Kayser Bengt, Tolleneer Jan
ISSUL, Université de Lausanne, Lausanne, Switzerland.
FABER, Katholieke Universiteit Leuven, Leuven, Belgium.
J Med Ethics. 2017 May;43(5):282-286. doi: 10.1136/medethics-2015-102659. Epub 2017 Feb 2.
Harm-reduction approaches are used to reduce the burden of risky human behaviour without necessarily aiming to stop the behaviour. We discuss what an introduction of harm reduction for doping in sports would mean in parallel with a relaxation of the antidoping rule. We analyse what is ethically at stake in the following five levels: (1) What would it mean for the athlete (the self)? (2) How would it impact other athletes (the other)? (3) How would it affect the phenomenon of sport as a game and its fair play basis (the play)? (4) What would be the consequences for the spectator and the role of sports in society (the display)? and (5) What would it mean for what some consider as essential to being human (humanity)? For each level, we present arguments for and against doping and then discuss what a harm-reduction approach, within a dynamic regime of a partially relaxed antidoping rule, could imply. We find that a harm-reduction approach is morally defensible and potentially provides a viable escape out of the impasse resulting from the impossibility of attaining the eradication of doping. The following question remains to be answered: Would a more relaxed position, when combined with harm-reduction measures, indeed have less negative consequences for society than today's all-out antidoping efforts that aim for abstinence? We provide an outline of an alternative policy, allowing a cautious step-wise change to answer this question and then discuss the ethical aspects of such a policy change.
减少伤害的方法用于减轻危险人类行为的负担,而不一定旨在阻止该行为。我们讨论在放宽反兴奋剂规则的同时,引入针对体育领域使用兴奋剂的减少伤害措施意味着什么。我们从以下五个层面分析其中的伦理利害关系:(1)这对运动员(自我)意味着什么?(2)它将如何影响其他运动员(他人)?(3)它将如何影响作为一种游戏的体育现象及其公平竞赛基础(游戏)?(4)对观众以及体育在社会中的角色会有什么后果(展示)?以及(5)对一些人认为的人类本质要素(人性)意味着什么?对于每个层面,我们都提出支持和反对使用兴奋剂的论据,然后讨论在部分放宽反兴奋剂规则的动态体系内,减少伤害的方法可能意味着什么。我们发现,减少伤害的方法在道德上是可辩护的,并且有可能为因无法根除使用兴奋剂而陷入僵局提供一个可行的出路。以下问题仍有待回答:与减少伤害措施相结合的更为宽松的立场,对于社会而言,是否确实会比当今旨在完全禁止使用兴奋剂全力以赴反兴奋剂努力产生更少的负面后果?我们概述了一项替代政策,允许谨慎地逐步改变以回答这个问题,然后讨论这种政策变化的伦理方面。