I am an Indian in US. I want my kid to become a doctor but he shows undue interest in arts. Initially it was just scribbling but now it’s like IT. How do I discourage my 6 year old kid from arts, paintings, and dinosaurs?

Someone who plans ahead to such an extent may find it well worth their while to mull through to the end possible outcomes from forcing a child away from art and into a medical school without regard to the child's wish. Let's consider a few such plausible future scenarios.

Scenario 1

Whoo! Glad to be done with the day. Great to lean back and enjoy some of this fine scotch. What's that? Yet another poor report card from Sanjeev? Apparently he's been lollygagging again, even after we confiscated all his art supplies. Honestly, I just don't know what to do about this boy. I'm at my wit's end. Why can't he appreciate how fortunate he is? I too was miserable at his age. Wanted to do nothing but play with paints and brushes. Look at me now. I hunkered down, gritted my way through medical school even though I hated every minute of it. That's what it takes to be a man, make the best of a bad situation and become responsible. Would he have so many advantages without all my sacrifice? Ungrateful little sniffler. Why should he get his own way when I couldn't? He's going to have to learn to be miserable just like me and roll with the punches. If I could do it, so can he.

Scenario 2

Dead at 28. How could I have known he was so miserable? Relatives buzzing around and yet everyone's so careful to keep their distance from me. Obviously too scared to ask why. Why did he jump? Why didn't he come to me if he was so miserable? Why did I do it? Why did I push him into medical school when he was just so miserable about it? All those times of 'Dad, can I...no, nothing, it's nothing'. It was all right there in front of me, his misery but I just didn't want to see it.

Scenario 3

Look at me. I look 50+ and I'm not even 40 yet. Wife walks by, yelling at me to take my feet off the coffee table. So what's new? Nag, nag, nag, can this woman even do anything else? Why is she even my wife? Ah, yes, dad, did everything dad told me to do including marry this woman and I can't even stand her. What? Now I can't even drink in my own house? I'll do as I damn well please in my own house. It's my house, dammit, paid for with my sweat and blood. Literal blood in the hospital. Hate the sight of blood, heh, and I'm a doctor. Ah, that sure hits the spot. Best medicine to take the edge off of her infernal nagging and that miserable hospital. Hate hospitals and oh, how I hate the patients, smelly, complaining, always complaining. Why did I even become a doctor? Dad again.

Nag's back. Sister's on the phone. Apparently it's about dad. Don't know why she went to visit him in the nursing home. Says something about bed sores. Thinks they're neglecting him. What the hell do I care about his effing bed sores? They can neglect him to death as far as I'm concerned. My life's a misery and he's to blame for all of it. Depressing old tyrant, he can rot in that nursing home for all I care. Ah, the latest brochure from the Museum of ***. Have been looking forward to their fall exhibition. Let's see, mmm...

Though being a considerate parent who doesn't force their agenda onto their children is no guarantee a child wouldn't grow up resentful and uncaring anyway, the men in these scenarios seem bitter or anguished, even contemptible, with no mystery as to how they got that way.

Why choose to inflict misery? And that's what a parent does when they force their kid to become a doctor or anything else regardless of what they themselves want. Such parents should then also wholeheartedly accept the outcome however that might play itself out, whether that means their children simply learn to perpetuate that misery by foisting it onto the next hapless generation or take drastic actions to end their misery or the parents themselves are neglected in old age by their children, three all too plausible scenarios. As the saying goes, misery loves company.

https://www.quora.com/I-am-an-Indian-in-US-I-want-my-kid-to-become-a-doctor-but-he-shows-undue-interest-in-arts-Initially-it-was-just-scribbling-but-now-it%E2%80%99s-like-IT-How-do-I-discourage-my-6-year-old-kid-from-arts-paintings-and-dinosaurs/answer/Tirumalai-Kamala

There are two types of men in this world… What are they?

A renowned psychologist, Viktor Frankl - Wikipedia was the founder of Logotherapy - Wikipedia, a theory of psychology that holds that a person's primary motivation is to find meaning in life.

