Be Fruitful and Multiply (but check with the league office first)

The issues are always interesting at the intersection of Bioethics and Sports Law. Robert Mathis, one of the top linebackers in the NFL, recently received a four game suspension for testing positive for the drug Clomiphene, better known by its trade name Clomid.

The drug is on the NFL’s banned substance list because it increases testosterone, an anabolic steroid naturally produced by the human body. But is it a performance-enhancing drug? Only if the performance being considered is that oldest of human physical endeavors: making babies.

Clomiphene is actually a selective estrogen receptor modulator or SERM. It is by far the most widely prescribed fertility drug for women and is also prescribed off-label for men. The theory is that if you lower the body’s production of estrogen you increase the production of testosterone and sperm counts rise.

The Indianapolis Colt and his wife already had three children but they wanted a fourth grandchild for Mathis’s mother when she was diagnosed with stage 4 cancer. The couple sought the assistance of Atlanta fertility doctor Steven Morgenstern, who prescribed the Clomid for Mathis to increase the probability of early conception. As soon as Ms. Mathis became pregnant, her husband went off the drug. But a random NFL drug test detected the presence of Clomiphene which stays in the body for some time after discontinuation.

In a written statement the NFL coldly explained: "A cornerstone of the program is that a player is responsible for what is in his body. Consistent application of the policy's procedures is critical to the integrity of the program."

One question is whether intent should play a part in the NFL’s enforcement of its rules. Should it matter if Mathis’s only intention was to “perform” better off the field not on it? The league says players should check with them before taking any substance prescribed by a physician. Indeed, the NFL rules provide for a Therapeutic Use Exception or TUE, but a player must first apply with his physician for the right to take a banned substance for therapeutic reasons. Mathis says he never thought whether a fertility drug could be on the banned list and the doctor says he, too, never made the connection.

In what job, however, does anyone have to share such personal and private matters with his employers? The decision to have a child under difficult circumstances should remain a personal matter even for NFL linebackers and, when it comes to such life decisions, the NFL should stay on the sidelines.