They still make the choice and all these guys are smart enough to know what they are doing. I do agree that the culture must change.
However, I guess i am optimistic, I feel like that change is already happening and doing so on a big scale. Personally, I really think what garmin has done to be a giant step in the right direction. In order to do that you have to have buy in from the managers, doctors and promoters. Columbia has also taken some steps in the anti doping fight within their organization. These are the two big, established but still up and coming american teams. Being that I think the change is occurring and from the top down, I don't see this point as an issue.