In May 2011, more than a decade after the International Association of Athletics Federations (IAAF) and the International Olympic Committee (IOC) abandoned sex testing, they devised new policies in response to the IAAF's treatment of Caster Semenya, the South African runner whose sex was challenged because of her spectacular win and powerful physique that fueled an international frenzy questioning her sex and legitimacy to compete as female. These policies claim that atypically high levels of endogenous testosterone in women (caused by (...) various medical conditions) create an unfair advantage and must be regulated. Against the backdrop of Semenya's case and the scientific and historical complexity of ?gender verification? in elite sports, we question the new policies on three grounds: (1) the underlying scientific assumptions; (2) the policymaking process; and (3) the potential to achieve fairness for female athletes. We find the policies in each of these domains significantly flawed and therefore argue they should be withdrawn. (shrink)

Advances in genetics and related biotechnologies are having a profound effect on sport, raising important ethical questions about the limits and possibilities of the human body. Drawing on real case studies and grounded in rigorous scientific evidence, this book offers an ethical critique of current practices and explores the intersection of genetics, ethics and sport. Written by two of the world's leading authorities on the ethics of biotechnology in sport, the book addresses the philosophical implications of the latest scientific developments (...) and technological data. Distinguishing fact from popular myth and science fiction, it covers key topics such as the genetic basis of sport performance and the role of genetic testing in talent identification and development. Its ten chapters discuss current debates surrounding issues such as the shifting relationship between genetics, sports medicine and sports science, gene enhancement, gene transfer technology, doping and disability sport. The first book to be published on this important subject in more than a decade, this is fascinating reading for anyone with an interest in the ethics of sport, bioethics or sport performance. (shrink)

There is a fundamental tension in many sports: human sex is not binary, but there are only two categories in which people can compete: male and female. Over the past 10 years, the International Association of Athletics Federations regulations have been at the centre of two notable legal disputes. The Court of Arbitration for Sport reached two contradictory rulings: in the first case, the IAAF regulations for the eligibility of athletes to compete in the female category were suspended on grounds (...) of "discrimination against the female category"; in the latter, the regulations were reaffirmed on grounds that although discriminatory, they are necessary to maintain a "level playing field" and to “protect” the female category. Although Semenya’s case has paved the way for questioning existing gender norms in sport, a new stable norm has yet to emerge from her case. The pharmacological solution put forward by IAAF to the tension between fairness and inclusivity of bodies non-conforming to two sexes is not, however, the only possible solution/resolution to the case, as I aim to show in this paper. Here I present some reflections on this topic and suggest how CAS should approach the case if it hopes to resolve it. (shrink)

We report here an emerging dispute in Italy concerning triage criteria for critically ill covid-19 patients, and how best to support doctors having to make difficult decisions in a context of insufficient life saving resources. The dispute we present is particularly significant as it juxtaposes two opposite views of who should make triage decisions, and how doctors should best be supported. There are both empirical and normative questions at stake here. The empirical questions pertain to the available level of evidence (...) that healthcare professionals would rather not be left alone with their ‘clinical judgments’ to make triage decisions, and to the accounts of distributive justice that doctors and healthcare professionals rely on, when making triage decisions. The normative questions pertain to how this empirical evidence should inform guidelines on how prioritisation decisions are made in a context of emergency, and who gets to have the authority to do so. This debate goes beyond the discussion of the care of critically ill patients with COVID-19 and has broader implications beyond the national context for the discussion of how to relieve moral distress in contexts of imbalances between healthcare resources and clinical needs of a population. (shrink)

“Public Trust in Expert Knowledge: Narrative, Ethics, and Engagement” examines the social, cultural, and ethical ramifications of changing public trust in the expert biomedical knowledge systems of emergent and complex global societies. This symposium was conceived as an interdisciplinary project, drawing on bioethics, the social sciences, and the medical humanities. We settled on public trust as a topic for our work together because its problematization cuts across our fields and substantive research interests. For us, trust is simultaneously a matter of (...) ethics, social relations, and the cultural organization of meaning. We share a commitment to narrative inquiry across our fields of expertise in the bioethics of transformative health technologies, public communications on health threats, and narrative medicine. The contributions to this symposium have applied, in different ways and with different effects, this interdisciplinary mode of inquiry, supplying new reflections on public trust, expertise, and biomedical knowledge. (shrink)

