Art Caplan has written several times on the need for regulations banning drug use and other performance enhancements by athletes. I have criticized some of his positions before. Recently, though, he came out against regulations banning another form of enhancement, regarding them as too intrusive, or perhaps arbitrary.

I don’t think he can make these positions consistent.

Caplan objects to moves to ban the use of “high altitude tents” – sleeping enclosures that mimic the low atmospheric pressure (hence low oxygen pressure) of high-altitude training sites. The natural bodily response to low oxygen partial pressures is to produce more red blood corpuscles, naturally increasing the blood’s oxygen carrying capacity. The effect is identical to the process of “blood doping” – the removal of an athlete’s own blood, and its re-transfusion of their own RBCs back into that athlete just before a contest, to increase the hematocrit and oxygen carrying capacity. This procedure is banned, but athletes who train at high altitudes naturally have elevated hematocrits without blood doping, and are thus at an inherent advantage over others. (It is no accident that the best long-distance runners come from Kenya, thousands of feet above sea level; body structure aside, Kenyan runners are better even than other African runners. For the same reason, Caplan notes, the US Olympic training center is in Colorado Springs, over a mile above sea level.) Athletes who train at low altitudes lose this benefit, but can mimic it by spending time in low-pressure tents. The World Anti-Doping Association now wants to prohibit the practice – though they will not prohibit simply training at high altitudes (and indeed they could not, given that some athletes live in countries at high altitude and have no other choice).

It is obvious that this attempted ban is unworkable and silly. Just what possible difference the WADA sees between sleeping in a tent that mimics high altitude, and sleeping in an ordinary room at high altitude, is too subtle for me. And the fact that their ban would essentially “lock-in” the physiological advantage enjoyed by those who happen to live at high altitudes or can afford to move there to train, while prohibiting others from doing anything to compensate, seems grossly unfair. But that is not Caplan’s concern.

Caplan believes that WADA’s motive for banning the tents is that they give an “unearned” enhancement – athletes benefit from them simply by sleeping, rather than training or working out. (I don’t know if he’s right about their reasoning, but we can skip that here.) He thinks WADA is attempting to maintain the purity of sport by prohibiting “passive” technologies of that kind, seeing them as equivalent to the unearned advantages provided by drugs. (If so, the WADA is very confused. For one thing, the oxygen-carrying advantage gained by living at high altitude is just as unearned as that gained by sleeping in a low-pressure tent. And the benefits of drugs – particularly steroids for muscle bulk – are often earned by way of extremely hard training and workouts; the drugs by themselves do not improve development or performance, but simply increase the body’s reaction to training. But again, that’s not the point here.) Caplan regards this as an unwelcome injection of moral values into the otherwise-technical debate over training methods:

There seems to be one main reason [for the proposed ban] — sleeping in a tent is a passive activity producing benefits that athletes do not “earn” or “merit.” . . . WADA is worrying about tents not for reasons of safety or even fairness but on ethical grounds — athletes should strive, not snooze, to succeed.

Linking the virtues to athletic success has some appeal. But when WADA uses a moral view of what makes sport worthwhile it is imposing a set of values rather than reflecting what athletes or the public want.

Other than making this point, he offers no argument as to why he regards this as objectionable. If I understand him correctly, however – and again, there is little evidence to go on – he regards this ban as improperly moralistic, while bans on steroids, blood doping, and other enhancements are merely concerns for safety, fairness, and other relevant issues.

This seems very hard to make sense of.

It’s disconcerting to hear that Caplan apparently regards safety and, still more, fairness, as something other than “ethical grounds” for regulating sports – that, in his view, insisting that games be fair does not constitute “a moral view of what makes sport worthwhile”, or that restricting training methods – and hence maximal athletic performance – for the sake of the higher-priority goal of safety is not “imposing a set of values”. I thought fairness was an ethical ground for human interactions; I also thought making explicit tradeoffs of safety over performance involved endorsing a particular set of relative values. In fact, I’m sure those are both the case – and that Caplan’s talking through his hat here.

Whatever this means for low-oxygen tents, however, it leaves Caplan in a precarious position regarding sports regulations overall. He strongly endorses limits on “dangerous” enhancements such as drugs, but here rejects limits on other forms of enhancement – not because they are safer, mind you, but because those limits involve “ethics” and “values”. (Neither does he apparently object to the abusive practices of pre-teen gymnastics coaches, or the high rate of injuries in rugby or hockey matches – all of them risks that athletes choose to take, often to their great harm.) It seems blindingly obvious that the refusal to allow steroids because they are dangerous precisely is an “imposition of a set of values”, just as certainly as is the condoning of grueling youth training or violent sports – but few will object to these positions because of widespread public agreement with them. Caplan can slide those past his readers without getting a critical look, then claim to be standing for freedom of conscience in opposing other forms of value-based judgments on more obscure issues.

In fact, Caplan seems to have put himself in a position in which, to be true to his reasoning about altitude tents, he must abandon his entirely value-laden position on drugs, which hardly looks less arbitrary than that of the WADA on red blood cells.