The American Academy of Neurology took a formal stance
Wednesday on the use of attention-altering drugs by
children who do not have a formal diagnosis. In a
position paper, the academy outlined the ethical issues for
treating healthy children with such drugs, a concept
known as neuroenhancement.
"Neuroenhancement is using a medication of any kind -- a
drug, a medication, to, in some way, improve, or at
least have the perception of improving cognitive
function, thinking, memory, performance in some way, in
someone who does not have a diagnosable condition,"
said Dr. Leon Epstein, who worked on the
The position comes on the heels of a similar paper done for
adult patients released in 2009. According to Epstein,
the issue is that children cannot make the same
decisions as adults, and doctors are supposed to make
decisions that are in the best interest of a child's
If a condition is diagnosed, the use of the medicine is a
treatment for that condition. Neuroenhancement is
common among college students who take stimulants such
as Adderall to help them study for exams. The drugs could
have been obtained secondhand from someone who was originally
prescribed the medication.
Dr. William Graf, of Yale University, who also worked on the
paper, said that the ADHD diagnoses have increased
12-fold over a 20-year period and some of those could
be attributed to over-diagnosis or over-treatment.
"I think that we have a problem with a large pharmaceutical
industry in this country that is growing, with the
number of tablets and pills that people take is
growing," Graf said. "We have to stop at some point and assess
how this should be practiced, especially with children
Much of the skepticism occurs at the intersection of
consumerism and medicine. Pharmaceutical companies are
allowed to advertise their products to the public and
critics say this is influencing what the public perceives
as proper medical treatment.
"The neuroenhancement issue is really the ethical issue
about whether or not it would be all right for a
physician to prescribe a medication," said Epstein,
head of the neurology division at Lurie Children's Hospital
in Chicago. "In this case we're talking about
stimulants, but it could apply to other medications,
to prescribe a medication to somebody, who is an
adolescent or a child, who does not have a diagnosable
"The position of this paper, of this committee, ultimately
was that no, that is not ethically
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