Professionalization of Exercise Physiologyonline                                


ISSN 1099-5862   Vol 6 No 7  July 2003 
 



 
 



    Editor-in-Chief
    Tommy Boone, PhD, MPH, MA, FASEP, EPC
 
 
 
Dietary "Sports" Supplements: The University Teacher’s Role in Teaching Values?
Tommy Boone
Professor and Chair
Director, Exercise Physiology Laboratories
The College of St. Scholastica
Duluth, MN 55811
 
“Exercise physiologists do not deal just in technical matters.  Their business is to deliver a service and to do it ethically, which goes to the heart of the profession.”  William T. Boone, Jr. 
WHILE IT IS important to teach sound sports nutrition, it is an ethical problem to teach students and athletes that it is okay to take supplements to level the playing field.  Or, is it unethical?  The question needs an answer.  The idea used to be that participation in sports teaches us about honesty and commitment to fair play.  Now, if young athletes have their way, it appears that they would rather substitute drugs and supplements for talent, skill, hard work, and motivation.  “Win at all costs” is today’s thinking!  The cheaters have become our heroes.  None of this is new.  Athletes have taken performance-enhancing drugs since the beginning of ancient sports.  So, what is the deal?  In short, aside from the wining of trophies, sports is also about teaching athletes the right and wrong behavior (ethics) of dealing with life’s challenges and problems to being successful.  Instead, sports are more about pharmacy than about ethics.  Managers of sports programs, coach of athletic teams, sports medicine physicians, and a host of others are pushing the cheaters’ rules of the game.  Doping, drugs, supplements and other dubious practices should not be part of athletics.  Exercise physiologists ought to be teaching that it is wrong to substitute supplements for athletic training.  Dietary supplements are unregulated.  Some are linked to serious health risks, yet athletes will risk even death to get their hands on the so-called “sports designer drugs”. 

Robert Voy, a medical doctor and past chief medical officer of the United States Olympic Committee, had this to say:  “…using performance enhancing drugs is cheating, plain, and simple” [1].  Everyone knows that a high percentage of athletes, young and old, are taking all kinds of drugs to get their personal best.  Winning is everything because that is exactly what we have encouraged athletes to think.  Participants in amateur sports believe it and, worse yet, many children between the ages of 10 and 15 years believe it.  They know more about retail outlets, the content of fitness magazines, the Internet sources, and the black market than the university teachers.  Who among exercise physiologists is analyzing the ethical questions that surround sports supplements?  Is there an ethical problem with the use of supplements?  Or, does it become an ethical problem only when the supplement becomes illicit or banned or when an athlete dies?  Who is addressing the ethical conflicts that arise when researchers take money from supplement companies and, afterwards, fail to report findings that are contrary to the industry’s beliefs or marketing strategies?  The conflict that arises from this kind of research is huge [2].  Failure to disclose it to students is a problem.  Teachers above most other professionals are suppose to be open-minded, objective, and fair when it comes to the education of students.  The fallout of questions that center directly on “competitive advantage” and “leveling the playing field” need a straightforward answer or otherwise it can only hurt the teaching profession [3]. 

Like the IOC medical code, most professions have a code of ethics and, clearly, the professional status of each is defined by agreed upon standards of conduct.  What I’ve come to realize is that when exercise physiologists are confronted with this particular point, they become defensive if not angry.  “Who are you to say these things to us?”  Or, “You don’t get it.  You are out of the loop?”  You can hear them saying, “Hey, we need the research grants from the supplement industry to build our laboratories so we can do good, quality research.”  I agree.  There isn’t any question that college departments need more money for all kinds of reasons, including research equipment and resources.  However, the university teacher’s task is to keep the work honest and to keep it ethical, which goes beyond buying, cleaning, calibrating, using laboratory equipment, and publishing more papers.  It means engineering new thinking, especially when the old thinking is problematic.  For example, when university teachers either encourage or look the other way when athletes use amphetamines, narcotics, anabolic agents, peptide hormones, and ergogenic nutritional aids like carnitive, chromium picolinate, creatine, and sodium bicarbonate, they are failing to speak against a way of thinking that goes against the spirit of fair competition.  I dare say that many academic exercise physiologists have not taken the time to justify their involvement with nutritional supplements, products, and services of the supplement industry and yet, according to Charles E. Yesalis and Virginia S. Cowart [4], authors of The Steroids Game, “…to win at the cost of your health, breaking the law, and cheating is wrong and cannot be justified.”  In my personal opinion, whatever we call reality with encouraging athletes to use dietary supplements to level the playing field, it is also mixed with an image of possibilities that lack in bringing order to the players’ lives.  Understandably, the use of ergogenic nutritional aids is not the same as anabolic-androgenic steroid use, but where do you draw the line? 

