SAMA joins furore over Semenya


Colleta Dewa

Johannesburg - The South African Medical Association (SAMA) has denounced the proposed rule changes by the International Association of Athletics Federations (IAAF) to impose an upper hormonal limit for athletes wishing to compete in the female category in international athletics competitions.

The proposed rule by IAAF is mainly targeting South Africa’s champion athlete Caster Semenya who has engaged in a legal battle with the IAAF over the issue.

According to Dr Angelique Coetzee, the SAMA chairperson, the proposed rule is unethical and invasive.

“We deem the requirement for hormonal manipulation in these athletes unethical and invasive. It runs in stark contrast to the entrenched principle of athletes competing in their natural state. Such rules are in our view excessive and would constitute a systematic affront to the dignity of all female athletes,” said Dr Coetzee.

Dr Coetzee added that in the interest of medical ethics, the medical profession is compelled to denounce any policies in sport, or any other fields, which are not compatible with the basic human rights principles of individual choice, confidentiality, consent, dignity, non-discrimination, and equity.

“The IAAF and other international sporting bodies should not be allowed to violate these core principles. Any medical decisions and interventions should be based on evidence from well-designed and well-conducted research. We are concerned that the arguments by the IAAF for regulating testosterone levels in such athletes are most likely based on a single, flawed study.

“SAMA urges medical scientists and doctors involved in the IAAF’s medical procedures and tests to pay due regard to scientific rigour, evidence-based practice and medical ethics. Until sound scientific evidence is generated, SAMA dismisses such flawed arguments,” added Dr Coetzee.

She also emphasised that the World Medical Association’s (WMA) Declaration of Geneva and its International Code of Medical Ethics require doctors to maintain the highest standards of professional conduct, not to allow their judgment to be influenced by unfair discrimination, to act in the patient’s best interest, and to do no harm.

“The WMA Statement on Principles of Health Care for Sports Medicine requires that physicians oppose or refuse to administer any such means or method which are not in accordance with medical ethics, and/or might be harmful to the athlete using it, especially procedures which artificially modify blood constituents or biochemistry, among others.

“Artificially lowering endogenous testosterone in athletes has to be considered unethical. In addition, doctors prescribing treatment of this nature for a condition that is not recognised as pathology will be in violation of medical ethics.”

She also indicated that that medical manipulation in sport is being implemented disproportionally.

“It is baffling that natural advantages in sport are being critiqued for athletics, but not for other sports. Basketball, high jump, and goal-keeping in soccer are examples where acromegaly, a condition responsible for excessive tallness would confer a clear advantage,” she said.

Dr Coetzee said issues of economic and social injustices can never be ignored when such decisions are made, adding that better resourced people or societies have more opportunities or exposure to environments that enhance sporting prowess, such as professional training programmes.

She said when individuals from such environments compete with those from disadvantaged societies, such as in the case of Caster Semenya, the playing field is obviously not level.

Dr Coetzee also raised concern over the fact that debates on natural attributes such as body shape and genetic composition seem to arise disproportionately more often with successful athletes from low- and middle-income countries.

“It be should be an essential principle of sport that athletes must perform in their natural state; unmodified by medical interventions. SAMA has carefully followed Ms Semenya’s involvement with sex verification policies for the past few years, including her recent high-profile appeal case against the IAAF’s new rules, which were scheduled to come into effect in November 2018. Due to her appeal, these are now expected on 26 March 2019.

She added that SAMA was rallying behind Semenya who has engaged in a legal battle with the IAAF.

“We support Ms Semenya in this legal battle and look forward to a successful outcome for her. We urge the IAAF to reconsider their stance on this issue and to rely on better and more extensive research emanating from the world’s greater medical community,” Dr Coetzee added.

Last week, South African Members of Parliament from across the political spectrum put their differences aside in all-round condemnation of the IAAF's bid to force Semenya to take substances to lower her testosterone levels.

SA’s Minister of Sport, Tokozile Xasa, recently led a high-powered delegation to the Court of Arbitration for Sport in Switzerland in a government-led mission to oppose the IAAF's proposed regulation to limit testosterone levels of the female athlete.

The court is expected to deliver its judgment on the matter towards end of March.








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