Ethical considerations: the participation of children in elite sports.

In a way, children involved in elite sports can be considered participants in an uncontrolled mass experiment with human beings. Sports have many benefits for children, especially when this activity is compared with the sedentary life styles of too many children all over the world. However, training in such sports is progressively becoming more prevalent in an earlier age in childhood, and potential risks of musculoskeletal disorders or diseases, social isolation to a restricted group with similar interests, and the psychologic stress of repetitive and monotonous sports activities for several hours each day, are concerning physicians. Added to these concerns are the dangers associated with hormonal and dietary manipulations practiced by athletes in elite sports. Ethics committees to control training procedures of gifted children and to propose higher age limits for participants, especially in international sports events, seem to be needed. Long-term effects of elite sports activities beginning in early childhood should be studied using appropriate epidemiologic methods. The basic ethical consideration is not to harm or alienate children by using them as objects for sports organizations, spectators or nationalists.