Frankl developed his theory during his years in a series of Nazi concentration camps. In his acclaimed memoir of this period, Man's Search for Meaning - Wikipedia, Frankl pretty much settled the question about the two types of men, two types of humans really, decent and indecent (see below from Man's Search for Meaning. Viktor E. Frankl, 1946, emphasis mine). ‘Pretty much settled’ because life experience in general seems to bear out the essential truth as Frankl perceived it, albeit most of the rest of us are much more fortunate and never experience such hellish, exigent circumstances.

Human kindness can be found in all groups, even those which as a whole it would be easy to condemn. The boundaries between groups overlapped and we must not try to simplify matters by saying that these men were angels and those were devils. Certainly, it was a considerable achievement for a guard or foreman to be kind to the prisoners in spite of all the camp's influences, and, on the other hand, the baseness of a prisoner who treated his own companions badly was exceptionally contemptible. Obviously the prisoners found the lack of character in such men especially upsetting, while they were profoundly moved by the smallest kindness received from any of the guards. I remember how one day a foreman secretly gave me a piece of bread which I knew he must have saved from his breakfast ration. It was far more than the small piece of bread which moved me to tears at that time. It was the human "something" which this man also gave to me - the word and look which accompanied the gift.

From all this we may learn that there are two races of men in this world, but only these two - the "race" of the decent man and the "race" of the indecent man. Both are found everywhere; they penetrate into all groups of society. No group consists entirely of decent or indecent people.

https://www.quora.com/There-are-two-types-of-men-in-this-world-What-are-they/answer/Tirumalai-Kamala

How true is it that according to Ray Kurzweil, we are reaching a point where sickness & disease are all conquerable?

Are we 'reaching a point where sickness and disease are all conquerable’, apparently according to a 2005 book? A notion grounded in reality or one that exists in the fantasy landscape inhabited by those in positions of enormous wealth and influence? I'm particularly stuck by the yawning, obscene contrast between the techno-utopia implied by this question and manifest reality. Some absurd propositions just beg to be introduced violently to the reality on planet Earth.

The example of Remote Area Medical - Wikipedia (RAM) helps puncture the brazenly clueless notion that human sickness and disease are anywhere close to being 'conquered'. Started by Stan Brock (philanthropist) - Wikipedia in 1985, RAM provides a variety of healthcare services to needy people in remote parts of the world.

Needy people in remote parts. Maybe people in earthquake-hit parts of so-called Third World countries like Haiti? Rather, the bulk of RAM's services are provided in the US. Not remote parts of the US mind unless somehow places like Inglewood, CA, Seattle, WA, Knoxville and Memphis, both in TN, and Las Vegas, NV, (see examples below) are remote in which case the word's patently become meaningless.

So, in the year 2017, affordable healthcare is still so much out of reach for so many millions in the US that thousands of Americans wait for hours, even overnight, to get really free medical, dental and vision care at huge RAM clinics organized in enormous stadiums to accommodate the huge numbers in need (see below from remote area medical Archives - Insurance Thought Leadership and The Atlantic, Olga Khazan, January 22, 2015. Life in the Sickest Town in America).

If so many people in arguably the most powerful and wealthiest country in the world, in fact its sole current superpower, can't even access basic healthcare, how likely is it that we are even remotely close to a time when sickness and disease are all conquerable?

To conquer sickness and disease, shouldn't their diagnosis be a given in any and all circumstance in the first place, and if even that's not guaranteed in the US of all places, what chances it's universally available and affordable elsewhere? And of course, these are times when guarantee of life itself doesn't even exist in conflict-ridden places like Syria, Iraq, Democratic Republic of Congo and so many other places, a time when unprecedented numbers of people have recently joined the ranks of refugees. Let's park this techno-utopia where it truly belongs, in the realm of fantasy...unless we accept as reality the future depicted by sci-fi movies like Elysium (film) - Wikipedia.

Sources for further reading:

The Atlantic, Olga Khazan, January 22, 2015. Life in the Sickest Town in America

The Guardian, Amy Woolard, November 23, 2016. The enormous pop-up clinic trying to bridge America’s health divide | Amy Woolard

The Guardian, Jessika Bohon, June 12, 2017. Rural Appalachia is facing a healthcare crisis. I fear it's going to get much worse | Jessika Bohon

Ray Kurzweil, 2005. The Singularity Is Near - Wikipedia

https://www.quora.com/How-true-is-it-that-according-to-Ray-Kurzweil-we-are-reaching-a-point-where-sickness-disease-are-all-conquerable/answer/Tirumalai-Kamala

What are some examples of “intentional” bad design?

