Dr. Murray: There is one misleading reason, and two robust reasons for opposing performance enhancing drugs (PEDs) in sport. “Fairness” is the misleading one. Why? Because we could “level the playing field” by allowing everyone to use anything and everything. That would be “fair.” But also nuts. Fairness becomes important once we’ve decided which technologies of enhancement should be permitted and which ones prohibited. All athletes should play by the same rules.

Here’s where the other two reasons come into play. Safety is one. Forty years ago athletes told me why they and their fellow athletes used PEDs: they didn’t want to lose to someone not as talented or dedicated but who won by using drugs. Wherever PEDs can make a decisive difference they become tyrannical: That is, if some competitors use them, it becomes almost impossible to compete successfully without using them yourself. And it’s fanciful to think that using large doses of powerful hormones or other drugs can be entirely benign. Especially in light of the ever-present pressure to push the envelope—using higher doses and adding more drugs to the mix.

Safety also alerts us to the ripple effects of PED use by elite athletes: younger, older, amateur, less talented athletes will also be tempted to boost their performances with the drugs their models are taking. They’re more likely to get their drugs from sketchy sources, and to lack the expert advice and supervision elite athletes can rely upon. This is the public health dimension of doping in sport.

For all that, I think Good Sport is the first popular book to make meaning and values in sport the central reason to shun performance enhancing drugs. To the extent that drugs weaken the connection between natural talents, dedication, and performance, they undermine why we care about sport. A carbon fiber vaulting pole allows the vaulter to go higher; but success still depends upon her speed, strength and technique. Enhancing the leap with small explosive charges under the heels of her shoes adds nothing good to the pole vault. We admire explosive speed in the hundred meter sprint along with the endurance required to run a marathon or ride the Tour de France. Using EPO, steroids, growth hormone and other PEDs muddies the connections among talents, dedication and performance.