The use of certain technologies, especially of specific pharmacological means, with the aim of improving performance, is forbidden in competitive sport. This practice, called doping, is repressed by increasingly strong anti-doping measures, which are overseen by the World Anti-Doping Agency (WADA). Even if these anti-doping developments essentially concern elite competitive sport, they influence society in general. Some agents present doping as a major societal problem, and the dealing with it is therefore considered a political priority. In several countries, the principles of anti-doping in elite sport are now applied outside of competitive sport, such as in the realm of fitness centres, and calls for further extension of regulations are regularly heard. Increasingly specific legislation has been introduced, in some countries in the form of criminal law that is also applicable to non-athletes.
These developments have spawned academic interest, and doping inside and outside elite sport, as well as the anti-doping efforts aimed at eradicating this practice, have become the subject of an active field of scholarly study. There is considerable overlap with two other important societal and scientific debates, one on the regulation of psychoactive drug use and one on overall human enhancement, i.e. the use of technology to improve human performance in general. Regarding sport, two diametrically opposed discourses can be found in the scholarly, but also lay, literature. Today's most vocal discourse is that of a zero tolerance approach, enforced in elite competitive sport by surveillance, repression and punishment. On the other hand, an opposing discourse can also be heard that finds anti-doping illogical and calls for the liberalisation of doping. These opposing positions would seem to have their limitations. Past experience with prohibition has shown that a zero-tolerance stance using stringent repression to curb a forbidden behaviour may lead to important (unintended) side effects, while there is insufficient public and political support for the total liberalisation of currently forbidden substances.
The general aim of this thesis is to contribute to the discussion on doping and anti-doping, and to sketch the outlines of an alternative way of dealing with doping inside and outside of sport. After a short introduction (Chapter 1) that sketches the historical background of the main issues, an analysis of modern anti-doping in elite sport is presented, highlighting some paradoxes and weaknesses at the basis of today's anti-doping policies (Chapter 2). Chapter 3 provides an analysis of the argument that allowing doping would merely result in a uniform shift of the playing field at the cost of greater health risks. It is shown that this is unlikely to be the case and a counterargument in favour of allowing some regulated forms of doping, because potentially leading to a more dynamic playing field, is then presented. Chapter 4 provides a perspective accounting for some of the side effects of modern anti-doping, also from a legal perspective. It highlights some of these side-effects and shows that anti-doping comes at a considerable cost to the individual athlete and the community. Chapter 5 then introduces the idea of using a harm reduction approach in the realm of doping in sport. First the principle of harm reduction is explained, building upon the evidence base in the field of recreational substance use. This is followed by a first attempt of applying its principles to doping practices in sport. Chapter 6 then takes the reasoning of the preceding chapter further by completing it with a specific analysis of the ethical implications of such a harm reduction approach for doping, concluding that such an approach can be defended. Chapter 7 finally provides a general discussion that ends with some conclusions and perspectives. The overarching conclusion of the thesis is that there is no society-wide solution to the problem of doping. Therefore practical ways of dealing with its presence aimed at containing its potential risks may represent preferable policy alternatives as compared to today's runaway effects of globalisation of anti-doping efforts, all while promising to enrich the spectacle of modern elite sport.