Abstract
Definition of the problem
Pharmacological cognition enhancement aims at an improvement of cognitive activity and performance in healthy people by means of appropriate drugs. Ethical implications of this kind of cognition enhancement stand in need of reflection.Arguments
For a number of reasons, the distinction between treatment and enhancement is fuzzy with regard to Attention Deficit Hyperactivity Disorder (ADHD). In consideration of the growing number methylphenidate prescriptions, one question addressed in this article is whether or not psychostimulants are used not only for therapy but also for cognitive enhancement by children and young people. The possibility of a "grey zone" between treatment and enhancement seems to open the field for medicalization of social and pedagogical problems as well as for "hidden enhancement." In clinical practice, the use of stimulants is associated with certain ethical problems concerning diagnosis, treatment and prevention of ADHD. Some of these problems are associated with the possibility of cognition enhancement. In order to evaluate ethical problems of pharmacological cognition enhancement, short-term and long-term consequences of stimulant use need to be taken into account. This refers to the level of transmitter balance in the learning process, to the level of individual learning strategies as well as to the level of interaction. This raises the question (1) of how well adapted the means of enhancement are with regard to the end of a comprehensive education and socialization, and (2) whether there are justifiable limits to the standardization of behavior and knowledge. (3) Moreover, stipulating an autonomous decision as a minimum prerequisite for legitimate cognition enhancement seems inadequate in the case of children and young persons.Conclusion
Considering the evidence and the many open questions associated with pharmacological cognition enhancement for children and young persons, it is concluded that it is indeed a morally problematic technique.References
Articles referenced by this article (26)
Amft H, Gerspach M, Mattner D (2002) Kinder mit gestörter Aufmerksamkeit: ADS als Herausforderung für Pädagogik und Therapie. Kohlhammer, Stuttgart
Döpfner M, Schultz D (2005) Interview in Gehirn und Geist, Dossier Nr. 2: Expedition Kindheit. Spektrum der Wissenschaft, Heidelberg, S 86–89
Droll W (2004) Von der Neurodynamik zur Psychodynamik: Die Regulationsdynamik bei AD(H)S. In: Fitzner T, Stark W (Hrsg) Doch unzerstörbar ist mein Wesen . . . Diagnose AD(H)S—Schicksal oder Chance? Beltz, Weinheim, S 87
Ferber L von, Lehmkuhl G, Köster I, Döpfner M, Schubert I, Frölich J, Ihle P (2003) Methylphenidatgebrauch in Deutschland. Versichertenbezogene epidemiologische Studie über die Entwicklung von 1998 bis 2000. Dtsch Arztebl 100:A41–46
Försterling F (2000) Die Rolle vorauslaufender Bedingungen in attributionalen Verhaltensmodellen. In: Försterling F (Hrsg) Kognitive und emotionale Aspekte der Motivation. Hogrefe, Göttingen, S 29
Goldstein S (1998) The power of parents: the most important things I’ve learned in 25 years in the field of ADHD. Vortrag auf dem 10. Weltkongress Children and adults with ADD, 15.–17. 10. 1998, New York
Goswami U (2001) So denken Kinder: Einführung in die Psychologie der kognitiven Entwicklung. Huber, Bern
Hyman S (2002) Ethical issues in psychopharmacology: research and practice. In: Marcus SJ (ed) Neuroethics: mapping the field. Conference Proceedings, May 13–14, 2002, San Francisco, California. Dana Press, New York
Expanding the horizon of reflection on health and disease.
J Med Philos, (5):461-473 1995
MED: 8830101
Show 10 more references (10 of 26)
Citations & impact
Impact metrics
Smart citations by scite.ai
Explore citation contexts and check if this article has been
supported or disputed.
https://scite.ai/reports/10.1007/s00481-006-0411-4
Article citations
Updates on treatment of attention-deficit/hyperactivity disorder: facts, comments, and ethical considerations.
Curr Treat Options Neurol, 14(6):594-607, 01 Dec 2012
Cited by: 3 articles | PMID: 22968494 | PMCID: PMC3501189
Review Free full text in Europe PMC
Similar Articles
To arrive at the top five similar articles we use a word-weighted algorithm to compare words from the Title and Abstract of each citation.
Will the "real boy" please behave: dosing dilemmas for parents of boys with ADHD.
Am J Bioeth, 5(3):34-47, 01 May 2005
Cited by: 35 articles | PMID: 16006369
A process for developing community consensus regarding the diagnosis and management of attention-deficit/hyperactivity disorder.
Pediatrics, 115(1):e97-104, 01 Jan 2005
Cited by: 33 articles | PMID: 15629972
[Graphomotor functions in children with attention deficit hyperactivity disorder (ADHD)].
Psychiatr Pol, 43(2):183-192, 01 Mar 2009
Cited by: 1 article | PMID: 19697788
Review
[Supervised off-label prescribing of methylphenidate in adult ADHD].
Encephale, 45(1):74-81, 16 Aug 2018
Cited by: 0 articles | PMID: 30122296
From Clinical Application to Cognitive Enhancement: The Example of Methylphenidate.
Curr Neuropharmacol, 14(1):17-27, 01 Jan 2016
Cited by: 22 articles | PMID: 26813119 | PMCID: PMC4787280
Review Free full text in Europe PMC