blog.bioethics.net

Art Caplan on Oscar Pistorious, the double amputee sprinter

Over at MSNBC, Art writes that he's not so sure that Pistorious should be allowed to compete in the Olympics:

Should anyone who must run on prosthetic legs be allowed to compete in the Olympics or other sporting events?

Oscar Pistorius, a college student from South Africa, has been told he can compete in the Beijing games this August, in either the 400-meter or the 1600-meter relay race as a member of the South African team, if he can reach a qualifying time.

The decision has been greeted around the world with approval. Some see it as a triumph for the disabled. It is easy to see why. Pistorius, known as the Blade Runner, is a very appealing, articulate young man who trains hard and sincerely wants a chance to compete. But I am not sure letting him run is the right decision.

Pistorius was born with major bones missing in both his lower legs. His legs were amputated at the knees when he was a child. He runs using artificial limbs made of carbon fiber, known as Cheetah blades. The controversy over whether Pistorius should be allowed to compete has focused exclusively on whether his Cheetah blades give him an unfair advantage.

Last January the International Association of Athletics Federations (IAAF) said, based on a report from a German scientist, that mechanical legs give anyone using them an advantage in a race. They are more energy efficient than human legs, ultra-light, springier and do not fatigue. The IAAF said since the Cheetahs helped athletes perform better, it would ban their use. That decision meant no Olympics for Pistorius.

Pistorius appealed the ban to the Court of Arbitration for Sport (CAS) in Lausanne, Switzerland. Scientists at six universities in three nations took a look at Pistorius’ artificial legs. They concluded that the available evidence about the advantages of the Cheetah blades was insufficient. Last week the court said that, until more evidence was produced, Pistorius was eligible. The IAAF backed down and Pistorius can now compete.

What if further study does show that Pistorius can run faster because his artificial Cheetah blades work better than legs? Should he or others be kept out of competitions involving able-bodied persons?

Defining an unfair advantage
Tiger Woods is probably one of the greatest golfers of all time. But, his vision was so poor that he was almost legally blind without contact lenses or glasses. In 1999, he had laser surgery on his eyes and his vision improved to better than 20/20. He had another procedure performed last year leaving him not only with improved vision, but better vision than most humans. Does laser-eye surgery that improves vision past 20/20 confer an unfair advantage on Tiger? And what's the difference between superhuman legs and superhuman sight?

When a modern American Olympian benefits from training at high altitudes, counseling from a sports physiologist and psychologist, expert physical therapy and a finely tuned diet, these steps could just as easily be seen as conveying an unfair advantage.

That's why it cannot just be "advantage" that determines whether someone can use technology to compete. The deciding factor is whether something confers a significant, not a slight advantage.

More important still is whether the technology modifies a bodily organ or completely replaces it. Pistorius’ Cheetah blades may not confer a big advantage, but they represent a much more significant replacement of a crucial body part than shaping your cornea with a laser, or improving your diet.

Continuity with history
Pistorius' amazing drive to compete may cause an even more troubling problem.

Sport demands continuity with its own history. If you make technological changes in the equipment — swimsuits, pole vaults, running shoes, skates, skis, baseballs, bats, playing surfaces, etc — then you undermine the ability of today’s athletes to be compared not only with their peers but with their predecessors.

Similarly, if people with artificial legs, artificial eyes that permit exquisite focus, pharmacologically enhanced muscles or emotions, or brain implants that permit unprecedented concentration or endurance enter into competition, then you no longer have a sport. The athletes are not comparable to those who attempted the same feats in earlier times.

We don’t expect to compare the performances of today to those of the ancient Greeks, but we do expect some ability to compare what happened today to be compared with what happened yesterday, a year ago, a decade ago or even 50 years ago.

It may be fascinating to see who can go the fastest on rocket-powered legs or throw a heavy weight the farthest using performance-enhancing drugs, or genetically engineered muscles. But what you have then is an exhibition or a show, not a sport. In some ways, this is what the professional wrestling and no-rules body building already are.

To be a sport you need something approximating a fair playing field, some boundaries on the attributes of those who compete so they are comparable to one another and some ability to compare today’s performance with those in the not-so-distant past.

That is why I am not sure Oscar Pistorius should compete.

He may not have a marked advantage, but his artificial limbs make him too different from those he competes against, and too unlike those who have raced before. It's not about giving him an opportunity. The issue is that Pistorius risks destroying exactly what he wants to do — compete in a sport.

Arthur Caplan, Ph.D., is director of the Center for Bioethics at the University of Pennsylvania.