University of Sydney, Australia.
J Med Ethics. 2009 Oct;35(10):611-5. doi: 10.1136/jme.2009.030882.
Reports in the popular press suggest that smart drugs or "nootropics" such as methylphenidate, modafinil and piracetam are increasingly being used by the healthy to augment cognitive ability. Although current nootropics offer only modest improvements in cognitive performance, it appears likely that more effective compounds will be developed in the future and that their off-label use will increase. One sphere in which the use of these drugs may be commonplace is by healthy students within academia. This article reviews the ethical and pragmatic implications of nootropic use in academia by drawing parallels with issues relevant to the drugs in sport debate. It is often argued that performance-enhancing drugs should be prohibited because they create an uneven playing field. However, this appears dubious given that "unfair" advantages are already ubiquitous and generally tolerated by society. There are concerns that widespread use will indirectly coerce non-users also to employ nootropics in order to remain competitive. However, to restrict the autonomy of all people for fear that it may influence the actions of some is untenable. The use of potentially harmful drugs for the purposes of enhancement rather than treatment is often seen as unjustified, and libertarian approaches generally champion the rights of the individual in deciding if these risks are acceptable. Finally, whether the prohibition of nootropics can be effectively enforced is doubtful. As nootropics use becomes widespread among students in the future, discussion of this issue will become more pressing in the years to come.
新闻媒体报道称，越来越多的健康人正在使用益智药或“益智药”（如哌醋甲酯、莫达非尼和吡拉西坦）来提高认知能力。虽然目前的益智药只能对认知表现有适度的提高，但未来可能会开发出更有效的化合物，而且它们的非处方使用也会增加。在学术界，这些药物的使用可能很普遍的一个领域是健康的学生。本文通过与运动领域相关问题进行类比，探讨了在学术界使用益智药的伦理和实际影响。人们常说，应该禁止使用提高运动成绩的药物，因为它们造成了不公平的竞争环境。然而，考虑到“不公平”的优势已经无处不在，并且社会普遍容忍这些优势，这一观点似乎值得怀疑。人们担心广泛使用会间接地迫使非使用者也使用益智药以保持竞争力。但是，为了防止它可能影响某些人的行为而限制所有人的自主权是站不住脚的。出于增强而不是治疗目的使用潜在有害药物通常被视为不合理的，而自由意志主义者的方法通常支持个人决定是否接受这些风险的权利。最后，禁止使用益智药是否能够有效执行也是值得怀疑的。随着未来学生中益智药的使用越来越广泛，这个问题在未来几年将变得更加紧迫。
