The Ethical Controversies of Drugging Our Kids (podcast transcript).

To listen to this blog click on: http://www.garageband.com/mp3cat/.UZCPZCmM4q2g/01_The_Ethical_Contr...



I wrote this writing as a final in my freshmen Philosophy class at SUA in 2001. I was asked to relate every philosophical theory we learned in the class to a current ethical controversy. Though I didn't include anything about Nutra Sweet and other products with Aspartame in them, since then I've learned more about how these poisonous sweeteners are a big cause and many of the mental "disorders" that kids and many others are experiences. For more on that please watch the movie: Aspartame Sweet Misery https://www.youtube.com/watch?v=BB-SXOYnXeY&feature=related

The Ethical Controversies of Drugging Our Kids

Are nervousness, dizziness, drowsiness and depression normal conditions for abnormally commercialized and consumerized kids? Or are they abnormal conditions that doctors need to try to fix with drugs? One-day people would have simply said, get some exercise, eat better or cheer up. Now, however, doctors say, “we got a drug just for you.” Some say the quick fix, drug’em up approach not only causes drug dependency, but it also often causes worse side effects than the original symptoms.

However, it is a big business, making many pharmaceutical companies loads of money. These pharmaceutical companies have incredible sway over clinical research and they give out generous handouts and kickbacks to doctors for promoting their products (1). If these companies are not supported, some say, there will be no research for important life saving vaccines and other very important drugs. Some doctors believe these drugs are really helping children. Other doctors just don’t see any alternative, even though they admit there are many pros and cons to these drugs.

According to some doctors, “problem youths,” who take prescribed antidepressant drugs, may end up becoming more of a problem while on these drugs, than while off. In the article, “The Drugging of America,” we find that one of the youths responsible for the Columbine shooting was on an antidepressant drug. Did this make him less of a problem? The article quotes an ABC’s Colorado affiliate KCNC News 4 report (5/4/99):

The coroner has released further toxicology reports on Eric Harris, one of the two dead suspects. Specialized testing shows levels of Luvox in Harris’s blood in a therapeutic range.

The author of the story goes on to say,

"It’s nice to know the kid wasn’t depressed when he assaulted his Columbine classmates. But it’s not so nice to know that parents are allowing kids to be dosed (and according to one researcher in Virginia, overdosed) with drugs in schools across the country. It seems that parents who don’t know how to be parents have found a way to “cope” with their misbehaved kids: dope‘em down (2)."

Other doctors contest that they have helped many young people get a hold on their depression with drugs. Whatever the case may be, one thing is for sure, the amount of drugs given to kids, supposedly to help their depression, Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD), is increasing drastically every year. The children who are currently being prescribed drugs are getting younger each year as well. In an article entitled “Are We Overmedicating Our Kids?” the author writes:

"FDA data reports that 3000 prescriptions for Prozac had been written for children younger than age one, and a 1999 study in the Journal of the American Medical Association (3) notes that antidepressant use amongst preschoolers has doubled between 1991 and 1995. According to a study at the University of North Carolina as reported on the website Doctor’s Guide (4), only eight percent of a surveyed group of 600 family physicians and pediatricians reported having received adequate training in the management of childhood depression. Yet that did not stop 72 percent of the same group from prescribing SSRIs [Selective Serotonin Reuptake Inhibitors] to children under age 18 (5)."

One is left with so many ethical questions: If doctors believe they can help a few kids with these drugs, should they not at least try to prescribe them and find those that they can help? Is it ethical for doctors who admit not being adequately trained, to be making decisions that can drastically affect the life of a child, who may experience extreme consequences? Can we know, if doctors don’t, how young is too young to give drugs to children? Should doctors be personally responsible for the side effects, if they are clearly written on the label of the prescription bottles? Is it an extreme jumping to conclusions to diagnose a kid with a mental illness so early in his or her life? Shouldn’t doctors try to get the condition under control at as young an age as possible, before it gets worse? Can we trust doctors to know what’s best for children? These are only some of the questions we should be asking.

