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Human experimentation and ethics at Essendon Football Club

The news that the AFL has charged James Hird, and other members of the Essendon Football Club’s management staff (including the club doctor, Bruce Reid) with bringing the sport into disrepute should surprise…

Essendon coach James Hird outside his home on August 14, 2013 after the AFL charged him and four other club officials for bringing the game into disrepute over the alleged banned supplements scandal. Julian Smith/AAP

The news that the AFL has charged James Hird, and other members of the Essendon Football Club’s management staff (including the club doctor, Bruce Reid) with bringing the sport into disrepute should surprise no-one.

Despite Hird’s protestations, this was always the most likely outcome. Essendon captain Jobe Watson’s revelations that he had been injected with the banned substance AOD-9064 in unprecedented quantities couldn’t have been overlooked.

And the equally concerning claim that some sort of a sports science experiment had been conducted at Essendon was too plausible to be ignored. Whether we will ever know the full details or not, it’s clear that something went badly wrong.

When the AFL sits down to consider the extent to which Essendon officials brought the game into disrepute, I hope they will consider the wider ethical implications of what has occurred.

In many regards, the issue of whether the Essendon players received a boost from the program is irrelevant. The reality is we don’t know whether AOD-9064, thymosin beta-4 or CJC-1295 enhances performance.

The chances are that they don’t work, or if they do, we don’t know whether it’s purely down to the placebo effect. But that’s not the point.

Those who prescribed the drug and those who condoned its use neither had evidence for its safety nor its efficacy. The clinical trials of AOD-9064 only established that it was an inefficient anti-obesity drug. And that was within bounds that appear to have been fantastically exceeded in the Essendon program.

The bottom line is that due to a lack of evidence, no-one could be sure whether it was safe to administer AOD-9064 in large quantities to a group of fit young footballers. Neither could anyone predict the outcome.

To understand just how serious the Essendon case is, it helps to know something about the evolution of medical ethics over the last 150 years.

A short history of medical ethics

Once upon a time, medical ethics mainly consisted of a code that regulated the behaviour of medical practitioners towards each other. And it insisted on the significance of the Hippocratic Oath to place patients first.

This held right of way into the 20th century – doctor’s were supposed to treat each other with respect, not to steal each other’s patients, or criticise other doctors' diagnoses or treatments; they also promised to treat their patients as best as they could.

But the Second World War and its aftermath changed all that. One of the many Nazi atrocities that came to light during the Nuremberg trials was that of horrific human experimentation undertaken by a number of doctors.

Karl Brandt was sentenced to death for a number of crimes including medical experiments on humans, and hanged on June 2, 1948. Wikimedia Commons

During their trial, the defendants argued that they broke no laws when conducting these experiments. The defence was rejected by the Nuremberg judges.

In handing down their sentence in 1947, the judges put forward a code they believed should guide human experimentation. This was later enshrined and extended in the World Medical Association’s Declaration of Helsinki (1964).

The key elements of Nuremberg and Helsinki were an insistence on the welfare of the patient and the absolute necessity of informed consent.

The Helsinki Declaration has gone through several revisions, but recalling the words of the first article of the Nuremberg Code should put the Essendon case into perspective:

The voluntary consent of the human subject is absolutely essential. This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, over-reaching, or other ulterior form of constraint or coercion.

Does it apply?

Make no mistake, this was a group of vulnerable young men, no matter how strong or tough. They were immersed in a culture that places loyalty to the club at a premium, coached and mentored by one of the club’s greatest legends, and overseen by a highly respected doctor.

It’s not too strong to suggest that their freedom of choice was curtailed, or that subtle and not-so-subtle forms of fraud, deceit and duress were part-and-parcel of the administration of the program.

Over time, the Helsinki Declaration’s iterations paid more attention to experimental design and research protocols. This is hardly suprising given the many scandals that occurred around the testing and introduction of new drugs in the post-war period.

Between 1959 and 1961, for example, contaminated polio vaccine was tested on babies at Victorian orphanages. And the thalidomide disaster in the early 1960s was one of the many instances that catalysed the introduction of new protocols insisting on ethical conduct in the design and implementation of clinical trials.

We know that the pharmaceutical industry has often rorted the system. But to run a clinical trial and put it through the wringer of regulatory approval involves adherence to detailed protocols insisting on informed consent and the protection of participants.

