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Abstract

 
Abstract No.:B-G2195
Country:Canada
  
Title:EXAMINING STAKEHOLDER PERSPECTIVES AND PUBLIC UNDERSTANDINGS OF THE ETHICAL AND SOCIAL ISSUES REGARDING THE MISUSE OF METHYLPHENIDATE (RITALIN)
  
Authors/Affiliations:1 Cynthia Forlini; 1 Nicole Palmour*; 1 Eric Racine;
1 Neuroethics Research Unit, Institut de recherches cliniques de Montréal, QC, Canada.
  
Content:Objectives: The misuse of prescription drugs (MPD) for non-medical purposes has sparked ethical debates (British Medical Association 2007; Health Canada 2007). Statistics show that in the USA, 48 million individuals over the age of 12 have abused prescription drugs (National Institute on Drug Abuse 2005). For example, there is mounting evidence that methylphenidate (Ritalin) is being misused by healthy college students. Review of prevalence rates shows a range from 6.9% to 35.3% for prescription stimulant abuse in this population and up to 11% of abuse for the specific goals of improving concentration, alertness and academic performance (McCabe et al. 2005; Low & Gendaszek 2002; Prudhomme White et al. 2006). Public understanding represents an important dimension of the social and ethical challenges related to such practices but has yet to be examined. Generally, the phenomenon of prescription misuse itself is still loosely defined in the bioethics literature.

Aims: Assess existing international print media coverage, bioethics literature and public health literature on the misuse of methylphenidate;
•Identify and analyze gaps in the ethical, social, and scientific perspectives about MPD.

Methods: A systematic review of international print media, bioethics literature and public health literature on MPD with methylphenidate was preformed. Content analysis focused on popular and academic descriptions of MPD, associated risks and benefits, ethical and social issues of MPD.

Results: Alternative frameworks are employed to describe MPD and discuss its ethical implications. The media portrays MPD as a “lifestyle choice” of individual citizens holding prescription medication in the same regard as other study tools as calculators and caffeine. In the bioethics literature much of the discussion surrounding MPD is based on descriptions of the phenomenon as “cognitive enhancement” emphasizing the potential benefits of increasing cognitive function beyond ordinary or average capacities. Public health studies on MPD name the phenomenon “prescription drug abuse” expressing concerns for the health of individuals engaging in the practice. Analysis of the literature revealed a common discussion of risks and benefits of MPD. However, the ethical discussion differed in focus between sources.

Conclusion: Discourses about prescription misuse currently differ substantially. If semantic pluralism and implicit assumptions about prescription misuse are not acknowledged, public health interventions and ethics discussions about this situation may be impeded since current frameworks hold distinct views and moral assumptions.


  
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