Ethics and Science of Medicating Children
Ethical Human Psychology and Psychiatry, Volume 6, Number 1, Spring 2004
The Ethics and Science of Medicating Children
Jacqueline A. Sparks
The University of Rhode Island Kingston, RI
Barry L. Duncan
Institute for the Study of Therapeutic Change Ft. Lauderdale, FL
Prescriptions for psychiatric drugs to children and adolescents have skyrocketed in the past 10 years. This article presents evidence that the superior effectiveness of stimulants and antidepressants is largely a presumption based on an empirical house of cards, driven by an industry that has no conscience about the implications of its ever growing, and disturbingly younger, list of consumers. Recognizing that most mental health professionals do not have the time, and sometimes feel ill-equipped to explore the controversy regarding pharmacological treatment of children, this article discusses the four fatal flaws of drug studies to enable a critical examination of research addressing the drugging of children. The four flaws are illustrated by the Emslie studies of Prozac and children, which offer not only a strident example of marketing masquerading as science, but also, given the recent FDA approval of Prozac for children, a brutal reminder of the danger inherent in not knowing how to distinguish science from science fiction. The authors argue that an ethical path requires the challenge of the automatic medical response to medicate children, with an accompanying demand for untainted science and balanced information to inform critical decisions by child caretakers.
D
uring the 1990s, prescriptions for psychiatric drugs to children and adolescents skyrocketed (Olfson, Marcus, Weissman, & Jensen, 2002; Zito et al., 2003). Evaluating the records of almost a million Medicaid and HMO youths, one of the largest and most comprehensive studies to date concluded that child and adolescent psychotropic utilization rates nearly tripled from pre-1990s levels (Zito et al., 2003). Total psychotropic
The Ethics and Science of Medicating Children
Jacqueline A. Sparks
The University of Rhode Island Kingston, RI
Barry L. Duncan
Institute for the Study of Therapeutic Change Ft. Lauderdale, FL
Prescriptions for psychiatric drugs to children and adolescents have skyrocketed in the past 10 years. This article presents evidence that the superior effectiveness of stimulants and antidepressants is largely a presumption based on an empirical house of cards, driven by an industry that has no conscience about the implications of its ever growing, and disturbingly younger, list of consumers. Recognizing that most mental health professionals do not have the time, and sometimes feel ill-equipped to explore the controversy regarding pharmacological treatment of children, this article discusses the four fatal flaws of drug studies to enable a critical examination of research addressing the drugging of children. The four flaws are illustrated by the Emslie studies of Prozac and children, which offer not only a strident example of marketing masquerading as science, but also, given the recent FDA approval of Prozac for children, a brutal reminder of the danger inherent in not knowing how to distinguish science from science fiction. The authors argue that an ethical path requires the challenge of the automatic medical response to medicate children, with an accompanying demand for untainted science and balanced information to inform critical decisions by child caretakers.
D
uring the 1990s, prescriptions for psychiatric drugs to children and adolescents skyrocketed (Olfson, Marcus, Weissman, & Jensen, 2002; Zito et al., 2003). Evaluating the records of almost a million Medicaid and HMO youths, one of the largest and most comprehensive studies to date concluded that child and adolescent psychotropic utilization rates nearly tripled from pre-1990s levels (Zito et al., 2003). Total psychotropic