The Lance Armstrong paradox: how saving lives can be wrong

Lance Armstong listens to the national anthem on the podium after winning the 2005 Tour de France. EPA/SRDJAN SUKI

The Union Cycliste Internationale (UCI) has officially upended the Elysian podium that held Lance Armstrong aloft as victor of seven Tours de France. Its ruling comes in the wake of the damning judgement of the US Anti-Doping Agency (USADA). Crashing down, the podium has obliterated perhaps the greatest ever sporting achievement, taking with it the vicarious elation of millions.

But this skydive from grace is extraordinary for another reason. Armstrong’s drug-fuelled dominance saved thousands from cancer and, if his charitable foundation Livestrong survives the cataclysm, could deliver many more.

Why shouldn’t we, then, embrace Armstong as the Maria Theresa of the mountain stage, rather than shun him as the pariah of the prologue? If it’s okay to take drugs to cure cancer, what’s wrong with taking drugs to win bike races to cure cancer?

Indeed, the effects of EPO, the principal agent in Armstrong’s alleged pharmaceutical arsenal, are achievable through a host of legal means. EPO increases the red blood cell count, aiding oxygen delivery to the out-sized leg muscles that propel elite cyclists over towering peaks.

Similar shifts come from training at altitude, sleeping in a low-oxygen air tent, or being born with the genetic variant that saw Finnish skier Eero Maentyranta win two gold medals at the 1964 Olympics. If EPO simply mimics the body’s normal physiology, don’t we have further reason to forgive Lance?

The reality is that most will concur with the UCI’s edict. We will not exonerate him despite the downstream good that has flowed from his misdemeanours. And our reasoning can be traced to values and, in particular, our finicky propensity to distinguish between means and ends.

In medicine, we tend to care a lot about getting better and not so much about the route there. In 2001 surgeon Jacques Marescaux, in New York, used remote-controlled robotics to remove a patient’s gallbladder in Strasbourg, France. But we didn’t hear cries of “cheat” resound through the operating suite. Rather, the innovation was extolled as creative genius.

By contrast, when four riders took “training” to a new level in the 1906 Tour de France, and caught a locomotive to gain competitive advantage, official and public umbrage took swift effect.

In sport, it seems we have a taste for doing it the hard way. We can overlook the genetic lottery that confers the giant’s monopoly on basketball, or the African’s command over endurance events. But they must struggle for their victories, face down imposing hurdles over years, and overcome them through brute determination and obstinacy.

We need our sporting heroes to undergo excoriating trials before we baptise them as gods because it fuels hope in our own lives. The legacy of athletic nobility is to show us commoners what’s possible, if not in our weekend outings with the Lycra brigade, in our mundane grappling with daily adversity.

Ironically, it’s our need of hope that prevents us finding inspiration in the team doctors of pro cycling who deftly administered a dazzling array of enhancers. If those same doctors wielded syringes to banish diabetes, heart disease or indeed cancer, we would embrace their dexterity with tearful gratitude.

In medicine, pharmaceutical expertise gives succour. In the peloton it erases the dreams that ease spectators through their quotidian struggle.

In Lance Armstrong, fallen cycling deity, and Livestrong, cancer charity extraordinaire, we saw an unprecedented conflation of the sporting and medical ends of pharmaceutical use. And it’s ever so tempting to see the sporting infraction justifying the ends of therapeutic success. But unless we disentangle these twin goals we risk bringing each to its knees.

Professional doping, regardless of lives spared, alienates fans and sponsors, jeopardising the future of the affected discipline. And benevolent foundations that nail their colours to a tainted sporting mast risk their brand becoming repugnant to other donors.

The lessons are complex but compelling. The public is merciless when betrayed by the guardians of their athletic aspirations. And organisations that rely on brand leverage from celebrity sportspeople face perilous times when the anointed stars misbehave. Even more so when they owe their very birthright to the star himself.

When those companies are dedicated to medical research, and not the bottom line, the stakes are high indeed. As Armstrong cedes chairmanship for a background boardroom seat, Livestrong attests to the pitfalls of aligning divergent institutional and sporting goals.

In the wash up, it must be made clear that sport is about bringing personal resolve to bear on anatomy under physical challenge. For the time being, the doggedness of some athletes who submit to chronic drug use and its side effects doesn’t count. But things may change. After all, our values may be entrenched, but they are not carved in stone.