ETHICS OF MEDICATING DIAGNOSED ADHD CHILDREN

Ethics of Medicating Medically Diagnosed ADHD Children

Brenna Pribyl
Brigham Young University

ETHICS OF MEDICATING DIAGNOSED ADHD CHILDREN

Attention Deficit Hyperactivity Disorder or ADHD is an interesting ailment as it seems to

be sweeping the nation like an epidemic. The weird thing about this ADHD epidemic is that there
is nothing medically concrete about diagnosing ADHD. One is medically diagnosed with ADHD
through behavioral observations from teachers and parents (Chronis et al., 2001). Instead of
trying to remedy a behavioral problem with behavioral therapy, the most common practice of
fixing children with ADHD is to prescribe medications (CDC, 2016). Medicating medically
diagnosed ADHD children is unethical because they arent being taught the life skills that will
improve their behavior and increase their quality of life. Behavioral therapy offers an ethical
ADHD treatment according to Utilitarianism because, in the long run, it will maximize their
pleasure in life.
Children that are diagnosed and medicated for ADHD dont have their overall quality of
life at the forefront of the decision making. Parents usually put their children on medications to
help them be better behaved and do better in school. In a recent study it was shown, that ADHD
medications dont improve academic achievement (Advokat & Vinci, 2012). The medications
are being used as a band-aid to try and fix behavioral problems, that in reality could be better
fixed through behavioral therapy.
When using the medications, parents and doctors may think that they are helping their
child, but behavioral therapy will help them in the long run. They dont need to be put on
medications to numb the problem. Major behavioral problems cause the diagnosis and
medication in the first place. Teachers complain to parents about their childrens behavior and
pressure the parents to get their child diagnosed and put on medications to improve their
classroom behavior (Rushton, Fant, & Clark, 2004). Because the children arent getting the help
they truly need, medicating children for ADHD is unethical according to Utilitarianism. The
doctors and parents arent looking to fix the root of the problem; the medications are a quick

ETHICS OF MEDICATING DIAGNOSED ADHD CHILDREN

fix. But the parents and doctors should be looking for ways to help improve childrens difficult
behaviors. Help which behavioral therapy provides in the long run and improves quality of life.
Children on ADHD medication often experience two things that decrease their quality of
life; side effects that behavioral therapy doesnt give them. Some of the medication side effects
include: decreased appetite, insomnia, stomachaches and headaches (Barkley, McMurray,
Edelbrock, & Robbins, 1990). Some children have such severe side effects that they have to go
off the medication immediately. It is also common for children to experience stunted growth
during the beginning months and years of treatment (Spencer et al., 2006). The medications are
so hard on their bodies that they dont grow and develop as they should. Medications might
lessen ADHD symptoms, but at the cost of putting the child in pain and discomfort. The pain that
the children experience violates the ethical theory of Utilitarianism because behavioral therapy
gives them a better quality of life without the side effects of the medications.
Although the medications can lessen the symptoms of ADHD in children, it isnt helping
children long term in improving their quality of life. I believe that medicating ADHD violates
Utilitarianism because the children arent getting the long term care and help that they need with
medications, despite it being the go-to treatment method. Behavioral therapy would do the best,
under Utilitarianism, because you are teaching the children how to behave and overcome their
behavioral and attention problems so that they can be functional as adults. Behavioral therapy
offers no physical side effects and children experience improved quality of life in the long run.
Behavioral therapy still effectively helps children who are misdiagnosed with ADHD. In
the AAP guidelines for diagnosing children with ADHD, they are told to get behavioral
evaluations from parents and teachers (Baughman, 2001). In another study about the statistics of
ADHD diagnosis procedures, it was noticed that most behavioral evaluations were done by
family members only (Rushton, Fant, & Clark, 2004). In a study, it was realized that some