As far as we know, there was no ethical clearance for what occurred at Essendon. Nor was there anything other than a purely speculative hypothesis about what a failed anti-obesity drug might do to enhance performance.

Ethically, this is a failure of governance on every level. It cuts against the gains that were made by the introduction of the Nuremberg Code and the successive revisions of the Helsinki Declaration – gains that were won at the cost of human lives and human rights.

It’s plausible that affected Essendon players might argue that their human rights have been contravened by this tawdry “experiment”. And it would be fitting for this to be recognised and no penalties attached to their part in the affair.

The case of those who oversaw or condoned the administration of the “supplements” program is altogether different. Here ignorance is no defence and, unless the AFL acts accordingly, they too will be party to the abuse.

Join the conversation

34 Comments sorted by

  1. terry lockwood

    maths/media/music/drama teacher

    "It’s plausible that affected Essendon players might argue that their human rights have been contravened by this tawdry “experiment”. And it would be fitting for this to be recognised and no penalties attached to their part in the affair."

    Plausible, but unlikely. Breaking ranks by speaking up would probably see you career quietly fade away if you are battling to secure a spot in the senior team. Only an established player can risk this. So many have the guts to plow into a pack to get the ball. Will one have the guts to stand up for what is right if it comes down to it? On behalf of the vulnerable early career players?
    A significant element in this affair is the 'nice guy' effect. James Hird certainly has a nice guy image. An ornament to the game. And so on. Jobe too. ('Simon the Likable' from Get Smart?) But all must be equal before the 'law' in what ever jurisdiction.

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  2. Patricia O'Connell

    logged in via email @yahoo.com.au

    Perhaps relying on media reports or governance reports to comment on issues of ethics is in itself and ethical issue. As a member, I am particularly confident of how far apart the reality of the sports medicine program is from that portrayed and how closely it resembles programs run and running at other clubs. The violation of players' human rights includes leaking of their confidential evidence to the ASSADA investigation by officers engaged in the investigation and detailing of the player briefing by AFL Players' Association to the media. If The Conversation wishes to have its two bob's worth, perhaps it might consider the ethical position of the AFL as an administrative and as a judge and jury given the make up of the commission and the competitive edge that may be gained by other clubs as a result of penalties to Essendon. I understand that may well be a focus of a major human rights lawyer over the coming weeks.

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    1. Greg Young

      Program Director

      In reply to Patricia O'Connell

      So Patricia, as a member of the Essendon Football Club, you do not see any ethical issues with injecting the players that you follow week in and week out with a drug that is not cleared for such use by any health authority in the world, and the results of which the club could not have foreseen.

      Interesting. For a devoted fan, you don't seem to care much about the players.

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    2. Daniel Robb

      logged in via Facebook

      In reply to Greg Young

      I'd like to add something to this conversation. Essendon aren't and have not been the only club using injections.
      I can refer you to this article published last year.
      http://www.theage.com.au/afl/afl-news/hawks-set-the-pace-in-injection-science-20120924-26hhg.html
      And as an Essendon support, like most we are waiting to hear Essendons side to the story. At the moment we only have 1 side, and that's what has been reported in the media, which should be taken with a grain of salt.
      Then once we have the full story, then feel free to write what you will, but until then, it's all speculation and opinion based writing.

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    3. Nick Stevens

      logged in via email @hotmail.com

      In reply to Greg Young

      The players have been openly steadfast in their support for each of the charged staff members, and have repeatedly outlined their faith in the club. They are undoubtedly far more aware of what happened at the club than any member of the public.
      Obviously there were some pretty massive failures at the club, but I'm pretty sick of people feigning such concern for the players' wellbeing while also being perfectly happy to ignore their views.

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    4. Greg Young

      Program Director

      In reply to Daniel Robb

      So the Zwitkowski report that Essendon commissioned and published on their website doesn't give their side of the story?

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    5. Greg Young

      Program Director

      In reply to Nick Stevens

      You pretty outrageously assume that I'm feigning my concern. I think I'm showing a lot more concern than most EFC fans I've encountered, who really just want the whole thing to go away and nobody at their club to be held responsible for anything.

      The accepted and public facts, if applied to any other workplace and group of employees, would be considered deeply shocking.

