A related BMJ article includes a quote from the president of the European College of Neuropsychopharmacology, in which he raises the ethical issues and asks how a drug that improves human performance in the absence of pre-existing cognitive impairment should be classified, condoned or condemned. He adds that “modafinil is not licensed for this use, and it will not be because it would be outside the current terms of reference of regulatory bodies. The non-medical use of mind altering drugs has hitherto broadly conflicted with the work ethic of many societies [and] has been very popular but leads to a range of demonstrable harms.”