When it came to light that New York Yankees pitcher Bartolo Colon had received autologous stem cell therapy from a clinic in the Dominican Republic, an important question came before Major League Baseball: should stem cell “therapies” be banned from big league ball?

Why would this therapy, as opposed to any other medical treatment, even be up for exclusion? Because the U.S-based Regenocyte, which has a clinic in the Dominican Republic, apparently has the regenerative technology to repair worn and failing shoulder and elbow tissue by injecting adult stem cells modified outside the body back into the same patients from which they were harvested. They can get players back onto the field as good as new (it would appear) in a year or less.

According to The Toronto Star, one of the doctors who assisted the procedure has been besieged by requests from other major league baseball players to receive the treatment. And because stem cells are not included (yet) on MLB’s list of banned substances, Colon’s doctors and lawyers have insisted he has violated no rules. But others are not so sure.

This is, of course, in many ways just a new variation on a well-established theme about moral issues related to enhancement and sport. These issues rear their heads every 4 years when the Olympics near and bioethicists (and others) consider anew questions of what constitutes “enhancement” of athletes. Does a swimsuit that makes makes Michael Phelps even more fish-like in the water constitute enhancement any more or less than using human growth hormone or steroids? We ask ourselves these questions time and time again, but much less frequently when it comes to our national pastime.

This debate is a little bit different through. The injection of a person’s own stem cells used for restorative purposes after an injury is not enhancement. But it certainly could be. The key to knowing whether this constitutes enhancement and/or should be a banned substance is understanding how are these stem cells modified when they are ex vivo. Are they modified to provide greater shoulder rotation or more elasticity in the tissues? Are they longer lasting than the original tissue in one’s arm or elbow? Then comes the grey zone question: what if they aren’t designed to do that, but as a bi-product in fact do result in better arms than one had before?

These are unknowns at this point, but are important questions to ask. Will MLB ban stem cells from baseball? At this point the jury is out. Should they? Absolutely not. These cells may have the potential to keep professional athletes healthier and in the game longer. Even if they are modified in certain ways ex vivo, the goal is to repair, not to make a superhuman arm. This distinction is the key, but will not be an easy line to draw. But it is important to keeping baseball as “pure” relatively as one can hope for.

Summer McGee, PhD