- The Washington Times - Sunday, November 30, 2003

This is the second part in a series of editorials on the challenges raised by the October report of the President’s Council on Bioethics.

All parents hope that their children will be happy at home and high-performing in school. To that well-intentioned end, parents and teachers often provide pharmaceuticals which help to focus the minds of easily-distracted students. But there could be hidden costs.

The use of psychotropic drugs such as Ritalin and Adderall to modify children’s behavior has skyrocketed over the last decade — a paper published in the Archive of Pediatric and Adolescent Medicine earlier this year said that the overall use of such pharmaceuticals tripled among children during the 1990s. Such medicines have proved a godsend for children who truly suffer from Attention Deficit/Hyperactivity Disorder (ADHD), particularly since they appear to be safe and non-addictive.

However, there is ample anecdotal evidence to suggest that such drugs are over-prescribed, especially since the ADHD diagnosis is inherently subjective. In addition, parents may be giving such drugs to healthy children (or children may self-medicate, as some college students do) in order to enhance their academic performance.

The non-therapeutic use of such drugs has significant social and ethical implications for the practice of parenting which require consideration. The council saw three specific areas for concern: “social control and conformity; moral education and medicalization; and the meaning of performance.”

Making rambunctious children conform to behavioral baselines though medication could stunt the development of their personalities. If such conformity becomes widespread, social tolerance for different personalities could diminish, resulting in a society which has been irretrievably dulled-down. As the council pointed out, “Diversity is not only a matter of options and choice, but also a matter of innate inclination and temperament, strength of desire and aspiration, and cultivated character.”

Medicalization could also have a negative effect on moral education. For full development, strong character requires terrible temptation. Medicines that decrease desire might also lessen willpower. In the longer-term, pharmacologically reducing the pull of a child’s negative impulses could also diminish development of his moral responsibility.

In addition to reducing a child’s moral agency, psychotropic drugs might also lessen his or her sense of achievement. Pharmaceuticals offer a short-cut to success. However, self-confidence and self-esteem are best acquired from challenges which have been overcome.

Notwithstanding those concerns, the use of such drugs is certain to grow, since parents will have a difficult time denying their children a chance to raise their performance. Yet they would be wise to exercise restraint. The dispensing of pharmaceuticals should not take the place of character development.

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