Ilina Singh,
BIOS – London School of Economics and Political Science, London, UK
The case of ADHD and methylphenidate treatment can be seen as emblematic of a broader set of processes, which could be termed the "psychiatrization" of child development and behaviour. The bioethics community has voiced broad concerns about the increasing use of psychotropic drugs in paediatric psychiatry, particularly about the implications of methylphenidate use for child authenticity, individuality, and enhancement. However, bioethical debate around these concerns has remained largely detached from children's actual experiences with diagnosis and stimulant drug treatment. The lack of empirical evidence for bioethical claims problematizes their validity and their implications for clinical and parenting practices.
This talk presents data from a pilot interview study that investigated children's moral self-understandings in relation to ADHD diagnosis and stimulant drug treatment. Children's reflections on their inner "badness" and "goodness" suggest that children's self-evaluations and moral self-understandings do appear to be structured by ADHD diagnosis and by the on/off ritual of stimulant drug dosing. However, stimulant
drug treatment does not appear to undermine a child's sense of personal authenticity: in this study, children taking methylphenidate reported that they believed a core dimension of their "real" selves was persistently "bad", despite medication. This finding complicates two strong bioethical assumptions: that there is inherent good in the authentic person him/herself; and that there is inherent value in the experience of having access to the core, authentic dimension of oneself.
Children's narratives are interpreted using a developmental framework; this framework is used to generate preliminary ideas about the clinical implications of these findings, as well as ideas about future research in this area.
Recent and forthcoming publications include:
Singh, I. [2005]. Will the 'real' boy please behave: Dosing dilemmas for parents of boys with ADHD. American Journal of Bioethics, 5[3], 34-47.
Singh, I. [2006]. ADHD, Culture and Education. Early Child Development and Care.
Singh, I. [2007]. Not just naughty: 50 years of stimulant drug advertising. In A Toon & E. Watkins [eds] Medicating Modern America. NYU Press.
Singh, I. [2007]. Evidence-based ethics: The case of authenticity in children taking stimulant drugs for ADHD. Clinical Child Psychology and Psychiatry. |
