Coping with 21st-century doping

Lance Armstrong's sad saga of doping and lying is over, allowing us to turn our attention to a far more important issue arising from the Armstrong era: what to do about the rise of ever more potent bio-enhancers in sports.
The "arms race" in this new age of augmentation has already begun, said the bioethicist Thomas Murray, former president of the Hastings Centre in Garrison, N.Y. It pits enforcers like the World Anti-Doping Agency, armed with strict bans on certain enhancers, against elite athletes — and their trainers, technicians and financiers — who are determined to get away with doping.
Antidopers justify their crackdown as a means of protecting athletes from potentially dangerous enhancers, and because the use of bio-boosters is unfair to nondoping competitors. Enhancers also threaten the "spirit of sports," in the words of the World Anti-Doping Code, which now guides most elite sports.
Currently, WADA bans a growing list of enhancers, including anabolic steroids, human growth hormone, amphetamines, beta-2 agonists (which relax the muscles around the airways and make breathing easier) and erythropoietin , or EPO (which increases oxygen levels in the blood). In future years this list might also include an arsenal of as-yet unimagined chemical compounds and technologies. Those could include everything from genetic alterations (so-called gene doping) to the regeneration of tissue using stem cells.
Today's dopers try to avoid detection by administering microdoses of enhancers that quickly clear the body, and by using natural versions of growth hormone and erythropoietin that cannot be easily differentiated from an athlete's own onboard supplies. They also use the Lance Armstrong techniques of avoiding testing when possible, and timing the use of banned substances to appear clean.
"The technology is there to detect minute levels of most substances," said Matthew Fedoruk, science director at the United States Anti-Doping Agency. "The challenge is that athletes are turning to substances that mimic natural substances in your body." Dr. Fedoruk added that resource constraints and athletes' sophisticated schemes to avoid detection can thwart investigators.
Drug companies, meanwhile, are developing a raft of new medications for diseases like muscular dystrophy and anaemia that could one day be used as enhancers. Scientists are studying genes associated with physical performance and muscle growth to see if drugs — or, someday, gene-modulating technologies — can be developed to activate the strengthening or other positive effects of those genes.
Beyond chemical fixes, neuroscientists are experimenting with noninvasive technologies that augment brain activity by bathing targeted regions in low levels of electricity (transcranial electrical stimulation) or a magnetic field (transcranial magnetic stimulation). Both appear to enhance cortical excitability and cognitive performance.
Bioengineers are in the early stages of developing artificial limbs and exoskeletons that one day may be better than real limbs. Andy Miah, an ethicist at the University of the West of Scotland, has suggested that scientists in the future might create embedded nano-devices to stimulate muscles to a sustained peak of performance. Hugh Herr, a biomechanical engineer at the M.I.T. Media Lab, recently told the journal Nature that "stepping decades into the future, I think one day the field will produce a bionic limb that's so sophisticated that it truly emulates biological limb function." He predicts the emergence of new human-machine sports. These might combine, say, track and field and Nascar.