Skip to main content

01.03.2018 | Original Research Article | Ausgabe 8/2018

Sports Medicine 8/2018

Trading Health Risks for Glory: A Reformulation of the Goldman Dilemma

Sports Medicine > Ausgabe 8/2018
Juan Marcos González, F. Reed Johnson, Matthew Fedoruk, Joshua Posner, Larry Bowers



The Goldman dilemma presented athletes with a Faustian bargain that guaranteed winning an Olympic gold medal in their sport but resulted in certain death 5 years later. Athletes’ responses to Goldman’s bargain were reported from 1982 to 1995. Several studies subsequently evaluated people’s willingness to accept the bargain proposed in the Goldman question. Our study updates Goldman’s question using contingent-behavior questions, a preference-elicitation method widely applied in economics, marketing and psychology to understand people’s choice behavior. Contingent-behavior questions ask people to evaluate hypothetical tradeoffs between outcomes when real-world decisions are unobservable, nonexistent, or unreliable.


A web-enabled survey was conducted with athletes in 50 sports between June, 2012 and April, 2013. Athletes were invited by their sport governing bodies in the United States to complete the online survey. Responses from 2888 athletes were collected. Our reformulation elicited athletes’ willingness to accept a performance-enhancing drug (PED) associated with the risk of a realistic fatal event, not certain death. A double-bounded dichotomous-choice question format was used to elicit athletes’ maximum acceptable mortality risk (MAMR) for winning an Olympic gold medal. Data were analyzed using an interval regression model to estimate the implicit probability of accepting a continuous risk level. MAMR was defined as the mortality risk level with a 0.50 probability of acceptance.


Estimated mean MAMRs varied between 7 and 14% across athletes in different ranks and sports. Elite athletes were generally the most willing to accept a fatal cardiovascular risk to win a gold medal in the Olympics. This range was similar to the levels of risk that patients accept for life-changing interventions.


Results suggest that very few athletes would be expected to accept a PED in the bargain postulated by the Goldman dilemma. Risk tolerance among elite athletes suggest they may be more aware of the potential financial and nonfinancial benefits of such a win, and/or less optimistic about their potential to move up in the level of competition without the use of PEDs.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Weitere Produktempfehlungen anzeigen
Über diesen Artikel

Weitere Artikel der Ausgabe 8/2018

Sports Medicine 8/2018 Zur Ausgabe
  1. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.