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Latest news and articles from VOICES
Ok, so the Guardian Education article on neuroenhancement is up. You can see it here: http://www.guardian.co.uk/education/2010/may/11/ritalin-drugs-young-people
It’s not as bad as it could have been, but it does excerpt all the most provocative bits of our American J of Bioethics-Neuroscience article (See here) and makes us sound as though we think neuroenhancement in young people is a good idea.
Three points in response:
1. We wrote the article to respond to a problem – the rising use of cognitive enhancers among young people in the US. We’re not endorsing these practices. We say that clearly in the article.
2. ADHD in the UK is still an under-recognized and undertreated condition. To suggest that neuroenhancement and ADHD are related problems in the UK context is irresponsible.
3. We need research on neuroenhancement among young people in the UK! The article says nothing about this.
There is a more accurate overview of our article on neuroenhancement in young people Smart drugs smarter students
The published article Neuroenhancement in Young People:Proposal for Research, Policy, and Clinical Management is also available in PDF
Ilina Singh, BIOS Centre, London School of Economics and Political Science
Kelly J. Kelleher, Centre for Innovation in Pediatric Practice, Nationwide Children’s
Hospital
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"We need proper research on neuroenhancement among young people in the UK. It's much too early to be talking about ways of managing or regulating neuroenhancement practices among young people in the UK context."
Neuroenhancement is an ever hot topic. In the last issue of the American Journal of Bioethics-Neuroscience I published an article with Dr Kelly Kelleher, a prominent US pediatrician, on neuroenhancement in young people. We looked at the US data on the increasing use of prescription medications to enhance cognitive performance among high school students and concluded that it's important to start thinking about how we might manage neuroenhancing practices, so as to minimize the risks and maximize the benefits of these practices. There are potentially serious safety risks of neuroenhancement if young people are left to trade their medications, or buy them off the internet. Of course there are also other social and ethical implications of neuroenhancing practices among young people, which we outline carefully in the article. We then suggest that one way of managing neuroenhancement among US kids is to allow primary care doctors to prescribe cognitive enhancers to young people -- within strict ethical parameters, the most important of which is, of course, safety.
In an interesting development, the UK media has got hold of this article and has been trying to get me to extrapolate from our arguments about the US context, to young people in the UK. I am really glad that the UK media is covering neuroenhancement, because we need to get a conversation on this topic started here. The problem is that it's much too early to talk about regulation in the UK -- we don't even have any systematic evidence of the rates of use of cognitive enhancers among young people in the UK. We only have lots of speculation and anecdotal reports. What we need is research in this area that can inform a discussion about management and regulation.
I have been trying for the past few months to get the UK media to publish an article that deals responsibly with this difficult subject and that calls for research on neuroenhancement among young people. I think it's putting the cart far before the horse to be discussing clinical management and regulation of neuroenhancement among UK young people, before we have proper evidence of neuroenhancing practices. But unfortunately calls for research don't make for interesting newspaper articles, and the Op-Ed I wrote on this subject for the Guardian was deemed too tame to publish.
Now the Guardian will publish an article in the education section on May 11th , which is likely to be informed by our American Journal of Bioethics-Neuroscience article. I respect the Guardian enormously -- it's the best national newspaper in the UK. But I very much hope the Guardian will not extrapolate from our article to make unnecessarily provocative arguments about neuroenhancement for under-18s on the NHS. I certainly don't believe this is an appropriate extension of our arguments, which focus on the US context. Still, we'll have to wait and see… |
In my last post, I talked about re-reading Robert Coles, a master storyteller of children’s lives. A few days ago a friend showed me a review of Judith Warner’s new book "We’ve got issues’ by the well-respected developmental psychologist Alison Gopnik who, it seems, doesn’t like Warner’s book. "It’s worse than science journalism", she says – "it’s just stories".
I agree that Warner’s book is pretty awful, full of sloshy sentimentality about children, parents, mental health and psychiatric drugs, backed up with blog and internet data. But Gopnik’s main complaint – that Warner’s book ‘illustrates the perils of preferring stories to science’ is also problematic.
Science doesn’t have an exclusive hold on the truth about whether kids are overdiagnosed or underdiagnosed, overmedicated or undermedicated; whether ADHD is real or not, or whether Ritalin helps kids or not. Science is just telling another kind of story, crafted with different kinds of tools. Granted, those tools are created in the hope that they can be more objective than ‘just telling stories’ – the randomized double-blind placebo controlled trial (the RCT) – much lauded by Gopnik as the antidote to just stories – is purpose-built for objectivity. But any scientific tool is constructed and manipulated by human beings. Science is full of human subjectivities, whether we like it or not.
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We have finally closed recruitment for the VOICES study, and I am now thick into the process of framing arguments, doing further analysis, and structuring the book that will emerge from the past 3 years of talking to children, as well as parents, teachers, peers, and the general public (everyone has something to say about ADHD and medicating children!).
Recently someone asked me why, with all the discussion and debate over ADHD and Ritalin-type drugs, there is so little information out there about what kids think. It’s a very good question. I have written about this a bit – arguing that essentially researchers don’t think of children as reliable informants (see the article in EMBO Reports, 2007). Others have suggested that we don’t have a ‘culture of listening to children.’ Both responses suggest a common problem: a lack of confidence about how to talk to children in the context of research.
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As part of participation in the VOICES ADHD Study, all young people are asked to draw their brains. We use the brain drawings to encourage children to discuss their ideas about...
- The relationship between brain and behaviour.
- The relationship between brain and the 'self' (eg. who I am as a person)
- How medication for ADHD works.
We encourage young people to be creative, and we remind them that it doesn't matter whether their drawings or their ideas are 'correct.'
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