The Unethicality of Antipsychotic Pharmaceutical Treatments for Children

July 4, 2013
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The rapid growth of pharmaceutical treatments for mental disorders in the United States has contributed to the emergence of a heated controversy among members of the medical field and interested members of the American public. This debate revolves around the ethicality of using antipsychotic medications to regulate psychiatric illnesses and behavioral disorders in youths. A careful cost-benefit analysis of the motives and repercussions surrounding the prescription of potent antipsychotic drugs such as Clozapine and Risperidone to children paints a damning picture of psychiatric prescription practices in the United States. The prescription of antipsychotic drugs to children is unethical in that it is medically hazardous, unsupported by scientific research, and harmful to society. Yet the practice persists, despite the existence of safer and healthier psychotherapeutic alternatives.
The prescription of antipsychotic drugs to children has been proven to be medically hazardous, engendering severe physical disorders. Psychology: Themes and Variations states that antipsychotic pharmaceutical treatments, or the administration of potent medications to persons with mental or behavioral disorders, involve dangerous artificial interference in the brain chemistry of patients (Weiten 75). According to the text, antipsychotic drugs that are designed to suppress levels of chemicals that cause manic and irregular behavior generate virtually permanent and irreversible neurological disorders in children. One such disorder, tardive dyskinesia, is characterized by debilitating muscular tics. Doctor Mark Olfson, professor of clinical psychiatry at Columbia University, notes that “long-term treatment with antipsychotic medications does increase the risk for tardive dyskinesia” (Interview). Perhaps the most troubling implication of this observation is that even if children are weaned off of antipsychotic drugs at some point in their lives, the physical scars of neurological disorders remain. The New York Times reporter Richard A. Friedman notes that tardive dyskinesia is irreversible and increasingly prevalent among users of newer antipsychotic drugs (A Call for Caution on Antipsychotic Drugs). Exposing children to this potential hazard undeniably betrays accepted standards of medical ethics. When swearing the Hippocratic Oath, new medical practitioners pledge to prescribe regimens for the good of their patients and to do no harm. Doctor Mark Olfson states that “In the treatment of child and adolescent psychiatric disorders, psychosocial treatments are almost uniformly safer than pharmaceutical treatments” (Interview). Thus, every physician that prescribes potent antipsychotic drugs to children is actively disregarding safer psychosocial treatments such as psychotherapy. In doing so, they are exposing their patients to unnecessary peril in violation of the Hippocratic Oath. Hence, it is evident that antipsychotic pharmaceutical treatments for children are unethical and medically hazardous.
The prescription of antipsychotic drugs to children is medically hazardous in that it engenders severe physical disorders such as sedation and diabetes. Doctor Mark Olfson supports this observation when he notes that “there is evidence that exposure to these medications [antipsychotic drugs] leads to increased weight, elevated serum cholesterol, and increased risk diabetes mellitus” (Interview). Furthermore, antipsychotic drugs have extreme sedative effects on children. The New York Times reporter Duff Wilson details a phenomena in which children are sedated, drooling, inexpressive and impersonal while being treated with antipsychotic drugs (Children’s Ordeal Shows Risks of Psychosis Drugs for Young). Thus, the individuality and basic functioning of children are sacrificed in order to control psychiatric and behavioral irregularities that could otherwise be effectively treated in a psychotherapeutic setting without placing children in a zombie-like state of sedation. This is an unethical assault on human life itself. A method of treatment that disregards the value of human life and strips a child of his unique personhood in order to regulate abnormal behaviors inevitably inflicts a net harm on the lives of the patient and his loved ones. Hence, the prescription of antipsychotic drugs to children is unethical in that it exposes them to unnecessary and severe medical hazards.
