This two-part feature series on bioethics explores the benefits and possible ethical implications of DNA testing and biometric tracking of professional athletes. This article discusses genetic testing, part 2 will look at wearable devices.
In late March, Zeke Upshaw collapsed on court with 40 seconds remaining in the Grand Rapids Drive’s season-finale, playoff-clinching G League basketball game. The 26-year-old player died two days later in a hospital in Grand Rapids, Mich., his grieving mother at his side. An autopsy later identified cardiac arrest as the cause of death, likely triggered by an abnormally large heart.
According to doctors, abnormalities such as these aren’t all that uncommon among elite athletes, and so begs the question: Could knowledge of Upshaw’s condition, derived from sophisticated technologies, have saved his life?
Many athletes have died from injuries sustained on-field over the years. Some of those have been caused by blunt force impacts in what is often considered a cost of playing professional sports. Deaths from cardiac failure are typically different, especially because some athletes have pre-existing conditions that put them at greater danger. A March 2017 report published by the Mayo Clinic called cardiac arrest the “leading cause of death in young athletes,” a standout group in what otherwise tends to affect older, less healthy adults. In these cases of sudden death in younger people, modern-day technologies could serve to better inform athletes and staff, and help trainers reduce risk.
Proponents of tracking technologies and DNA testing tout such benefits as improved athletic ability and reduced risk of injury. In the case of Upshaw and other young athletes with unknown heart abnormalities, tracking and DNA testing might actually save lives. As with all technology, however, sensors and genetic tests are double-edged swords. The benefits for leagues and team owners might outweigh the benefits for the majority of athletes. Technology companies and the teams and leagues that support their creations often tout the Orwellian positives of their innovations while sidestepping the potential bioethical implications for the very humans whose careers and data are at stake.
“I don’t think the players quite understand that these wearables can be used by the owners in a manner that’s not in the best interest of a particular player,” said Alan Milstein, a sports and bioethics lawyer who serves as chairman of the litigation department at the firm Sherman Silverstein.
Milstein has litigated for such sports figures as the Houston Rockets’ All-Star Carmelo Anthony, former Ohio State Buckeyes running back Maurice Clarett, and former NBA players including Allen Iverson, an All-Star who spent most of his career with the Philadelphia 76ers, and Eddy Curry, a center with stints on the Chicago Bulls, New York Knicks, Miami Heat, and Dallas Mavericks.
Curry’s case is a prime example of DNA testing seemingly being used against the best interests of a player. After the 2004/05 NBA season, Curry fell into a contentious negotiation with the Bulls. The Chicago center had missed the final 13 games of the regular season and the Bulls short playoff run after experiencing an irregular heartbeat and collapsing on court. Chicago insisted that Curry take a DNA test to determine whether he was predisposed to a fatal heart condition. Curry refused, claiming the request was a gross violation of privacy. The case was ultimately dropped when he was handed off to the Knicks during the offseason. Curry would go on to play 212 games over the next three years for New York, and played his last NBA game in 2012.
The fear, Milstein said, is that athletes would be forced to compromise on privacy to the detriment of their images, and possibly even their careers if such data were to be collected and wielded by the owners. At the end of the day, owners are in the money-making business: constantly hunting for ways to hire the best talent with the smallest potential impact to their bottom lines.
Requiring athletes to take DNA tests is banned under today’s collective bargaining agreements. But Milstein said he could see how something like that could eventually be worked into CBAs if athletes were won over with incentives. Perhaps regular gene testing in exchange for higher salaries.
Genetic testing in athletics has a checkered past. While today the technology is being touted as a way to help athletes reach heightened levels of potential, DNA tests have historically been used in less virtuous ways.
In 1986, for example, Spanish hurdler Maria José Martínez-Patiño was forced to endure a genetic test that revealed she carried the Y (male) chromosome. The test identified her as genetically male, even though she was physiologically female due to a condition called androgen insensitivity syndrome. Though Martínez-Patiño was unaware she had AIS, and had always identified as a woman, she was publicly shamed. She was accused of cheating, and stripped of her national title and athletic scholarship. Her running times were also erased from Spain’s athletics records.
Looking beyond cases like that of Curry and Martínez-Patiño, though, DNA testing can promise numerous benefits. A host of direct-to-consumer DNA testing companies have emerged in recent years that teach people all about their ancestry and predispositions to certain life-threatening conditions—most notably Ancestry.com and 23andMe. Many of those companies, including Athletic Genetix, market to consumers the potential health and wellness benefits of such testing. With Athletic Genetix, a swab of spit yields a detailed report about a person’s genes and how the types of exercises they do and food they consume might affect performance, recovery and weight loss.
For consumers, that information seems at worst harmless right now, and at best might produce positive health outcomes. But those health results have no real effect on most people’s careers. In contrast, professional athletes’ livelihoods are based directly on physical output and their ability to perform high-strain activities at optimal levels for an extended period of time.
In 2016, the Australian Institute of Sport, the high performance sports agency responsible for training Australian Olympians and Paralympians, published a position statement in the British Journal of Sports Medicine in which it claimed that there are currently “no scientific grounds for the use of genetic testing for athletic performance improvement, sport selection or talent identification.” The AIS discouraged athletes and coaches from using direct-to-consumer genetic tests, citing a lack of “validation and replicability” and the lack of involvement of a medical practitioner.
The AIS does, however, support genetic research that aims to enhance the understanding of athlete susceptibility to injury or illness. Such genetic research, it said, should only be conducted after “careful consideration of a range of ethical concerns,” and with “adequate informed consent.”
Would preventive DNA testing have saved the life of Zeke Upshaw? Maybe, maybe not. But the knowledge it gives us is almost certain to become a bigger part of the sports world in the years to come. And athletes of the future will have to weigh how such DNA tests might also impact (and potentially negatively affect) their professional careers.