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Creating fear: the ‘doping deaths’, riskcommunication and the anti-dopingcampaignBernat Lópeza

a Department of Communication Studies, Universitat Rovira iVirgili, Tarragona, SpainPublished online: 26 Feb 2013.

To cite this article: Bernat López (2014) Creating fear: the ‘doping deaths’, risk communicationand the anti-doping campaign, International Journal of Sport Policy and Politics, 6:2, 213-225, DOI:10.1080/19406940.2013.773359

To link to this article: http://dx.doi.org/10.1080/19406940.2013.773359

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Creating fear: the ‘doping deaths’, risk communication and theanti-doping campaign

Bernat López*

Department of Communication Studies, Universitat Rovira i Virgili, Tarragona, Spain

One of the most recurrent topics in the anti-doping literature is the one about ‘dopingdeaths’, or the more encompassing ‘doping health hazards’. This is hardly surprisingsince one of the main justifications for the current anti-doping policies is that they havebeen set up to protect athletes’ health. This article critically examines the rational andempirical basis for the claims concerning famous ‘doping deaths’, such as those of ArthurLinton, Tom Simpson or the Dutch and Belgian cyclists who allegedly died due toerythropoietin (EPO) abuse in the late 1980s and early 1990s. It is argued that theseclaims have become common sense or naturalized knowledge through repetition and lackof critical confrontation, and it is demonstrated that they are untenable under closescrutiny. It is therefore concluded that they are perfect examples of a discourse of fear,or risk communication at the service of a social control and surveillance agenda, namely,the one embodied by anti-doping.

Keywords: anti-doping; EPO; growth hormone; mass media; propaganda; riskcommunication

Introduction: anti-doping as the object of study

An important theoretical proviso of this article is that, in our opinion, what deserves scrutinyfrom a social-scientific perspective is anti-doping, not doping, because doping as personalbehaviour and/or a cultural phenomenon does not need to be explained: it is self-explanatoryor self-evident in the sense that it is a logical consequence of the tenets of modern sport and,more widely, modernity (Møller 2008, 2010). The object of this study is thereforeanti-doping as a wide array of more or less concerted policies at a national and internationallevel, and especially as an ideology sustaining and steering these policies. This arguablyprovocative point of view stems from a critical reading of the seminal book by the Britishsports scholar Barrie Houlihan Dying to win (Houlihan 1999).

This volume, sponsored by the Council of Europe and clearly devoted to making a casefor effective and coordinated anti-doping policies, is a real eye-opener in this regard. InChapter 5, entitled ‘Defining the problem: the ethics of doping’, the author thoroughlyexamines one by one the arguments raised against doping and therefore in favour ofanti-doping policies, and reaches the following conclusion:

Attempts to identify a set of morally objectionable qualities inherent in the current range ofbanned substances and practices is probably the weakest source of a viable policy rationale (. . .)

International Journal of Sport Policy and Politics, 2014Vol. 6, No. 2, 213–225, http://dx.doi.org/10.1080/19406940.2013.773359

*Email: bernat.lopez@urv.cat

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[T]here are no definitive criteria that distinguish between the acceptable and the unacceptable.(Houlihan 1999, p. 123)

The logical conclusion of this reasoning should arguably be that anti-doping in its currentprohibitionist version has no ethical basis and should therefore be abandoned or profoundlychanged. Instead, the author offers the authorities enforcing anti-doping policies ‘a moreprofitable avenue for reaching a publicly convincing basis for current policy’, namely, ‘toabandon the search for an a priori rationale for policy and concentrate on middle orderjustifications’ (1999, p. 124) which root ‘the legitimacy of a policy in the level of popularsupport it commands’. In other words, ‘the challenge to the sports authorities is to develop apersuasive definition of doping and a programme of policy implementation that takesaccount of the need to sustain popular disapproval of doping’ (1999, p. 128). Strippingaway the rhetoric, the conclusion one can draw from Houlihan’s reasoning is that neither anethical nor a rational justification of the ban on doping is essential for it to be successfullyenforced; it is merely sufficient to keep people convinced of its rightness, which leads to the(crudely stated) conclusion that one of the most important facets of anti-doping policiesshould be the manufacture of public consent through propaganda strategies.

Most of Houlihan’s analysis is quite plausible, and the same applies to its arguablyunintended implications: doping is essentially unobjectionable from the perspective of amodernistic ethic,1 and therefore what begs an explanation is how such a powerful, globaland almost unchallenged phenomenon as anti-doping has thrived, despite lacking a set ofrationally sustainable justifications. What social science, as a modernistic endeavour, needsto explain, therefore, is anti-doping as a socio-cultural and socio-political phenomenon: itsrise and success, the social forces and interests behind it, and the means and strategies it hasused to achieve the hegemony of its discourse and its radical solutions.