The practice of prescribing antipsychotic drugs to children is not rooted in legitimate scientific research. Rather, it is characterized by faulty and unethical methods of diagnosis and prescription. Psychology: Themes and Variations states that mental disorders such as schizophrenia and dissociative identity disorder are not tangible, easily understood biological phenomena (Weiten 4). It reports that they are merely classifications constructed by psychiatrists who author the Diagnostic and Statistical Manual of Mental Disorders in an attempt to name a plethora of overlapping psychiatric irregularities. This haziness clearly contributes to the rampant misdiagnosis of mental disorders in children and the subsequent erroneous prescription of harmful medications to them. The New York Times reporter Duff Wilson writes that antipsychotic drugs are regularly prescribed to children who throw “temper tantrums” that are rarely actual indicators of psychosis (Child’s Ordeal Shows Risk of Psychosis Drugs for Young). His article relays the story of a toddler whose tantrums, spawning from family troubles and delays in language developments, led him to be diagnosed with bipolar disorder and put on a deleterious antipsychotic drug regimen. This child’s experience sums up precisely what is askew with the prescription of antipsychotic drugs to children. The lives of millions of children are being threatened by reckless diagnostic and prescription practices that lack scientific bases. In the case of the young child who was misdiagnosed with bipolar disorder, childhood deficiencies that could be resolved through therapy were misinterpreted as symptoms of psychosis, resulting in the prescription of dangerous antipsychotic medications to him. According to the article, such cases are pervasive. Thus, it is clear that too little is known about mental illnesses in children to justify the prescription of potent antipsychotic medications to them. A medical practice that lacks sufficient epidemiological research, is characterized by faulty methods of diagnosis, and has deleterious effects on young human lives is clearly an affront to ethical and moral standards to which all human societies adhere. In fact, it is roughly equivalent to human experimentation. On the contrary, psychotherapeutic alternatives have a legitimate scientific basis. Any college student or graduate who has taken an Introductory to Psychology class knows that non-drug therapy for mental illnesses can be traced back to Austrian neurologist Sigmund Freud’s pioneering work on psychoanalysis in the late nineteenth-century. Thus, it is unethical for a doctor to pursue antipsychotic pharmaceutical treatments for children when safer and scientifically supported alternatives exist.
The prescription of antipsychotic drugs to children is unsupported by scientific research in that it is often characterized by the off-label administration of potent drug regimens to children. Psychology: Themes and Variations defines the off-label prescription of drugs as being the prescription of drugs for purposes for which they are not intended or approved (Weiten 77). The New York Times’ Duff Wilson reports that antipsychotic drugs have been prescribed for off-label use to small children, including preschoolers (Child’s Ordeal Shows Risk of Psychosis Drugs for Young). He notes that the efficacy and safety of off-label use of antipsychotic drugs by children has not been proven by scientific research. This practice is similar to the misdiagnosis of psychotic disorders and the subsequent erroneous prescription of medications to small children in that is characterized by youngsters receiving potent drug treatments for psychosis in the absence of actual psychosis. The article states that antipsychotic drugs like Risperdal are being used to treat autistic disorder and attention deficit disorder, though doing so has not been sanctioned or approved by the Federal Drug Administration, which was established in part to supervise the ethics of the pharmaceutical industry. Thus, psychiatrists that violate unenforced FDA regulations are effectively contravening ethical guidelines for medicine. Moreover, it is an affront to the moral and ethical fabric of society to put children without psychosis on drugs that are used to treat psychosis for adults in the absence of scientific research proving the safety of doing so. Evidence-based treatments are being passed over in favor of medically unsafe, off-label pharmaceutical treatments that lack scientific and ethical bases.
