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1/6/2016 Something to die for: Rebutting the Mirkin & Goldman dilemma | Sports Integrity Initiative
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D O P I N G D O P I N G
S O M E T H I N G T O D I E F O R :
R E B U T T I N G T H E M I R K I N &
G O L D M A N D I L E M M A
When news about the Russian doping scandal broke in 2015, it hit headlines everywhere. Organisations directly
involved – such as like the World Anti Doping Agency (WADA), the International Olympic Committee (IOC) and
the International Association of Athletics Federations (IAAF) – felt action was immediately needed, as did a
number of governments around the world. Consequently, in January 2016, the Chief Executive Of cer of UK
Anti-Doping, Nicole Sapstead, was called upon as witness in a parliamentary inquiry that emerged from the
IAAF blood les expose[1]. When answering a question on why she did not think criminalising doping would
have the necessary deterrent effect, she said:
“There was one study where a group of athletes or sportspeople were asked, ‘This is a magic pill and, if you
take this magic pill, it will assure you that you can win your competition event. You will be top of the game,
would you take it?’ Startling, over 50% said of course they would take it. You then overlay that with, ‘If we
then told you that in five years’ time, as a consequence of taking that magic pill, you would die would you still
take it?’ You would expect the response rate to drop significantly but, no, it didn’t. So I could equally argue
that a criminal charge, death—if you are prepared to dope I wonder if either of those two are something that
you would consider.”
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In emphasising the extraordinary mind-set athletes are equipped with and the challenges this may cause for
educators and legislators, Sapstead subscribes to an idea about drug use and elite sport that has been circulated
in academia and journalism for decades. Not only have many people heard that athletes are willing to die for a
medal, the idea is so powerful that – as evidenced by Sapstead’s use of it – it may in uence legislation in the
area. This exceptionalism of the athlete psyche, we are told, is one of the most important reasons why it is so
dif cult to combat doping.
A t h l e t e s w i l l d i e f o r a m e d a lLet us put one thing straight: Athletes are willing to put their health at risk for sporting achievements. That
proposition can be con rmed by a number of sports such as boxing, cycling, American football and downhill
skiing, just to name a few. In that regard, sport is a place where people can risk their health and get intense
experiences in return. The will to take risks, however, is not an expression of carelessness towards the body.
Athletes depend on their body to perform, so they take care of it every day. The fact that athletes dope in order
to be competitive does not counter this. It is worth remembering that most drugs used for performance
enhancement in sport are medicines invented to help sick
people get healthy. Not the opposite. Few athletes who make
a living from their sport would consume substances with no
considerations at all. They might have a careless attitude to
diet supplements, vitamins and maybe also painkillers
(Roderick, Waddington, & Parker, 2000), but when it comes to
more potent drugs or actual doping substances or methods, they will re ect on the consequences of what they
are doing. So, one cannot extrapolate from the fact that
athletes take risks to a proposition saying that they are willing
to take years off of their life swallowing a lethal substance just
to win, set a record, or have a chance at a professional
contract. They are not willing to die for a medal, as it is often
claimed. How then, did this become accepted wisdom?
T h e M i r k i n s u r v e yWhen discussing educational campaigns’ lack of ability to convince athletes to stay clear of drugs, scholars and
anti-doping of cials have for many years sought to explain this by reference to the well-known ‘fact’ that the
wish to win Olympic gold – in some cases – eliminates all rational considerations. In line with Sapstead, as
evidence they often refer to a nearly forty-year-old survey that has reached almost mythological status. This
was, for instance, what sociologist Ivan Waddington did in his review of doping in British sport. Waddington
points to the naiveté he thinks dominated when an of cial report on the problem of doping argued that if only
athletes had suf cient knowledge on the side effects of drugs, they would refrain from taking them. He
emphasises the report’s lack of awareness of the power of athletic ambition, and states:
Mirkin’s study is indeed the classic evidence on athletes’ carelessness. However, a number of basic facts about
the study remain unknown: How exactly was it undertaken? How many runners were surveyed? Who were
they? What was the response-rate? What was the exact question they were asked? Were the answers
distributed as ‘Yes’ and ‘No’ or was it a Likert-type scale? To the best of my knowledge, no sources that make a
thorough account of the study exist. It is nevertheless often repeated as fact. When browsing through the
literature referring to the survey, it is surprising to see how some present Mirkin’s question in one way, others
slightly differently. However, none reproduced the original question directly or offered a reference to the
source. Instead, scholars typically refer to one of two other works. The rst – which Waddington for instance
cites – is an article by the American sports historian Terry Todd. Todd mentions Mirkin’s survey, paraphrases his
question and reports the result in a similar manner to Waddington above (Todd, 1987). However, the source
Todd thereafter cites is not Mirkin, but an article on the subject in the San Diego Union newspaper from
1982[2]. That article has itself no references to the source of the information. The other work typically referred
to is the American sport physician Bob Goldman’s book Death in the Locker Room from 1984. Goldman also
mentions Mirkin’s survey, but again without any speci c reference to it. He makes it known, though, that Mirkin
is the (co)author of ‘the famous’ Sports Medicine Book (Goldman, Bush, & Klatz, 1984). To my knowledge, this
book is the closest one can get to the original source. However, it is interesting to note that in his book, Mirkin
only mentions his survey in passing. In the chapter on drugs, he lets us know that:
He thereafter states that: ‘To my amazement, more than half of the athletes responding stated that they would
take my magic pill’ (Mirkin & Hoffman, 1978, p. 84). That is all! No further references or other details. Mirkin
indicates that not all of the ‘more than hundred top runners’ responded to the question. But how many actually
‘Nor did they [the authors of the report] refer to Mirkin’s study of over a hundred competitive runners, more
than half of whom indicated that they would take a “magic pill” that guaranteed them an Olympic gold medal,
even if it would kill them within a year’. (Waddington, 2005, p. 482; Waddington & Smith, 2009, p. 111).