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    6. Nick Stevens

      logged in via email @hotmail.com

      In reply to Greg Young

      With respect, if you're going to call out my outrageous assumption then it's complete rubbish to do the same to Essendon fans in the next sentence. Of course fans are concerned at what happened at the club, and of course people should be held accountable. People such as Dank, Robinson, Robson and to an extent Evans already have. Unfortunately none of them are the household name that Hird is and will not satisfy a public that's been selectively fed salacious tidbits for 6 months.
      The '"accepted and public facts" as you call them are no such thing. The media reporting something does not make it "fact" even if their collective Arts degrees somehow included extensive backgrounds in corporate governance and medical science.
      The public know bugger all. People need to quit pretending otherwise

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    7. Greg Young

      Program Director

      In reply to Nick Stevens

      I think you are being extremely generous in your assessment of what is going on at Essendon and what is accepted and public. I refer mainly to things that Essendon themselves published on their own website.

      As I said, if this was just some workplace somewhere, and the manager concerned was not a big hero of yours, I suspect you might have a different view of "an environment of pharmacological experimentation that was never under control" as Zwitkowski found in his report. If you look at this as an OHS issue, as the article does, you should be able to see that it is utterly scandalous and the club should have taken disciplinary action against Hird long ago. We would have expected that had it been a bank, miner, retailer, or anybody else that we are not barracking for.

      You don't park your sense of ethics at the door just because it is a football team.

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    8. Nick Stevens

      logged in via email @hotmail.com

      In reply to Greg Young

      This article invokes parallels with Nazi Germany, it deserves zero credit.
      As for the Hird must go stuff, well maybe he does need to go. However, I also can't see how him being given the benefit of doubt for the time being by people that believe he's earned it whips people into such a frenzy, particularly before he's had a chance to defend any charges against him. Is the presumption of innocence just a load of bollocks?

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    9. Greg Young

      Program Director

      In reply to Nick Stevens

      It is not a criminal proceeding when you are talking about an internal company disciplinary matter over proper management and governance, so presumption of innocence doesn't come into it. His complete disregard for the safety of his employees is the reason EFC should have stood him down as soon as the Switkovski report was made public.

      Try to think outside the sporing box you are making for yourself, and look at this as the OHS and corporate governance issue that the report described it as. If…

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    10. Greg Young

      Program Director

      In reply to Nick Stevens

      "This article invokes parallels with Nazi Germany, it deserves zero credit."

      Rubbish. The author draws no such parallels, he merely recounts the way medical ethics changed in the wake of the Second World War.

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    11. Nick Stevens

      logged in via email @hotmail.com

      In reply to Greg Young

      Complete disregard for the safety of his employees? Is that why the players are still firmly behind him? Do you think the public know better than them? Does largely disregarded first hand evidence such as this not trump wild speculation by opinion writers as to Hird's intentions?
      http://resources1.news.com.au/images/2013/04/11/1226618/599637-hird-emails.jpg
      The Switkowski report highlights failures in governance that have been subsequently addressed, four men have lost their jobs, and reputations…

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    12. Nick Stevens

      logged in via email @hotmail.com

      In reply to Greg Young

      Fair enough. I would contend that it's a fairly loaded reference

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    13. Rick Fleckner

      Student

      In reply to Greg Young

      It’s not too strong to suggest that their freedom of choice was curtailed, or that subtle and not-so-subtle forms of fraud, deceit and duress were part-and-parcel of the administration of the program.

      No, it is too strong to suggest, based on no evidence. This entire article implies an intimate knowledge of the goings on at my club (yes, I too am a member). This article and Greg Young's comment above are at the same level of plausibility, that is, they rely on gossip garnered from tabloid, agenda driven sensationalist rubbish. As Kevin Sheedy has said, charging Bruce Reid is like pointing a gun at Bambi. I am really disappointed with the lack of credibility on display on The Conversation, at times.

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    14. Greg Young

      Program Director

      In reply to Rick Fleckner

      "This article and Greg Young's comment above are at the same level of plausibility, that is, they rely on gossip garnered from tabloid, agenda driven sensationalist rubbish. "

      Such as the Switkowski report published on Essendon's own website, for example. That is what I have been quoting from.

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  3. Michael Guy

    Clinical Psychologist

    When this story broke in February I remembered being surprised at how big the Essendon players were in early 2012 compared to how skinny they were in 2011. My surprise leaves me with little doubt that it wasn't weights and diet alone that achieved the results. James Hird looked like a school boy who had been caught red handed.

