During a recent trip to visit our large family in Ireland, the entire clan was rooting for Katie Taylor, the homegrown boxing phenom, in her quest for Olympic gold. We watched Ethiopians and Kenyans dominate so many of the running events and Jamaica’s Usain Bolt, still the fastest man in the world. We bantered about Michael Phelps’ incredibly long torso, huge lung capacity, long arms and big feet and mused about the physical attributes conducive to championship swimming.
As the family debated state-of-the-art training strategies — informed by cutting-edge science including the latest in sports physiology — one of my young nephews proclaimed that "soon we will all be bionic or mutants." Indeed, advances in medicine have complicated the politics of fair play in the face of fierce competition with so much at stake. Gold-medal winners, particularly in high-profile events, stand to enjoy massive revenue from sponsors, ads and promotions.
One high-profile issue facing the International Olympic Committee in advance of the London Games was whether a young South African, Oscar Pistorius, nicknamed "Blade Runner," could compete with the rest. Pistorius was born without fibulae and had partial amputations of both legs before age 1. He is now equipped with high-tech prostheses. Would a win in the 400-meter race be the result of an unfair advantage? Technology only improves over time, and there can be no doubt that subtleties of this conundrum will be often revisited in the future.
Performance-enhancing drugs, on the other hand, have been used for decades. They include androgenic and corticosteroids, drugs to increase the production of red blood cells and human growth hormone. The World Anti-Doping Agency, or WADA, actively works to identify doping agents as they are developed and to evolve technology used to test for and catch cheaters.
What about gene doping? Since scientists cracked the entire human genetic sequence during the Clinton administration, a great deal of research has gone into finding cures for disease including cancer. In the coming years, gene therapy will become an increasingly powerful tool in medicine.
"WADA is preparing for the advent of gene doping — an abuse of gene therapy," according to Clive Cookson of the Financial Times.
WADA is not yet equipped to screen for gene doping, but, when ready, it will only look for interventions that modify an athlete’s existing genome. Actual breeding of athletes and manipulation of genes involved at conception take this one step further. Cookson writes that Andy Parkinson, chief executive for UK Anti-Doping, compares it to an arms race.
The ethical and scientific challenges that must be addressed to ensure fair play today are a far cry from 1912 when Duke Kahanamoku traveled to the Stockholm Olympics to win a gold medal in swimming. The legend is that he was so cold when he got there, he had to stuff newspapers inside his clothes to fight the chill. Fortunately, he was not disqualified. He went on to medal in the 1920, 1924 and 1932 Olympics.
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Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.
