Bioethics in Sport
DOI:
https://doi.org/10.6016/ZdravVestn.3465Keywords:
bioethics, ethical issues, medicine, professional athletes, sportAbstract
Whether recreational or professional, sport is an integral part of human life, so its daily impact on society is undeniable. It is, therefore, important to recognise the role of moral values and ethics in sport, which can help to ensure fairness and preserve the integrity of professional sports. In recent years, there has been a growing awareness of the importance of implementing these values in professional sport, as it is crucial to enable physical performance without compromising the very essence of sport. However, using prohibited substances and methods in professional sports today has become an increasingly worrying ethical issue, particularly in sports medicine. The primary aim of sports science, especially sports physiology, is to help athletes improve their performance and prevent and overcome injuries, while the primary goal of sports management and some athletes is often to win, which can lead to unethical means to achieve this goal. This behaviour raises many ethical doubts and highlights the need for a framework to address these contemporary challenges increasingly facing professional sport today. Bioethics can effectively address these challenges by examining medical and scientific advances’ ethical, social, moral, and legal implications. By considering the values, principles, and norms underlying medical and scientific practices, bioethics in the context of sport can provide guidance and recommendations for bioethical decision-making concerning (bio)ethical doubts or controversies that may arise, such as the use of performance-enhancing drugs, non-therapeutic use of gene therapy and ethical considerations related to using new technologies. This paper, therefore, aims to emphasise the importance of bioethics as a bridging science in sport in the context of the (bio)ethical challenges that increasingly characterise the professional practice of sport today.
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References
1. Bloodworth AJ, McNamee M. Sport, Society, and Anti-Doping Policy: An Ethical Overview. Med Sport Sci. 2017;62(1):177-85.
DOI: 10.1159/000460748
PMID: 28571026
2. Matolić T, Jurakić D, Podnar H, Radman I, Pedišić Ž. Promotion of health-enhancing physical activity in the sport sector: a study among representatives of 536 sports organisations from 36 European countries. BMC Public Health. 2023;23(1):750.
DOI: 10.1186/s12889-023-15589-9
PMID: 37095502
3. Vargas-Mendoza N, Fregoso-Aguilar T, Madrigal-Santillán E, Morales-González Á, Morales-González JA. Ethical Concerns in Sport: When the Will to Win Exceed the Spirit of Sport. Behav Sci (Basel). 2018;8(9):1-18.
DOI: 10.3390/bs8090078
PMID: 30177618
4. Coakley J. Sports in Society: Issues and Controversies. 13th ed. New York, US: McGraw Hill; 2021.
5. Mavrinac M, Turina IS, Bunjevac I. Can Contemporary Sport do without Its Ethics? — A Need for Systematic Education. JAHR. 2011;2(3):75-92.
6. Camporesi S, McNamee M. Bioethics, Genetics and Sport. New York, US: Routledge; 2018.
DOI: 10.4324/9781315709253
7. Burns L, Weissensteiner JR, Cohen M, Bird SR. A survey of elite and pre-elite athletes’ perceptions of key support, lifestyle and performance factors. BMC Sports Sci Med Rehabil. 2022;14(1):2.
DOI: 10.1186/s13102-021-00393-y
PMID: 34980226
8. Grunseit AC, MacNiven R, Orr R, Grassmayr M, Kelly B, Davies D, et al. Australian athletes’ health behaviours and perceptions of role modelling and marketing of unhealthy products. Health Promot J Austr. 2012;23(1):63-9.
DOI: 10.1071/HE12063
PMID: 22730943
9. Yaffe Y, Levental O, Arey DL, Lev A. Morality and Values in Sports Among Young Athletes: The Role of Sport Type and Parenting Styles - A Pilot Study. Front Psychol. 2021;12(2).
DOI: 10.3389/fpsyg.2021.618507
PMID: 33643147
10. Constantin PN, Stanescu R, Pelin F, Stoicescu M, Stanescu M, Barkoukis V, et al. How to Develop Moral Skills in Sport by Using the Corruption Heritage? Sustainability (Basel). 2021;14(1):1-17.
DOI: 10.3390/su14010400
11. Malve HO. Sports Pharmacology: A Medical Pharmacologist’s Perspective. J Pharm Bioallied Sci. 2018;10(3):126-36.
DOI: 10.4103/JPBS.JPBS_229_17
PMID: 30237683
12. Post SG, editor. Encyclopedia of Bioethics. 3rd ed. Farmington Hills, US: Macmillan Reference USA; 2004.
13. Ekmekci PE. Physicians’ Ethical Dilemmas in the Context of Anti-Doping Practices. Ann Sports Med Res. 2016;3(7):139-48.
PMID: 28070567
14. Hughes D. The World Anti-Doping Code in sport: update for 2015. Aust Prescr. 2015;38(5):167-70.
DOI: 10.18773/austprescr.2015.059
PMID: 26648655
15. Mcnamee M. Sport, Medicine, Ethics. New York, US: Routledge; 2014.
DOI: 10.4324/9781315885971
16. Škerbić MM. Bioethics of Sport – The Look Toward the Future of Sport. Pannoniana. 2020;4(1):119-40.
17. Zeigler-Hill V, Besser A, Gabay M, Young G. Narcissism and Exercise Addiction: The Mediating Roles of Exercise-Related Motives. Int J Environ Res Public Health. 2021;18(8):1-16.
DOI: 10.3390/ijerph18084243
PMID: 33923617
18. Thieme D, Hemmersbach P, eds. Doping in Sports. New York, US: Springer; 2010.
DOI: 10.1007/978-3-540-79088-4
19. Baron DA, Martin DM, Abol Magd S. Doping in sports and its spread to at-risk populations: an international review. World Psychiatry. 2007;6(2):118-23.
PMID: 18235871
20. Tuffs A. Doped East German athletes to receive compensation. BMJ. 2002;324(7353):1544.
DOI: 10.1136/bmj.324.7353.1544/b
PMID: 12089087
21. Ryall E. Introduction to Philosophical Issues in Sport Science. Philosophies. 2019;4(4):57.
DOI: 10.3390/philosophies4040057
22. World Health OrganisationWHO Guidelines on Physical Activity and Sedentary Behaviour. Geneva (CH): WHO Press; 2020.
23. Bratina N, Hadžić V, Batellino T, Pistotnik B, Pori M, Šajber D, et al. Slovenian Guidelines for Physical Activity in Children and Adolescents in the Age Group 2–18 Years. Zdrav Vestn. 2011;80(12):885-96.
24. McFee G. Sport, Rules and Values: Philosophical Investigations into the Nature of Sport. London, GB: Routledge; 2004.
DOI: 10.4324/9780203299876
25. Vicente-Salar N, Fuster-Muñoz E, Martínez-Rodríguez A. Nutritional Ergogenic Aids in Combat Sports: A Systematic Review and Meta-Analysis. Nutrients. 2022;14(13):1-32.
DOI: 10.3390/nu14132588
PMID: 35807770
26. Tan SH, Lee A, Pascovici D, Care N, Birzniece V, Ho K, et al. Plasma biomarker proteins for detection of human growth hormone administration in athletes. Sci Rep. 2017;7(1):10039.
DOI: 10.1038/s41598-017-09968-7
PMID: 28855568
27. Škerbić MM. How did William J. Morgan Shape the Ethics of Sport? Kinesiology. 2021;53(2):326-35.
DOI: 10.26582/k.53.2.16
28. Omar-Fauzee MS, Nazarudin MN, Saputra YM, Sutresna N, Taweesuk D, Chansem W, et al. The Strategies for Character Building through Sports Participation. Int J Acad Res Bus Soc Sci. 2012;2(3):48-58.
29. Lumpkin A. Modern Sport Ethics: A Reference Handbook. 2nd ed. Denver, US: ABC-CLIO; 2016.
DOI: 10.5040/9798400686948
30. Sutar B, ed. Health and Physical Education: Textbook for Class IX. New Delhi (IN): National Council of Educational Research and Training; 2016.
31. Turina IS, Brkljacić M, Grgas-Bile C, Gajski D, Racz A, Cengić T. Current Perspectives of Potter’s Global Bioethics as a Bridge between Clinical (Personalized) and Public Health Ethics. Acta Clin Croat. 2015;54(4):509-15.
PMID: 27017727
32. Azariah J. Bioethics Science: is it? J Med Ethics Hist Med. 2009;2(2):18.
PMID: 23908732
33. Škerbić MM, Radenović S. Bioethics of Sport: The Presence of Bioethical Topics in the Field of Philosophy and Ethics of Sports in Croatia and Serbia. JAHR. 2018;9(2):159-84.
DOI: 10.21860/j.9.2.2
34. Greenfield BH, West CR. Ethical issues in sports medicine: a review and justification for ethical decision making and reasoning. Sports Health. 2012;4(6):475-9.