Anti-dopism, the ‘doping deaths’ cliché and the discourse of fear

To begin with, this article proposes a simple conceptual distinction: we shall refer to anti-dopism (De Lignières and Saint-Martin 1999) as the ideology or the articulated set of beliefs,principles, dogmas, discourses and slogans sustaining and legitimating anti-doping, which isunderstood as the ensemble of institutions, personnel, regulations and practices aimed ateradicating doping from sport. The concept ideology is used here in Norman Fairclough’sterms, as being ‘in the service of sustaining unequal relations of power’ (2001, p. 70;original italics), ‘the prime means of manufacturing consent’ (2001, p. 3) or, in a cognatedefinition, ‘the particular set of shared ideas that obscure how powerful groups dominateothers’ (Barnhurst 2005, p. 241).

This article focuses on the ideological facet of anti-doping, or anti-dopism, andapproaches its study through the critical analysis of a particular discursive device deployedin the framework of a broader propaganda strategy2: the cliché of ‘doping deaths’, used tofuel social fears about death and physical decay allegedly caused by performance-enhancingsubstance use.

It is well known that fear has always been central to propaganda strategies (Füredi 1997,2005, Delumeau 1999, Altheide 2002). Our object of study is therefore fear, or moreprecisely, fear as a social product and its relation to the anti-doping campaign. This articledraws on the theoretical contributions of the American media scholar David L. Altheide andhis work on risk communication, the discourse of fear and media logic and formats, and on acritical examination of famous ‘doping deaths’ such as those of Arthur Linton and TomSimpson, as well as the ‘EPO casualties’ (López 2011) and the ‘human Growth Hormone

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(hGH) victims’ (López 2012). The main conclusion is that one of the pillars of theanti-doping propaganda campaign has been the successful creation and diffusion of socialfear around the health hazards of some doping practices, especially hormone doping. Thisdiscourse of fear needs to be considered as propaganda for three main reasons:

– In spite of all the scientific rhetoric supporting it, its evidential basis is very weak.Disconnection between fact and discourse is one of the main ingredients ofpropaganda.

– It has been massively diffused both by the expert literature and by the mass media, andthrough repetition it has reached the status of common sense or ‘what everybodyknows’ (Fairclough 2001). Repetition is another fundamental propaganda technique.

– It has succeeded in scaring the citizenry, the policy-makers and the athletes them-selves, and has therefore allowed the anti-doping ideology to impose its discourse ondoping as ‘the truth’ and to legitimate and impose its radical solutions.

Let us illustrate this with two examples drawn from everyday life. In a recent ‘lay’ discussionabout the rationality of anti-doping in which the author participated, one of the peopleinvolved ultimately acknowledged that he was supportive of it because doping was some-thing he was ‘indefinably but really scared about’, due to its real and as yet unknowndangers. What he was expressing was a widely shared feeling of fear concerning doping anddrugs more broadly. This is the typical kind of social fear that arises in response to an‘insidious, pervasive, but not easily recognizable’ evil ‘that infuses social life and isresponsible for many of the ills that beset us’, to use the words with which the Americananthropologist F. Allan Hanson has compared the modern scare about drugs in Americansociety with the role played by witchcraft some centuries ago (Hanson 1993, p. 123, quotedin Hoberman 2005, p. 265).

A second example was provided by a radio talk-show on the Catalan public networkCatalunya Ràdio where the positive test of Alberto Contador in the 2010 Tour de France wasbeing discussed. One of the participants, the TV showman Xavier Sardà, asked in a frivoloustone for a general lifting of the ban on drugs in sports so that ‘cyclists would be allowed to doas they will’. Another participant, the philosopher Ferran Sàez, immediately replied bysarcastically suggesting: ‘OK, but then let’s broadcast the heart attacks live and let’s all seethese cyclists dying live on TV’.

This learned man was alluding to the nowadays almost universal cliché of ‘dopingdeaths’, an imprecise number of athletes who have allegedly died due to doping abuse. Theseare the same victims alluded to by an American doctor and anti-doping activist, who oncestated: ‘I am not so much concerned with getting the athlete to the finish-line first, but withgetting him there alive’.3 The very factuality of these deaths and the resulting idea thatdoping kills people have become popular common sense, a naturalized assumption, to usethe term proposed by the theorist of the Critical Language Study, Norman Fairclough.According to this author, ‘ “common sense” is substantially, though not entirely, ideological’(Fairclough 2001, p. 69; original italics). Let us therefore examine the facts behind thiscommon sense assumption.