This paper aims to bring a novel approach to the discussion of unfair advantages in sport by looking for a local criterion of fairness instead of a universal criterion. A local criterion of fairness would not solve the general dispute over what counts as an unfair advantage, but it would be beneficial in evaluating specific cases and could guide further discussion about them. We seek a local criterion of fairness by comparing the specific property advantages of Caster Semenya and Eero (...) Mäntyranta. South African Semenya is a middle‐distance runner whose right to compete in the female category has been challenged owing to her assumed difference of sex development and related high level of testosterone. Finnish Mäntyranta was a cross‐country skier with an exceptionally high haematocrit level. We examine whether there is a relevant difference between their advantages that would justify treating the athletes differently. We propose that the criterion ‘not attainable by other athletes in the same category’ could stand as a local criterion of fairness under certain conditions. However, its proper application requires further discussion on how to justify categories in sport. (shrink)

The authority of bioethics as a field of inquiry and of bioethicists as scholars with a distinctive expertise is being questioned on various fronts. Sarah Franklin’s 2019 Nature commentary ‘Ethical research – the long and bumpy road from shirked to shared’ is the latest example. In this paper, we respond to these challenges by focusing on two key issues. First, we discuss the theory and practice of bioethics. We argue that both of these endeavours are fundamental components of this field (...) of inquiry and that bioethics cannot be reduced to the contribution that it makes to the production of biopolicy, as Franklin suggests. Second, we contend that bioethicists have distinctive skills and knowledge that place them at an epistemic advantage in discussing normative questions. Hence, we reject views that deny the specific contribution that bioethicists can bring to assessing the ethics and governance of science and technology. We conclude by arguing that—despite formal and substantive differences between disciplines—philosophers, social scientists and other scholars should join forces and engage in critical friendships rather than turf wars to move towards the just governance of science and technology. (shrink)

These words were written by ethicist Jonathan Glover in his paper “Future People, Disability and Screening” in 1992. Whereas screening and choosing for a disability remained a theoretical possibility 16 years ago, it has now become reality. In 2006, Susannah Baruch and colleagues at John Hopkins University published a survey of 190 American preimplantation genetic diagnosis clinics, and found that 3% reported having the intentional use of PGD “to select an embryo for the presence of a disability.” Even before, in (...) 2002, a controversy was generated by the case of Candace A. McCullough and Sharon M. Duchesneau, a lesbian and deaf couple from Maryland who set out to have a deaf child by intentionally soliciting a deaf sperm donor. (shrink)

The Concussion in Sport Group guidelines have successfully brought the attention of brain injuries to the global medical and sport research communities, and has significantly impacted brain injury-related practices and rules of international sport. Despite being the global repository of state-of-the-art science, diagnostic tools and guides to clinical practice, the ensuing consensus statements remain the object of ethical and sociocultural criticism. The purpose of this paper is to bring to bear a broad range of multidisciplinary challenges to the processes and (...) products of sport-related concussion movement. We identify lacunae in scientific research and clinical guidance in relation to age, disability, gender and race. We also identify, through multidisciplinary and interdisciplinary analysis, a range of ethical problems resulting from conflicts of interest, processes of attributing expertise in sport-related concussion, unjustifiably narrow methodological control and insufficient athlete engagement in research and policy development. We argue that the sport and exercise medicine community need to augment the existing research and practice foci to understand these problems more holistically and, in turn, provide guidance and recommendations that help sport clinicians better care for brain-injured athletes. (shrink)

