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Neuroenhancements 'not justifiable’ for healthy kids

Wednesday March 13, 2013
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The American Academy of Neurology has released a position paper on the drawbacks of prescribing drugs to boost cognitive function in healthy children.

The AAN noted a growing trend of teens using "study drugs" before tests and parents requesting attention deficit hyperactive disorder drugs even for kids who do not meet the criteria for the condition. The academy has spent the past several years analyzing all available research and ethical issues to develop this official position paper, published March 13 on the website of the journal Neurology.

"Doctors caring for children and teens have a professional obligation to always protect the best interest of the child, to protect vulnerable populations and prevent the misuse of medication," William Graf, MD, of Yale University in New Haven, Conn., and a member of the American Academy of Neurology, said in a news release. "The practice of prescribing these drugs, called neuroenhancements, for healthy students is not justifiable."

The statement provides evidence that points to dozens of ethical, legal, social and developmental reasons why prescribing mind-enhancing drugs, such as those for ADHD, for healthy people is viewed differently in children and adolescents than it would be in functional, independent adults with full decision-making capacities. The academy has a separate position statement that addresses the use of neuroenhancements in adults (see the PDF of that statement at www.neurology.org/content/early/2009/09/23/WNL.0b013e3181beecfe.full.pdf).

The article notes many reasons to decide against prescribing neuroenhancement including: the child’s best interest; the long-term health and safety of neuroenhancements, which has not been studied in children; a possible lack of complete decision-making capacities among children and teenagers while their cognitive skills, emotional abilities and mature judgments are developing; the need to maintain doctor-patient trust; and the risks of over-medication and dependency.

"The physician should talk to the child about the request, as it may reflect other medical, social or psychological motivations such as anxiety, depression or insomnia," Graf said. "There are alternatives to neuronehancements available, including maintaining good sleep, nutrition, study habits and exercise regimens."

A PDF of the position statement is available at http://bit.ly/16sLuE1.


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