‘Doping will kill you’: the myth of the ‘doping deaths’

There is almost no history (be it popular, scholarly or both) of doping that fails to mention its‘casualties’ in the most literal sense: athletes that have allegedly died due toperformance-enhancing drug abuse. Among the most often quoted names, one can find

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the cyclists Arthur Linton, who holds the honour of being considered the first ‘dopingcasualty’ in the late nineteenth century; Knud Enemark Jensen, who died during the 100-kmteam time trial in the 1960 Rome Olympics, and Tom Simpson, who collapsed and died onthe slopes of the Mont Ventoux during the 1967 Tour de France. To these identified cyclists,one can add an imprecise number of Belgian and Dutch riders (around 18, according to themajority of accounts; López 2011) who allegedly died of erythropoietin (EPO) overdosein the late 1980s and early 1990s; among them, the most prominent names are those ofpro rider Johannes Draaijer (1963–1990) and ex pro Bert Oosterbosch (1957–1989). Outsidethe cycling world, the names of the German heptathlete Birgit Dressel4 (1960–1987), theAmerican athlete Florence Griffith-Joyner (1959–1998) and the American football player,Lyle Alzado (1949–1992) are often quoted. The latter three cases illustrate even better howlittle we actually know about the relationship between drug intake and fatal side effects, andhow much baseless speculation can be triggered by a famous athlete’s death at a young age.Let us focus though on the Linton and Simpson cases as they are probably the most quoted‘doping deaths’ in the anti-doping literature, in order to test the solidity of the scholarshipsustaining these stories.

A search in Google Scholar with the words ‘Arthur Linton’ doping yields 82 hits, quitean impressive amount of scholarly articles and book chapters that mention the death of thelate nineteenth century cycling star in connexion with drug intake. Linton seems to havebecome the official ‘first recorded casualty of doping’. Analysing some of these references,one realizes they have in common a characteristic found in other accounts of ‘dopingcasualties’: a striking lack of consistency and historical rigour in the details provided. Onecan, for instance, read the following in the authoritative IOC Medical Commission’s reporton Harmonisation of Methods and Measures in the Fight Against Doping in Sport, writtenby the IOC Medical Commission’s president Prince de Merode and sports physicianP. Schamasch: ‘In “modern” times, probably the first fatal incident occurred during theBordeaux-Paris cycling race in 1879 [sic], where England’s Linton died after having beendoped with trimethyl by his “manager”, who was the owner of a cycle factory’ (De Merodeand Schamasch 1999, p. 4). No source is provided for this assertion, which seeminglycontains at least four major errors: Arthur Linton died in 1896, not in 1879; nor did he dieduring the 1896 edition of the race (which, incidentally, he won) but 2 months later, on 23July 1896 (Dimeo 2007, Moore 2011); the Bordeaux–Paris race did not exist in 1879, as itwas staged for the first time in 1891; and Linton’s manager, ‘Choppy’ Warburton, was notthe owner of a cycle factory (Moore 2011).

Another authoritative anti-doping source, M. Verroken, wrote: ‘Probably the firstreported drug-related death in sport was the cyclist, Arthur Linton, in 1968 [sic], who wasreportedly administered strychnine by his coach’ (Verroken 1996, p. 18). The suspiciousdrug here is no longer ‘trimethyl’ but ‘strychnine’, and Verroken is obviously confusingLinton with Tom Simpson, although Simpson himself died in 1967, not in 1968; she isnonetheless more cautious than other authors as she informs us that ‘later reports suggest thatLinton died of typhoid fever’ (ibid.). Some years later, the same author mentions Linton’scorrect date of death, although she keeps attributing it to doping (Verroken 2006, p. 2). Twoother notable anti-doping researchers, Charles Yesalis and Michael Bahrke, wrote in asimilar vein that ‘the first fatality attributed to doping was reported in 1886 [sic]: ArthurLinton, an English cyclist, is said by some to have overdosed on “tri-methyl” (. . .) during a600 km (373 miles) race between Bordeaux and Paris’ (Yesalis and Bahrke 2001, p. 46). Andwe can even find a fourth date for the alleged drug-related death of the unfortunate Linton:the year 1896 (see, for instance, Casajús 2005, Jenkins 2006, p. 81, Krych and Goździcka-Józefiak 2008, p. 62), which as mentioned above is the actual date of his death, although all

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these sources stick to the traditional explanation of Linton’s death as drug related, despite anutter lack of evidence sustaining this assertion (see below).