    The other week I watched some of the former sports scientist interview and thought he was mainly telling the truth. Of most concern was the 'black ops' comment that…

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  4. Paul Thomson

    Managing Director

    Won a few ARC grants lately have you mate?

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  5. Nick Stevens

    logged in via email @hotmail.com

    Another article basing its facts on media reports. Where are you getting your information that AOD 9604 was administered in large dosages?
    Is vague circumstantial evidence enough to assume that anyone was administered thymosin beta-4 or CJC-1295 enhances performance?
    Are comparisons to the Nazis not ridiculous and needlessly inflammatory?

    It is articles like this that cultivate ignorant and logically fallacious statements like this one from 'Clinical Psychologist' Michael Guy a few comments…

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  6. Phil Murray

    logged in via Facebook

    This feels overstated. But if we accept there has been ethical failures, the issue for me is how ill-placed the AFL is to take action.
    You would think the AFL would have required each club to have a named director responsible for governance of Health & Safety matters. Do they? As it is they cannot nail responsibility on anyone at Director level. Taking action against named individuals in middle management is to direct their attack at entirely the wrong level.
    Essendon appear to have eight directors. Should they not be taking some specific actions now?

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  7. Terry Reynolds

    Financial and political strategist

    Thanks James Bradley for bringing some sanity to the issue.

    We are often left wondering what has been going on after the Eagles took the field in the early nineties.

    I would like to know if Collingwood players were tested after the repeat grand final with St Kilda in 2009 when St Kilda looked like a team that was still recovering from the previous week's hard fought out draw and then to watch Collingwood players dashing around as though they were fresh.

    Essendon, have a long history of…

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    1. Nick Stevens

      logged in via email @hotmail.com

      In reply to Terry Reynolds

      Hahaha, what on earth do St Kilda have to do with anything?
      The irony of you calling Essendon fans childlike and contemptuous is awesome

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    2. Terry Reynolds

      Financial and political strategist

      In reply to Nick Stevens

      Nick Stevens, you seem to a self appointed apologist for the Essendon Football Club. The Club President and many officials have resigned over this. No one likes cheats and you must have witnessed that with cycling and the damage it has done the sport.

      It is your Club Essendon that has damaged AFL, no one else.

      St Kilda like most other Clubs did not cheat on its salary cap or used performance enhancing substances to win matches. I am proud that the Saints play the game fairly.

      Goodness knows what Brendan Goddard is now thinking.

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    3. Nick Stevens

      logged in via email @hotmail.com

      In reply to Terry Reynolds

      1. I am aware that people have lost their jobs
      2. You are correct in saying that nobody likes cheats
      3. I'm not saying that anyone else has damaged the AFL
      4. What performance enhancing substances have Essendon players taken?
      5. Why are St Kilda relevant to anything?
      6. Brendan Goddard's twitter feed makes it quite clear what he is thinking if you're actually interested, and has done for six months now. Same as the rest of the players, whose opinions are given no credence by people such as you

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    4. Phil Murray

      logged in via Facebook

      In reply to Nick Stevens

      On your question 4, it seems we do not know at the moment.
      But substances have been administered in a cavalier fashion without proper records kept. The approach seemed to be to find substances that were performance enhancing, including one not approved for human consumption, which were not specifically banned. Whether they actually had any impact may be unknown.
      So your question rather diverts attention from the issue as known so far - namely unethical pharmacological experimentation?

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    5. Nick Stevens

      logged in via email @hotmail.com

      In reply to Phil Murray

      I believe Terry diverted from the issue Phil. When it is stated as if a fact that players were on performance enhancing substances I think it deserves to be challenged.
      I have not once stated that no one should be held accountable or that Essendon was above any fault and deserves no penalty. Indeed, some people have already been held accountable, and some further sanctions could very well be appropriate.
      What I do question is stating as fact things that the public simply do not know, and disregarding…

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    6. Terry Reynolds

      Financial and political strategist

      In reply to Nick Stevens

      Six months ago the Australian Crime Commission in its wisdom as did the Minister for Sport, the AFL and NRL jointly announced serious allegations against Essendon and the NRL's Cronulla Sharks regarding misuse of banned substances. It is not the public that is making these allegations - it is the authorities.