“The risks are something the takers ignore, or the suppliers say nothing about.  Added to this is the fact that the IOC was able to find Nandrolone in over 14% of muscle-building supplements it tested, all claiming to be ‘natural, safe, or steroid-free’ athletes.”  -- sports-drugs.com
Recently, a colleague said: “Exercise physiologists appear to lack a critical connection between building character and competitive sports.”  Is it true?  Have the decades of emphasis on ergogenic aids to improve sports training and/or performance caused us to think that it is okay to do “whatever it takes” to improve athletes’ ability to win?  After all, winning is the name of the game.  And, as exercise physiologists developed themselves as researchers, they became good at researching nutritional supplements.  No one took the time to think that it might be wrong since supplements were not banned drugs.  So, it was easy to think that the way to better athletics is through dietary supplements and, for a long time, I also taught the typical sports supplements information.  Why not?  It seemed to be the right thing to do.  Today, however, it is different.  Yet, there are essentially no exercise physiologists who are willing to argue against the use of supplements.  It is next to impossible to find exercise physiologists who will agree that taking sports supplements to win is wrong.  It is part of what exercise physiologists do. 
“The use of nutritional or dietary supplements is completely at the athlete’s own risk, even if the supplements are ‘approved’ or ‘verified’.” – Athlete Advisory, United States Anti-Doping Agency
The idea that supplements are somehow wrong has not been discussed in great detail.  The problem then arises as to the message students are getting.  Certainly, the teaching of sports nutrition (and thus many types of supplements) to level the playing field offends many who enjoy competitive sports without drugs making them into a circus show.  We might conclude that the current method of athletic enhancement is based on conflicting values.  We need to take the idea that athletes can and should do whatever necessary to win far more seriously.  Such thinking is not in the best interest of athletes.  It also lacks awareness of a sound objective reality that ought to be part of the professional development of exercise physiology.  If this view has any merit at all, then it is just a matter of time the competence of academic exercise physiologists will need to be rethought.  Others understand this point.  Parents are getting the message.  Frankly, I have never understood how values can be taught when athletes, winners or otherwise, are encouraged to take performance-enhancing supplements.  It is a contradiction in sport ethics.  Simply stated: We have no business of encouraging children and young people to believe that the only reason to play sports is to win.  It is an absurd notion. 
“The potential benefits to society and to the individual from sport will only be maximized where fair play is center stage.”  -- Council of Europe
It is now a matter of members communicating that intellectual dishonesty in exercise physiology weakens the integrity of the evolving profession.  Central to membership in a professional organization is the moral balance and appreciation for ethically based thinking.  Members are expected to demonstrate the capacity to think well for the sake of developing the highest organizational values and standards.  Their participation gives rise to a rational professional understanding of the ethical principles upon which the rules of professional conduct are based.  The member who understands this moral connection will act out of desire to do the right thing.  Similarly, the professor’s tasks, who is a member of yet another professional organization of educators, should be to:
1. Teach a morally defensible way for graduates to interact with the public sector.  Students should be taught that rules govern sports and life.  The idea that “fairness” is an out-dated concept is morally unacceptable. 
2. Teach that cheating is unacceptable.  Even if every athlete is using supplements to gain an advantage, it is wrong and unacceptable behavior.
3. Discuss the importance of the rules of sports and the ethical principles upon which sports are based, particularly with reference to moral learning and development beyond sports.
4. Emphasize that winning at all costs is a gross misunderstanding of sports and the admirable qualities of athletes upon which others model their lives.
5. Speak out when the sports behavior of athletes, coaches, and researchers is inappropriate, especially when athletes are not taught the dignity in defeat.
6. Model, through personal and professional behavior, the thoughts and feelings of what is right and acceptable sports behavior. 
7. Demonstrate a genuine commitment to fairness and honesty in sports competition. 
8. Counsel individual members of the profession and athletes, in particular, to help them understand what is right and fair in athletics.
This paper is probably the first of many that will argue that exercise physiologists must pay attention to issues of an ethical dimension to their teaching if a full professional statement of their work is to be achieved.  It is also an effort of ongoing work to pull academic exercise physiologists out of a “deadly” way of thinking or myth [5] and into a declared statement of values that define the professional practice of exercise physiology.  This effort is clearly vital to the adoption of the ASEP mindset [6] that leads to a fuller understanding of exercise physiology professionalism.  By mindset, I’m referring to the criteria that define professionalism (e.g., expertise, autonomy, and altruism).  University teachers can’t just sit back and develop their “specialized knowledge” and argue for “independence” without also paying attention to the ethical side of professional development (altruism).  This is also another way of saying that university teachers cannot overlook the ethical concerns of their clients.  Other healthcare professionals understand this point all too well.  That is why physical therapists have not only defined their exclusive body of knowledge and practice as well as their right (through licensure) to control entry into and practice within the profession.  They understand that if the practice is not defined by ethical thinking [7], the practice of physical therapy is meaningless.

