Case in Point: Off-label performance enhancement The big idea: How does a manager make a promotion decision after learning that the preferred candidate is using an off-label, performance-enhancing medication? The scenario: A senior vice president, "Mark," in an investment firm must decide which of his two best employees to promote to the position of managing vice president. The vice president had initially preferred "Jeff" over "Donald," but that decision had become far from clear-cut when Mark learned, after inadvertently overhearing an office conversation, that Jeff was taking a medication off-label: Adderall, a stimulant primarily prescribed for people who have attention-deficit hyperactivity disorder. Jeff did not have ADHD. As Mark pondered the situation, questions arose: How should he deal with this? Whom should he promote? Was it fair to Donald - or any of the other high-performing employees at the firm - to promote someone who illicitly used a substance not medically required in order to boost his performance? What is "true" performance, and what are the boundaries? How much would Jeff's work suffer if for some reason his surreptitiously obtained Adderall prescription was cut off? What are the implications for Evergreen's other employees? Mark realized that he needed to consider a variety of ethical and strategic issues in making his decision and that one way to highlight those issues was to consider "parallel" cases. Is this like a professional cyclist using human growth hormone, or is it more like someone simply doing yoga or starting the day with a cup of coffee? In addition, he needed to consider the potential impact of this personnel decision: How would the promotion of Donald or Jeff benefit the firm? Would either promotion increase the firm's vulnerability? The resolution: Mark promoted Donald. Although Evergreen's employees are encouraged to boost their professional productivity through commonly available secondary means (meditation, healthy diet, etc.), Jeff's off-label use of Adderall seemed to be a bridge too far and was predicated on deceiving a physician. This presented an undue risk to the organization and was inconsistent with the firm's values. The lesson: In addition to their intended, direct benefits, technological advancements often trigger new complexities, both ethical and strategic, that affect management decision making. This makes it all the more important to analyze the full ramifications of choices being considered. What principles should influence the ethical use of technology? What potential consequences are relevant? What values are at stake? What parallel cases help us identify the lines we are unwilling to cross? Leaders should consider many facets of such decisions before pursuing a course of action. ―Jared Harris Harris is a professor of business administration at the University of Virginia's Darden School of Business.