Can you imagine the Olympics but with doping allowed? In the US, this has become a reality. On May 24, 2026, the first-ever edition of the Enhanced Games started in Las Vegas. The Enhanced Games are a privately funded multi-sport event in which athletes are permitted to utilize performance-enhancing substances. However, the substances used in the Games must be legal under the rules of the US Food and Drug Administration (FDA). Athletes participating in the Games receive a sort of salary as well as substantial prize money: up to $250,000 for event winners and a $1 million bonus for breaking a world record. Professional athletes, including Olympic medallists, have joined the competition. This is the case, for instance, of the 2022 world champion British swimmer Ben Proud. In short, the main (declared) vision behind the Enhanced Games is that “[t]he idea that athletes should compete substance-free is a 20^th-century invention, not a timeless moral principle” (minute 0:53).

But should the State allow this type of event? In this post, I argue that International Human Rights Law does not necessarily prohibit such competitions. However, it requires States to monitor and, where appropriate, regulate them in light of the potential health implications for both athletes and the wider public. From a human rights perspective, the decision to permit these events should be evidence-based, subject to ongoing review and monitoring, and adopted through a transparent and participatory process. At the same time, the use of performance-enhancing drugs raises a series of philosophical, ethical, and sociological issues that call for perspectives extending beyond the law.

The Debate

The Enhanced Games have sparked considerable controversy in recent weeks. Critics argue that they pose significant risks to athletes’ health, are unfair from a sports perspective, and may encourage the use of performance-enhancing substances among future generations. It has also been noted that they constitute a large-scale marketing campaign, as their organisers and sponsors sell performance-enhancing and longevity drugs to consumers. The connections with politics have likewise attracted attention: among their investors are Donald Trump Jr, the eldest son of Donald Trump, and Peter Thiel, co-founder of Palantir Technologies and recently described as the “most influential right-wing intellectual of the last 20 years”.

Supporters, by contrast, contend that human enhancement is not a novel phenomenon. Throughout history, individuals have sought to increase their physical capacities in a variety of contexts: think of military performance, work productivity, and cosmetic surgery, to mention a few. In addition, it is argued that the Enhanced Games could facilitate safer use of substances already consumed unsafely in other sporting competitions. Finally, the Enhanced Games have been presented not merely as a sporting event but also as a scientific program that may eventually contribute to a better understanding of how to live healthier and stronger lives (minute 0:30).

Bodily Autonomy vs State Interference

States have human rights obligations in the sporting context “as in any other area of human life” (Dulitzky, p. 351). As far as doping is concerned, it is well established that States cannot impose it to increase athletes’ sporting abilities, as this would constitute a clear interference with several rights, including, potentially, freedom from torture and degrading treatment, the right to bodily integrity, and, more broadly, the right to health. Russian State-sponsored doping has been strongly criticised from this perspective. However, whether States should allow competitions that permit the use of performance-enhancing substances voluntarily taken by athletes and approved by the national drug agency is a different (and more complex) question.

The key issue raised by the Enhanced Games concerns the balance between, on the one hand, athletes’ right to bodily autonomy, conceived as the right to make decisions about one’s own body, and, on the other, the obligation of the State to protect the health of its citizens. This tension is not new. Comparable questions arise in relation to matters such as abortion, organ donation, and assisted dying. These issues involve a range of rights, including the right to privacy, the right to life, and, above all, the right to health.

What the right to bodily autonomy actually entails, and therefore the extent to which States should permit or restrict behaviours that may affect an individual’s health, is not fully determined under International Human Rights Law. Kambovski observes that the content of this right in international human rights instruments “is too fluid and leaves a number of ambiguities” (p. 41). In both the human rights literature and policy documents, this right has been framed predominantly in terms of sexual and reproductive rights, whereas no comparable development has taken place in the field of human enhancement.

International Human Rights Law, nevertheless, provides some guidance in relation to substances that may adversely affect health. States are not necessarily required to prohibit them altogether. Rather, they have a duty to regulate their consumption. In addressing alcohol, tobacco, and drugs, General Comment 14 on the right to health, adopted by the Committee on Economic, Social and Cultural Rights, affirms that States should discourage their use (para. 15) and promote information campaigns to raise awareness of their health risks (para. 36).

