Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Collections
    • Subjects A-Z
    • Residents & Fellows
    • Patient Pages
  • Podcast
  • CME
    • Article CME
    • Podcast CME
  • About
    • About the Journals
    • Contact Us
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Collections
    • Subjects A-Z
    • Residents & Fellows
    • Patient Pages
  • Podcast
  • CME
    • Article CME
    • Podcast CME
  • About
    • About the Journals
    • Contact Us
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Share

March 26, 2013; 80 (13) Views & Reviews

Pediatric neuroenhancement

Ethical, legal, social, and neurodevelopmental implications

William D. Graf, Saskia K. Nagel, Leon G. Epstein, Geoffrey Miller, Ruth Nass, Dan Larriviere
First published March 13, 2013, DOI: https://doi.org/10.1212/WNL.0b013e318289703b
William D. Graf
From the Departments of Pediatrics and Neurology (W.D.G., G.M.), Yale University, New Haven, CT; Institute of Cognitive Science (S.K.N.), University of Osnabrück, Osnabrück Germany; Department of Pediatrics (L.G.E.), Northwestern University's Feinberg School of Medicine, Chicago, IL; Departments of Neurology, Child & Adolescent Psychiatry, and Pediatrics (R.N.), New York University Langone Medical Center, New York; and Department of Neurology (D.L.), Ochsner Medical Center, New Orleans, LA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Saskia K. Nagel
From the Departments of Pediatrics and Neurology (W.D.G., G.M.), Yale University, New Haven, CT; Institute of Cognitive Science (S.K.N.), University of Osnabrück, Osnabrück Germany; Department of Pediatrics (L.G.E.), Northwestern University's Feinberg School of Medicine, Chicago, IL; Departments of Neurology, Child & Adolescent Psychiatry, and Pediatrics (R.N.), New York University Langone Medical Center, New York; and Department of Neurology (D.L.), Ochsner Medical Center, New Orleans, LA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Leon G. Epstein
From the Departments of Pediatrics and Neurology (W.D.G., G.M.), Yale University, New Haven, CT; Institute of Cognitive Science (S.K.N.), University of Osnabrück, Osnabrück Germany; Department of Pediatrics (L.G.E.), Northwestern University's Feinberg School of Medicine, Chicago, IL; Departments of Neurology, Child & Adolescent Psychiatry, and Pediatrics (R.N.), New York University Langone Medical Center, New York; and Department of Neurology (D.L.), Ochsner Medical Center, New Orleans, LA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Geoffrey Miller
From the Departments of Pediatrics and Neurology (W.D.G., G.M.), Yale University, New Haven, CT; Institute of Cognitive Science (S.K.N.), University of Osnabrück, Osnabrück Germany; Department of Pediatrics (L.G.E.), Northwestern University's Feinberg School of Medicine, Chicago, IL; Departments of Neurology, Child & Adolescent Psychiatry, and Pediatrics (R.N.), New York University Langone Medical Center, New York; and Department of Neurology (D.L.), Ochsner Medical Center, New Orleans, LA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ruth Nass
From the Departments of Pediatrics and Neurology (W.D.G., G.M.), Yale University, New Haven, CT; Institute of Cognitive Science (S.K.N.), University of Osnabrück, Osnabrück Germany; Department of Pediatrics (L.G.E.), Northwestern University's Feinberg School of Medicine, Chicago, IL; Departments of Neurology, Child & Adolescent Psychiatry, and Pediatrics (R.N.), New York University Langone Medical Center, New York; and Department of Neurology (D.L.), Ochsner Medical Center, New Orleans, LA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Dan Larriviere
From the Departments of Pediatrics and Neurology (W.D.G., G.M.), Yale University, New Haven, CT; Institute of Cognitive Science (S.K.N.), University of Osnabrück, Osnabrück Germany; Department of Pediatrics (L.G.E.), Northwestern University's Feinberg School of Medicine, Chicago, IL; Departments of Neurology, Child & Adolescent Psychiatry, and Pediatrics (R.N.), New York University Langone Medical Center, New York; and Department of Neurology (D.L.), Ochsner Medical Center, New Orleans, LA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
Pediatric neuroenhancement
William D. Graf, Saskia K. Nagel, Leon G. Epstein, Geoffrey Miller, Ruth Nass, Dan Larriviere
Neurology Mar 2013, 80 (13) 1251-1260; DOI: 10.1212/WNL.0b013e318289703b

