Anti-Doping in Sport and Human Enhancing Technologies in Army

Any meaningful discussion of future land warfare should include enhancing combat effectiveness by integrating technology with the soldier.  While such discussions usually involve the exciting ethical dilemmas presented by the ‘super soldier’, the complementary discussion about the practicalities of how Army is to get from the present to the ‘super soldier’ receives less attention. 

The Future Land Warfare Report 2014 indicates Army’s willingness to consider technology being ‘in’ the soldier (e.g. drugs and cybernetic implants) in addition to being ‘on’ the soldier (e.g. exoskeletons) through the ‘fusing of biology with technology’ (para. 32) and the consequences of using ‘long lasting stimulants’ (para. 44).  If the future of land warfare is to make use of human enhancing technology, Army needs policy to enable and support the transition from soldier to ‘super soldier’. 

Human enhancement technology policy is becoming a reality for many market sectors, including education (‘smart drugs’ in high schools), emergency services (anabolic steroids in law enforcement) and entertainment (beta blocker use among classical musicians).  Thinking on human enhancing technology is dominated by international sport’s anti-doping policy, the World Anti-Doping Code (the Code).  Like other market sectors, the Australian Defence Force (ADF) has adopted parts of the Code to manage human enhancing technologies, and in particular, human enhancing drugs.  The Code has been called by some ‘first generation’ human enhancing management policy.  It is unclear whether importing sport’s attempt to manage human enhancing technology using the Code is appropriate for military contexts. 

The Code interacts with Australian soldiers through DI(G) PERS 15-5 adoption of the World Anti-Doping Agency’s Prohibited List.  Under DI(G) PERS 15-5, the definition of a ‘prohibited substance’ includes Sections 1-3 and 5 of the Prohibited List (the Prohibited List includes Sections 0-9 and two special listings sections).  This prohibits the use of, among other drugs, peptide hormones (like those for which the Essendon Football Club were sanctioned) and diuretics (often used to support weight control).  Notably, it also means that other substances entered onto the Prohibited List (e.g. stimulants) are outside the remit of DI(G) PERS 15-5. 

The Code establishes prohibition of a drug or method based on failing two of three tests.  There must be:

• evidence or experience of a drug being ‘performance enhancing’ (Article 4.3.1.1),
  
   
• actual or potential health implications (Article 4.3.1.2), or
  
   
• violation of the ‘Spirit of Sport’ (11 values defined to be the essence of Olympism, such as ‘ethics, fair play and honesty’ and ‘fun and joy’) (Article 4.3.1.3).

(Exactly how a substance or method fails the Spirit test has never been made public, such as how a value is violated, whether the drug fails because it violates just one value, or whether more than half of the 11 values have to be violated).

Taken at face value, these three tests may mean performance enhancing drugs of interest to Army might be discounted from consideration.  There is a fundamental difference of purpose between a policy designed to protect the integrity of sport and Army’s need to protect the integrity of combat soldiers.  Examined through the lens of Army’s interests in the well-being and integrity of combat soldiers, Army may see the performance enhancing value of a peptide hormone as delivering a combat advantage.  Equally, enhanced combat survivability might make the health implications of a drug for athletes nonsensical.  Finally, it seems odd to deny a soldier access to a drug (e.g. peptide hormones) that may lead to a combat advantage or improved survival rates on the grounds it violates ‘fair play’ or ‘fun and joy’. 

The three criteria used to list a substance or method on the Prohibited List have also been criticised as lacking transparency and accountability.  Administrators have a ‘stunning degree of elasticity’ to prohibit any substance or method, without having to reveal the reasons behind their decision to list a substance or being held accountable for their decisions.  For example, the decision to prohibit mildronate (the substance for which Maria Sharapova was sanctioned) appeared to be based on assumptions a number of athletes were using the drug with intent to enhance performance.  It was listed despite equivocal evidence it enhanced sports performance, no evidence being offered in relation to particular health implications (it is a therapeutic drug) and no indication of how its use failed the Spirit of Sport test.  That is, the decision to enter a substance onto the Prohibited List lacks both transparency and accountability.  Without transparency or accountability, it is unclear whether the reasons for prohibiting a substance under the Code are appropriate for that prohibition extending to the Australian Army. 

While the Prohibited List may have been a useful starting point for the ADFs engagement with human enhancing technology policy, it is clearly time for the ADF to begin maturing towards ‘second generation’ policy.  In particular, policy settings need to evolve to better account for both the discovery and integration of technologies ‘in’ the soldier if Army is to transition to the ‘super soldier’.  A good start is for Army to lead the development of ‘second generation’ human enhancement policy based on sound evidence, good governance, and the values and traditions of Australia and its military.