The Enhanced Games through the Lenses of the Right to Health

Leaving aside the (relevant) marketing and political connotations of the event for the purposes of the inquiry, one might argue that the Enhanced Games strike a reasonable balance between bodily autonomy and State interference, since the substances used in the competition must be legal under FDA rules. Drugs used by athletes during the Games include, for example, testosterone, erythropoietin, and anabolic steroids, whereas substances like heroin and cocaine are prohibited. In addition, these substances can only be taken under medical supervision, and the health of participating athletes is constantly checked.

Nonetheless, the long-term effects of the substances used in the Enhanced Games are not entirely clear. The World Anti-Doping Agency (WADA) has strongly condemned the Enhanced Games, describing them as “a dangerous and irresponsible concept” and noting that many athletes suffer long-term side effects as a result of doping. Moreover, although the substances are approved by the FDA, their use for athletic enhancement constitutes an off-label use, meaning that they are employed for an indication that has not been officially approved. For these reasons, even if the performance-enhancing drugs used are legal under domestic law, concerns relating to athletes’ right to health may still arise (p. 256).

Unsurprisingly, international documents related to doping emphasise its negative impacts on health. The 2005 UNESCO International Convention Against Doping in Sport highlights this concern in both its preamble and various articles, such as Art. 19. Similarly, the 1989 Council of Europe Anti-Doping Convention refers to “the dangers to health inherent in doping” (Art. 6). The 2021 WADA World Anti-Doping Code likewise states that “anti-doping programs seek to protect the health of Athletes” (p. 13). The UN Special Rapporteur on the Right to Health also observed that doping may have adverse health consequences for individuals (A/HRC/32/33, para. 11).

As discussed above, International Human Rights Law does not require States to prohibit by default events such as the Enhanced Games. However, given the broad consensus reflected in international legal instruments that performance-enhancing substances may have negative health consequences, States have a duty to monitor this type of event and, where necessary, regulate them.

Human Rights Principles Can Guide the Regulation of These Events

International Human Rights Law can also provide States with principles to guide the decision-making regarding the authorisation of events such as the Enhanced Games. These principles could be inferred from General Comment 14. Although they are articulated in the document in relation to the development of a national public health strategy (para. 43(f)), their relevance can be extended more broadly to decisions concerning whether to permit events that may have a significant impact on the health of participants.

According to these principles, the decision on whether to allow sports events like the Enhanced Games, and under which conditions, should:

1. Be evidence-based. States should assess whether, and to what extent, the substances permitted in the event affect the health of athletes. They should also consider potential consequences for the wider public, such as whether the event contributes to increased use of performance-enhancing substances among young people.
2. Be subject to ongoing review and monitoring. Any decision to permit the event should be periodically reassessed in light of new scientific evidence and evolving circumstances in order to determine whether different conditions might justify a different regulatory approach.
3. Be adopted through a transparent and participatory process. Relevant stakeholders, including athletes’ associations, leading international organisations in the field, and medical experts, should be involved in the decision-making process.

Conclusion

International Human Rights Law does not necessarily require States to prohibit events such as the Enhanced Games, which involve the use of substances approved by national drug agencies but prohibited by sporting governing bodies. Rather, in light of the broad consensus regarding the potential negative impact of certain substances, even when legally permitted, on athletes’ health, as well as the possible wider public health implications of such events (for instance, in terms of the “normalisation” of performance-enhancing drug use), States have a duty to monitor and potentially regulate this type of competition. The right-to-health framework provides principles that can guide decision-making on whether to allow such events, and under which conditions. Be that as it may, the Enhanced Games raise questions that extend beyond law alone. They call for a broader set of philosophical, ethical, and sociological considerations, which require close collaboration between policymakers, lawyers, and experts from these other disciplines.

I thank my friend and colleague Dr. Carlotta Manz for the exchange of views on this blog post.