We report on two areas in which UK law and ethics seem out of step with each other. 2013 saw the passing of the Human Transplantation (Wales) Bill, which will introduce an opt-out system of organ donation in Wales from 2015. In the first section, we discuss the convoluted evolution of the Bill and some potential problems that we consider may prevent it from achieving its intended goal of increasing the number of organs transplanted. The prospect of being able to enhance human cognition through cognitive-enhancing drugs (“smart drugs”) also presents a nexus of questions associated with future ambitions, hopes, and concerns as a society. How these drugs might affect the future of work and employment is beginning to generate wide public engagement in the UK and forms the focus of the second section.

The prospect of being able to take safe and effective drugs to improve mental functioning is becoming a reality. With the potential for widespread use of cognitive enhancers by large sectors of the population, this article discusses the rationale behind the development of these drugs and how society might benefit from them. Important ethical questions and scenarios are also raised. Scientists are urged to explore the implications of their work and engage in active debate with a wide range of interested stakeholders about the ethical and moral consequences of these new technologies to ensure maximal benefit with minimal harm.