Live Strong or Live Wrong?

Late last month, renowned cyclist and cancer activist Lance Armstrong was stripped of his record seven Tour de France titles and banned for life from competitive sport for doping. Mr. Armstrong has repeatedly denied the allegations, and has only tested positive once for a banned substance — cortisone — for which he provided a prescription. The prohibited steroid was in a doctor-provided cream used by many riders to treat saddle sores.

Despite this, the United States Anti-Doping Agency — a non-governmental organization recognized by the US Congress as the official anti-doping agency for Olympic and Pan American sport — concluded that Mr. Armstrong was at the center of “the most sophisticated, professionalized and successful doping program that sport has ever seen.” In addition to direct evidence of the use of performance enhancing drugs by Lance, the report also contained sworn affidavits from 11 of his teammates, all of whom admitted to doping and who testified against him.

Neither Mr. Armstrong nor the International Cycling Union have contested the findings, which is not itself an admission of guilt, but the consequences for both Lance and the sport of competitive cycling are considerable.

Lance has already been forced to step down as the head of Livestrong, the group he founded in 1997 to provide support for cancer patients and to lobby for increased funding of research and treatment programs. He’s also been dropped by several of his sponsors, including Nike and Anheuser-Busch. Finally, he faces numerous lawsuits. SCA Promotions, which paid Mr. Armstrong millions in bonuses following his Tour de France victories, wants all of its money returned. The delight of his detractors, many of whom see Lance as arrogant and self-promoting, is palpable.

Lance and the charity he founded will undoubtedly survive, albeit tarnished. Competitive cycling, at least in its current form, is less likely to endure. Normally, when an athlete is stripped of a title, it is re-awarded to the runner up. When the International Olympic Committee stripped Marion Jones of medals won at the 2000 Sydney Olympics, for example, they gave the 200 meter title to Bahaman-native Pauline Davis-Thompson.  The only time a title is not re-awarded is when the runner up is also accused of a rule violation.  That is the case here.

None of Mr. Armstrong’s seven Tour de France titles are to be re-awarded. Lance’s first Tour victory was in 1999 over Swiss rider Alex Zülle. In 2000, 2001 and 2003 he defeated German racer Jan Ullrich. In 2002, he bested Spanish cyclist Josebe Beloki. In 2004, it was the German rider Andreas Kloden. Finally, in his last race in 2005, Lance prevailed over Italian cyclist Ivan Basso.  Of these five also-rans, not a single one is clean. For example, Alex Zülle was banned from the Tour in 1998 for using erythropoietin, a banned blood boosting drug. Similarly, Jan Ullrich was found guilty of doping by the international Court of Arbitration of Sport and banned for life.

Illegal doping was so common during that time that current Tour de France director Christian Prudhomme has stated that the Armstrong years “depict an era and a system which are forever soiled.” The problem is that nothing has changed in the intervening decade. If anything, doping in cycling (as with many other competitive sports) is even more pervasive and increasingly difficult to prove.

Random drug tests can be used to test for illicit use of performance-enhancing drugs like steroids, but such tests are usually performed on the day of competition. However, most performance-enhancing drugs are used only during training, allowing athletes to work harder and to improve performance while leaving plenty of time for the drugs to wash out and become undetectable. To combat this, out-of-competition testing is becoming more commonplace but is very expensive and time-consuming.

Many athletes are also using novel drugs for which anti-doping tests do not yet exist. The only way to combat this is to store and reanalyze samples from years past as new drug tests become available. But this does little to combat the problem in real time, and the legality of stripping someone of a title when they test positive for a drug that wasn’t on the list of prohibited substances at the time of competition is questionable.

Trying to ferret out cheating through screening and testing of athletes is, if anything, a losing battle. As the Red Queen in Lewis Carroll’s Through the Looking-Glass once said, “it takes all the running you can do, to keep in the same place.” Dopers will always be one step ahead of the anti-doping cops, so long as there are personal and financial incentives to cheat. Winning athletes earn millions in endorsements and the respect of fans, while losing athletes go home empty handed.

This is not to suggest that there aren’t honest athletes out there. For every cheater there are hundreds of competitors who choose to do the right thing. Nor do I want to suggest that we should just give up and let competitive sport become a drug-fueled free-for-all, as some pundits have argued. But changing a culture of competition that encourages and rewards cheating will require more than just developing new anti-doping tests and punishing wrongdoers like Lance Armstrong and Marion Jones. We need to focus less on catching the cheaters and more on deterring them. But whether or not we can do that in an era when competitive sports are worth nearly a trillion dollars annually remains to be seen. I’m not sure that we can.

[This blog entry was originally presented as an oral commentary on Northeast Public Radio on November 1, 2012. It is also available on the WAMC website.]

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About Sean Philpott-Jones

A public health researcher and ethicist by training, Sean holds advanced degrees in microbiology, medical anthropology, and bioethics. He is currently Chair of the Bioethics Department at Clarkson University's Capital Region Campus and Director of the Bioethics Program of Clarkson University-Icahn School of Medicine at Mount Sinai, and Director of two Fogarty-funded programs to provide research ethics education in Eastern Europe and in the Caribbean Basin. Until his term expired in August 2012, he served as Chair of the US Environmental Protection Agency’s Human Studies Review Board, an advisory panel that reviews the scientific and ethical aspects of research involving human participants submitted to the EPA for regulatory purposes.
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