It seems, however, that the most repeated date is 1886; Yesalis and Bahrke (2001) cite theAustrian sports physician Ludwig Prokop (1970), one of the pioneers of the anti-dopingcampaign in the 1960s and early 1970s (Dimeo 2007), as the source for the Linton story andthe 1886 date. Prokop does indeed mention 1886 as the year of death, and in turn cites as hissource an article by the American sports physician M.M. Novich (1964), which could not beretrieved in our research. Nonetheless, a search in another classic anti-doping book,Jean-Pierre de Mondenard’s Dictionnaire du dopage, brings us to the seemingly originalsource of the Linton story: a monograph published in 1899, shortly after Linton’s death, by aFrench doctor, Georges Deschamps, who mentions ‘poor Arthur Linton – a cyclist lookedafter by Choppy Warburton (. . .) [who] passed away after his victory in Bordeaux-Paris1896’ (Deschamps 1899, pp. 28–29, quoted in DeMondenard 2004, p. 177). Deschamps putthe correct date of death, but at some point in the quotation chain someone changed 1896 for1886, a mistake that has lasted until today. He also correctly states that Linton died after the1896 edition of the race, but his phrasing suggests a connection between the cyclist’sexertions and his death, which future writers have elaborated upon by openly stating thathe died during the race . . . due to an overdose of drugs.

Two recent publications have succeeded in introducing a measure of order in this mess ofdates and data. The sports historian Paul Dimeo, after revising the available evidence on thecase, wrote the following in his authoritative book A history of drug use in sport 1876–1976(2007, p. 8):

We cannot say that his death was due to drug use because there is no evidence either way. Wedefinitely cannot say that it was ‘recorded’ as such, or that it was in 1886. . . . Therefore, wecannot interpret the fact of his death as proof of the continuity and health risks of doping inhistory.

And the biographer of Linton’s manager, Choppy Warburton, wrote the following (Moore2011, p. 79):

Despite the lack of conclusive evidence, the incident has resulted in Linton being immortalizedas the first athlete to die as a result of taking drugs in competition. He undoubtedly competed intoo many races over too short a period of time, took insufficient rest, and was in poor physicalcondition when he turned home to Aberaman to recuperate. Soon after his arrival, he becameunwell with an undiagnosed illness that developed into typhoid fever, a disease that has beendescribed as the scourge of the over-trained. On the 23rd July 1896 [two months after winningBordeaux-Paris] he died of heart failure.

Although this author was not a professional researcher, one cannot but give him more creditconcerning the accuracy of his account than the vast majority of the authors mentionedabove, who have been arguably quoting on hearsay or repeating some poorly documentedclaims by early anti-doping campaigners.

A similar search in Google Scholar for ‘Tom Simpson’ doping yields an even highernumber of hits: up to 217. It would hardly be an exaggeration to say that, if Linton hasentered the ‘hall of fame of doping victims’ as the first one in history, Simpson is the most(in)famous. This could be due to the combination of five circumstances: (1) he died muchmore recently than Linton; (2) he died when the anti-doping campaign was starting to gainmomentum; (3) he died while competing in the most famous bike race in the world; (4) hisdeath was broadcast live on TV and (5) he was an Englishman, hailing therefore from the

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heart of the developed world and from one of the fatherlands of anti-dopism and theanti-doping campaign.

This provocative assertion is based on the fact that while Simpson’s sudden death wasnot the first to happen during a cycling race, it is the only one to be continuously mentionedby the mainstream anti-doping literature. For instance, to our knowledge, nobody hasrecorded the tragedy of Raúl Motos and Joaquín Polo. On 3 August 1958, only 9 yearsbefore Simpson’s dramatic collapse on the slopes of the Ventoux, these two Spanish riderssuddenly died during the second stage of the Volta a Portugal (Lisboa-Alpiarca), not aparticularly long one at only 107 km. ‘Raúl Motos rode to the finishing line exhausted,collapsed and had to be taken to hospital, where he passed away shortly after (. . .) AnotherSpanish rider, Joaquín Polo (. . .) also passed away (. . .) in the Santarem hospital’. Bothdeaths were attributed to ‘sun stroke’. According to the press reports, the stage was ridden ata temperature of 38� (El Mundo Deportivo, 4 August 1958, cover page).

Commenting on the tragic event 2 days later, the prestigious cycling journalist RamonTorres, known as Grandpa (‘l’avi’ in Catalan) in reference to him being the most senior andrespected in his job, seemed to be in little doubt as to the cause of these deaths:

In days gone by, particularly hot ones, the stages would start at seven or even six in the morning.Precisely to spare the riders the havoc caused by riding during the sunniest hours (. . .) I do notremember any recorded cases of ‘sunstroke’ in cycling under these healthy schedules. Recently,though, the demands of the spectacle have imposed themselves, whereby the riders have beenforced to start racing in the hours when the sun crushes even those not riding. (El MundoDeportivo, 6 August 1958, p. 5).