It has to be recognized by exercise physiologists that “instilling values” (such as fair play and sportsmanship) is imperative to professional development.  It allows members of the profession to evolve to professional status whereby they can justify their practice as ethical and honest.  This is clearly not something exercise physiologists discuss or teach in their college classes.  It doesn’t get research data collected or manuscripts published.  It may even be argued that discussion of professional issues is a waste of time and unnecessary.  This seems to be the case among some gatekeepers (university teachers) throughout the United States.  Their lack of a formal education about professionalism and the ethics of a professional practice may be one reason why their appreciation for the professionalization of exercise physiology is rudimentary.  There is also the problem that stems from groupthink [8-10], especially when speaking the truth is compromised by the powerful position of the organizations to which the members belong. 

Exercise physiologists have a Code of Ethics [11] that applies to the members of the American Society of Exercise Physiologists.  Exercise physiology ethics, therefore, applies to members of the ASEP organization and to no one else.  This reason, among others, is both a standard and a challenge because it teaches and guides exercise physiologists in the right way to practice the profession.  This is true of the profession of exercise physiology just as it is of the physical therapy or nursing professions.  As suggested earlier, teaching ethics is not part of the mix of exercise physiology courses, yet it should be for obvious reasons.  Students need to be aware that they are part of a profession defined by a scope of practice that is technically and professionally part of their altruistic beliefs.  But, it is self evident that the understanding of ethics is poor among students.  This is why university teachers should teach a course in the professional ethics of exercise physiology [12].  And, the entire subject matter should be part of the curriculum not by chance but by purpose.  Needless to say, though, this is not happening.  Professors are seldom organized to teach ethics nor do they typically search for opportunities to do so.  So, how are students going to develop habits of ethical thinking so that they can understand their professional responsibility to the public?

If one reflects on the importance of instilling values among our students, we can agree that there is a problem.  Not only is the clash of interests between sports medicine and exercise physiologists unsettling, it is central to a better understanding of how we should collectively manage our ethical concerns and issues [13].  It is easy to look the other way.  It is difficult to look at the problem, especially since it also requires acknowledging that his/her direct participation in sports medicine has contributed to the problem.  It is my belief that the “beginning of wisdom” is triggered by coming to grips with what is best for our students’ education and future job opportunities [14].  And, admittedly, it is hard to change one’s perspective, especially when it is comfortable, but that is exactly the simplicity of right thinking for the right reasons.  It is also clear that instilling values is not just worth discussing, but is valuable both in the support of the students’ education and emotional growth.  This point has received greater attention among other more established groups of professionals who have addressed the issues underlying training rather than education.  Training is not an education, and all training is defined by its absence of elaboration of meaning (values).  Perhaps this is the crux of the problem and the reason for new standards of professional development by the ASEP organization that should be taught by university teachers.

People who identify with this description can be found in all kinds of careers in exercise physiology.  By virtue of their challenges to find both professional respect and financial stability, that is, those without the doctorate degree, they have navigated to a variety of organizations that appear to act more on their behalf.  Many have conformed to the values and beliefs of these organizations and, therefore, are in adherence to their mission.  Others continue to struggle with finding the organization that fits into their notion and personal values that associate with exercise physiology.  It is a huge struggle of values, ideals, and identities tempered with a hopeful expectation that something better will come along (in the form of licensure, in particular).  Ultimately, this radical idea was pushed through in Louisiana and, as such, has failed to address the needs of exercise physiologists throughout the United States.  In short, those who challenged the system and made the big splash (i.e., licensure) were not prepared for licensure not defining their professionalism.  Sustainable professional growth is doable only when founded on existing practices of organizational development inspired by ethical thinking.  To expect the same results from an altogether different approach is suggestive of running a race without proper training before hand.  It simply violates the path to professionalism [15] and, in the end, upsets the collaborate effort to bring about real change, respect, and cooperation with other healthcare professionals.

