Skip to main content
Top
Published in: Sports Medicine 5/2009

01-05-2009 | Current Opinion

Genetic Testing and Sports Medicine Ethics

Authors: Prof Michael John McNamee, Arno Müller, Ivo van Hilvoorde, Søren Holm

Published in: Sports Medicine | Issue 5/2009

Login to get access

Abstract

Sports medicine ethics is neither a well established branch of sports medicine nor of medical ethics. It is therefore important to raise to more general awareness some of the significant ethical implications of sports medicine practices. The field of genetics in sports is likewise in its infancy and raises significant ethical concerns. It is not yet clear how genetics will alter our understanding of human potential and performance in sports. While a number of professional medical bodies accept genetic interventions of a therapeutic nature, we argue that the use of genetic technologies to predict sports potential may well breach both the European bioethics convention and North American anti-discrimination legislation, which are designed to support important ethical ideals and the ongoing commitment of the physician to the welfare of their patient. We highlight further ethical problems associated with confidentiality and consent that may arise in genetic testing as opposed to more conventional methods of testing in sports medicine. We conclude that genetic testing in sport that is not strictly limited to the protection of the athlete against harm, should be viewed in a very sceptical light by sports medicine professionals.
Literature
2.
go back to reference The Human Genetics Society of Australasia. HGSA position statement on genetic testing and sport performance. Alexandria: The Human Genetics Society of Australasia, 2007 The Human Genetics Society of Australasia. HGSA position statement on genetic testing and sport performance. Alexandria: The Human Genetics Society of Australasia, 2007
4.
go back to reference Savulescu J, Foddy B. Comment: genetic test available for sports performance. Br J Sports Med 2005 Aug 1; 39 (8): 472PubMedCrossRef Savulescu J, Foddy B. Comment: genetic test available for sports performance. Br J Sports Med 2005 Aug 1; 39 (8): 472PubMedCrossRef
5.
go back to reference Miah A, Rich E. Genetic tests for ability? Talent identification and the value of an open future. Sport Educ Soc 2006; 11 (3): 259–73CrossRef Miah A, Rich E. Genetic tests for ability? Talent identification and the value of an open future. Sport Educ Soc 2006; 11 (3): 259–73CrossRef
6.
go back to reference Munthe C. Selected champions: making winners in the age of genetic technology. In: Tamburrini CT, Tännsjö T, editor. Values in sport: elitism, nationalism, gender equality and the scientific manufacture of winners. London: Taylor and Francis, 2000: 217–31 Munthe C. Selected champions: making winners in the age of genetic technology. In: Tamburrini CT, Tännsjö T, editor. Values in sport: elitism, nationalism, gender equality and the scientific manufacture of winners. London: Taylor and Francis, 2000: 217–31
7.
go back to reference Munthe C. Ethical aspects of controlling genetic doping. In: Tamburrini C, Tännsjö T, editors. The genetic technology and sport: ethical questions. London: Routledge, 2005: XII, 223 S Munthe C. Ethical aspects of controlling genetic doping. In: Tamburrini C, Tännsjö T, editors. The genetic technology and sport: ethical questions. London: Routledge, 2005: XII, 223 S
8.
go back to reference Murray TH. Assessing genetic technologies: two ethical issues. Int J Technol Assess Health Care 1994 Fall; 10 (4): 573–82PubMedCrossRef Murray TH. Assessing genetic technologies: two ethical issues. Int J Technol Assess Health Care 1994 Fall; 10 (4): 573–82PubMedCrossRef