Termed 'defensive' or Hostile architecture - Wikipedia, a cornucopia of 'intentional' unpleasant design abounds all around us, especially in affluent urban centers. Examples of unpleasant design (see below from 1, 2, 3, 4, 5, 6) conspicuously shape public spaces to placate haves at the expense of have-nots, i.e., their aim ‘isn’t to achieve something good, like a safety goal’, but rather to keep certain people out.

Crudely executed ones such as the London Spikes (7) puncture the carefully constructed facade of how we engender consensus around the idea of what's publicly acceptable, which usually entails some form of hostility to the homeless.

Predictably of short duration, such outcries are responses to how public space is shaped, not about why it's being done in the first place. They also deflect attention from the core issue of how complicity is inherent to public consensus, how public policy usually assuages the wants of the haves at the expense of the needs of the have-nots.

Plenty more global examples of defensive architecture by Nils Norman - Wikipedia on his web-site (6).

Bibliography

1. Slate, Kristin Hohenadel, June 12, 2014. Are Anti-Homeless Sidewalk Spikes Immoral?

2. Guardian, Ben Quinn, June 13, 2014. Anti-homeless spikes are part of a wider phenomenon of 'hostile architecture'

3. Fagstein, June 13, 2014. “Homeless spikes” are gone — but what about Montreal’s other homeless deterrents?

4. The Atlantic, Robert Rosenberger, June 19, 2014. How Cities Use Design to Drive Homeless People Away

5. Guardian, Alex Andreou, February 18, 2015. Defensive architecture: keeping poverty unseen and deflecting our guilt

6. Archives | Dismal Garden

7. Petty, James. International Journal for Crime, Justice, and Social Democracy 5.1 (2016): 67-81. The London Spikes Controversy: Homelessness, Urban Securitisation and the Question of ‘Hostile Architecture’

https://www.quora.com/What-are-some-examples-of-%E2%80%9Cintentional%E2%80%9D-bad-design/answer/Tirumalai-Kamala

Can we genetically modify animals to procure organs for humans?

Why the need to use animal organs for human transplants? Is there even such a need? No, rather it's a technological solution proposed for an urgent but non-scientific supply and demand problem, namely, shortage of organs. More people die on waiting lists than receive transplants. This fait accompli is apparently all that's necessary to breathe life into the need for Xenotransplantation - Wikipedia, i.e., animal organ transplant into humans. However, accepting this fait accompli at face value is not only dangerous but also quite disingenuous for the following reasons.

Why Xenotransplantation Isn't An Appropriate Response To The Organ Crisis: It Doesn't Address The Underlying Issue

Transplant waiting lists keep growing. Not too few donors. Rather too many potential recipients. While donations and transplants remain steady, numbers waiting for transplants grow year-on-year (1) in developed countries. Scenario is palpably ghastlier in poorer countries, where forget transplants, even dialysis is usually beyond reach for many organ failure patients.

Why is the need for transplants increasing though? This is typically swept under the carpet as increasing morbidity rates. But why are morbidity rates increasing in the first place, especially in developed countries? Somehow this, the very crux of the matter, gets short shrift in both the biomedical literature and popular media.

~80% of those on waiting lists need kidneys due to ESRD (end-stage renal disease, Chronic kidney disease - Wikipedia). Increasing numbers of organ failure patients have ESLD (end-stage liver disease) (2). Most common predisposing factors are alcoholic liver cirrhosis (3), diabetes (4) and obesity (5). Clearly lifestyle issues drive need for more transplants. That is not to imply all transplants are for lifestyle-mediated chronic diseases but rather that much of the annual increase is driven by such preventable increases in morbidity.