This occurred because no one took the time to organize for sustainable change defined by established procedures.  This is not true with the ASEP organization.  The founding members inspired change by literally beginning with the smallest problems first and, then, moved to more crucial concerns as they unfolded.  While the task may seem nearly impossible, the ASEP vision has catalyzed a new and profound organizational structure and social context for all exercise physiologists that have never existed before.  The 1997 founding of the exercise physiology professional organization meets the needs of its members, which is not a revolutionary idea in itself.  However, creating an organization just for exercise physiologists is revolutionary.  As a result, students interested in exercise physiology should become members and, therefore, confirm their commitment to the observable differences between ASEP and other organizations.  Another important task of university teachers is to send signals to their students that it is okay (if not expected) for them to join ASEP and become part of the change process.  Exercise physiology is a profession.  Students should be encouraged to challenge conventional thinking about exercise physiology so that new ideas will be considered, developed, embraced, and nurtured.  The time is right to address this new model of thinking about exercise physiology; one with values and hopes about a professional healthcare career with social, economic, and technological implications in addition to the obvious physical and athletic concerns.  This would ultimately enhance the public’s view of the practice of exercise physiology.

The university teacher’s responsibility is awesome and even unmatched by most other professions.  Teaching is not for everyone.  Thinking right is a challenge, especially when asked to examine presuppositions that many exercise physiologists take for granted.  Again, the idea of encouraging sport supplements is a natural behavior, yet it is practiced with unfortunate consequences.  The seemingly unrelated “do whatever it takes to win” is often crafted in real life situations to accommodate the notion that its okay to cheat on one’s resume to get a job or misrepresent someone else’s work for your work to get a promotion.  This unbundling of the right way to think is a poor investment in the students’ education.  Many correctly understand this point; others have abandoned making the connections between an education and right (ethical) thinking.  Interestingly, corporations understand the commitment to education and ethics.

“A number of corporations have been moving to create ethics officers who report to the highest level of authority and play increasingly major roles in setting and reviewing corporate policy…” – John B. Bennett [16] 
Is this what ASEP should do?  With an “ethics officer” there might be an increased emphasis placed on ethical behavior.  On the other hand, the commitment of one person to keep ethical thinking central to the organization’s purpose may not be a great idea.  Why?  Because professionalism incorporates ethics and all members ought to value the commitment to professional development.  Being unfaithful to the challenges and opportunities to educate students in the most ethical manner cannot be tolerated.  Members of other professions understand that ethical practices under gird the integrity of their products and their fundamental relationship with the larger community.  The professor’s task is no different.  Education is about seeing what students can become.  Here again, the role of the professor is to set the example in terms of attitudes and values. Similarly, the role of a board member of any organization is helping the members do the right thing even when they hear statements like, “Why even bother with ethics.  Everyone is doing it.  Get real.” Or “Who are we hurting?  Athletes want the stuff.”  Regardless of whether they want it or whether they have been taught that performance-enhancing drugs and supplements are okay, it is the wrong message for young people.  Athletes should be athletes, nothing more, nothing less. 

But, unfortunately, there is strong financial incentive and support throughout the United States by business-minded executives to exploit athletes to ensure maximum financial benefit to their companies.  They represent individuals with very low standards of ethics.  They are responsible to no one but their business partners and activities.  Members of ASEP (and especially the Board of Directors) ought to be (as well as the university teachers) responsible to their stakeholders (i.e., ASEP members and students, respectively).  What they do and say (or fail to do and say) influences the professional development of the organization and board members’ ability to achieve the ASEP vision.  This is why questionable practices must be written about.  A starting point for coming to this understanding is the Exercise Physiologist’s Code of Ethics.  The ASEP organization is serious about ethics.  It has to be because it is a professional organization.  It is also a new way to perceive the world of exercise physiology.  That is, a new paradigm (model) for exercise physiologists.  Naturally, those who practice the present paradigm are at risk of losing something with the change in paradigms [17].  They will think the shift is absurd, stupid, or just a waste of time.  However, this article and others like it throughout the print copy journals and the Internet sources represent the beginning of the trend to a new way to think about exercise physiology. 

