There is little data in India on the use of performance enhancing drugs in sports. But personal and incidental information shows that their use is far more extensive than is believed. This use occurs beyond the arena of high-level competitive sports. Even if the guidelines of the national and world anti-doping agencies were to become effective, they would not impact the larger environment where such drug use appears to be extensive. Which ethical guidelines advise the sports medical practitioner in prescribing medicines and training regimes for the athlete? Of particular concern is the role of paediatricians since training for sports or physical fitness is increasingly a youth phenomenon. The following is a discussion note, prompted by personal and anecdotal experience.