I'm still mystified by certain aspects of Major League Baseball's drug policy.

Consider the following:

An aging pitcher is suffering from a variety of persistent injuries. They are healing slowly. He is depressed and lethargic, and anxious about his career. He goes to see his doctor. The doctor finds that the patient's testosterone count is low. He prescribes the pitcher a small dose of testosterone, as part of his rehab. The patient is desperate, and the doctor agrees to experiment with testosterone, and see if it speeds recovery.

Questions:

1. Has the pitcher violated MLB's drug policy? As far as I can tell, yes. Testosterone is on baseball's list of banned substances.

2. Has the patient violated the law? Of course not. Testosterone is an FDA approved medication.

3. Has the doctor done anything wrong? Not at all. The doctor could also have prescribed human growth hormone, if he wanted to. Even though HGH is not approved for injury recovery, a physician is free to prescrbe virtually any drug he/she wants to, in an off-label manner.

4. Should the doctor and the athlete feel guilty about what they've done? I don't see why. The foundation of our medical system is that physicans have broad leeway to act in the best interests of their patients, and if the physician thinks that testosterone might help the athlete he's entirely within his rights to prescribe it. The pitcher is also entitled to take every step he can to regain his health. Surely it is wrong--if not unconstitutional-- for an employer to impede an employee from receiving the best medical attention.

5. Will Major League Baseball ever find out about the pitcher's testosterone use? Not unless the pitcher tells someone. The transaction between a patient and a doctor is, of course, covered by patient confidentiality laws.

6. Does this mean that lots of professional athletes may already be using substances like testosterone--and we have no way of finding out? Of course!

7. So why did Vina and Pettitte and Bennett get in trouble? Because, presumably, they obtained their HGH without an prescription--which is illegal.

8. So wait. The league's drug policy is an attempt to prevent the use of drugs without a prescription? No. Its supposed to prevent the use of a broad class of drugs. But since the league's policies clearly can't govern drugs prescribed legally by a physican--particuarly if they are undetectable-- it has the effect of only preventing the use of drugs obtained illegally.

9. I'm confused. Aren't there already laws in place in America preventing the use of drugs without a prescription? Yes. (And I'm confused too.)

Will someone please tell me if I've got this right?