Enhanced Games have not established harm-reduction achievement

A perspective article published in the Harm Reduction Journal examines the governance conditions required for enhancement-permissive sport to function as a credible harm reduction strategy. The study, authored by Libin Zhang and Xinyou Lv, specifically evaluates the Enhanced Games, a commercial sporting event that publicly permits the use of performance-enhancing substances. This approach directly challenges traditional prohibition-centred anti-doping regimes. The authors argue that the central issue is not simply whether enhancement should be allowed, but rather under what specific governance structures a commercialised model can be considered a legitimate form of harm reduction.

The proponents of the Enhanced Games invoke several key principles to justify their model. They cite transparency, medical supervision, scientific rigor, and athlete autonomy as primary arguments. The core claim is that open and supervised enhancement is less harmful than clandestine, unsupervised use. However, the article distinguishes between the potential for harm reduction and the actual achievement of harm reduction outcomes. The authors note that permission, organiser-reported transparency measures, and structured medical contact may support harm-reduction potential, but these factors alone do not establish that harm reduction has been achieved.

To evaluate the legitimacy of such sports, the article develops a non-compensatory legitimacy test across six distinct domains. These domains include comparative evidentiary adequacy, transparent risk and uncertainty disclosure, independent medical and ethical oversight, non-coercive and revisable consent, longitudinal monitoring and continuing care, and institutional accountability with clear commercial boundaries. The final domain is particularly critical, as it distinguishes between governable conflicts of interest and commercialised risk production. In the latter scenario, commercial actors help shape or normalise bodily risk while retaining insufficient responsibility for the outcomes.

The authors applied this six-domain test to the public record available through 15 August 2026. Their review included registry and filing materials that describe the study design, oversight arrangements, a standard-form athlete agreement, and a five-year follow-up plan. The company behind the Enhanced Games reports that the interventional phase of the study has concluded. However, a significant gap remains in the public record, as the registry posts no study results.

Several critical aspects of the Enhanced Games remain unresolved according to the review. Comparative outcomes remain unresolved. Event-wide exposure rules also remain unresolved. Additionally, the executed contract terms, continuing care provisions, and effective role separation between medical and commercial interests remain unclear.

The article emphasizes the importance of separating formal institutional documentation from organiser-reported claims and external research. It also distinguishes these from unresolved event-specific information and normative inference.

The conclusion of the perspective is that while enhancement-permissive sport may have harm-reduction potential, actual achievement requires more than just permission and basic medical contact. It demands comparative evidence and governance that is independent, transparent, non-coercive, and longitudinally accountable. When applied to the public record of the Enhanced Games, the authors find that the event is only partially evaluable. Consequently, harm-reduction achievement has not been established.

Subject of Research: Legitimacy test for enhancement-permissive sport as harm reduction

Article Title: When can enhancement-permissive sport count as harm reduction? A legitimacy test for the enhanced games

Article References: Zhang, L., & Lv, X. (2026). When can enhancement-permissive sport count as harm reduction? A legitimacy test for the enhanced games. Harm Reduction Journal. https://doi.org/10.1186/s12954-026-01548-1

Image Credits: AI Generated

DOI: 10.1186/s12954-026-01548-1

Keywords: Enhanced Games, Harm Reduction, Performance Enhancement, Sport Governance, Athlete Autonomy, Medical Oversight, Anti-Doping, Commercial Sport, Risk Disclosure, Longitudinal Monitoring, enhancement-permissive, sport