Smart drugs for cognitive enhancement: ethical and pragmatic considerations in the era of cosmetic neurology
Smart drugs for cognitive enhancement: ethical and pragmatic considerations in the era of cosmetic neurology
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DOI：
10.1136/jme.2009.030882
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发表时间：
2009-10-01
影响因子：
4.1
通讯作者：
Cakic, V.
中科院分区：
文献类型：
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作者：
Cakic, V.
大众媒体的报道表明，聪明的药物或“益智药”，如哌甲酯，莫达非尼和吡拉西坦越来越多地被健康人用来增强认知能力。尽管目前的益智药只能适度改善认知能力，但未来可能会开发出更有效的化合物，并且其标签外使用将增加。使用这些药物可能是司空见惯的一个领域是学术界的健康学生。本文回顾了学术界使用益智药的伦理和实用意义，并与体育辩论中的药物相关问题进行了比较。人们经常认为，应该禁止使用提高成绩的药物，因为它们造成了不公平的竞争环境。然而，这似乎是可疑的，因为“不公平”的优势已经无处不在，并普遍为社会所容忍。有人担心，广泛使用将间接迫使非使用者也使用益智药，以保持竞争力。然而，由于担心会影响某些人的行动而限制所有人的自主权是站不住脚的。使用潜在有害的药物来增强而不是治疗通常被认为是不合理的，自由主义的方法通常支持个人决定这些风险是否可以接受的权利。最后，禁止使用促智药是否能有效地执行还值得怀疑。随着促智药在未来学生中的广泛使用，对这个问题的讨论在未来几年将变得更加紧迫。
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.