Bad diets and sedentary lifestyles are apparently impossible to change as are the underlying socioeconomic structure and accompanying culture that increasingly make these the norm the world over. In other words, preventable, consumption-driven practices that predispose to transplant-requiring chronic health conditions have been allowed to seed and settle into society, no questions asked. Let's state the obvious. Where's the profit in prevention? Changing the culture, especially diet and lifestyle, is hard work, and even less appetizing for those habituated to feeding on the profits to be made from chronic diseases.

Thus, once such preventable diseases have taken root, capital intensive high-tech solutions to treat them including even xenotransplants become all the rage. Few mention that the organ crisis is nothing new, having existed since at least the 1980s (6). Evidently a case of the tail wagging the dog, the prevailing hegemony is thus to hardly ever allude in the first place to why need for organs is increasing and how to reduce it but rather to bemoan the organ crisis and contrive ever more creative and ethically challenging ways to increase the organ pool.

These creative though ethically challenging solutions started with expanding the definition of appropriate transplant sources. Originally, only deceased donations were allowed. Then definition of death expanded to include the legal fiction of two types of death, circulatory death (traditionally used) and brain death (7) so organs could be harvested from more bodies. Obviously brain death 'decriminalizes the harvesting of beating hearts' (8). Then donations from the living got the nod. Any surprise organ trafficking and global black market in organs followed suit (9), especially among the multitude too poor to feed themselves or their children (10, 11, 12)? After all their bodies are all they can offer the market.

Some European countries such as Greece and Spain have even taken the creative urge to extremes, embracing the currently fashionable Nudge theory - Wikipedia by introducing opt-out consent (13), where people are automatically presumed to have given consent to post-death organ donations unless they specifically take the trouble to opt-out while they're still alive. Supposed rationale is we humans are well-intentioned but lazy. Well-intentioned as in of course, we intend to choose to donate our organs after death but somehow we're too lazy to ever get around to giving the necessary legal heft, i.e., consent, to our good intentions.

And of course, desperation increasingly permeates the medico-legal culture which now explores using even infected (14) and mismatched kidney transplants (15). Meantime, the ongoing US drug overdose epidemic provides a ghastly book-end to the organ crisis by increasing organ availability (16).

Why Xenotransplantation Isn't A Solution To The Organ Crisis: Immunological Rejection & Infectious Disease Risk

And so we arrive at xenotransplantations, a path to unlimited supply of donors and their organs at least in theory. After all, what other purpose for this planet and its various denizens but to serve the human's needs. Unfortunately for the human, in this instance biology has turned out to be a more intractable partner.

• Immunological rejection remains a vexing issue decades into the project with little sign of improvement (17) but that's not the only concern.
• SARS (Severe acute respiratory syndrome - Wikipedia) in 2003, Bird flu (Influenza A virus subtype H5N1 - Wikipedia) in 2007, Swine flu (2009 flu pandemic - Wikipedia) in 2009, MERS (Middle East respiratory syndrome - Wikipedia) in 2012, Ebola virus disease - Wikipedia in 2014 and Zika fever - Wikipedia in 2015, these are major infectious disease outbreaks since just the mid-2000s, many of them Zoonosis - Wikipedia, jumps from animals to humans. Obviously then known and even as yet undiscovered viruses being transmitted from the animal donors to organ recipients remains an ever-present danger (18). Yes, a high-powered group led by Harvard geneticist George Church used CRISPR-cas9 (CRISPR - Wikipedia) to delete potentially harmful DNA sequences at 62 sites in pig cells (19) but that was just a preliminary proof of principle study. Do we really need to concoct yet another path for more pathogens to jump species and thrive in humans, which may well turn out to be the risk with Xenotransplantation?

In other words, technocracy encourages solutionism rather than trying to understand the fundamental crux of the problem, which in this case is spiraling rates of lifestyle-driven chronic diseases. Reducing them would automatically reduce the need for transplants in the first place (see below from 20, emphasis mine).

'Medical strategies to prevent end-stage organ failure

The prevention or delay of end-stage organ failure must be accomplished to reduce the need for organ transplantation and to achieve national self-sufficiency. This approach is especially relevant to low-income countries, where resources can be better used for other pressing medical needs. Thus, education programmes about organ donation for the public and the media should also address the maintenance of a healthy lifestyle. Early detection and prevention of diseases leading to end stage organ failure, such as diabetes, cardiovascular disease, and kidney disease, is necessary.'