‘A few years ago I polled more than a hundred top runners and posed this question: “If I could give you a pill
that would make you an Olympic Champion – and also kill you in a year – would [you] take it?”’
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did respond remains unknown.
Nevertheless, the result’s shocking implications for our understanding of drugs, sport and athletes’
extraordinary psychological constitution has apparently been suf cient for many scholars to think that it
needed to be passed on. However, the unclear status of the source and the lack of precise data have made
authors add and subtract on the content as they have seen t. Thus, in one of the main works on doping in sport
written in the 1980s, Foul Play, the British scientists Tom Donohoe and Neil Johnson open their chapter on the
future of sport in this way:
Four things are worth pointing out. First, in this account of the survey it is no longer top runners, but ‘American
top athletes’ in general who took the survey. Second, now the drug the athletes were asked to consider was not
described as something that would kill them, but merely as something that could kill them. Third, there is an
apparent clari cation in that it was almost ‘55 per cent of the sample’ who answered in the af rmative. And
nally, it is surprising to learn that Donohoe and Johnson does not reference Mirkin, Todd nor Goldman as their
source of the information, but a completely unspeci ed ‘Northern Ireland Institute of Coaching article’
(Donohoe & Johnson, 1986, p. 175).
When looking through texts forwarding the Mirkin study’s result, it is usually stated that around half of athletes
are willing to exchange their life for a medal. However, the American journalist Will Carroll made a different
claim. In his 2005 book on drugs in American baseball, The Juice, I found the most extreme example on narrating
the survey. His book opens promising with a foreword saying how important it is to get rid of myths and hearsay,
because ‘the intellectual sloppiness rampant in most steroid screeds […] is in many ways far more dangerous
than the steroids themselves’ (Carroll, 2005, p. X). But later, when referencing the Mirkin study in his discussion
of athletes’ fanatical desire for glory, he lets us know that: ‘Astonishingly, more than 90 percent of those polled
said they would take the substance’ (Carroll, 2005, p. 231)[3].
Given this background – the uncertainty of the actual design, content and results of the study, but also the lack
of reliable references – it seems reasonable to suggest that Mirkin never actually performed a ‘poll’ of ‘more
than hundred top runners’ – at least not in the way researchers typically use this term. Instead, his poll was
more like the casual poll one might pass on to colleagues at a meeting to ascertain whether the new walls should
be painted white or grey. So, a more accurate explanation is that Mirkin did in fact pose his question to the
runners, but he did not do so as part of a genuine scienti c survey, following basic methodological guidelines.
For this reason, he only mentions the response in passing in his book, but did not describe or publish it as an
independent piece of research. To the extent that ‘a survey’ was actually carried out, Mirkin perhaps informally
queried the athletes he worked with as part of his profession as a sport physician without ever intending the
results to be anything more serious. As he gradually collected the answers, he may have written them down or
simply just relied on his memory. Later, he used this as a striking, albeit slightly misleading, introduction to his
chapter on performance enhancing drugs to illustrate how dangerous a temptation doping is. Such approach is
in line with the defensive attitude to doping in the 1970s, where the actual physiological effects of the drugs
were often deliberately downplayed as part of an educational strategy trying to convince athletes that drugs
were of no use. In keeping with this, after having presented his shocking nding in his book, Mirkin emphasises
that ‘[t]he psychological dependence on drugs is the main reason they are used today’ (Mirkin & Hoffman, 1978,
p. 84).