According to the journalist, the fatal stage started at 3 pm. More details are given of thedeaths: Raúl Motos collapsed shortly before the finishing line and was given an injection ofCoramin; Joaquín Polo fell during the race, ‘a victim of the sun’ and was taken to hospital bya journalist. No doctor was available to help these riders, according to the newspaper.

Two other riders, the Spaniard Andrés Trobat and the Portuguese Boas, also ended up inhospital with sunstroke, although we are informed that Trobat was ‘out of danger’ on 5thAugust (El Mundo Deportivo, 6 August 1958, p. 5; La Vanguardia, 6 August 1958, p. 21).The only indirect allusion found in the consulted newspapers (El Mundo Deportivo, ABCand La Vanguardia) to the possibility that these deaths had been caused by something elseare to be found in the statements of the manager of one of the teams involved, AlfonsoGuzmán, who is quoted as insisting that ‘heat, only the tremendous heat we have encoun-tered in Portugal (. . .) is responsible’ for the two deaths (La Vanguardia, 7 August 1958,p. 19).5

Therefore, according to the Spanish press, Motos and Polo died of sunstroke and nothingelse. Would the British press have reached the same conclusion had the unfortunate ridersbeen their fellow countrymen? In any case, what the best informed commentators haveconcluded is that Simpson died due to a coincidence of five circumstances (see, for instance,Fotheringham 2007): high temperature, overexertion, dehydration due to diarrhoea, andamphetamine and alcohol intake. Probably the order of relevance is the same, sinceamphetamines (alone or mixed with alcohol) could hardly be the direct cause of suddendeath in a well-trained athlete, while overheating in conjunction with overexertion anddehydration is a proven cause of sudden death in athletes and non-athletes. The relevantquestions are therefore why amphetamines have been singled out almost unanimously as thecause of Simpson’s death, and why the conclusion drawn from this tragedy is that drugs insport must be banned and offending athletes severely punished, instead of the more plausible

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logical ones of preventing athletes from drinking too much alcohol before entering races, oravoiding such testing climbs as Mont Ventoux, or, as ‘l’avi’ Torres pointed out with over-whelming common sense, prohibiting midday starts in summer races. Our contention is thatthe version of the facts focusing on amphetamines eventually prevailed because it wasinstrumental for the anti-doping campaign. It has been a useful distortion for propagandisticpurposes, one of a series of distortions or biased presentations of facts culminating in the‘EPO deaths’, a story extensively researched by this author (López 2011).

Uncovering the mythical nature of the ‘doping deaths’ cliché: EPO and hGH

The Danish sports professor Verner Møller was one of the first scholars, if not the very first,to challenge the cliché of ‘doping deaths’ with his thorough research on the circumstancessurrounding the death of one of those alleged doping victims, the Danish cyclist KnudEnemark Jensen (Møller 2005).

Møller’s article in Sport in History was the direct inspiration for our own research on the‘EPO deaths’, a series of sudden deaths in cycling in the late 1980s and early 1990s, whichprobably induced the Catalan philosopher to ironically request that cyclists’ heart attacks bebroadcast live. If Jensen’s and Tom Simpson’s deaths were instrumental in the establishmentof the first anti-doping activities, the ‘EPO deaths’ story, given the supposedmassive numberof cases, helped pave the way for the eventual institutionalization of anti-doping in the late1990s and early twenty-first century.

As our research on the ‘EPO deaths’ has already been published in Sport in History, vol.31, number 1 (López 2011), this article will offer only a brief summary. To stress theimportance of these deaths for the legitimization of the anti-doping campaign, we labelledEPO as the ‘drug of mass destruction’ in the war on drugs in sport. Mirroring the Iraq warand the discourse about the weapons of mass destruction, the pervasive and insistent claimsabout the ravages of EPO were simply baseless. This point was demonstrated with anin-depth analysis of 36 academic texts (journal articles and book chapters) and 24 newsreports published in the main English-speaking newspapers mentioning the EPO deaths. Athorough source analysis of these 60 texts was performed, concluding that only two of themquote more or less solid sources for the claim that EPO killed the athletes, and both of thesewere journalistic, not academic texts. Furthermore, these sources were only commenting onthe facts, not giving accounts of them as first-hand witnesses or doctors involved inpost-mortem examinations. As for the rest, they either take it for granted the causal link,or refer to other sources that do not mention any source for the claim.