ETHICS OF MEDICATING DIAGNOSED ADHD CHILDREN

clinicians cherry pick diagnosis criteria and there was an over diagnosis of boys, who were
diagnosed twice as much as girls were (Bruchmller, Margraf, & Schneider, 2012).
With misdiagnosed children, prescribing medications that they dont need doesnt
improve their quality of life. Because the ADHD diagnosis procedure lacks material results,
there is a huge risk of misdiagnosis. It is unethical to prescribe medications to children because
in Utilitarianism, you want to do the best thing for the most amount of people and you want to
minimize pain. The children who may have some ADHD behaviors, but arent actually ADHD
would still benefit from behavioral therapy. They would learn to address the behavioral
problems that they do have and would overcome those difficulties. The Centers for Disease
Control says that the children are highly recommended to go through behavioral therapy for a
period of time before any medications are prescribed (CDC, 2016).
The few long term studies we do have, suggest that behavioral therapy helps improve
quality of life in the long run for children. Indeed, it could be argued that the medications
provide the relief that is needed from ADHD behaviors. We have plenty of short term studies
that show the effectiveness of ADHD medications in children. We just dont have the data to see
how it affects these children as they grow up and become adults; if the medications they take as
children continue to be effective in calming ADHD behaviors when they are adults. We simply
dont have the studies with those answers.
It is true that behavioral therapy takes longer to implement and take effect, but in the few
long term studies we do have, behavioral therapy does better in alleviating ADHD behaviors. In
the long run, isnt better to prepare children to be productive adults, which would ultimately
improve their quality of life? This would be consistent with ethical practices of Utilitarianism.
If they had behavioral therapy as children, they would have worked out their problems years ago,
minimizing the pain of their ADHD symptoms, and would be able to be happy and productive

ETHICS OF MEDICATING DIAGNOSED ADHD CHILDREN

adults. And even if they hadnt worked out their problems, they would have developed the skills
that would at least help them lessen their problems and still allow them to be more productive.
In a 3-year case study, the results of combined medication and behavioral therapy for a
severely ADHD child showed that in the long run, behavioral therapy was more effective in
lessening the symptoms of ADHD (Chronis et al., 2001). The medications did better at the
beginning, but through intense behavioral therapy provided by his single mother and his
teachers, they were able to teach him proper behaviors and how to better focus in the classroom
(Chronis et al., 2001). In another long term study it was determined that the effectiveness of
behavioral therapy was equal to medications in improving quality of life. It was also
acknowledged in the study that it is very difficult to standardize the behavioral therapy
implementation among parents and teachers, so there would always be a degree of variance in
the effectiveness rating. But ultimately it was a combination of medications and behavioral
therapy that made the most difference for children (Swanson et al., 2008).
Behavioral therapy is a lot of work and a lot of time. It takes a team effort between
professionals, parents and teachers to effectively correct ADHD behaviors. And I can understand
the desire for quick relief from severe ADHD symptoms, but the ethical thing to do for the child
is to put them through behavioral therapy. They will learn how to behave better, focus for longer
periods of time, think ahead and set goals. All of these outcomes will help them improve the
quality of their personal and professional life. Medicating ADHD children with only medication
is unethical, as the risks outweigh the possible benefits and cause much more pain and suffering
on the childs end. Behavioral therapy is the ethical route to take to help children deal with their
ADHD. And for those with severe ADHD problems, it would still be ethical to provide them the
combined treatment method, which addresses both the short term and long term needs of the
child.

ETHICS OF MEDICATING DIAGNOSED ADHD CHILDREN

References
Advokat, C. & Vinci, C. (2012). Do Stimulant Medications for Attention-Deficit/
Hyperactivity Disorder (ADHD) Enhance Cognition?, Current Directions in
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-directions-in-adhd-andits-treatment/do-stimulant-medications-enhance-cognitionBarkley, R. A., McMurray, M. B., Edelbrock, C. S., & Robbins, K. (1990). Side effects of
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for Disease Control and Prevention, http://www.cdc.gov/ncbddd/adhd/data.html

ETHICS OF MEDICATING DIAGNOSED ADHD CHILDREN

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