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Health and performance challenges in the era of human enhancement: insights from sport medicine professionals

  • Ke Hu
  • , Christian Schneider
  • , Mark R. Hutchinson
  • , Emin Ergen
  • , Michael Geistlinger
  • , Iain Killoughery
  • , Klaus Michael Braumann
  • , José Kawazoe Lazzoli
  • , Jane Seto
  • , Xavier Bigard
  • , André Debruyne
  • , Anna Jegier
  • , Theodora Papadopoulou
  • , Pedro Manonelles
  • , Francisco Arroyo
  • , Mourad Ghrairi
  • , Ana V. Cintrón
  • , Petra Zupet
  • , Marcelo Bichels Leitão
  • , Umutcan Kayikci
  • Daniel Arkader Kopile, Fabio Pigozzi, Chiara Fossati, Alessia Di Gianfrancesco, Luigi Di Luigi, Kirill Micallef Stafrace, Anca Ionescu, Bernd Wolfarth, Metin Ergün, William O. Roberts, Konstantinos Natsis, Camille Tooth, Sandra Rozenštoka, José Antonio Casajús, Borja Muniz-Pardos, Roberto Lohn Nahon, Malav Shroff, Minhao Xie, Demitri Constantinou, Dina CJanse van Rensburg, Bülent Ülkar, Andrew Jowett, Victoriya Badtieva, Jean François Kaux, Peter Baumgartl, Clea Hadjistephanou Papaellina, Jürgen Steinacker, Julio Motta-Pensabene, Rüdiger Reer, Norbert Bachl, Sergio Migliorini, Maher Zahar, Mark Stuart, James Bilzon, Giuseppe Massazza, Bruno Di Pietro, Khaled Massoud Hassan, Felix Albuquerque Drummond, Bertrand Fincoeur, Andrea Petróczi, Yannis Pitsiladis
  • Hong Kong Baptist University
  • Orthopaedic Centre Theresie
  • University of Illinois at Chicago
  • Gloria Sports Arena
  • University of Salzburg
  • University of Hamburg
  • Universidade Federal Fluminense
  • Murdoch Children's Research Institute
  • University of Melbourne
  • Union Cycliste Internationale
  • European Federation of Sports Medicine Associations (EFSMA)
  • Medical University of Łódź
  • Defence Medical Rehabilitation Centre (DMRC)
  • Universidad Católica San Antonio de Murcia
  • Sport Med
  • FIFA Medical Centre of Excellence
  • Puerto Rico Sports Medicine Federation
  • University of Puerto Rico
  • Institute for Medicine and Sports (IMŠ)
  • Instituto de Endocrinologia E Medicina Do Exercico
  • Hacettepe University
  • Université Paris Nanterre
  • German Sport University Cologne
  • Health Ministry
  • Foro Italico University of Rome
  • Mater Dei Hospital
  • Authority for Integrity in Maltese Sports (AIMS)
  • National Institute of Sports Medicine
  • Carol Davila University of Medicine and Pharmacy
  • Humboldt University of Berlin
  • German Society for Sports Medicine and Prevention
  • Turkish Sports Medicine Association
  • University of Minnesota Twin Cities
  • Aristotle University of Thessaloniki
  • University of Liege
  • French-Speaking Olympic Sports Medicine Research Network (ReFORM) International Olympic Committee (IOC) Research Centre for Prevention of Injury and Protection of Athlete Health
  • Riga Stradins University
  • LLC–International Federation of Sports Medicine (FIMS) Collaborating Centres of Sports Medicine (CCSM)
  • Latvian Sports Medicine Association
  • Carlos III Health Institute
  • University of Zaragoza
  • Titular Member of the Brazilian Society of Exercise and Sports Medicine (SBME)
  • World Olympians Association
  • China National Institute of Sports Medicine (NISM) Sports Medicine Hospital of NISM
  • University of the Witwatersrand
  • South African Sports Medicine Association (SASMA)
  • University of Pretoria
  • Ankara University
  • Olympic Park Sports Medicine Centre
  • Sechenov First Moscow State Medical University
  • Restorative and Sports Medicine
  • Austrian Society of Sports Medicine and Prevention
  • University of Cyprus
  • Ulm University
  • European Initiative for Exercise in Medicine (EIEIM)
  • University of San Carlos of Guatemala
  • World Triathlon (WT)
  • Tunisian Centre of Sports Medicine and Science
  • University College London
  • University of Bath, Department for Health
  • British Association of Sport and Exercise Medicine
  • University of Turin
  • University of Rome La Sapienza
  • Egyptian Ministry of Youth and Sports
  • Egyptian Association of Sports Medicine
  • Porto Alegre/Sports Medicine Institute
  • Swiss Federal Institute of Technology Lausanne
  • Faculty of Health and Sport Sciences
  • Széchenyi István University

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In the pursuit of sporting success, some elite athletes prioritise peak performance over long-term health, frequently resulting in significant and enduring health consequences. The Enhanced Games (TEG) position themselves as a bold experiment in transhumanism, advocating for the use of performance-enhancing drugs (PEDs), including methods banned by World Anti-Doping Agency (WADA), to push the boundaries of human athletic potential. 

Objectives: The aim of this study is to explore the perspectives of sport physicians, sport scientists, physiotherapists and other allied healthcare professionals on treating and supporting “enhanced athletes”, with the view of informing future guidelines. 

Methods: Participants were invited via email and personal contacts within sport medicine communities to complete a brief anonymous survey via QuestionPro™. Descriptive statistics were performed using Excel™ and RStudio™. Results: A total of 323 healthcare professionals responded (82% were sport physicians), among whom 74% expressed a willingness to treat acute lesions and/or chronic diseases in “enhanced athletes”. In comparison, a considerable minority (30%) expressed support for assisting athletes in their use of PEDs and methods under medically supervised conditions, with high consistency across professional roles. A relatively high readiness was observed in sport physicians treating acute (77% versus 58%; p < 0.01) and chronic (75% versus 63%; p = 0.11) diseases for “enhanced athletes”. As far as WADA rules and/or national anti-doping laws apply, this support presupposes compliance with the code and the respective national laws to protect physicians from serious professional, legal and personal consequences. 

Conclusion: The preliminary findings align with the broader goal of fostering a sport culture that values both peak performance and the short- and long-term health of all participants. These results emphasise the necessity of implementing professional guidelines and comprehensive support systems designed to safeguard the long-term well-being of all athletes and underscore the urgent need for further research into the impact of TEG on sport and its community.

Original languageEnglish
Pages (from-to)2627-2640
Number of pages14
JournalSports Medicine
Volume55
Issue number10
Early online date16 Jun 2025
DOIs
Publication statusPublished - Oct 2025
Externally publishedYes

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