Being labeled a cheater depends on the rules. No one in professional body building cheats because they use steroids or HGH. Those are acceptable methods to achieve the desired ends of body building. If pro sport X limited the number of hours you could train in a day/week/month, than simply exceeding that number would be “cheating.” Gladwell used the example of pitchers replacing a tendon in their elbow after their original (or natural) one wore out. Nobody sees this as cheating, yet this is entirely unnatural. He also cites an anecdote from the book he’s reviewing, “The Sports Gene,” about a Finnish XC skier whose blood carries something like 1.6 times the red blood of an average athlete. He has, by birth, not training, an enormous cardiovascular advantage over normal athletes. He didn’t work for this capacity. He didn’t earn it. He was simply born with it. So what’s the problem with that sport’s governing body saying “okay, the highest natural levels of, say, hematocrit are X, so the hematocrit level of any athlete may not be higher than 1.2X”? Why not level the playing field? Hamilton makes what I think is the most interesting point about doping that I’ve ever heard. He points out that doping rewards work ethic, not natural advantages of other athletes. Wouldn’t most people agree that how hard you work should count for at least as much as what genetic advantages you were born with? Furthermore, their entertainment value notwithstanding, professional sports are almost entirely inconsequential. They don’t actually affect what really matters in life (access to food, rule of law, political, legal or economic systems, family, love, etc…). Since they are inconsequential, and there is no agreed upon “spirit of sport,” professional associations should focus less on the stigma of performance enhancing drugs and decide what set of rules they should enforce. Professional cycling has proven entirely unable to prevent the use of EPO, yet they still quixotically attempt to ban it. The only people this hurts is those who aren’t doping. As I mentioned above, the UCI should simply set an upper hematocrit bound based on what is healthy, then stick to that. Sure it won’t solve all cheating problems within the support, but it will take the wind out of the sails of a major source of cheating (simply by bringing it into the fold of what’s allowed).

Oh man, this post really had me thinking for the past few days… I’m not sure I’ve come to any conclusions, but here are some of my thoughts:
Do genetic advantages make sports unfair? Possibly, but so might socioeconomic advantages. A kid born in Bangladesh, working their family farm, doesn’t have access to the same training opportunities, facilities, etc. that a middle-class American kid in ten different after-school sports programs does.
In some ways, I can see how genetic advantages make sports unfair. If you’re a 5’2″ adult, you have a significant genetic disadvantage when you decide you want to be the best basketball player of all time. The person who has a hard time building up muscle also has a genetic disadvantage here. The difference between the two? Performance enhancing drugs may help the skinny, but they really aren’t going to do much for the short guy. So, while performance enhancing drugs have leveled the playing field for the skinny guy (and allowed him to compete based on his work ethic, etc.), it has only widened the gap for the short guy.
Also, for most team sports, performance isn’t solely about your own body’s physical abilities. Winning a football game involves strategy, teamwork, and mental prowess. The quarterback who has great “intuition” and stealthy “decision making skills”? They might be just the person you need for your team. You could have the best arm in the world and still not win every game, especially if it takes you 20 seconds to evaluate the position of your receivers down field. Here, the genetic ability to think quickly comes into play. I feel like in many team sports, the variety of genetic abilities of the team athletes can complement each other, instead of making the sport completely unfair.
Finally, there has been a lot of focus recently on sporting organizations and their responsibility in keeping their players safe. Take the NFL concussion settlement, for instance. The players became concerned that the sideline doctors were more concerned with pleasing the team owners and coaches (who, lets be honest, want to make money) rather than the players’ well being, and in turn would send them back out onto the field right away, even though they had serious injuries. Would completely accepting performance enhancing drugs into sports cause doctors and coaches to pressure athletes to take more than was necessarily good for them (just for the $$ value of winning)? I don’t know how many performance enhancing drugs have health risks and/or negative side effects, but this might be something to think about too. Don’t know much about this though.
Overall, I agree that genetic advantages make sports unfair, but I’m not sure it’s an issue that performance enhancing drugs can actually help. For the short person wanting to play basketball or the quarterback who doesn’t have quick mental evaluation skills, this may only serve to widen the playing field (no pun intended). It may work for certain things, like bodybuilding, because of the nature of the competition, but I’m not certain that a blanket acceptance of performance enhancing drugs is the best thing for sport in general.