Cyclist
Does cycling have a problem with over-the-counter medication? Part 2: Ethics
In the second of a three-part series – read the first part here – investigating the use of store-bought rugs for enhancing performance, Cyclist asks what the moral dilemma might be.
One of the most important questions in all of this is why does it really matter? Beyond the health considerations, that’s where Ask Vest Christiansen, associate professor at the Department of Public Health and Sport Science at Aarhus University in Denmark, comes back in. He’s spent his professional life examining the attitudes and norms toward doping and what it says about humans and their values. It is, he concludes, complicated.
‘Many see anti-doping as black and white,’ he says. ‘But when you dig a little deeper, you can see there’s an incoherence and inconsistency in their outlook. When I do talks, I often ask the audience, what’s the definition of doping? They reply that it’s performance-enhancing and unnatural. I say, so Coca Cola then. It contains caffeine, which is a proven performance-enhancer, it’s not natural and okay, it’s not illegal but it used to be, before it was removed from the list in 2004, partly because it’s so commonplace in society and it wasn’t a great look when Coca Cola was the main sponsor.
‘Okay, they might reply again, but what about if something’s natural? That is fine. So you can extract your blood and reinfuse it, I say. That’s pretty natural as it’s all your own blood. So, is that okay? Not at all, they reply.
‘You find with “doping”, whether at recreational or elite level, the less you know, the clearer your views. The more you look into this area, the less clear you are.’
Which, certainly when it comes to legal over-the-counter (OTC) medication, ultimately comes down to a cyclist’s individual stance. Take retired American professional Taylor Phinney, who became a vocal advocate to stop popping the pills. ‘I love to see @StevoCummings win,’ he wrote on his Twitter account in 2012. ‘He, like me, follows his own personal policy of no caffeine pills and no painkillers. Purest of the pure!’
‘I’ve always been someone who likes to rely on my own body to solve any sort of sickness, a cold or fever, as opposed to just jumping into taking Tylenol or whatever,’ he explained in a later interview, ‘so I wasn’t really comfortable with the whole painkiller/caffeine type of thing. In addition to that, it just felt uncomfortable that I would be fooling my body into feeling something that it wasn’t supposed to be feeling.
‘You must ask why are you taking a painkiller? You are doing that to mask effects that riding a bike is going to have on your body… essentially, you are taking a painkiller to enhance your performance. But the whole reason we get into sport in the first place is to test our bodies, to test our limits. If you’re taking something that is going to boost your performance, that is not exactly being true to yourself, not exactly being true to your sport.’
Seen through an academic lens, this is ‘moral disengagement’. Moral disengagement is a term evolved from developmental psychology and concerns the process of convincing the self that ethical standards do not apply to oneself in a particular context, in this situation road cycling. This is done by disabling the mechanism of self-condemnation. Thus, moral disengagement involves a process of cognitive re-construing or re-framing of potentially destructive behaviour as being morally acceptable without changing the behaviour or the moral standards.
In Christiansen’s 2023 paper that kickstarted this Tour de OTC Medication, they asked the participants to reply on a sliding scale of one to seven, how much do you agree with a specific statement? ‘The question might be something like, is it okay to use an OTC medication because everybody’s using it? Or it’s okay to use because you’re not hurting anyone?’ he says. ‘We’re still looking at the data but what we’re starting to see, and has certainly been seen elsewhere, is that the best predictor of medication use is moral disengagement.’
One of the causes of this moral disengagement is immersing yourself in your choice of activity. ‘We undertook a study years ago into what’s been called “student doping” or “cognitive enhancement”,’ says Ask. This would cover what’s known as smart drugs that are most often stimulants or cognitive-enhancing drugs like prescription medication Ritalin and Modafinil. Students might acquire them on prescription or online.
‘One of our findings was that their use was much more prevalent in the health faculties than it was in the arts faculties. So, the more people know about a drug, the more they’re immersed in that world, the more they might use it, whereas in the philosophy department, they’d go, “No, this is absolutely wrong. I’m not taking that.”
‘There’s an element of this as a recreational cyclist. The more you invest time and energy into something, the more immersed you are in that world.’ In essence, if you start to think of your body as a machine that can be tuned in one way or the other, the more you’ll start seeking marginal gains to enhance performance, staircasing from one product to another. This is the gateway theory.
‘There’s a certain statistical probability that if you go from sports drinks and protein shakes to something like creatine, the next natural step might be an anabolic precursor and then anabolic steroids,’ says Christiansen. ‘But for every step, it’s only a fraction of the population. So, yes, there’s a greater chance if you have done A then you will do B. But you might be down to less than 5% for each step. It’s not like if you drink one beer, you’ll end up as a heroin addict.’
Stay tuned for part three, where we’ll look at some cases. Find part one here.
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