Why prohibit study drugs?: On attitudes and practices concerning prohibition and coercion to use pharmaceutical cognitive enhancement

This article combines methodologies and explorations from the fields of anthropology and applied ethics in order to examine the ethical assumptions underlying the illegal status of pharmaceutical cognitive enhancers (PCEs) such as Adderall and other prescription stimulants often used to improve concentration, motivation, and alertness. We begin by presenting empirical data from ethnographic fieldwork conducted among university students, professors, and police officers in New York City. The data show that the students are not concerned with the illegality of PCEs, and while some students experience pressures related to performing well, they do not feel pressured into using PCEs. The empirical material furthermore reveals that the practices of the authorities in relation to PCE use are relaxed and do not always reflect the law. We then present a detailed ethical analysis of a certain type of argument in favor of the prohibition of PCEs, which has received little careful analysis in the bioethical literature. Our analysis, drawing on the philosopher Robert Nozick's specification of coercion and the sociologist N. A. Fitz's understanding of social pressure, shows that legalization of PCEs would not necessarily involve or bring about direct coercion; nor would it bring about morally problematic forms of coercion or social pressure. While the article shows that prohibition might not make a difference to uses of pharmaceuticals for enhancement, it also questions whether the gray zones between practices of the authorities and the actual law might in some ways be understood as coercive.