The World Medical Association, as the global representative of the medical profession, urges its 71 national member associations to join WMA in taking a leading role to discuss the problem of doping, publicize information about the dangers involved and assist in uncovering and prohibiting such misuse.

Recent events have brought out how great a problem doping in sport has become and how systematically it is being used in the professional sports world. A significant abuse in this area also occurs on the amateur sports level and, unfortunately, often with even more dangerous drugs.

Therefore, the profession must rally to oppose doping and censure any colleagues who involve themselves in doping whether for the sake of their own profit or for the misunderstood intention of helping the athletes involved. No physician can have any doubt about the fact that involvement in doping is unethical.

A number of declarations and laws have clearly expressed this. The medical oath itself has a basic ethical rule that medical knowledge can only be used for the benefit of society and human beings. The Declaration of Geneva also makes this clear: "My patient's health will always be my first consideration."

The primary problem for the medical profession is the involvement in the use of doping in the elite sport branches. A physician who participates in such abuse is conducting himself in an unethical and, in some cases, criminal manner. The argument that if physicians did not so involve them-selves, the athletes' health would be placed in even greater danger is a spurious and unacceptable argument. It is nothing less than a poor alibi which any physician involving himself provides to sports promoters for the abuse taking place.

Physicians must help sports promoters by providing information, especially to the young, about the clear risks to their health on both the short and long-term with the abuse of such substances. Physicians and professional associations should also support those sports physicians who are performing good and honorable work and who in no way wish to be heaped together with physicians who might be participating in doping practices.

The World Medical Association has been aware of the problem of doping for the past twenty years when it first began to appear. In 1981, the WMA adopted a Declaration entitled Principles of Health Care for Sports Medicine which was then revised and expanded in 1987 and 1993. The Declaration is not only focused on doping, but on the ethical principles of sports medicine as a whole. The paragraph which particularly refers to the problem of doping is paragraph 4.

Clearly, the problem is not solved by declarations alone. It is also quite possible that physicians who might be involved in this in some countries are not even members of their national medical associations. Thus, there is also need for other measures.

There is no doubt, however, that it is a medical task to inform about the dangers involved in doping and to be alert to the possibility that patients with whom physicians come in contact could be on their way to a substance abuse problem in this respect. No doubt there is also a need for some legal initiatives -- including limiting access to such substances. However, it will be of no help to do so if these substances are easily available in other countries, even to the point of over the counter sale in pharmacies. Therefore, international action is called for to introduce restrictions.

The WMA will continue to keep this topic under close scrutiny and review.