In light of the World Anti Doping Agency’s 2013 Code Revision process, we critically explore the applicability of two of three criteria used to determine whether a method or substance should be considered for their Prohibited List, namely its (potential) performance enhancing effects and its (potential) risk to the health of the athlete. To do so, we compare two communities of human guinea pigs: (i) individuals who make a living out of serial participation in Phase 1 pharmacology trials; and (ii) (...) elite athletes who engage in what is effectively ‘unregulated clinical research’ by using untested prohibited or non-prohibited performance enhancing substances and methods, alone or in combination. Our comparison sheds light on norms of research ethics that these practices exacerbate with respect to the concepts of multiplicity, visibility, and consistency. We argue for the need to establish a proper governance framework to increase the accountability of these unregulated research practices in order to protect the human guinea pigs in elite sports contexts, and to establish reasonable grounds for the performance enhancing effects, and the risks to the health of the athlete, of the methods and substances that might justify their inclusion on the Prohibited List. (shrink)

Caster Semenya is done with track and field. At 29, her hopes for a continued career as a professional middle-distance runner are dashed. After her case against International Association for Athletics Federation 1 was dismissed by the Court for Arbitration of Sport on 1 May 2019, she has switched to football later in the year.1 Semenya’s case may have come to its legal conclusion, however it has generated an aporia regarding the binary classification in athletics, which has yet to be (...) solved.2 It is time the implications of the fair equality of opportunity principle as a normative basis for the construction of categories in sport are taken seriously to move forward the debate on unfair advantages in sport. Loland conditionally justifies restricting the women’s category to athletes with testosterone levels below a certain threshold, on the basis of the FEO principle, and of a distinction between stable and dynamic inequalities between athletes. …. (shrink)

The recent boom of direct-to-consumer (DTC) genetic tests, aimed at measuring children?s athletic potential, is the latest wave in the ?pre-professionalization? of children that has characterized, especially but not exclusively, the USA in the last 15 years or so. In this paper, I analyse the use of DTC genetic tests, sometimes coupled with more traditional methods of ?talent scouting?, to assess a child?s predisposition to athletic performance. I first discuss the scientific evidence at the basis of these tests, and the (...) parental decision in terms of education, and of investing in the children?s future, taken on the basis of the results of the tests. I then discuss how these parental practices impact on the children?s right to an open future, and on their developing sense of autonomy. I also consider the meaning and role of sports in childhood, and conclude that the use of DTC genetic tests to measure children?s athletic potential should be seen as a ?wake up? call for other problematic parental attitudes aimed at scouting and developing children?s talent. (shrink)

This Bioethics and Biopolitics: Presents and Futures of Reproduction symposium draws together a series of articles that were each submitted independently by their authors to the JBI and which explore the biopower axis in the externalization of reproduction in four contexts: artificial gestation, PGD for sex selection, women’s rights, and testicular cryopreservation. While one contribution explores a “future” of reproduction, the other three explore a “present,” or better, explore different “presents.” What may counts as “present,” and what may count as (...) “future,” has dramatically different connotations depending on the geographical declination of the tense. (shrink)

The assessment of chronic pain is a highly unmet medical need. Chronic pain is also the subject of a large and costly category of legal claims. Yet, with pain cases, the jury always face a doubt: is the claimant faking or malingering? How can we be assured that the claimant is 'really' in pain? Most recently, several new neuroimaging technologies are promising to solve these questions, by rendering pain visible, measurable and, to some degree, verifiable. The results of these advancements (...) have prompted us to think of pain in a different way, i.e. as an altered brain state in which functional connections are modified, with components of degenerative aspects. But, does this imply the stronger claim that these technologies allow us to 'know', or to literally 'see', the pain of others? Is the pain being objectified by these techniques? And if so, what might the law do differently, or do better? (shrink)

