I am sitting in bed composing this piece, waiting for my Starbucks coffee to brew, knowing that after having my first morning cup my writing performance will be enhanced. I may very well play some tennis today, being sure to take a few doses of my NSAID of choice before to lessen the likelihood of pain and stiffness, thus enhancing my performance. Come to think about it, was is not a performance enhancing drug? Maybe only recreational drugs....
When a professional athlete has an injury, he or she is sent to some form health professional who intervenes in some way, presumably trying to restore and enhance their function. These interventions may involve medications, to enhance healing and function (performance). Why are some banned and others accepted? For some injuries injections or oral administration of glucocorticoids are prescribed to enhance healing. So tell my why these "steroids" are acceptable while anabolic steroids are not?
Not infrequently athletes require surgery to address some issue. Is the surgery only allowed to restore where they were before their injury or is it allowed for the surgery to take them to a new state where their performance is enhanced? Take Tommy John surgery for an example. In these cases the surgeon leaves the athlete in an new anatomical state. Could or should this be viewed as performance enhancing surgery? What if surgical techniques and bionics progresses to a point to where implanted devices really give an edge?
Perhaps this is all part of a larger struggle we have with drugs in general. We understand that drugs can both impair and enhance our function and we seem to have a problem with both of these. Creating legal and regulatory boundaries on their use should yield more benefit than harm. I am not sure that's the case. Maybe we need to consider the possibility that fewer rules in this arena will lead to better outcomes.