When enhanced games outpace public health and ethics. Commentary.

The enhanced games, a new sports event scheduled to take place in the United States in the spring of 2026, propose a competition model in which the use of performance-enhancing drugs (PEDs) is openly permitted and encouraged. This initiative represents a radical departure from long-established sporting norms and is strongly criticised by major international institutions, due to its potential public health consequences and ethical implications. PEDs use poses significant risks, ranging from severe physical damage to long-term mental health effects. The enhanced games risk normalising these substances, particularly among vulnerable populations such as youth, who are highly influenced by elite athletes and media narratives. This commentary examines the conceptual frameworks underpinning sport, performance enhancement, and doping as well as the main issues that may arise in relation to these games. Particular emphasis is placed on the possible implications for public health, from both an ethical and a health perspective.