The prescription of antipsychotic drugs to children negatively affects society by reinforcing socioeconomic disadvantage among youths. Doctor Mark Olfson states that “there is strong evidence that these medications [antipsychotic drugs] are overused, especially in disadvantaged groups such as children in foster care who have disruptive behavioral disorders” (Interview). In other words, potent antipsychotic drug regimens are used as “quick-fixes” for children whose caretakers cannot afford the safer and superior psychosocial treatments that well-to-do, insured families have access to. This betrays internationally accepted standards of medical ethics such as the Hippocratic Oath and The World Medical Association’s Declaration of Geneva. According to Psychology: Themes and Variations, these ethical codes of conduct state that societal boundaries such as social standing ought not interfere with a doctor’s duty to his patient (Weiten 15). The New York Times reporter Duff Wilson states that “children covered by Medicaid are given powerful antipsychotic medicines at a rate four times higher than children whose parents have private insurance” (Poor Children Likelier to Get Antipsychotics). He reports that there is a paucity of psychiatrists accepting Medicaid. Subsequently, low-income families are increasingly turning to Medicaid-accepting pediatricians who are able to prescribe cheap antipsychotic drugs but are untrained to administer safer psychotherapeutic treatments such as intensive counseling. Therefore, it is clear that the American health care and insurance industries are systematically violating the Declaration of Geneva’s imploration that social standing not be a deciding factor in the quality of treatment administered to a patient. How will disadvantaged, state-dependent youths with disruptive behavioral and psychiatric disorders ever achieve better socioeconomic conditions than those into which they were born if they are relegated to a level of low-quality psychiatric care? It is evident that the practice of prescribing antipsychotic drugs to children throws fairness and equal opportunity to the wayside. In conclusion, the prescription of antipsychotic drugs to children, the most dangerous form of treatment for psychiatric illnesses, is in an ethical travesty in that is overwhelmingly class-based. The case-specific needs of young patients are superseded by the socioeconomic conditions into which they were born. In turn, this negatively affects society by infringing upon the principle of equal opportunity through the systematic reinforcement of disadvantage.
The prescription of antipsychotic drugs to children has severe social and pecuniary implications for society as a whole. The New York Times reporter Duff Wilson states that ninety-six million dollars in public funds were spent last year on antipsychotic drugs for youth Medicaid recipients, including three infants (Child’s Ordeal Shows Risk of Psychosis Drugs for Young). The financial rationale, that the costs of pharmaceutical treatments are cheaper and more affordable for taxpayers, is horribly myopic. How will hundreds of thousands of sedated, drug-dependent youths be able to contribute to society as they transition into adulthood? Pharmaceutical treatments obviously do not miraculously teach their younger users effective coping and social skills that would allow them to be productive members of society. They merely tamper with brain chemistry in attempt to regulate symptoms of complex mental disorders. This applies to both privately and publicly insured children who are put on potent antipsychotic drug regimens. Thus, antipsychotic pharmaceutical treatments are simply setting children up for lives of pharmaceutical dependency and social failure. There is undeniably a long-term financial loss in our policy of making an undeniably dangerous treatment easily accessible to children. This raises ethical questions about the continuance of this practice, which debilitates children, in light of scientific research proving the harmfulness of doing so. In essence, the existence of healthier, psychosocial alternatives to pharmaceutical treatments that socially prepare children for adulthood render the latter unethical and unnecessary. Doctor Mark Olfson expresses this viewpoint, saying, “I strongly believe that more needs to be done to make evidence-based psychosocial treatments available to these children” (Interview). These beneficial non-drug treatments, unlike pharmaceutical treatments, are more ethically and morally desirable when viewed in the light of their positive social and pecuniary consequences.
The practice of prescribing antipsychotic medications to children, when taking into consideration its negative repercussions and the existence of healthier alternatives, clearly violates accepted standards of medical and societal ethics. These drugs cause severe physical harm, including irreversible neurological disorders and diabetes. Furthermore, the prescription of them to children is characterized by a lack of scientific research for use among youths; Due to this, misdiagnosis, erroneous prescription and risky off-label use are rampant. Moreover, underprivileged youths are disproportionately affected by these prescriptions and their hazardous health effects because the quality of health care that children receive in the United States is largely based on the socioeconomic conditions into which they were born. Furthermore, antipsychotic pharmaceutical treatments do not teach these underprivileged youths, as well as other young users of antipsychotic drugs, the invaluable social and behavioral skills that they are in need of. If drug treatment was the only option for treating psychiatric and behavioral disorders, perhaps it could be said to be necessary and justified for children with severe psychiatric disturbances. However, as stated by Doctor Mark Olfson, safer therapeutic alternatives exist. This damning evidence leaves one to conclude that the prescription of antipsychotic drugs to children is an unethical detriment to individuals and society as a whole. How many more young lives will be ruined before the nation demands change?

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Mikey123 said...
Sept. 29, 2016 at 7:56 pm
This is great! Do you have any online references or links to your sources?
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