Additionally, a newspaper-based search on sudden death in cyclists in the late 1980s andearly 1990s in Europe was performed, finding that in the 6-year period between 1987 and1992 there are indeed references to nine Dutch and six Belgian victims, an average of 1.25deaths per year per country. These data were compared with epidemiological studies onsudden death and it was concluded that there was nothing particularly suspicious in thisfigure in statistical terms. Van Teeffelen et al. (1991, quoted in Carrière 1992), for instance,estimated the annual incidence of sudden death in sports in the Netherlands in the early1990s to be around 150 per year. Maron et al. (2009) reviewed 1866 recorded cases ofsudden death in young athletes in the United States between 1980 and 2006, a yearly averageof 71.7.

Thirty-five scientific articles referring to the alleged deleterious effects of EPO abusewere further reviewed. Of these, the vast majority do not provide any kind of solid evidencefor these side effects, but simply take them for granted. On the other hand, the reviewedscientific literature on sudden death in young athletes makes no mention of EPO intake as a

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possible cause. The reviewed experimental haematological and cardiovascular researchdownplays or directly rules out the possibility of EPO intake provoking sudden death inathletes.

This research shows, therefore, that, rather than standing on solid ground, the expertswho contributed to spreading the story of the EPO deaths were in fact ‘fighting the fog’(Møller 2010, p. 12). Nonetheless, they succeeded in stigmatizing EPO prescription andconsumption for performance-enhancing purposes. The combination of this broadly circu-lated story about the deadly dangers of EPO and the politically induced scandal of the 1998Tour de France prepared public opinion in the Western world for the repressive turnanti-doping was to take in the ensuing years.

After finishing this study, our focus moved to another vituperated and feared moderndoping drug, hGH (López 2012). Although hGH has not been presented as the ‘killingsuperdrug’ EPO is supposed to be, it has also played a prominent role in the scaremongeringcampaign surrounding hormone doping. A content analysis was carried out of 110 articlesmentioning hGH as a doping drug published between 1983 and 1999 in the mainEnglish-speaking newspapers. The main finding of this analysis is that the lay pressassociated hGH with a wide array of negative concepts and meanings familiar from theanti-doping campaign (cheating, abuse, illegality, stealth, trouble . . .), and particularly withseveral health hazards and even (indirectly) with death, by insisting on the fact that it used tobe extracted from cadavers prior to 1985 and cadaveric hGH (which conveys a risk ofinfection with the lethal Kreutzfeld-Jacob disease) could still be bought on the black market.In order to assess the empirical basis of these claims, a thorough examination of the credibleacademic literature on doping with hGH was conducted.

This literature review, including 40 articles and book chapters, unveiled an unexpectedpanorama if you still believe in science as a source of knowledge: the vast majority of theseclaims are actually suppositions or deductions, not based on actual empirical (experimentalor epidemiological) research. All the ominous side-effects attributed to hGH intake forperformance-enhancing purposes have been extrapolated from the symptoms of unwellpersons: patients overproducing growth hormone as a consequence of a tumour of thepituitary gland, resulting in a condition known as acromegaly, or patients receiving hGHas a replacement therapy due to a dysfunction of their pituitary gland. The story about the useof cadaveric hGH is also lavishly quoted by the expert literature. The truth is that so far littleoriginal research has been conducted on the side effects of hGH supplementation in healthyadults, and that the few studies carried out have only revealed mild side effects like fatigue,joint and muscle pain, fluid retention symptoms and increased dermal viscosity.

We concluded, therefore, that a substantial part of both the expert community and thegeneral media have insistently associated hGH doping with severe and even fatal sideeffects, despite the total lack of empirical evidence substantiating the claims about theseeffects. Particularly noteworthy is the insistence in both the expert literature and the generalmedia in indirectly linking the drug with death by continuously referring to the old method ofobtaining it from the pituitary glands of cadavers, even though this method was abandonedin 1985 for safety reasons and substituted by synthetic, safe hGH.

When it comes down to how doping with EPO and hGH has been publicly presented,what we find is scaremongering claims originated by a group of experts personally com-mitted to the anti-doping campaign, but hardly, if at all, substantiated by conclusive proof.Nothing is new under the sun: as early as 1984, the American sports physician Bob Goldmanpublished a book with a title as explicit as Death in the locker room, where he disclosed theresults of a 7-year research into the use of steroids in sports. Goldman is blunt in hisconclusions: ‘Now that I’ve finished my research, I’m no longer open-minded. I can state

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unequivocally that drugs, especially anabolic steroids (. . .) bestow few benefits, and noneworth the terrible risks of taking them’ (quoted from the 1992 edition of the book: Goldmanand Klatz 1992, p. 5). However, to our amazement, less than 15 lines below this categoricalclaim Goldman writes: ‘[I have read] nearly 800 scientific articles about steroids, and (. . .)[I have] learned that the science of endocrinology is in its infancy. Much research remains tobe done before anyone completely understands how steroids, specially anabolic steroids,work’ (ibid.).