T h e G o l d m a n D i l e m m aMaybe because he could not validate the source, or simply wished to nd out whether it was only runners that
were so fanatic, a few years later Bob Goldman conducted his own survey. It is that survey which has been
famously known as the ‘Goldman Dilemma’. Goldman states that his survey – except for replacing runners with
track & eld and power athletes – mirrors that of Mirkin. He goes on to give a few more details than his
predecessor does. He thus posed the following question to 198 so-called ‘world class athletes’:
Over many years of intensive training, athletes know how their bodies adopt to their discipline, therefore to win
‘In a survey conducted by Dr. Gabe Mirkin, over a hundred top American athletes were asked if they were
given the option of taking a drug which would make them an Olympic champion but which could kill them
within a year, would they take it? Almost 55 per cent of the sample said they would take the drug (Donohoe &
Johnson, 1986, p. 125 emphasis in original)’.
‘If I had a magic drug that was so fantastic that if you took it once you would win every competition you
would enter, from the Olympic decathlon to Mr Universe, for the next five years, but it had one minor
drawback – it would kill you five years after you took it – would you still take the drug?’ (Goldman et al.,
1984, p. 32).To this question, also more than fifty percent – 103 athletes (52 percent) – apparently replied in
the affirmative. Against this background Goldman thinks, and many has followed him, that the claim about
athletes’ extreme willingness to take risks when Olympic gold is at stake is justified. However, as the
Canadians Rob Beamish and Ian Ritchie rightly point out, Goldman’s question is even more absurd than
Mirkin’s (Beamish & Ritchie, 2005). The premise is too fantastic and too unrealistic to be taken seriously[4].
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‘every competition you would enter’ is simply comic book nonsense. This absurdity in Goldman’s question may
also be the reason why many scholars, when referring to the
accepted wisdom of athletes’ carelessness, chose to paraphrase
Mirkin’s question but combine it with Goldman’s results. That is, they
rely on Mirkin’s premise to promote Goldman’s conclusion.
Just for those reasons, it is highly doubtful whether the athletes
would have provided the same answer if the inquirer had had the pill
in his hand, and they had to swallow it on the spot if they answered
‘yes’. Goldman is actually aware that the athletes might have reacted
differently if such a pill actually existed. However, immediately after
mentioning this precaution, he chose to disregard his own logic and
states that: ‘Perhaps this argument is correct, but the evidence
suggests otherwise’ (Goldman et al., 1984, p. 32). However, Goldman
does not provide any evidence.
As noted above, the point here is not to deny that athletes are willing to make big sacri ces in orer to ful l their
ambitions, but simply to stress that, despite this, there are limits to how far they are willing to go. It was
therefore praiseworthy when a group of doping scholars decided to re-test Goldman’s ndings and said
something along the lines of: ‘Okay, let’s see if we can replicate Mirkin’s and Goldman’s results, but in surveys
and with questions operating under a proper methodological design’.
The result was not surprising: ‘Only 2 out of 212 samples reported
that they would take the Faustian bargain offered by the original
Goldman dilemma’ (Connor, Woolf, & Mazanov, 2013). Connor and
colleagues found this even if the question they posed was not as
unrealistic as Goldman’s was – it was not ‘every competition’, but
‘only’ ‘an Olympic Gold Medal’ the respondents could win. Thus,
among present day elite athletes, less than one percent would
apparently be ready to take the substance. Moreover, their attitude
mirrors that of the general population: When a representative
sample was asked the same question, also less than one percent
accepted the bargain (Connor & Mazanov, 2009). So, even if the
desire to win is an essential element in elite athletes’ psychology,
they are not equipped with an extraordinary psyche that makes them willing to die for a medal[5].
However, the results from the Mirkin survey and Goldman dilemma are still repeated and used as evidence
pertaining to the extraordinary athletic mind-set, as we saw in the recent government inquiry featuring Nicole
Sapstead, CEO of UKAD. For three reasons this repetition is, if not deadly, then at least unhealthy for sport.
First, it undermines the trustworthiness of those of cials, academics and journalists forwarding the nonsense.
Second, on false premises it risks in uencing legislation, rules, regulations and educational campaigns; for
instance by introducing excessive monitoring of athletes through anti-doping, as they cannot be trusted to
manage their own drug use. Third, it reproduces two other of today’s major prejudices about drugs and sport.
One is that the premise of the question (‘it would kill you’), contributes to the misperception that doping drugs
are deadly[6]. The other, that the result (‘more than half…’) portrays athletes as sports idiots in the most literal
sense of the word.
As the past decade’s revelations in sports such as athletics, cycling, and baseball have clearly demonstrated,
there certainly are enough issues to tackle when it comes to the use of drugs in sport. We should focus on these
instead of wasting energy battling unsubstantiated myths that draw our resources and attention in the wrong
direction. Let’s get real!
F o o t n o t e s[1] See more at e.g. (The Sunday Times, 2015).