      All that the public know is that the other 17 AFL Clubs and a dozen or so NRL: clubs are not involved, and accordingly have not brought the game(s) into disrepute. I would hope that it is not true and life just goes on, however that seems unlikely now and Bombers supporters blaming others and crying foul from misguided loyalty until the matter if settled is wrong.

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    7. Nick Stevens

      logged in via email @hotmail.com

      In reply to Terry Reynolds

      Allegations that have not been proven after six months and remain merely allegations. It is reckless to state otherwise. As I've said, I'm sure the club have messed up, but surely it would be wise to wait for all the facts before jumping to conclusions as to exactly how. Please try to keep an open mind and vary your media consumption. There is no way you can say definitively that any loyalty is misguided and I strongly disagree with the implication that to say otherwise is deluded.
      Anyway, that's enough out of me.

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    8. Terry Reynolds

      Financial and political strategist

      In reply to Nick Stevens

      You have probably said enough Nick. No one really wants to see James Hird or the Essendon Football Club found guilty of anything, nor do we want any Essendon Football players to have after effects of dubious substances administered by the Club.

      It is irritating to see some people coming out from blind loyalty defending something that you admit we don't know the outcome of yet. But it is certain there was a program going on which was secretive and poor record keeping of it was maintained.

      The rest of us are concentrating on the season and the performance of all clubs.

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    9. Phil Murray

      logged in via Facebook

      In reply to Nick Stevens

      Nick, you are correct of course but it feels a bit as though you are clutching at whatever straws may be available.
      The AFL seem to be on the wrong tack behaving as if it is a tribunal matter the point of which is to punish rascals, rather than to focus on punishing the club.
      I see your James Hird email. It can be read in a positive context but also as what someone would write when wanting to keep their nose clean. I would have been a lot more positive if it had demanded management controls over the activity. But that could just be that Hird has little management training or experience. Then who was Hird's manager? No one I guess. There is the issue I suspect.
      But to pre-empt you, we do not know.

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  8. Patricia O'Connell

    logged in via email @yahoo.com.au

    Goodwin's law .. I believe that is what it is called. Sorry nowI didn't get back to comments yesterday. Loved the psychological analysis via TV and the comments re the supplements program based on what the media said was administered and how often. Loved the passion for the players well being and the outrage. Would be inspirational stuff from competitors if true. Oh and Goodwins Law...better look it up for yourself unless you're happy receiving my interpretation. Goodwins Law applies to this article. I am sure someone at Melb Uni has come across it. It applies to making comparisons with Nazi Germany when you are sliding down the slope with a losing argument. Bit like "jumping the shark" when your tv drama is losing traction. Shows how fatten poor facts are propped up by sensationalism.

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    1. Lisa Mounsey

      GP registrar

      In reply to Patricia O'Connell

      Hmm, as useful a concept as it is, don't think 'Godwin's Law' applies to this article. I think that the author was giving us a short history of medical ethics in order to make a point about informed consent.

      To me, informed consent is the key part of this whole saga (beyond governance, doping, media, conflicts of interest, etc) because it directly affects the players. ie, Could the players have been fully informed about the risks and benefits of using these drugs when little is known about the safety and efficacy? And, could they have given consent freely, when their employer club & hero coach were the ones seeking it?

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  9. Luke Weston

    Physicist / electronic engineer

    We can walk in to any supermarket and buy the likes of Swisse UltiScam Ancient Indian Snake Oil, and we have the likes of Ricky Ponting and Lleyton Hewitt endorsing these products on TV, with the implication that these products will improve your athletic performance. Doesn't this normalise the idea in society that you can and you should just pop some expensive pills and this will improve your athletic performance?

    And without getting into the technical details of pharmacology or biochemistry…

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    1. Phil Murray

      logged in via Facebook

      In reply to Luke Weston

      I am glad to see someone else disturbed by our beloved principled sports stars selling their souls.
      But it must only be practical to ban stuff that you can track in the body? I guess most (but maybe not all) of this Swisse rubbish cannot be so tracked and has no material effect apart from that on the pocket.
      It is time the type of distinction you seek is emphasised by pharmacies being forced to separate
      sale of prescribed medicines from the other stuff. Maybe the assistants for the prescribed products can wear white coats and those selling the other stuff have to dress up as clowns. But I digress.

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