mental health and performance for athletes. Using Multidimensional Scaling, the research team created a two-dimensional point map of participant responses. Hierarchical Cluster Analysis was then used to reveal underlying clusters in the data.FindingsSeven clusters emerged from the data: Stress Management, Mental Skills, Self-Awareness, Managing Setbacks, Intentional Practice, Team Relationships, and Social Support. Though all clusters were rated as important to mental health and/or performance, the Managing Setbacks cluster displayed high importance ratings for both mental health and performance.ConclusionOur preliminary findings suggest a comprehensive approach to athlete thoughts, feelings, and behaviors contributes to optimal mental health and performance for North American athletes.     

Acceptance by athletes of a virtual reality head-mounted display intended to enhance sport performance

While a growing number of studies have highlighted the potential of virtual reality (VR) to improve athletes’ skills, no research has yet focused on acceptance of a VR head-mounted display (VR-HMD) designed to increase sport performance. However, even if technological devices could potentially lead to performance improvement, athletes may not always accept them. To investigate this issue, the Technology Acceptance Model (TAM) examines if perceived usefulness, perceived ease of use, perceived enjoyment, and subjective norms (i.e., social influence) are positive predictors of intention to use a specific technology. The aims of the present study were to test with competitive athletes the validity of the TAM before a first use of a VR-HMD intended to enhance sport performance and to examine to what extent the level of practice and the type of sport practiced have an influence on the previous variables of the TAM. The study sample comprised 1162 French athletes (472 women, 690 men, M_age = 24.50 ± 8.51 years) who usually practiced a sport in competition (from recreational to international level). After reading a short text presenting the VR-HMD and its interests for sport performance, the participants filled out an online questionnaire assessing their acceptance of this technological device before a first use. The results of the structural equation modeling analysis revealed that perceived usefulness, perceived ease of use, perceived enjoyment, and subjective norms were positive predictors of intention to use this VR-HMD, validating the suitability of the TAM for investigating the acceptance by athletes of a VR-HMD designed to increase their sport performance. The results also showed that athletes of all sport levels (a) had a significant intention to use VR, (b) found it quite useful (except for recreational athletes), quite easy to use, and quite pleasant to use, even if their entourage would not encourage them to use it (except for international athletes), and (c) found the VR-HMD easy and pleasant to use whatever the sport practiced. Notably some athletes (e.g., triathletes, swimmers, cyclists) did not find the VR-HMD significantly useful and did not have significant intention to use it to increase their performance. Identifying acceptance by athletes of such a device may increase the likelihood that it will be used by athletes of different levels and from different sports, so that they can benefit from all its advantages related to the improvement of their sport performance. Needs-based targeted interventions may also be conducted toward athletes who might be reluctant to integrate this type of device into their training.     

Is it wrong to impose the harms of human life? A reply to Benatar

Might it be morally wrong to procreate? David Benatar answers affirmatively in Better Never to Have Been, arguing that coming into existence is always a great harm. I counter this view in several ways. First, I argue against Benatar’s asserted asymmetry between harm and benefit—which would support the claim that any amount of harm in a human life would make it not worth starting—while questioning the significance of his distinction between a life worth starting and one worth continuing. I further contend that his understanding of hedonism and desire-fulfillment theories distorts their implications for the quality of human life; as for objective-list theories, I rebut his critique of their human-centered basis of evaluation. Notwithstanding this multi-tiered challenge to Benatar’s reasoning, I conclude with praise for his work and the intellectual virtues it embodies.     

Hey stud: Race, sex, and sports

This article is an examination of how the intersection of sport and race plays out in the sexualization of the sporting role of African American male athletes. Further, the article is an examination of the multiple roles the media, sport, and race play as these impact the public persona of African American male athletes in high-profile sports. The article concludes with a number of recommendations for ending the negative images of African American male athletes. To the white public, we are athletes, rappers, preachers, singers—and precious little else. We are also robberts, rapists, mentally deficient and sexually well endowed. —Ellis Cose, The Envy of the World: On Being a Black Man in America (2002; New York: Washington Square Press, 3–4) First of all, let me say good after ... good late afternoon. Because of the HIV virus I have attained, I will have to announce my retirement from the Lakers today. I just want to make clear, first of all, that I do not have the AIDS disease, because I know a lot of you want to know that, but the HIV virus. My wife is fine, she’s negative, so no problem with her. I plan on going on, living for a long time, bugging you guys like I always have. So you’ll see me around. I plan on being with the Lakers and the league—hopefully [Commissioner] David [Stern] will have me for a while—and going on with my life. I guess now I get to enjoy some of the other sides of living—that [were missed] because of the season and the long practices and so on. I just want to say that I’m going to miss playing. And I will now become a spokesman for the HIV virus because I want people, young people, to realize they can practice safe sex. And, you know, sometimes you’re a little naive about it and you think it could never happen to you. You only thought it could happen to, you know, other people and so on and on. And it has happened. —Magic Johnson—Press Conference at L.A. Lakers Compound Washington Post, November 9, 1991     

The “Second Place” Problem: Assistive Technology in Sports and (Re) Constructing Normal

Objections to the use of assistive technologies (such as prostheses) in elite sports are generally raised when the technology in question is perceived to afford the user a potentially “unfair advantage,” when it is perceived as a threat to the purity of the sport, and/or when it is perceived as a precursor to a slippery slope toward undesirable changes in the sport. These objections rely on being able to quantify standards of “normal” within a sport so that changes attributed to the use of assistive technology can be judged as causing a significant deviation from some baseline standard. This holds athletes using assistive technologies accountable to standards that restrict their opportunities to achieve greatness, while athletes who do not use assistive technologies are able to push beyond the boundaries of these standards without moral scrutiny. This paper explores how constructions of fairness and “normality” impact athletes who use assistive technology to compete in a sporting venue traditionally populated with “able-bodied” competitors. It argues that the dynamic and obfuscated construction of “normal” standards in elite sports should move away from using body performance as the measuring stick of “normal,” toward alternate forms of constructing norms such as defining, quantifying, and regulating the mechanical actions that constitute the critical components of a sport. Though framed within the context of elite sports, this paper can be interpreted more broadly to consider problems with defining “normal” bodies in a society in which technologies are constantly changing our abilities and expectations of what normal means.     

Reflections on athletes and eating disorders

ObjectivesThe purposes of this paper were to offer reflections, thoughts, and observations on the burgeoning research regarding eating disorders in athletes over the past 25 years, to comment on the findings and clinical implications of the studies contained in this special issue, and to provide suggestions for future research.ResultsDisordered eating and eating disorders are complex, multidimensional, and multiply determined, and can affect the health and performance of athletes in both genders and most sports. Although coaches and teammates can be significant sources of weight and body image pressure, they can also play a positive role in identification and prevention.ConclusionsFurther research is needed in several areas. These include a broader focus that includes athletes believed to be at less risk, most notably males and non-lean sport athletes, and ironically younger athletes, who may be at greatest risk. We also need more research related to treatment of athletes with eating disorders and especially how we might better motivate them for recovery.