Bibliography

1. Organ Procurement and Transplantation Network

2. Williams, Roger, et al. "Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis." The Lancet 384.9958 (2014): 1953-1997.

3. Williams, Roger, et al. "Implementation of the Lancet Standing Commission on Liver Disease in the UK." The Lancet 386.10008 (2015): 2098-2111. https://www.researchgate.net/pro...

4. Wild, Sarah H., et al. "Type 2 diabetes and risk of hospital admission or death for chronic liver diseases." Journal of hepatology 64.6 (2016): 1358-1364.

5. Williams, Bronwen, Michelle Clayton, and Joanne Bosanquet. "Obesity: a growing threat to liver health." Gastrointestinal Nursing 13.Sup10 (2015): S16-S19.

6. Miller, Melanie. "A proposed solution to the present organ donation crisis based on a hard look at the past." Circulation 75.1 (1987): 20-28. http://circ.ahajournals.org/cont...

7. Truog, Robert D., and Franklin G. Miller. "Changing the conversation about brain death." The American Journal of Bioethics 14.8 (2014): 9-14.

8. Epstein, Miran. "Constructing the Legal Concept of Death: The Counterhegemonic Option." The American Journal of Bioethics 14.8 (2014): 45-47.

9. Scroll, Sanjay Nagral, August 3, 2016. Better buy than die? The unfortunate enduring saga of organ sales in India

10. Epstein, Miran. "The ethics of poverty and the poverty of ethics: the case of Palestinian prisoners in Israel seeking to sell their kidneys in order to feed their children." Journal of medical ethics 33.8 (2007): 473-474. https://www.researchgate.net/pro...

11. Budiani‐Saberi, Debra A., and Francis L. Delmonico. "Organ trafficking and transplant tourism: a commentary on the global realities." American Journal of Transplantation 8.5 (2008): 925-929. https://www.researchgate.net/pro...

12. Danovitch, Gabriel M., et al. "Organ trafficking and transplant tourism: The role of global professional ethical standards—The 2008 Declaration of Istanbul." Transplantation 95.11 (2013): 1306-1312. https://www.researchgate.net/pro...

13. The Economist, Nov 20, 2008. Opting out of opting out

14. Stat, Elie Dolgin, March 18, 2016. Surgeons to test use of infected kidneys for transplants

15. Orandi, Babak J., et al. "Survival benefit with kidney transplants from HLA-incompatible live donors." New England Journal of Medicine 374.10 (2016): 940-950. http://www.nejm.org/doi/pdf/10.1...

16. The Guardian, Amanda Holpuch, May 1, 2016. Drug overdose epidemic has driven increase in organ donors, data shows

17. Tirumalai Kamala's answer to Is xenotransplantation remotely possible?

18. Tirumalai Kamala's answer to What would happen to humans if they were affected by endogenous retroviruses as a result of xenotransplantation?

19. Yang, Luhan, et al. "Genome-wide inactivation of porcine endogenous retroviruses (PERVs)." Science 350.6264 (2015): 1101-1104. http://arep.med.harvard.edu/pdf/...

20. Delmonico, Francis L., et al. "A call for government accountability to achieve national self-sufficiency in organ donation and transplantation." The Lancet 378.9800 (2011): 1414-1418. http://www.who.int/transplantati...

https://www.quora.com/Can-we-genetically-modify-animals-to-procure-organs-for-humans/answer/Tirumalai-Kamala

Does occasional use of anticholinergic drugs such as Benadryl have serious neurological risks?

It's important to keep in mind the following issues about the recent epidemiological study (1, 2) that examined the connection between cumulative anticholinergic drug use and incident dementia when considering the extent to which its results are generalizable.

