Why does one boost? An under-researched area

The BBC recently had a story Paralympic athletes who harm themselves to perform better which described various ways how disabled athletes try to boost their performance level. Common boosting techniques (boosting is prohibited by the International Paralympics Committee (IPC),) highlighted by the articles are:

• Overfilling the bladder, by clamping a catheter
• Sitting on a drawing pin
• Use of tight leg straps
• Twisting and/or sitting on the scrotum
• Cracking or breaking a bone

In a survey of 60 Beijing Paralympics athletes, the IPC found that 17% had tried boosting — and the real number may be higher than that self-reported percentage.

Boosting was also covered in recent days by other media (including The Conversation) and even an ethics news service

However most, if not all, the coverage misses the real story.

The Ethics news service finishes their piece saying:

The disturbing anecdotes about boosting add a new dimension to the bioethics debate about whether sportsmen should be allowed to take performance-enhancing drugs. Can pain and mutilation really be regarded as performance-enhancing drugs?

I submit this answer is already given. The IPC prohibits it because its seen as doping and because its not healthy. Its also not a new dimension. Performance enhancement happens in many ways not just drugs and more enhancement procedures beside drugs are prohibited in the Olympics and Paralympics.

The aforementioned BBC piece states:

But remarkably little scientific research has been done to assess how many athletes are willing to take these extreme measures to improve their performance.

I submit to get an exact answer to this question will be impossible. Very few if any who are having an active career will admit to doping in any form and many who won will not state it after the fact. And boosting is only one form of performance enhancement.

Paralympians of course are also susceptible to dope and the IPC is part of the broader Anti-Doping efforts and has its own Anti-Doping code

Assuming that the 17% mentioned is the number (although some say it could be 30%) is the number, the question I think that really needs an answer is: what makes them to dope or boost even if health risks are involved? And what makes them not dope and boost?

Donovan, Egger, Kapernick and Mendoza investigated in 2002 what might prevent so called non-disabled athletes to take illegal performance enhancing drugs in Sport. They found that the likelihood of drug use will be highest when

a) threat appraisal is low b) benefit appraisal is high c) personal morality is neutral d) perceived legitimacy of the laws and enforcement agency is low e) relevant reference groups are supportive of drug use and f) high vulnerability on personality factors (e.g. low self-esteem, risk taker, pessimist)

(A Conceptual Framework for Achieving Performance Enhancing Drug Compliance in Sport.“ Sports Medicine 32.4 (2002): 269-84.)

It might be interesting to see how these factors might rank for disabled athletes or whether there are other factors. We know that disabled people are treated badly in society and that negative reporting of disabled people is still prevalent. We know that disabled people who are part of sport have higher self-esteem than the ones not part of sport circles.

One paper in 1994 found that the positive effects are greater for International athletes than national /regional/recreational ones.

I submit that the why is under researched although the answer might be obvious. Also the solution is not thematised enough. If it’s the societal reality a disabled person, including a disabled athlete, faces that moves the person toward extreme measures just testing them for doping in all its forms does not solve the issue of why and without solving the why we do not solve the doping problem.