9.
go back to reference Maron BJ. Distinguishing hypertrophic cardiomyopathy from athlete’s heart: a clinical problem of increasing magnitude and significance. Heart 2005 Nov; 91 (11): 1380–2PubMedCrossRef Maron BJ. Distinguishing hypertrophic cardiomyopathy from athlete’s heart: a clinical problem of increasing magnitude and significance. Heart 2005 Nov; 91 (11): 1380–2PubMedCrossRef
10.
go back to reference Corrado D, Thiene G. Protagonist: routine screening of all athletes prior to participation in competitive sports should be mandatory to prevent sudden cardiac death. Heart Rhythm 2007; 4 (4): 520–4PubMedCrossRef Corrado D, Thiene G. Protagonist: routine screening of all athletes prior to participation in competitive sports should be mandatory to prevent sudden cardiac death. Heart Rhythm 2007; 4 (4): 520–4PubMedCrossRef
11.
go back to reference Pelliccia A, Fagard R, Bjørnstad HH, et al. Recommendations for competitive sports participation in athletes with cardiovascular disease: a consensus document from the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 2005; 26 (14): 1422–45PubMedCrossRef Pelliccia A, Fagard R, Bjørnstad HH, et al. Recommendations for competitive sports participation in athletes with cardiovascular disease: a consensus document from the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 2005; 26 (14): 1422–45PubMedCrossRef
12.
13.
14.
go back to reference Council of Europe. Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine. Oviedo: The Council of Europe, 1997 Council of Europe. Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine. Oviedo: The Council of Europe, 1997
16.
17.
go back to reference Dunn WR, George MS, Churchill L, et al. Ethics in sports medicine. Am J Sports Med 2007 May 1; 35 (5): 840–4PubMedCrossRef Dunn WR, George MS, Churchill L, et al. Ethics in sports medicine. Am J Sports Med 2007 May 1; 35 (5): 840–4PubMedCrossRef
18.
go back to reference Waddington I, Malcolm D, Roderick M, et al. Drug use in English professional football. Br J Sports Med 2005 April 1; 39 (4): e18CrossRef Waddington I, Malcolm D, Roderick M, et al. Drug use in English professional football. Br J Sports Med 2005 April 1; 39 (4): e18CrossRef
19.
go back to reference Rankinen T, Bray MS, Hagberg JM, et al. The human gene map for performance and health-related fitness phenotypes: the 2005 update. Med Sci Sports Exerc 2006 Nov; 38 (11): 1863–88PubMedCrossRef Rankinen T, Bray MS, Hagberg JM, et al. The human gene map for performance and health-related fitness phenotypes: the 2005 update. Med Sci Sports Exerc 2006 Nov; 38 (11): 1863–88PubMedCrossRef
21.
go back to reference Miah A. Genetically modified athletes: biomedical ethics, gene doping and sport. London: Routledge, 2004 Miah A. Genetically modified athletes: biomedical ethics, gene doping and sport. London: Routledge, 2004
22.
go back to reference Clayton EW. Ethical, legal, and social implications of genomic medicine. N Engl J Med 2003 Aug 7; 349 (6): 562–9PubMedCrossRef Clayton EW. Ethical, legal, and social implications of genomic medicine. N Engl J Med 2003 Aug 7; 349 (6): 562–9PubMedCrossRef
23.
go back to reference Yang N, MacArthur DG, Gulbin JP, et al. ACTN3 genotype is associated with human elite athletic performance. Am J Hum Genet 2003 Sep; 73 (3): 627–31PubMedCrossRef Yang N, MacArthur DG, Gulbin JP, et al. ACTN3 genotype is associated with human elite athletic performance. Am J Hum Genet 2003 Sep; 73 (3): 627–31PubMedCrossRef
24.
go back to reference Lucia A, Olivan J, Gomez-Gallego F, et al. Citius and longius (faster and longer) with no alpha-actinin-3 in skeletal muscles? Br J Sports Med 2007 Sep; 41 (9): 616–7PubMedCrossRef Lucia A, Olivan J, Gomez-Gallego F, et al. Citius and longius (faster and longer) with no alpha-actinin-3 in skeletal muscles? Br J Sports Med 2007 Sep; 41 (9): 616–7PubMedCrossRef
