HOW HE SEES IT Ethical line is fuzzy on the use of steroids

People who don't tell the truth are very good at lying to your face. Anyone who has watched the truth-shaving of such well-known confabulators as Ken Lay, Bill Clinton, Bernard Ebbers and Charles Keating knows what I mean.
Baltimore Oriole slugger Rafael Palmeiro apparently has joined the ranks of those who will be remembered as being good at delivering the big lie.
Palmeiro has tested positive for steroid use just five months after sitting in front of a congressional committee and denying unequivocally that he was a "juicer."
This rapid fall from grace of a 3,000-hit and 500-home-run candidate for the Hall of Fame has left sportswriters fuming. He seemed to be a guy you could trust. But, as anyone who has to deal with addicts knows, truth evaporates when it comes to their drug of choice.
The Palmeiro implosion and the steroid scandal that continues to haunt major league baseball raises a huge and fundamental ethical question .
It is easy to condemn steroid use. The drugs, while effective, are dangerous. But what if they were not? How are professional and amateur sports going to deal with the impending explosion in performance-enhancing drugs and bioengineering tricks that can boost performance with little or no risk for the user?
For example, at my school, the University of Pennsylvania, physiologist Lee Sweeney is trying to find ways to tweak genes to make muscles grow bigger and more dense. This research holds out real hope for those with muscular dystrophy and other debilitating muscle diseases.
Stronger muscles
But the gene transfer technology he is working on also will allow normal muscles to be made bigger and stronger. Figuring out who may or may not have engaged in "gene-doping" will prove next to impossible. And it is likely that there will be little risk associated with genetically altering muscle cells.
Similarly, scientists around the world are busy making pills that enhance our performance a bit by letting us sleep better, fight fatigue, slow the loss of memory, speed up learning, recover more quickly from hard exertion and calm anxieties. Some of us already are benefiting from drugs like these when we use Ambien, Provigil, Ritalin, Prozac or Effexor.
So what are we going to say when the archer, the chess master, the competitive marksman, the NASCAR driver or the women's professional golfer says "if I take these same drugs I just might get enough of an edge to move ahead of my competition"?
Throughout the 1990s when home runs were flying out of baseball stadiums, launched by players who obviously were using steroids, when professional football linemen got huge, when track and field records continued to fall, not much in the way of protest was heard. Americans are in love with those who take risks to break a record, or one another's bones, in the name of sport.
Nor do Americans gripe when we show up at the Olympics with our athletes who have the best training, superb diets, and top-flight equipment and drub athletes from poor nations, some of whom seem to have shown up just to get a decent meal. We are used to employing science to our advantage when it comes to sports, so why should we draw the line at genetic engineering or new miracle pills?
Ethical question
There is nothing about the reaction to Palmeiro's downfall that indicates we are ready to deal with the fundamental ethical question raised by his use of steroids -- how can we draw the line when it comes to enhancement? Is the point of sport to see what human beings can do without aid of any sort in fair competition? If so, we may need to close the training facilities and cut back on what dietitians and trainers are allowed to do.
But if the point of sports is to test the limits of human performance, then we had better get ready to add genetic engineers and a bevy of pharmacologists to the hordes of specialists now working with elite athletes from elementary school to the pros.
X Caplan is chairman of the Department of Medical Ethics at the University of Pennsylvania School of Medicine. Distributed by the Los Angeles Times-Washington Post News Service

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