Pressure to perform and body cult
But who are these people who are taking illegal doping substances? The image of the muscle-bound bodybuilder pumping himself full of anabolic steroids is only one facet of reality. In addition to bodybuilding, other sports such as fitness and health sports are also susceptible to doping. And this despite the fact that the umbrella organizations of bodybuilders and the fitness studio industry are clearly opposed to doping. But wherever a beautiful, well-trained body is at the forefront of training, there is a great temptation to use aids to reach the goal of the dream body more quickly. Also at risk are athletes for whom competition performance is the main focus, such as marathon runners and cyclists. Fitness and performance are now regarded as indicators of success. Doping is therefore also an expression of our performance-oriented and body-fixed society. This is not only a problem for adults: Children and adolescents suffer particularly under the pressure, and so it is not surprising that more and more young people are resorting to doping substances. Up to 9% of all pupils have already taken doping substances themselves at least once; the starting age is 16 to 19 years.
“Boys and young men are susceptible to these substances,” explains Professor Heiko Striegel, Deputy Medical Director of Sports Medicine at the University Hospital of Tübingen.
“Her goal is to achieve a muscle-strengthened dream body, according to as we know it from many glossy magazines.”
Doping on prescription?
Hobby dopers are always embedded in sworn networks. The first contact with doping often takes place via trainers, training partners or studio owners; in relevant internet forums tips and experiences with the most diverse drug cocktails are diligently exchanged. Thanks to friends in the gym and the flourishing Internet mail order business, it is now easy to get doping substances – but the fact that a large number of illegally imported substances contain too little, none at all or the wrong ingredients does not seem to worry users. In the case of preparations that are injected subcutaneously, there is also the risk of sepsis due to unsterile needles or injection solutions, and an abscess can form at the injection site. Even more frightening is the fact that apparently every fourth hobby doper obtains his substances from a doctor. In a survey even every third user stated that he is under medical supervision.
According to a statement by the Central Ethics Committee, “participation in doping contradicts the physician’s fundamental duty to maintain the health of his patient”. However, doping is not only incompatible with medical ethics, it is also punishable according to § 6a of the Medicines Act: “It is forbidden to place drugs […] on the market, prescribe or use for others for doping purposes in sport”. A violation is punishable by imprisonment for up to three years or a fine.
Suspicion of doping: Warning of risks
However, if the doctor becomes aware that his patient is doping, he is neither obliged nor entitled to file a complaint, as a complaint would constitute a breach of medical confidentiality. However, the doctor should warn the patient urgently and unequivocally of the risks and point out the prohibition of doping. Each doctor must decide for himself whether to discontinue treatment. In principle, he may reject the medical treatment of doping persons on the basis of the existing freedom to conclude contracts – an exception, of course, is emergency care. The Ethics Committee, however, is against general non-treatment of dopers on the basis of the Geneva vow. Should the patient nevertheless wish to continue doping or even demand the doctor’s assistance with doping, the Ethics Committee grants the doctor the right to discontinue treatment. The situation is different for doping in children and adolescents. Here the breach of confidentiality to protect a higher value legal asset would be justifiable. In any case, the doctor should talk to the parents and, if necessary, inform the attending doctor. According to the Medicines Act, the supply or use of drugs for doping purposes in sport to persons under the age of 18 is a particularly serious case, which is punishable by imprisonment.