Risk communication, the media and the manufacture of fear

The ‘meaning career’ (Altheide 2002) of EPO and hGH in public discourse (i.e. the mean-ings and concepts associated with these substances in the media and the expert literature)amounts to a successful process of manufacturing truth by the anti-doping campaign. Twomodern institutions and the people involved in them are to be found behind this process: onthe one hand, an important part of the expert community, in particular physicians andscientists engaged in anti-doping activities, and on the other, a section of the mass mediaand journalists. The ideas of the American critical media scholar David L. Altheide may beuseful to help us understand this process and the role played by these institutions and people.

The hegemonic discourse on the health dangers of EPO, hGH and other doping drugscould be considered a perfect example of risk communication as defined by Altheide.According to this author, risk communication is a form of propaganda and a strand of thepublic relations industry. It can be seen as a set of communication strategies and practicesdevoted to promoting a discourse of fear, which ‘may be defined as the pervasive commu-nication, symbolic awareness and expectation that danger and risk are a central feature of theeffective environment’ (Altheide 2010, p. 147).

Risk communication is essentially devoted to creating fear as a social product, whosepervasiveness is one of the main traits of the contemporary risk society. According toAltheide (2010, p. 150), ‘fear limits our intellectual and moral capacities, it turns us againstothers, and it changes our behaviour and perspective, and makes us vulnerable to those whowould control us in order to promote their own agendas’. In fact, behind risk communicationand the promotion of a discourse of fear one can usually find certain agencies, institutionsand individuals who

essentially promote self-serving propaganda and misinformation, on the one hand, whilecarving issues and problems to be solved through consumption (. . .) of products, services, orpolicies that are not isomorphic (. . .) to the nature and extent of the offending risk. (Altheide2010, p. 146)

In short, risk communication is strategic communication promoting a discourse of fear,which creates and spreads fear as a social product. Social fear increases social demand for apolitics of fear, which is essentially devoted to promoting more and more social control andsurveillance policies, agencies and technologies: ‘more risk communication calls for more(. . .) control and scrutiny (. . .). We become accustomed to more control, and it is graduallytaken for granted’ (Altheide 2010, p. 151). In other words, ‘the face of fear is expandedsurveillance’, including ‘invasive drug testing’ (Altheide 2010, p. 152).

This strand of Altheide’s theories accounts for the role played by the anti-doping experts.According to the American sociologist, risk communication is promoted by ‘an army ofsocial scientists and other intellectuals – or “issue fans” (. . .) [serving] as claims makers,marketing their target issues and agendas’ (Altheide 2002, pp. 3–4). In the case of

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anti-doping, most of them are medical doctors and/or scientists in the field of medical andbio-chemical sciences, invested with both social prestige and credibility. Many of them havebeen actively involved in the anti-doping campaign and/or in the anti-doping governancestructure that has been set up as a consequence of the success of this campaign (Dimeo2007). Their repeated claims about the health hazards of doping channelled through thescholarly publication system are poorly backed by the kind of empirical evidence thatdifferentiates science from other kinds of social discourse such as art, propaganda orreligion, as our previous work demonstrates (López 2011 and 2012). These claims, none-theless, remain almost totally unchallenged and have succeeded in creating and spreadingsocial fear about doping. This in turn has paved the way for a politics of fear in this field,resulting in an escalation in social control and surveillance policies and agencies, like theNational Anti-Doping Organizations (NADOs) and World Anti-Doping Agency (WADA).

In order to explain the role of the mass media and journalists in this story, one must takeinto account that, according to Altheide, risk communication is nowadays an essentiallymass-mediated practice. The discourses of fear, whatever their object, find easy access to themass media and audiences because fear is highly entertaining, and entertainment is central tothe ‘media logic’. Altheide defines media logic as the ‘rationale, emphasis, and orientationpromoted by media production, processes, and messages’ which ‘tends to be evocative,encapsulated, highly thematic, familiar to audiences, and easy to use (. . .) The entertainmentformat is the communication/organizational envelope that shapes – and often distorts – theresulting message’. This format is ‘visual, brief, action oriented and dramatic’ and ‘producesan exciting and familiar tempo’ (Altheide 2010, p. 147).

