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2. Some supporters of enhancement technologies even argue that it is not only morally permissible to use enhancement technologies to make people more healthy, longer-lived and smarter, but that we are morally obliged to do so (e.g., Harris J. Enhancing Evolution: The Ethical Case for Making Better People. Princeton: Oxford University Press; 2010; or Savulescu J. Genetic interventions and the ethics of enhancement of human. In: Steinbock B, ed. The Oxford Handbook of Bioethics. Oxford: Oxford University Press; 2007:516–35.). It is beyond the scope of this commentary to discuss this issue and take a position on it.

3. Mehlman, MJ. Cognition-enhancing drugs. The Milbank Quarterly 2004;82(3):483–506, at 492.CrossRefGoogle ScholarPubMed

4. See note 3, Mehlman 2011, at 127.

5. Garasic MD, Lavazza A. Moral and social reasons to acknowledge the use of cognitive enhancers in competitive-selective contexts. BMC Medical Ethics, 2016; available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4812634/# (last accessed 19 Jan 2017).

6. Ms. P. mentions piracetam. If we imagine that the authors of the vignette have the United States context in mind, this is additionally troublesome.