Sports organizations' principles prohibiting performance-enhancing drugs without medical need create complexity in defining 'medical need' and fairness.

“what's they probably put out some underlying principle said probably said you cannot take a drug that enhances performance unless you have a medical need I don't know if they've said that but if they have then then it could get really tricky because now you say well who defines the medical need what about you know now is it fair if we take the person who's just below the threshold for needing it who says I don't get to take the drug but the person who's just above the threshold who does you have then also this idea of a fairness”