An important consequence of this theoretical approach is the counter-intuitive conclu-sion that the media system does not play a primary role in this process, but rather acts as anessential, but secondary echo chamber for the risk messages created and promoted by‘claims makers’ (Altheide 2010) actively involved in a particular campaign and who havea particular agenda in mind. A similar point is made by Frank Füredi when he claims that ‘themedia amplify or attenuate but do not cause society’s sense of risk (. . .) The mediapreoccupation with risk is a symptom of the problem and not its cause’ (Füredi 1997,p. 52). This does not amount to saying that the media’s role is an unimportant one in thepromotion of a culture of fear: on the contrary, it is essential in the sense that claims makersare dependent upon the media system to promote and disseminate their messages and toadvance their political agendas. And it is widely accepted amongst the scholarly communitythat the effects of the distorted media representation of any social issue can be deleterious forits effective and rational management:

The driving force of the news coverage (. . .) can actually distort understanding of the issues,leading politicians, funding agencies, academic disciplines, and even agency personnel whoactually deal with the alleged problem to make adjustments that are counterproductive and makematters much worse (. . .) The social landscape is littered with failed programs and reactivepublic policies proclaiming the litany of deliverance from an effective environment defined byfear. (Altheide 2002, pp. 50, 56)

The intrinsic nature of the modern media system, its ‘media logic’ as manifested in theprevailing media formats, ensures that scaremongering messages of any kind find easyaccess to audiences. However, these messages do not usually originate in the media systemitself, but stem from claims makers’ strategies. An exception to this reactive and amplifyingrole could be when particular journalists join the campaign to become primary disseminatorsof its messages. This would be the case with the Irish former pro cyclist and Sunday Times

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sportswriter Paul Kimmage (2007), as well as the Irish journalist David Walsh and Frenchcolleague Pierre Ballester (Walsh and Ballester 2006, Walsh 2007, Ballester 2008), but, asstated above, this is the exception rather than the norm.

Conclusions

The alarming claims about the health dangers of doping with EPO and hGH (and otherdoping drugs like steroids in an earlier stage of the anti-doping campaign) made byauthoritative claims makers (mainly medical doctors and scientists who are anti-dopingactivists), despite a lack of conclusive scientific evidence, have easily influenced publicopinion through a media whose modus operandi is the entertainment imperative andspectacular logic (Altheide 2002). The issues of ‘doping deaths’ or ‘doping health dangers’are therefore perfect examples of risk communication and the discourse of fear as defined byAltheide (2002 and 2010). These claims have become common sense or naturalized knowl-edge (Fairclough 2001) through repetition and lack of confrontation with critical sources,and the sentiments of fear they have triggered among the public have ultimately helpedcreate a social demand for a politics of fear regarding the management of doping. Theensuing products are institutions and policies that enforce increased surveillance, control andrepression of elite athletes and (more worryingly) increasingly of the sporting population ingeneral and even the common citizenry, as a Danish case demonstrates (Christiansen 2011).

It is therefore concluded that the issue of ‘doping deaths’ has become a baseless cliché inthe expert literature as well as in the lay press, serving an ideological agenda: the onepromoted by anti-dopism in order to advance its stance on performance-enhancing substanceintake in elite sport, and to ensure a broad acceptance of a ‘politics of fear’ (Füredi 2005) toeradicate it.

Notes1. The one based on the principles of individual freedom, responsibility and self-determination.2. It is not our goal here to enter into an in-depth discussion about such concepts as ‘propaganda’ and

‘propaganda campaign’ in the context of anti-dopism. Our stance is that, as a very active ideology,anti-dopism has long deployed propaganda techniques and strategies. The term ‘campaign’certainly deserves some qualification: although one could hardly talk about a centrally steered,long-term and carefully designed ‘campaign’, it is undeniable that there have been and alreadyexist very active ‘campaigners’, and that since the institutionalization of anti-doping agencies(World Anti Doping Agency, National Anti Doping Organizations), one can properly speak aboutfull-fledged campaigns, openly presented as such.

3. Dr. Randy E. Eichner, Quoted in David Powell, ‘Blood Doping Risks Revealed’, The Times, 14November 1990.

4. For a dramatic account of Dressel’s death, see Hoberman (1992).5. Another death of a cyclist en routewhich was attributed to sunstroke has been documented in our

research. On 16 August 1926, tragedy struck a bicycle race held in Santander, Spain, when thelocal rider José Sierra died in the course of the competition.

That day was sweltering, which made the riders go at a moderate pace until the bottom of [themountain pass of] La Braguía. V.[icente] Trueba [the cycling legend who was to become thefirst ever winner of the Mountains competition at the 1933 Tour de France] made severalattacks (. . .) and José Sierra Portilla (. . .) answered by sticking to his wheel. (Neila Majada2005, p. 46)

Just after crossing the summit of La Braguía, Sierra died. There are several versions of the cause ofthis fatality, one of which points towards ‘the heat and the enormous exertion’ he had made in trying

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to counter Trueba’s attacks (Neila Majada 2005, p. 46). This could therefore be a documented caseof sunstroke killing a cyclist as early as 1926.

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