[2] ‘High Risk Gamble to Obtain Winning Edge’, San Diego Union, 13 July 1982.
[3] Carroll also makes up his own formulation for the question asked. In his version of the Mirkin study, it was
young athletes that were polled, and their suicidal tendencies were not only exposed if Olympic gold were at
stake, but also if they could win a national championship. ‘The desire for glory is exempli ed in a survey that
asked young athletes if they would take a drug that would guarantee them an Olympic gold medal or national
championship, even if they knew the substance would cause them to die within ve years. Astonishingly, more
than 90 percent of those polled said they would take the substance’ (Carroll, 2005, p. 231).
[4] As point of departure for their criticism of Goldman’s study, Beamish and Ritchie also mentions Mirkin’s
survey. But even they have no reference to the source. They restrict themselves to reference Goldman.
[5] To be fair, as the point of departure for their study, Connor, Woolf and Mazanov do not really question the
validity of Goldman’s survey. They accept its ndings as valid, but wants to see whether the result can be
reproduced 30 years later. When nding that it cannot, the authors offer a number of explanations on the
observed difference. The most important being a signi cant difference in legality and acceptance of drugs in
sport when comparing the early 1980s with the 2000s. Between the two studies, WADA entered the stage and
the national and international sport bodies’ position on doping and the athletes’ attitude to drugs changed
dramatically. Hence, according to the authors, the difference in result is not a consequence of the design of the
1/6/2016 Something to die for: Rebutting the Mirkin & Goldman dilemma | Sports Integrity Initiative
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Ask Vest Christiansen is an Associate Professor at the Department of Public
Health - Sport Science at Aarhus University, Denmark. He is also a manager of
the International Network of Humanistic Doping Research and has written a
number of research pieces on anti-doping (click here
-->
respective studies, as I argue, but simply re ects changing attitudes over time (Connor et al., 2013).
[6] As pointed out above, most doping drugs are medicines developed to help sick people get well. In fact, very
few, if any, elite athletes have died from doping. Even the fatality of a known doper does not reliably give us
causality. Millions of elite and non-elite athletes have survived years of doping.
R e f e r e n c e s• Beamish, R., & Ritchie, I. (2005). From Fixed Capacities to Performance-Enhancement: The Paradigm Shift in
Science of ‘Training’ and the Use of Performance-Enhancing Substances. Sport in History, 25(3), 412-433.
• Carroll, W. (2005). The Juice: The real story of baseball’s drug problems. Chicago: Ivan R. Dee.
• Christiansen, A. V., & Møller, V. (2007). Mål, medicin og moral: om eliteatleters opfattelse af sport, doping og
fairplay (Ambitions, drugs and morality: On elite athletes’ attitudes to sport, doping and fair play). Odense:
University Press of Southern Denmark.
• Connor, J. M., & Mazanov, J. (2009). Would you dope? A general population test of the Goldman dilemma. Br J
Sports Med, 43(11), 871-872. doi:10.1136/bjsm.2009.057596
• Connor, J. M., Woolf, J., & Mazanov, J. (2013). Would they dope? Revisiting the Goldman dilemma. Br J Sports
Med, 47(11), 697-700. doi:10.1136/bjsports-2012-091826
• Donohoe, T., & Johnson, N. (1986). Foul Play: Drug Abuse in Sports (Reprinted ed.). Oxford, New York: Basil
Blackwell.
• Goldman, B., Bush, P. J., & Klatz, R. (1984). Death in the locker room: Steroids & sports. London: Century
Publishing.
• Mirkin, G., & Hoffman, M. (1978). The Sports Medicine Book. Boston: Little, Brown and Company.
• Roderick, M., Waddington, I., & Parker, G. (2000). Playing Hurt: Managing Injuries in English Professional
Football. International Review for the Sociology of Sport, 35(2), 165-180. doi:10.1177/101269000035002003
• The Sunday Times. (2015). The Doping Scandal. Retrieved from
http://features.thesundaytimes.co.uk/web/public/2015/the-doping-scandal/index.html#/
• Todd, T. (1987). Anabolic steroids: The gremlins of sport. J.Sport Hist, 14(1), 87-107.
• UK Culture Media and Sport Committee. (2016). Oral evidence: Blood Doping in Athletics, HC 430, Tuesday
26 January 2016.
http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/culture-media-and-
sport-committee/blood-doping-in-athletics/oral/28038.html.
• Waddington, I. (2005). Changing patterns of drug use in British sport from the 1960s. Sport in History, 25(3),
472-496.
• Waddington, I., & Smith, A. (2009). An introduction to drugs in sport: Addicted to winning? (2. ed. ed.).
Abingdon: Routledge.
• This text is rewritten and expanded version of a section appearing in the Danish language book by
Christiansen & Møller, 2007, pp. 127-130.
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