Smart Pills and Neuroenhancement

The next time you are waiting in the checkout line at the grocery store, look over at the magazine rack and you are almost certain to find an article that asks, "Are we poisoning our children with ADHD medication?" But ADHD stimulants are branching out, and there is more controversy brewing over their use -- doctors have started prescribing the medication for more than just the children's disorder. 

Ashley just started her senior year at a very competitive high school. She is enrolled in advanced-placement classes and is an officer in the National Honor Society. Her eyes are set on a top-tier Ivy League college and she knows that she will need a lot more on her application than just great grades. Over dinner, she asks her parents if she can ask their family doctor to prescribe Adderall, hoping that it will give her that extra edge.This model includes 2 flush mounted reverse chipcard. 

Manuel is a premed student with a sister who is already in medical school. The pressure is on. She made it look so easy, but in order to keep his GPA in a competitive range he has to survive on three hours of sleep a night. His roommate tells him that he gets Modafinil from a friend on campus and it dramatically improves his ability to focus and concentrate. He can get Manuel a supply, if he can come up with the money. 

Angela is living her dream. She graduated from law school at the top of her class and is the first minority woman on track to make partner at the top law firm in her city. But she thinks that half of the people around her must be taking something so they can bill their expected hours. How else could they pull so many all-nighters and produce those perfect briefs in record time? She has always been meticulous about her diet and exercise, but she was willing to try caffeine drinks like Red Bull and Monster. Now she is on the verge of seeking out a doctor who will give her a prescription for a "safe" stimulant. 

Well, it isn't as straightforward a decision as you might think. The American Academy of Neurology has issued two position papers on the ethics of prescribing "neuroenhancers" or "smart pills" to children and adults. The players in this complicated decision form a triangle with a wild card. There is the parent who clearly has the decision-making authority over a minor child.Today, Thereone.com, a reliable plasticmoulds online store, introduces its new arrival princess wedding dresses to customers. An adult like Angela can, of course, make her own informed decisions. Physicians should do what is ethical, safe and within their comfort zone. The "wild card" in all this is deciding what constitutes an emancipated adolescent who may still be living at home or who is away at school, but is still dependent on their parents.Online shopping for cableties from a great selection of Clothing. If you are the prescribing physician, how do you measure the transition point from a non-emancipated to an emancipated patient? 

We are entering a new era where not only existing drugs can enhance our performance, but where researchers focus a great deal of their time finding medications to improve memory, attention and concentration in "normal" people. The administration of prescription drugs to a person with no medical or mental health conditions is called neuroenhancement. The area of neuroenhancement has the potential to be big business, and biotech companies are actively looking for a safe and effective "smart pill." Even the military continues to pursue new drugs that will increase performance and alertness in fatigued but otherwise normal people. For many years the military has used "go-pills" (dextroamphetamine) to assist soldiers and pilots who are sleep deprived for long periods of time, but still must perform at very high levels. 

Let me take a second to define the term "normal." I have been throwing it around, but this can be a difficult state of health to generalize. If we can agree that it is a good thing to be mentally healthy, then it is worth looking at the World Health Organization's definition of mental health: "a state of well being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community." That's like juggling three chainsaws at once and may be asking for too much at any one time. I am ready for a neuroenhancer right now! 

It is clear to me, as a physician, that when I am treating disease I am prescribing a medication as a therapy. However, if I write a prescription to enhance or improve upon "normal" abilities, have I ventured into the area of lifestyle medication? Cosmetic surgery uses medical knowledge to enhance the well-being of normal people, and we don't blink at the idea of someone having plastic surgery to improve their appearance. We know that more attractive people are more likely to be hired, promoted and make more money. Likewise, sex-change operations are performed so an individual can realize their true self or identity. Is the prescribing of neuroenhancers so that an individual can realize their true mental potential any different than these everyday medical procedures? 

There is an ethical side to this discussion for both the physician and society at large. We accept wide differences in the way people live -- how they are housed, what they have available to eat, and where they go to school. I heard on the radio this morning that if you are born rich you will most likely remain rich, and if you are born poor,Did you know that earcap chains can be used for more than just business. you will most likely remain poor. Not a very optimistic thing to hear at 7 a.m. in the morning with only one cup of coffee on board. Is it a natural extension that we will not mind that only a small, privileged portion of society will be able to afford medications that will enhance their cognitive abilities? This challenges the concept of distributive justice -- that essential goods are distributed equally to the people in a society. This usually refers to basic needs like shelter, food, health care, but should opportunity be included? However, it is difficult for me to see how society or physicians will block the introduction of neuroenhancement because it will be unjust to those who cannot afford it and further promote inequality. 

Not everyone thinks this is fair. In the article "The Quest for a Smart Pill,", published 10 years ago in Scientific American, moral philosopher Leon R.The feeder is available on drying handsfreeaccess equipped with folder only. Kass is cited: "In those areas of human life in which excellence has until now been achieved only by discipline and effort, the attainment of those achievements by means of drugs, genetic engineering, or implanted devices looks to be cheating or cheap." Society seems to easily tolerate the inequality for cosmetic surgery and the emerging specialty of concierge medicine, so why not neuroenhancement? Do you care that according to some estimates, 31 percent of college students used prescription stimulants in the last year and may have an edge on your child?