DOI: 10.1177/1941738112459327
PMID: 24179585
35. Trivino JL. The Challenges of Modern Sport to Ethics: From Doping to Cyborgs. Toronto (CA): Lexington Books; 2013.
36. Varkey B. Principles of Clinical Ethics and Their Application to Practice. Med Princ Pract. 2021;30(1):17-28.
DOI: 10.1159/000509119
PMID: 32498071
37. Dunn WR, George MS, Churchill L, Spindler KP. Ethics in sports medicine. Am J Sports Med. 2007;35(5):840-4.
DOI: 10.1177/0363546506295177
PMID: 17218662
38. Council of EuropeRevised European Sports Charter. Strasbourg, FR: Council of Europe Publishing; 2022.
39. Murthy AM, Dwyer J, Bosco JA. Ethics in sports medicine. Bull NYU Hosp Jt Dis. 2012;70(1):56-9.
PMID: 22894696
40. Ionescu AM, Pitsiladis YP, Rozenstoka S, Bigard X, Löllgen H, Bachl N, et al. Preparticipation medical evaluation for elite athletes: EFSMA recommendations on standardised preparticipation evaluation form in European countries. BMJ Open Sport Exerc Med. 2021;7(4).
DOI: 10.1136/bmjsem-2021-001178
PMID: 34745648
41. Gee CJ. How does sport psychology actually improve athletic performance? A framework to facilitate athletes’ and coaches’ understanding. Behav Modif. 2010;34(5):386-402.
DOI: 10.1177/0145445510383525
PMID: 20935240
42. Škerbić MM. Bioethics of Sport and Its Place in the Philosophy of Sport. Synth Philos. 2019;34(2):379-374.
DOI: 10.21464/sp34209
43. Carrard J, Morais Azevedo A, Gojanovic B, Edouard P, Pandya T, Robinson DG, et al. Sport and exercise medicine around the world: global challenges for a unique healthcare discipline. BMJ Open Sport Exerc Med. 2023;9(1).
DOI: 10.1136/bmjsem-2023-001603
PMID: 37020535
44. Olympia RP, Lucas C, Doraiswamy V, Funghi C, Wakefield HM, Wakefield BH, et al. “SPORTS ARE FUN”: A Guide for the Discussion of Sport-Related Films. Glob Pediatr Health. 2019;6(6).
DOI: 10.1177/2333794X19860657
PMID: 31312676
45. Singh AR. Modern Medicine: Towards Prevention, Cure, Well-being and Longevity. Mens Sana Monogr. 2010;8(1):17-29.
DOI: 10.4103/0973-1229.58817
PMID: 21327168
46. Kolt GS. Practice domains in sports medicine and sport science. J Sci Med Sport. 2010;13(3):287.
DOI: 10.1016/j.jsams.2010.03.001
PMID: 20308018
47. McCrory P. What is sports and exercise medicine? Br J Sports Med. 2006;40(12):955-7.
PMID: 17124107
48. Brocherie F, Beard A. All Alone We Go Faster, Together We Go Further: The Necessary Evolution of Professional and Elite Sporting Environment to Bridge the Gap Between Research and Practice. Front Sports Act Living. 2021;2(2).
DOI: 10.3389/fspor.2020.631147
PMID: 33585813
49. Kimura R. Bioethics as a Superinterdisciplinary Science. Društvena istraživanja. 1996;5(3-4):589-96.
50. Blackburn S. Ethics: A Very Short Introduction. Oxford, GB: Oxford University Press; 2021.
DOI: 10.1093/actrade/9780198868101.001.0001
51. Simon RL, Torres CR, Hager PF. Fair Play: The Ethics of Sport. 4th ed. Boulder, US: Westview Press; 2015.
52. Cleret L, McNamee M, Page S. ‘Sports Integrity’ Needs Sports Ethics (and Sports Philosophers and Sports Ethicists Too). Sport Ethics Philos. 2015;9(1):1-5.
DOI: 10.1080/17511321.2015.1049015
53. Mercader V, Galván-Vela E, Ravina-Ripoll R, Popescu CR. A Focus on Ethical Value under the Vision of Leadership, Teamwork, Effective Communication and Productivity. J Risk Financ Manag. 2021;14(11):1-32.
DOI: 10.3390/jrfm14110522
54. Bell B. Sport Studies. Exter, GB: Learning Matters; 2009.
55. Blauwet C, Greenfield BH, Ham EL, Spill G, Mukherjee D. The Team Physician: Ethical and Legal Issues. PM R. 2015;7(10):1089-94.
DOI: 10.1016/j.pmrj.2015.09.002
PMID: 26494373
56. Petróczi A, Aidman E. Psychological drivers in doping: the life-cycle model of performance enhancement. Subst Abuse Treat Prev Policy. 2008;3(1):7.
DOI: 10.1186/1747-597X-3-7
PMID: 18331645
57. Echemendia RJ, ed. Sports Neuropsychology: Assessment and Management of Traumatic Brain Injury. New York, US: Guilford Press; 2006.
58. Burgess DJ, Naughton GA. Talent development in adolescent team sports: a review. Int J Sports Physiol Perform. 2010;5(1):103-16.
