I had an interesting talk with a genetics professor about this a few years ago. To sum up his argument, if increasing intelligence was as easy as dumping a chemical (in this case a nootropic, like a -racetam), nature would have already found the solution throughout the course of evolution. According to him, it is unlikely that supplementing with nootropics won't have deleterious consequences in the long term.
Obviously, I know just as well as you that the LD50 for supplements like piracetam is quite high; even unattainable, in some studies. I also believe that empirical studies with piracetam have shown a significant effect on mental acuity in the short term, with regard to a few categories. Nonetheless, I think there is some merit to this professor's argument, as the long term effects have not been well categorized at this time. This may or may not be a matter of grave importance.
In our case, most of us on this board are doctors in training, who will soon be MD's in 1-4 years. If you ask me for my opinion on the ethics of this population taking nootropics, I will have to say I consider it completely unethical. What if 15-20 years down the line, our brain physiology becomes dependent in some way on a nootropic that has been taken for years, and increasing the dosage only works for some time. At this point, the drug may stop working entirely, or the side effects may be too much to handle as a practicing physician. What now? You cannot go out and buy a new brain, and all those resources used to train you will go to waste. Additionally, think about the patients that could be needlessly harmed.
At the same time, I am in favor of an extremely limited selection of performance enhancers like caffeine. The reasoning here is that we have MUCH more experience with this drug, especially with regards to the long term effects. So to sum up my argument, I am morally and ethically against most performance enhancers, with the exception of well-characterized ones like caffeine.