• Though interesting, these results need to be confirmed by other independent studies on larger numbers of patients.
• This study was restricted to patients 65 years and older.
• Authors studied cumulative, not occasional, exposure to Anticholinergic drugs. As defined in this study, cumulative anticholinergic exposure was defined 'as the total standardized daily doses (TSDDs) dispensed in the past 10 years' (1, emphasis mine), is quite different from occasional use, which is presumably not daily use.
• The Anticholinergic drug Benadryl is a 1st generation Antihistamine, containing Diphenhydramine, a Histamine H1 receptor antagonist. In the case of diphenhydramine, the daily dose criterion used in this study was 50mg.
• Authors studied whether long-term cumulative intake of all sorts of combinations of antihistamines, antidepressants, antivertigo, antiparkinson, antipsychotics, bladder antimuscarinics, skeletal muscle relaxants, gastrointestinal antispasmodics and antiarrythmics predisposed those 65 years or older to incident dementia, i.e., newly diagnosed dementia. They did not study outcome of prolonged Benadryl intake alone.
• There is currently little biological basis in the scientific literature for linking cumulative anticholinergic use to outcomes like Alzheimer's disease. Even the authors of this study could make a plausible case only for people with Parkinson's disease, i.e., for people with pre-existing brain damage.

This answer therefore discusses the particulars of the question as asked, that is the effects of occasional, i.e., not daily, use of the anticholinergic Benadryl.

'Serious neurological risks' of occasional Benadryl use consist of strong albeit temporary dose-dependent effects on the central nervous system. It can sedate as well as profoundly impair psychomotor function, i.e., tasks, such as driving an automobile, that require both concentration as well as fine motor skills.

Antihistamines are typically used to treat allergy symptoms, specifically those associated with allergic rhinitis such as runny nose, sneezing, itching. A common symptom of allergic reactions, excess histamine is the consequence of Mast cell degranulation caused by their binding to complexes of Allergen bound to Immunoglobulin E, i.e., antigen-antibody complexes (see figure below from 3). When taken during allergy episodes, antihistamines bind histamine receptors, thereby preventing mast cell-derived histamine from doing so. This in turn prevents the full expression of allergy symptoms such as runny nose, sneezing and itching. So far so good.

Problem is action of 1st generation and even some 2nd generation antihistamines isn't limited to just inhibiting the excess histamine that's secreted when large numbers of mast cells degranulate during an allergy episode.

With its own source of histamine, the brain also widely expresses histamine receptors. The tuberomamillary nucleus, a cluster of neurons in the posterior hypothalamus, synthesizes histamine, and these neurons project into various regions of the brain as part of the histaminergic nervous system, and all four types of histamine receptors are abundantly expressed in the brain in distinct patterns (see figures below from 4, 5).

Since most 1st generation and even some 2nd generation antihistamines penetrate the Blood–brain barrier, they can have profound effects on brain function including Anticholinergic effects, sedation and effects on psychomotor function.

Temporary impairment of driving skills is a prominent example of diphenhydramine's effect on the brain. In 2004, the US National Highway Traffic Safety Administration reviewed antihistamine effect on driving-related skills by examining a total of 130 scientific papers published on the subject until 1998 (6). Among other findings, it concluded (6, emphasis mine),

'There is overwhelming evidence from the experimental literature that the 1st-generation antihistamines produce objective signs of skills performance impairment as well as subjective symptoms of sedation'

Obviously, 1st generation antihistamines include diphenhydramine, the one in Benadryl (see figures below from 6).

Bibliography

1. Gray, Shelly L., et al. "Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study." JAMA internal medicine 175.3 (2015): 401-407. https://www.researchgate.net/pro...

2. Harvard Health Publications, Beverly Merz, January 18, 2015. Common anticholinergic drugs like Benadryl linked to increased dementia risk - Harvard Health Blog

3. NIAID Researchers Identify Potential Drug Target for Allergies

4. Thurmond, Robin L., Erwin W. Gelfand, and Paul J. Dunford. "The role of histamine H1 and H4 receptors in allergic inflammation: the search for new antihistamines." Nature Reviews Drug Discovery 7.1 (2008): 41-53.

5. Haas, Helmut, and Pertti Panula. "The role of histamine and the tuberomamillary nucleus in the nervous system." Nature Reviews Neuroscience 4.2 (2003): 121-130.