DOI: 10.1123/ijspp.5.1.103
PMID: 20308701
59. Petróczi A, Naughton DP. Popular drugs in sport: descriptive analysis of the enquiries made via the Drug Information Database (DID). Br J Sports Med. 2009;43(11):811-7.
DOI: 10.1136/bjsm.2008.052894
PMID: 18981038
60. Koller DL. Team Physicians, Sports Medicine, and the Law: an Update. Clin Sports Med. 2016;35(2):245-55.
DOI: 10.1016/j.csm.2015.10.005
PMID: 26832974
61. Anderson LC, Gerrard DF. Ethical issues concerning New Zealand sports doctors. J Med Ethics. 2005;31(2):88-92.
DOI: 10.1136/jme.2002.000836
PMID: 15681672
62. Gosić N. Bioetika in vivo. Zagreb: Pergamena; 2005.
63. Koh D, Gan WH, eds. Textbook of Occupational Medicine Practice. 5th ed. Singapore, SG: World Scientific; 2022.
DOI: 10.1142/12512
64. Verow P. Sports and occupational medicine: two sides of the same coin? Occup Med (Lond). 2006;56(4):224-5.
DOI: 10.1093/occmed/kqj027
PMID: 16733253
65. Testoni D, Hornik CP, Smith PB, Benjamin DK, McKinney RE. Sports medicine and ethics. Am J Bioeth. 2013;13(10):4-12.
DOI: 10.1080/15265161.2013.828114
PMID: 24024796
66. Baroni BM, Oliveira Pena Costa L. Evidence-Based Prevention of Sports Injuries: Is the Sports Medicine Community on the Right Track? J Orthop Sports Phys Ther. 2021;51(3):91-3.
DOI: 10.2519/jospt.2021.0104
PMID: 33645293
67. Sim J. Sports medicine: some ethical issues. Br J Sports Med. 1993;27(2):95-100.
DOI: 10.1136/bjsm.27.2.95
PMID: 8358592
68. Baggaley R, Calleja JM, Marum L, Marum E. Knowledge is power; information is liberation. Bull World Health Organ. 2013;91(12):898-898A.
DOI: 10.2471/BLT.13.132464
PMID: 24347724
69. Van Hiel A, Van Assche J, De Cremer D, Onraet E, Bostyn D, Haesevoets T, et al. Can education change the world? Education amplifies differences in liberalization values and innovation between developed and developing countries. PLoS One. 2018;13(6).
DOI: 10.1371/journal.pone.0199560
PMID: 29928058
70. Simon RL. The Ethics of Sport: What Everyone Needs to Know. New York, US: Oxford University Press; 2016.
DOI: 10.1093/wentk/9780190270209.001.0001
71. Devitt BM, McCarthy C. ‘I am in blood Stepp’d in so far...’: ethical dilemmas and the sports team doctor. Br J Sports Med. 2010;44(3):175-8.
DOI: 10.1136/bjsm.2009.068056
PMID: 19948531
72. Gillon R. Medical ethics: four principles plus attention to scope. BMJ. 1994;309(6948):184-8.
DOI: 10.1136/bmj.309.6948.184
PMID: 8044100
73. Koskinen JS, Heimo OI, Kimppa KK. A Viewpoint for More Ethical Approach in Healthcare Information System Development and Procurement: The Four Principles. Commun Comput Inf Sci. 2012;313(1):1-9.
DOI: 10.1007/978-3-642-32850-3_1
74. Shaw RM. Ethics, Moral Life and the Body: Sociological Perspectives. Londin, GB: Palgrave Macmillan; 2015.
75. Dauda B, Denier Y, Dierickx K. What Do the Various Principles of Justice Mean Within the Concept of Benefit Sharing? J Bioeth Inq. 2016;13(2):281-93.
DOI: 10.1007/s11673-016-9706-4
PMID: 26825296
76. Weatherill S. Principles and Practice in EU Sports Law. Oxford, GB: Oxford University Press; 2017.
77. Zmuda Palka M, Bigosińska M, Siwek M, Angelova-Igova B, Mucha DK. Doping in Sport-Attitudes of Physical Trainers Students Regarding the Use of Prohibited Substances Increasing Performance. Int J Environ Res Public Health. 2023;20(5):1-9.
DOI: 10.3390/ijerph20054574
PMID: 36901582
78. Vlad RA, Hancu G, Popescu GC, Lungu IA. Doping in Sports, a Never-Ending Story? Adv Pharm Bull. 2018;8(4):529-34.
DOI: 10.15171/apb.2018.062
PMID: 30607326
79. Blank C, Kopp M, Niedermeier M, Schnitzer M, Schobersberger W. Predictors of doping intentions, susceptibility, and behaviour of elite athletes: a meta-analytic review. Springerplus. 2016;5(1):1333.
DOI: 10.1186/s40064-016-3000-0
PMID: 27563528
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