"Personal Autonomy and Authenticity: Adolescents’ Discretionary Use of Methylphenidate" by Amos Fleishmann and Avigayl Kaliski has been published in the most recent issue of Neuroethics:
Abstract
Minors with attention-deficit-hyperactivity disorders (ADHD) are liable to use pharmacological treatment against their will and may find their authentic “I” modified. Thus, their use is widely criticized. In this study, the effect of ADHD drugs on adolescents’ personal experience is examined. The goal is to understand how psychological changes that young people experience when they take these medications interrelate with their attitude toward being medicated. Methylphenidate is the most common pharmacological treatment for ADHD. We look into the change that Israeli adolescents undergo when they use it; their experience in controlling the change, and their assessment of the meaning of the change for their lives. Thirty-eight adolescents participated in semi-structured interviews. The findings, analyzed using grounded theory, show that methylphenidate affects the participants’ demeanor, mood, and even preferences. The participants, aware of these effects, apply discretion in taking methylphenidate and thus influence their traits and their willingness to engage in various activities. When needing to prepare for a matriculation exam, for example, they take methylphenidate; when they need to be creative or sociable, they avoid it and enjoy what they consider the advantages of ADHD, such as creativity and spontaneity. As discretionary users, they shape their life stories in a way that makes them more meaningful and diverse, better tailored to their social surroundings, and more useful in maintaining personal autonomy in the course of pharmacological treatment of ADHD.