Although many supporters of supplements and ergogenic aids would have us believe otherwise, this is a controversial topic.  The controversy goes beyond the individual’s code of ethics [18].  The multimillion-dollar sports nutrition market itself is a questionable part of sports.  Preying on the desires of athletes who seek an edge, the manufacturers of sports nutrition supplements are gambling that athletes are willing to take risks and do almost anything to win.  Understanding this point, the obligations of the university teacher are to teach the differences between fallacious and valid evidence and to dispel erroneous and baseless beliefs [19].  Dr. Edward Shils, author of The Academic Ethic, a report of a study group of the international council on the future of the university, said it best: “The critical scrutiny of the tradition (of his subject) and particularly of the most recent increments to it is an obligation of a university teacher to his colleagues in his own university and at others, present and future, even where it requires that he render negative judgments on their work.” [19, p. 59]

The last point, of course, centers directly on the take-home message to one very important question: “What is best for student athletes?”  The university teachers’ obligation is to be honest with students and colleagues.  No trait is more noticeable in university teachers than the passion to do the right thing.  When they do, they earn the trust of their students.  This is the kind of stuff that sets exercise physiology teachers apart from the others. 

“You have to tell it like it is.”  -- William T. Boone, Jr. 


References
1. Voy, R. (1991). Drugs, Sport, and Politics. Champaign, Illinois: Leisure Press, p. xvi.
2. Boone, T. (2002). Exercise Physiology Quackery and Consumer Fraud. Professionalization of Exercise Physiology-online. Vol 5 No 5 [Online]. http://www.asep.org/asep/asep/ExercisePhysiologyQuackery.html
3. Boone, T. (2002). Professional Behavior in the Academic Ranks of Exercise Physiology. Professionalization of Exercise Physiology-online. Vol 5 No 7 [Online]. http://www.asep.org/asep/asep/ProfessionalBehavior.html
4. Yesalis, C.E. and Cowart, V.S. (1998). The Steroids Game. Champaign, IL: Human Kinetics, p. vii.
5. Boone, T. (2001). The Sports Medicine Myth. Professionalization of Exercise Physiology-online. Vol 4 No 7 [Online]. http://www.asep.org/asep/asep/SportsMedicineMyth.html
6. Boone, T. (2002). A New Academic Paradigm for Exercise Physiology Teachers. Professionalization of Exercise Physiology-online. Vol 5 No 9 [Online]. http://www.asep.org/asep/asep/TeachingWithINTEGRITY.html
7.  Boone, T. (2003). Ethical Thinking:  What Is It and Why Does It Matter? Professionalization of Exercise Physiology-online. Vol 6 No 6 [Online]. http://www.asep.org/asep/asep/EthicalThinkingANDexercisephysiology.html
8. Boone, T. (2003). Overcoming Institutional Inertia with Leadership. Professionalization of Exercise Physiology-online. Vol 6 No 2 [Online]. http://www.asep.org/asep/asep/OvercomingInstitutionalInertiaWithLeadership.html
9. Boone, T. (2002). Exercise Physiology of the Future: Thinking Out of the Box. Professionalization of Exercise Physiology-online. Vol 5 No 11 [Online]. http://www.asep.org/asep/asep/ThinkingOutsideTheBoxExercisePhysiology.html
10. Boone, T. (2003). The Power of Individuality. Professionalization of Exercise Physiology-online. Vol 6 No 4 [Online]. http://www.asep.org/asep/asep/powerOFindividuality.html
11. American Society of Exercise Physiologists. (2003). ASEP Code of Ethics. [Online]. http://www.asep.org/asep/asep/ethics.htm
12. Boone, T. (2003). Introduction to Professional Ethics. Professionalization of Exercise Physiology-online. Vol 6 No 5 [Online]. http://www.asep.org/asep/asep/ProfessionalETHICS.html
13. Boone, T. (2003). Organizational Code of Moral Principles and Values. Professionalization of Exercise Physiology-online. Vol 6 No 3 [Online]. http://www.asep.org/asep/asep/OrganizationalCodeOfMoralPrinciples.html
14. Boone, T. (2003). The Making of American Exercise Physiology. Professionalization of Exercise Physiology-online. Vol 6 No 1 [Online]. http://www.asep.org/asep/asep/AmericanExercisePhysiology.html
15. Boone, T. (2002). The Passionate Pursuit of Professionalism: A Critical Analysis. Professionalization of Exercise Physiology-online. Vol 3 No 10 [Online]. http://www.asep.org/asep/asep/Passionate.html
16. Bennett, J.B. (2001). Leadership, Ethics, and Philosophy. Academic Leadership: The Online Journal. [Online]. http://www.academicleadership.org/
17. Barker, J.A. (1992). Paradigms: The Business of Discovering the Future. New York, NY: HarperCollins Publishers.
18. Antonio, J. and Stout, J.R. (2001). Sports Supplements. Baltimore, Maryland: Lippincott Williams & Wilkins
19. Shils, E. (1983). The Academic Ethic. Chicago, IL: University of Chicago Press.
 
 

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