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In the past the TUE system was abused in cycling, but all the available evidence suggests that is no longer the case. If you don't have such a system in place then you get into the ridiculous situation where riders are unable to compete because they can't take a medicine that will treat eminently treatable ailments, i.e. like with Vaughters' wasp sting in, I think, the 1999 Tour.
If 'it's within the rules' is the new 'never tested positive,' then we might as well give up on the idea of clean sport.