EPO and the "Goldman Dilemma"

There's an interesting article in the New York Times that reviews recent findings on the use of moderate doses of Darbepoetin Alfa (one of the "EPO" class of drugs) to treat diabetes, kidney disease and anemia.

Will Olympic Athletes Dope if They Know It Might Kill Them?

The findings indicate strongly that even in amounts previously considered fairly safe, the drug was associated with higher risk of death and was little better than a placebo in terms of improving patient outcomes. To quote the article:

"Going in, we had really expected that Epo would make people feel better and improve their outcomes," says the study’s lead author Dr. Marc Pfeffer, a professor at Harvard University Medical School and senior physician at Brigham and Women’s Hospital in Boston. "We certainly had to reject that hypothesis."

The article goes on to talk about the "popularity" of EPO as an illegal performance-enhancing drug that is still in widespread use by endurance athletes seeking an illegal edge. Towards the end of the article it cites surveys done by a researcher named Bob Goldman, who began in the 1980s to ask elite athletes whether they would take a drug that guaranteed them a gold medal but would also kill them within five years. To his surprise, more than half of the athletes said yes. When he repeated the survey biannually for the next decade, the results were always the same. About half of the athletes were quite ready to take the bargain.

When asked the same question, almost all non-athletes turn down this Faustian bargain.