From http://bioethics.georgetown.edu/pcbe/reports/beyondtherapy/chapter3.html
The central question becomes: Which biomedical interventions for the sake of superior performance are consistent with (even favorable to) our full flourishing as human beings, including our flourishing as active, self-aware, self-directed agents? And, conversely, when is the alienation of biological process from active experience dehumanizing, compromising the lived humanity of our efforts and thus making our superior performance in some way false—not simply our own, not fully human? Better nutrition seems an obvious good, a way of improving our bodily functioning that serves human flourishing without compromising the “personal” nature or individual agency of what we do with our healthy, well-nourished bodies. But moving outward from there, the puzzle gets more complicated. Where in the progression of possible biological interventions do we lose in our humanity or identity more than we gain in our “performance”? Is there a way to distinguish coffee and caffeine pills to keep us awake from Modafinil to enable us to avoid sleep entirely for several days, from amphetamines to keep us more alert and focused, from human growth hormone, steroids, and EPO to improve strength and endurance, from genetic modifications that make such biological interventions more direct and more lasting? All of them alter our bodily workings; all of them to varying degrees separate self-directed experience from underlying biology.
Does that mean that we are incapable of distinguishing among them, humanly and ethically? Can our disquiet about pharmacological and genetic enhancement withstand rational scrutiny? More deeply, what does the prospect of such interventions tell us about the nature of human activity and the meaning of human identity? These are perhaps the deepest questions for the ethical analysis that follows. But to see why this is so, we must first consider some more familiar sources of ethical disquiet.
Modafinil can be detected in urine tests.