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Lumifer comments on Crazy Ideas Thread, Aug. 2015 - Less Wrong Discussion
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Once you legalize "anything goes", this will very rapidly change.
I have a few responses to this. First, I'm not arguing for "anything goes". I think performance enhancing drugs should be made available by prescription and require approval of a sports physician of sorts.
Second, training injuries are quite common. A large fraction (perhaps even the vast majority) of my runner friends have had at least moderate injuries from training, and I see no one arguing to ban running in particular. It seems fairly clear to me that a smaller fraction of people who do performance enhancing drugs right now develop problems equivalent in severity. If you have evidence suggesting otherwise, I'd be interested in hearing it.
Third, some performance enhancing drugs seem fairly safe. Take EPO for example. While I'm not an expert, it seems that even massive overdoses are not that bad:
Would you be okay with legalizing performance enhancing drugs which have been demonstrated to be safe?
(Oh, and people reading this, don't read this as "EPO is safe" because I have not investigated that in depth. I'm arguing on the principle that some performance enhancing drugs have less potential for harm than others.)
Let me start by saying that I think people should be able to do whatever they want with their bodies.
Having said this, I am wary of setting up an incentive system where you're encouraging people to achieve superior performance during seconds or minutes at potentially high long-term cost. We probably have different central examples in mind -- what comes to my mind is not steroids with lesser side effects or better versions of EPO, but rather PCP to suppress pain and something to throw your metabolism into overdrive (e.g. at the cost of future cancer).
How well do you think this will work in e.g. Kenya or Myanmar? Don't forget that we have empirical data, for example East Germany in the 1970s and 80s.
Eh. I am highly suspicious of spectator sports because by now they became a huge highly corrupt machine which is interested in nothing but generating money and maintaining control. It might legalize performance drugs if it thinks it will get more money and control this way.
As to the answer to your question "in general", see the first sentence of this comment :-)
Perhaps I was unclear. My point is that this happens even without performance enhancing drugs. I know a few people who have permanently injured themselves from sports training and performance, and I'm very confident none of them took performance enhancing drugs. I am not convinced that legalizing performance enhancing drugs would make this worse, and I think it stands a good chance of making it better by putting it all out in the open. I'd be interested in seeing if there's evidence either way.
Certainly, some doctors are better or worse than others. Athletes may get inappropriate prescriptions if prescription drugs are approved for athletics. Again, I don't really see your point given that I think poor training is comparably dangerous.
As for the latter example, it seems to me that the problems in East Germany were not from use of performance enhancing drugs per se (though they played a role), but lack of informed consent, secrecy, and short-term thinking. Their system considered the athletes to be fungible, and valued short term winning over the athletes' health. And it's not drugs that did all of the damage; hard training (perhaps made more possible with drugs) is a major culprit as well. Athletes should have a choice about whether to take certain drugs or participate in certain training exercises, and they should understand the true risks involved with each choice. They should do this without coercion and be allowed to get other opinions.
I understand that. The difference lies in tools that you can bring to bear. Screwing yourself up via biochemistry is MUCH easier than screwing yourself up via hard training.
The point is that the safeguard of "there is a doctor involved" is not much of a safeguard.
These are going to be present regardless. The issue, again, is tools which you can use.
Imagine a competition (winning which leads to money and fame) which is based on how contorted a pose can you get into. Under normal conditions you'll certainly get overtraining side-effects: winners will have overstretched ligaments and muscles, will suffer from habitual dislocation, etc. But now imagine that you allow breaking and resetting bones in new configurations, transplantation of organs to new places in your body and other things like that. It's the same competition, but the tools are different.
Appreciate your reply. I think it has helped me refine my thinking.
My immediate thought was to agree, but upon reflection, I'm not sure I do agree. The availability heuristic could play a role here. I'll try to make your claim more precise. One interpretation is that you are more likely to injure yourself sooner by taking drugs than by training. I'm not sure that's actually true. I definitely can think of examples where someone taking a drug died shortly afterward. "Hard training" seems to imply things which take time to develop, like stress fractures. However, I'd include training related accidents under training, and I don't think those are unlikely early on. I'd also include things like heat exhaustion and heart attacks there.
I'd give a higher probability to drugs being easier to cause severe damage in the short term, especially if they are illegal (impure) drugs (which are not relevant to the question of legalization), but I'd like to see more clear data on the precise risks.
If I understand your argument, it's that some athletes will have less of a safeguard, not that doctors are not much of a safeguard in general. I also want to highlight again that the same is true for training.
I'm interested in whether we are assigning blame appropriately. Do you think if the other issues I mentioned had been addressed, the athletes would still be taking on unacceptable risk from performance enhancing drugs specifically?
I think I can understand the parallels you are making between taking performance enhancing drugs and body modification. I suppose this argument fails to convince me because I don't think body modification should be off the table either!
Training already produces substantial changes in the human body, and I see no relevant difference between changes induced surgically or through natural biology, provided that the level of risk is equivalent for both. Perhaps one relevant fact is that training induced changes will generally revert themselves if you stop training, and surgical changes won't.
I can think of a variety of ways in which drugs are more dangerous than training (some of which you mentioned):
I can probably produce more if I work at it :-)
My point is that "someone with a medical degree is around" doesn't actually provide much safety by itself -- it all depends on the context. A wealthy US doctor (who can be sued, stripped of a license, kicked out of his country club, etc.) has a very different set of incentives than some guy with an M.D. in a poor country whose only chance of success in life is to extract superhuman performance out of a sports team he's advising.
Again, it's up to the athlete to decide which risk is acceptable and which is not. My concern is with a system of incentives, not with whether an individual athlete will make a "right" or "wrong" decision.
I think I'm more suspicious of long-term costs for short-term gains, rather than risk levels...
You make fair points, though ultimately I'm not convinced that legalizing at least certain performance enhancing drugs will lead to problems worse than that which can be found via bad training.
I'll be thinking about this and might change my mind.