‘Although it is clear no athletes that the Digital, Culture, Media and Sport committee report identifies have cheated or broken any anti-doping laws, the report highlights areas within the Anti-Doping code where athletes, along with their support team, may have manipulated the system to access the use of stronger, otherwise banned drugs.
‘They can do this by obtaining a therapeutic use exemption certificate (TUE). To obtain a TUE the athlete and their practitioner have to submit evidence that there is a medical need for the athlete to use stronger medication to address their current condition and protect their health. The evidence is reviewed by an independent panel and either approved or declined.
‘Issues arise when the athlete who may have a condition such as asthma could present to their medical officer complaining of significant breathing problems despite using prescribed inhaler therapy.
‘The doctor may deem it appropriate to prescribe oral corticosteroids (which require a TUE), and once the TUE is in place the athlete can still compete using the stronger otherwise banned medication.
‘This raises several ethical issues in that:
1) if the athlete requires such strong medication to overcome their condition is their health at risk if they continue compete?
2) if they use the medication do they gain an extra advantage over their competitors other than treating the medication condition?
3) why hasn’t the long term care of the athlete been adequately managed to control the athletes medical condition?
‘A further issue that may be created due to the negative perception of athletes using TUE’s, is an athletes who actually requires a TUE for a legitimate medical reason may feel pressure not to use it. This might mean they compete with a medical condition that is not adequately controlled and therefore put their health at risk.
‘With the pressures on funding decisions for sports made on performance and success at Olympic Games and World Championships, athletes and their support teams are under immense pressure to get results.
‘This ultimately leads them pushing the boundaries within the rules of the sport to gain advantages against their opponents. How far athletes and their support team push the limits within the rules is an ethical question. Until the grey areas of the World Anti-Doping Agency code are addressed athletes and their team will continue to have questions asked of them should they seek to use medication requiring a TUE.’
Dr John Dickinson is head of the respiratory clinic at the University of Kent and lecturer in the School of Sports and Exercise Sciences. He carries out breathing assessments at Medway Park Sports Centre. He has tested Olympians and elite athletes from almost every sport, including GB cyclists and members of Team Sky.
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