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Comment

Downloads
3778

Share

  • Article
  • Figures & Data
  • Info
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

The use of prescription medication to augment cognitive or affective function in healthy persons—or neuroenhancement—is increasing in adult and pediatric populations. In children and adolescents, neuroenhancement appears to be increasing in parallel to the rising rates of attention-deficit disorder diagnoses and stimulant medication prescriptions, and the opportunities for medication diversion. Pediatric neuroenhancement remains a particularly unsettled and value-laden practice, often without appropriate goals or justification. Pediatric neuroenhancement presents its own ethical, social, legal, and developmental issues, including the fiduciary responsibility of physicians caring for children, the special integrity of the doctor–child–parent relationship, the vulnerability of children to various forms of coercion, distributive justice in school settings, and the moral obligation of physicians to prevent misuse of medication. Neurodevelopmental issues include the importance of evolving personal authenticity during childhood and adolescence, the emergence of individual decision-making capacities, and the process of developing autonomy. This Ethics, Law, and Humanities Committee position paper, endorsed by the American Academy of Neurology, Child Neurology Society, and American Neurological Association, focuses on various implications of pediatric neuroenhancement and outlines discussion points in responding to neuroenhancement requests from parents or adolescents. Based on currently available data and the balance of ethics issues reviewed in this position paper, neuroenhancement in legally and developmentally nonautonomous children and adolescents without a diagnosis of a neurologic disorder is not justifiable. In nearly autonomous adolescents, the fiduciary obligation of the physician may be weaker, but the prescription of neuroenhancements is inadvisable because of numerous social, developmental, and professional integrity issues.

GLOSSARY

ADHD=
attention-deficit/hyperactivity disorder;
DSM-V=
Diagnostic and Statistical Manual of Mental Disorders, 5th edition;
DTCA=
direct-to-consumer advertising;
ELHC=
Ethics, Law and Humanities Committee;
MTF=
Monitoring the Future

Footnotes

  • Members and staff of the Ethics, Law and Humanities Committee are listed in the appendix.

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at www.neurology.org

  • Received July 2, 2012.
  • Accepted December 5, 2012.
  • © 2013 American Academy of Neurology
View Full Text

AAN Members: Sign in with your AAN member credentials (e-mail or 6-digit Member ID number)

Non-AAN Member subscribers: Sign in with subscriber credentials

Log in using your username and password

Forgot your user name or password?

Purchase access

AAN members must change their passwords on the AAN site

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  

Disputes & Debates: Rapid online correspondence

  • Pediatric Neuroenhancment
    Steven M. Rothman
    Published April 16, 2013
  • Reply to Rothman
    William D. Graf
    Published April 16, 2013
Comment

NOTE: All contributors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.

  • Stay timely. Submit only on articles published within the last 8 weeks.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • 200 words maximum.
  • 5 references maximum. Reference 1 must be the article on which you are commenting.
  • 5 authors maximum. Exception: replies can include all original authors of the article.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All contributors, besides the first/corresponding author, must complete a separate Disputes & Debates Submission Form and provide via email to the editorial office before comments can be posted.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • GLOSSARY
    • METHODS
    • PEDIATRIC NEUROENHANCEMENT AND EMERGING PRACTICE TRENDS
    • ETHICAL DECISION-MAKING PRINCIPLES FOR NEUROENHANCEMENT IN PEDIATRIC POPULATIONS
    • DEVELOPMENTAL ISSUES RELEVANT TO NEUROENHANCEMENT
    • SOCIAL AND LEGAL ISSUES RELEVANT TO NEUROENHANCEMENT
    • PROFESSIONAL ISSUES RELEVANT TO NEUROENHANCEMENT
    • DISCUSSION
    • AUTHOR CONTRIBUTIONS
    • STUDY FUNDING
    • DISCLOSURE
    • APPENDIX
    • ACKNOWLEDGMENT
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info

More Online

CME Course

Related Articles

  • No related articles found.

Topics Discussed

  • All Pediatric
  • All Ethics in Neurology/Legal issues
  • Intelligence
  • Professional conduct and ethics
  • Harm/ risk (analysis)

Alert Me

  • Alert me when this article is cited
  • Alert me if a correction is posted
  • Alert me when eletters are published
Advertisement
Neurology: 92 (8)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2019 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise