Abstract
Is it possible for the “natural” athlete who competes without chemical assistance to achieve record-breaking performances in sports requiring strength, power, speed, or endurance? Because doping tests are infrequently positive in international sports, it has been widely believed that the answer is yes — and that few athletes competing in major sporting events, including the Olympic Games and the Tour de France, use performance-enhancing drugs. But multiple sources of evidence, including personal testimony1,2 and an ever-increasing incidence of doping scandals, suggest the opposite: that widespread use of performance-enhancing drugs has fundamentally distorted the upper range of human athletic performance. . . .

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