The persistence of doping in professional sports—either by individuals on an isolated basis and by whole teams as part of a systematic doping programme—means that professional sport today is rarely if ever untainted. There are financial incentives in place that incentivise doping and there are data that show that doping is often a systematic, organised enterprise. The main question to be answered today in professional sports is whether doping’s repressive anti-doping policies do not have greater negative consequences for society. Whilst (...) some have suggested legitimising safe doping under medical control, in this paper, I argue that doing so will do little to prevent clandestine use of dangerous performance-enhancing substances, and suggest an alternative solution to lifting the ban on doping, i.e. starting from extending liability for doping in sport beyond athletes to those holding power and authority over athletes, to changing winning incentives for doping, to making sport sustainable in the longer time by devising ways of providing athletes with a steady income which is not linked to record breaking or sponsorships. (shrink)

Reviews of philosophical books run the risk of being either excessively and unconstructively critical or superficially praiseworthy. To avoid both these risks, we test the approach outlined by Häyry in his book Rationality and the Genetic Challenge: Making People Better? by applying it to an eighth genetic challenge, namely, a variation of the genetic enhancement challenge discussed by Häyry as it applies to sports. We assess whether genetic enhancement in sports should be conceived as an eighth wonder or an eighth (...) cardinal sin that stems from the interaction between genetics and society, question whether Häyry’s nonconfrontational approach is really useful for dealing with these issues, and discuss how his method can be improved. (shrink)

The American Journal of Bioethics, Volume 12, Issue 1, Page 39-40, January 2012.

The Ethics of the New Eugenics, edited by Calum MacKellar and Christopher Bechtel ,An introductory “Note on the Text” states: “The research on which this book is based was commissioned by the Scottish Council on Human Bioethics. It is the result of the collective work of many individuals at the Scottish Council on Human Bioethics. Initial drafting and subsequent editing was the work of Calum MacKellar and Christopher Bechtel, as agreed to by the Ethics Committee of the Scottish Council on (...) Human Bioethics. They were appointed principal editors by the Council.” is a useful introductory reference book for those interested in the use of genetic technologies to improve the human species. MacKellar is the director of research for the Scottish Council on Human Bioethics and a visiting professor of bioethics at St. Mary’s University College London, and Bechtel is a research fellow at the SCHB. The Scottish Council on Bioethics commissioned and supported research for this volume. .. (shrink)

This document is designed to give guidance on assessing researchers in bioethics/medical ethics. It is intended to assist members of selection, confirmation and promotion committees, who are required to assess those conducting bioethics research when they are not from a similar disciplinary background. It does not attempt to give guidance on the quality of bioethics research, as this is a matter for peer assessment. Rather it aims to give an indication of the type, scope and amount of research that is (...) the expected in this field. It does not cover the assessment of other activities such as teaching, policy work, clinical ethics consultation and so on, but these will be mentioned for additional context. Although it mentions the UK’s Research Excellence Framework, it is not intended to be a detailed analysis of the place of bioethics in the REF. (shrink)

In this paper I discuss the ethical justifiability of the limitation of freedom of movement, in particular of the ban on running outdoors, enforced in Italy as a response to the COVID-19 outbreak in the spring of 2020. I argue that through the lens of public health ethics literature, the ban on running falls short of the criterion of proportionality that public health ethics scholars and international guidelines for the ethical management of infectious disease outbreak recommend for any measure that (...) restricts essential individual freedoms, such as the freedom of movement. The public health ethics framework, however, falls short of explaining the widespread public support that the running ban has had in Italy. I discuss possible factors which could explain the public support for the ban in Italy. Finally, I raise the question of what societal implications the abandonment of the public health ethics framework based on proportionality might have. I conclude that if it is the case, as the history of pandemics teaches us, we will experience further waves of COVID-19 outbreaks, it becomes very important to raise these questions now, with an eye towards informing public health policies for the management of future COVID-19 outbreaks. This discussion should not become politicized along the lines of liberal pro-lockdown/conservative anti-lockdown. Instead, we should reflect on the trade-offs of lockdown policies according to a pluralist framework, in which COVID-19 related deaths are not the only possible value to pursue. (shrink)