By Michael Schrage

A top executive I know recently decided to take Inderal before making high-pressure/high-anxiety presentations. The impact was immediate. She felt more relaxed, confident and effective. Her people agreed.

Would she encourage a comparably anxious subordinate to take the drug? No. But if that employee’s anxiety really undermined his or her effectiveness, she’d share her story and make them aware of the Inderal option. She certainly wouldn’t disapprove of an employee seeking prescription help to become more productive.

No one in America thinks twice anymore if a colleague takes Prozac. (Roughly 10% of workers in Europe and the U.K. use antidepressants, as well). Caffeine has clearly become the (legal) stimulant of business choice and Starbucks its most profitable global pusher (two shots of espresso, please).

Increasingly, prescription ADHD drugs like Adderall, dedicated to improving attention deficits, are finding their way into gray market use by students looking for a cognitive edge. When one looks at existing and in-the-pipeline drugs for Alzheimer’s and other neurophysiological therapies for aging OECD populations with retirements delayed, the odds are that far more employees are going to be taking more drugs to get more work done better.

Performance-enhancing (or degraded performance-delaying) drugs will become as common as that revitalizing cup of afternoon coffee.

Should that be encouraged? Or should management pretend those options don’t exist?

Most managers would believe they’re doing a good thing if they encouraged a hard-of-hearing employee to explore a hearing aid or a visually-impaired colleague to consider glasses. By contrast, encouraging an under-performing subordinate to lose 25 pounds, get a hair transplant or contact-lenses would likely inspire a formal complaint to Human Resources and/or a possible lawsuit. Ironically, the money isn’t the issue here; the business norms associated with perceived cosmetic and aesthetic concerns are radically different from those attached to job performance and productivity.

Putting aside the sporting world for the moment, the legal and political reality is that it’s (currently) neither a crime nor an ethical violation to pop a pill (or wear a patch) that helps you become less anxious, more alert, more energetic, more focused and/or more productive. Just as importantly, in a difficult economic environment, companies want their employees to be less anxious, more alert, more focused and more productive. Workers lacking those qualities may be first in line for that unfortunate round of layoffs.

Indeed, is it ethical to discourage or ignore an option that might help an employee be more productive and keep his or her job? Or is it unethical to encourage employees to seriously consider the pharmaceutical enhancement? Presumably, a manager couldn’t fire an employee for refusing to take a pill any more than they could sack a hearing-impaired employee who declined to wear a hearing aid. But if — or when — “job performance” and “performance enhancement” become inextricably intertwined, what then?

My own view: Depending on employment laws, employees shouldn’t be hired, fired or retained based on their willingness to use medically-approved performance-enhancing drugs. But companies should be allowed to create internal awareness about safe and legal performance-enhancing drugs as a workplace option. There should be neither stigma nor stimulus to their use.

Thus, the politics are as provocative as the ethics: In America, for example, employers are being required to provide “free” contraceptives as part of health care reform. But if a country is concerned about global competitiveness and economic growth, why shouldn’t health care coverage extend to safe and effective performance-enhancing drugs? The more governments become involved in health care, the more seriously they must consider the workplace productivity implications of their programs and policies. As people grow older, distinctions between “health care” and “performance enhancement” blur into semantic mush.

The aging workforces of a France and Germany don’t just need to avoid illness, they need to improve productivity. What a challenging public policy conundrum. Will Chinese or Russian or Indian bosses encourage their employees to take performance enhancing drugs? What an intriguing global context for economic competition.

Michael Schrage is a research fellow at MIT Sloan School’s Center for Digital Business. He is the author of Serious Play and the forthcoming Getting Beyond Ideas. This post first appeared at the Harvard Business Review Blog.