ABSTRACT
The therapeutic use exemption (TUE) process is an important but controversial aspect of anti-doping policy. Athletes’ medical conditions may in some cases require treatment involving substances or methods on the World Anti-Doping Agency’s Prohibited List (PL). A TUE may be granted where certain criteria are fulfilled, and the relevant anti-doping authorities deem this a medical necessity that will not compromise the integrity of sporting competition. We discuss, first, a number of foundational questions regarding the implementation of TUEs and challenges to the existence of the policy itself. We go on to defend a TUE policy with minimal modifications in terms of fairness and justice, but with a more transparent and detailed rationale. Second, we critically evaluate recent policy discourse regarding its openness to exploitation of the policy and how this might be reduced. We reject calls for complete transparency on the grounds of the privacy of athletes’ healthcare data and support an approach to anti-doping policy that is more attentive to the needs and indeed autonomy of individual athletes.