6. Moskowitz, Herbert, and Candace Jeavons Wilkinson. Antihistamines and driving-related behavior: A review of the evidence for impairment. No. HS-809 714,. 2004. http://ntl.bts.gov/lib/26000/260...

https://www.quora.com/Does-occasional-use-of-anticholinergic-drugs-such-as-Benadryl-have-serious-neurological-risks/answer/Tirumalai-Kamala

If the Olympic Committee wanted to allow performance enhancing drugs, which would be the best ones to allow?

If the Olympic Committee allowed performance enhancing drugs (PEDs), problem is not knowing which ones would work best since they're developed to be safe and effective in the sick while drug use in sports is done by the healthy.

Since drugs aren't tested for their effectiveness in the healthy and since doping is illegal in sports, athlete drug use is entirely underground where drugs tested in a therapeutic context for treating diseases get surreptitiously co-opted for performance enhancement by the sports industrial complex of doctors, coaches, support staff and most importantly athletes who empirically test these drugs on themselves.

Growth hormone - Wikipedia (HGH) is a case in point. Developed to treat childhood growth disorders such as Prader–Willi syndrome - Wikipedia, athletes started using it to enhance their performance thinking if HGH increases muscle mass and reduces fatigue in the ill, it should do likewise in healthy athletes. Problem is HGH is known to benefit those who under-produce it. Could it do the same in those who produce normal levels of it? Data on HGH given to the healthy is limited to small studies in the elderly (1) which only suggest adverse events outweigh limited benefits, i.e., they're unhelpful, and yet HGH use among athletes soars (2, 3, 4). Some athletes may even naturally over-produce HGH, which may be why they turned out to be good in sports in the first place.

What if supplemental HGH was just flushed out of those who produce normal or extra levels of it? A waste. And what if it produced toxicity in those who produce normal or extra levels of it? A tragedy. Since PEDs haven't been tested for their safety and effectiveness in healthy bodies, athletes taking them are playing Russian roulette with their health.

As with society's failed war on drugs, attitude to PEDs in sports is also driven by a counter-productive, moralistic crackdown even as more and more athletes use them, 'a losing battle not against any particular substance, but rather human nature' as a recent article put it (5). In recent years, high-profile individuals like former US Track & Field CEO Doug Logan - Wikipedia have come out publicly against PED prohibition (5).

Destigmatizing PEDs would encourage thorough scientific tests of their safety and efficacy in athletes. No more Russian roulette, no more unnecessary and avoidable risk. One such, funded by Dallas Mavericks' owner, Mark Cuban - Wikipedia, is an FDA-approved two-year US $800,000 exploratory study of HGH at the University of Michigan to examine whether it helps recover from anterior cruciate ligament surgery (6).

Only a cultural change could bring PED use in sports out of the shadows. After all thorough scientific tests are necessary to identify which ones are optimal for athletes. More such studies would maybe help change the culture of drug use in sports from an illegal, underground, widely prevalent but heavily risk-laden endeavor to an open but regulated and therefore safer practice.

Bibliography

1. Liu, Hau, et al. "Systematic review: the safety and efficacy of growth hormone in the healthy elderly." Annals of Internal Medicine 146.2 (2007): 104-115. http://citeseerx.ist.psu.edu/vie...

2. HGH: Performance enhancer or healer? ESPN, Tom Farrey, Sep 5, 2006. HGH: Performance enhancer or healer?

3. The case for HGH, ESPN, Tom Farrey, Jan 17, 2007. The case for HGH

4. Analysis: Pharmaceutical firms cash in on HGH abuse. USA Today, David B. Caruso, Jeff Donn, December 31, 2012. Analysis: Pharmaceutical firms cash in on HGH abuse

5. The Drugs won: The case for ending the sports war on doping. Vice Sports, Patrick Hruby, August 1, 2016. The Drugs Won: The Case for Ending the Sports War on Doping | VICE Sports

6. A study might change the way sports thinks about human growth hormone. ESPN, Bonnie D. Ford, Dec 4, 2015. A study might change the way sports thinks about human growth hormone

https://www.quora.com/If-the-Olympic-Committee-wanted-to-allow-performance-enhancing-drugs-which-would-be-the-best-ones-to-allow/answer/Tirumalai-Kamala