26.
go back to reference Janssens ACJW, Gwinn M, Bradley LA, et al. A critical appraisal of the scientific basis of commercial genomic profiles used to assess health risks and personalize health interventions. Am J Hum Genet 2008; 82 (3): 593–9PubMedCrossRef Janssens ACJW, Gwinn M, Bradley LA, et al. A critical appraisal of the scientific basis of commercial genomic profiles used to assess health risks and personalize health interventions. Am J Hum Genet 2008; 82 (3): 593–9PubMedCrossRef
27.
28.
go back to reference Trusty JM, Beinborn DS, Jahangir A. Dysrhythmias and the athlete. AACN Clin Issues 2004 Jul-Sep; 15 (3): 432–48PubMedCrossRef Trusty JM, Beinborn DS, Jahangir A. Dysrhythmias and the athlete. AACN Clin Issues 2004 Jul-Sep; 15 (3): 432–48PubMedCrossRef
29.
go back to reference Garratt CJ. Clinical indications for genetic testing in familial sudden cardiac death syndromes: an HRUK position statement. Heart 2008 Apr 1; 94 (4): 502–7 Garratt CJ. Clinical indications for genetic testing in familial sudden cardiac death syndromes: an HRUK position statement. Heart 2008 Apr 1; 94 (4): 502–7
30.
go back to reference Jordan BD, Relkin NR, Ravdin LD, et al. Apolipoprotein E epsilon4 associated with chronic traumatic brain injury inboxing. JAMA 1997 Jul 9; 278 (2): 136–40PubMedCrossRef Jordan BD, Relkin NR, Ravdin LD, et al. Apolipoprotein E epsilon4 associated with chronic traumatic brain injury inboxing. JAMA 1997 Jul 9; 278 (2): 136–40PubMedCrossRef
31.
32.
go back to reference Shickle D, Chadwick R. The ethics of screening: is ‘screeningitis’ an incurable disease? J Med Ethics 1994 Mar 1; 20 (1): 12–8PubMedCrossRef Shickle D, Chadwick R. The ethics of screening: is ‘screeningitis’ an incurable disease? J Med Ethics 1994 Mar 1; 20 (1): 12–8PubMedCrossRef
33.
go back to reference Gillon R. Ethics needs principles–four can encompass the rest–and respect for autonomy should be ‘first amongequals’. J Med Ethics 2003 Oct 1; 29 (5): 307–12PubMedCrossRef Gillon R. Ethics needs principles–four can encompass the rest–and respect for autonomy should be ‘first amongequals’. J Med Ethics 2003 Oct 1; 29 (5): 307–12PubMedCrossRef
34.
go back to reference Murray T. Genetic exceptonalism and future diaries: is genetic information different from other medical information? In: Rothstein MA, editor. Genetic secrets: protecting privacy and confidentiality in the genetic era. New Haven(CT): Yale University Press, 1997: xvi, 511 Murray T. Genetic exceptonalism and future diaries: is genetic information different from other medical information? In: Rothstein MA, editor. Genetic secrets: protecting privacy and confidentiality in the genetic era. New Haven(CT): Yale University Press, 1997: xvi, 511
35.
go back to reference Yesley MS. Genetic privacy, discrimination, and social policy: challenges and dilemmas. Microb Comp Genomics 1997; 2 (1): 19–35PubMedCrossRef Yesley MS. Genetic privacy, discrimination, and social policy: challenges and dilemmas. Microb Comp Genomics 1997; 2 (1): 19–35PubMedCrossRef
Metadata
Title
Genetic Testing and Sports Medicine Ethics
Authors
Prof Michael John McNamee
Arno Müller
Ivo van Hilvoorde
Søren Holm
Publication date
01-05-2009
Publisher
Springer International Publishing
Published in
Sports Medicine / Issue 5/2009
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.2165/00007256-200939050-00001

Other articles of this Issue 5/2009

Sports Medicine 5/2009 Go to the issue

Review Article

Swimming Exercise

Review Article

Exercise and Fatigue