In “Drugging Away the Pain of Youth,” Peter Ellingsen writes:

"Melbourne child psychiatrist George Halasz believes ADHD is partly created by drug companies. He argues that the 24-fold increase in the prescription of stimulant medication from 1990 to 1998 does not reflect a rise in the prevalence of ADHD. Rather, it illustrates how market-driven health care prescribes drugs for children as a first, instead of a last, resort (6)."

In Dr. Peter Breggin’s book Talking Back to Ritalin he writes, “Ritalin and amphetamine have almost identical adverse effects on the brain, mind and behavior, including the production of drug-induced behavioral disorders, psychosis, mania, drug abuse, and addiction.”

Many doctors have also linked depression, ADD and ADHD to lack of proper nutrients, like a lack of fatty acids (Omega 3, 6 and 9), found in such foods as fish, primrose, pumpkin, hemp, mustard and flax seed oils, and many other health foods. Fatty acids are good fats-the kinds that help digest and break down fat in the digestion and help burn fat stored in the body. A big problem is the growing sales of “fat free” foods, which are extremely dangerous to the brain, as well as to the body (in fact, though it may appear paradoxical, there is a lot of research showing that these “fat free” foods are a big cause of obesity (7)).

Other nutrients kids lack are neurotransmitters like acetylcholine, vitamins, minerals and l-amino acids, the building blocks of protein. Neurotransmitters are the chemicals used to transfer electrical impulses from neuron to neuron in the brain, making thought possible. Among the many chemical neurotransmitters are fatty acids and enzymes. Jane’s Brain Page describes the chemical workings of the brain as follows:

"Low levels of acetylcholine can contribute to lack of concentration and forgetfulness and may cause light sleep. The body synthesizes acetylcholine from the nutrients choline, lecithin, and DMAE, and ancillary nutrient cofactors, such as vitamins C, B1, B5, and B6, along with the minerals zinc and calcium. Acetylcholine helps… primitive drives and emotions. It also controls the release of pituitary hormone vasopressin, which is involved in learning (8)."

Every chemical impulse in the brain and every chemical reaction in the body are aided by a catalyst, such as an enzyme. Many chemicals are classified as enzymes, such as all vitamins and minerals. Unfortunately, thanks to the damming (and cementing off) of rivers in industrial countries, most farm soil is extremely deficient in minerals. (Throughout history, most soils received their minerals and other nutrients when rivers overflowed their banks and brought rich minerals from the mountains to the fertile farmlands that surround river communities. Because rivers in most countries are no longer allowed to overflow their banks, soil is not allowed to replenish its mineral content, and overtime it is becoming more and more mineral deficient).

All things in a natural state contain enzymes. However, when food is processed, overcooked (especially microwaved), pasteurized, genetically engineered, homogenized, and when soil is laden with pesticides, herbicides and fungicides, the naturally occurring enzymes are killed. Therefore, the food becomes enzymatically denatured, which is another way of saying, what was once live food, is now dead food. When food is consumed in a dead state, the body has to use its naturally occurring enzymes to try to break it down, depleting the naturally occurring enzymes of the body and brain, causing the functioning of the body and the brain to be drastically reduced, including the functioning of the immune system and the normal functioning of thought. Running your body on low levels of enzymes is like trying to run a complex computer program on a computer that has very small available memory storage.

Instead of taking dangerous unnatural and synthetic drugs like Ritalin, Prozac and Lithium, shouldn’t kids eat sashimi (raw fish), sushi and raw organic fruits and vegetables, instead of processed garbage (which is completely dead food), from such fast food places as McDonald’s or Pizza Hut? If kids ate live foods, perhaps their brains would get recharged again with the essential fatty acids, vitamins, mineral and other enzymes, which all aid the chemicals in their brains for normal brain functioning.

Along with a lack of nutrition, don’t almost all kids these days suffer from insufficient amounts of exercise? With a little more exercise, their brains would naturally secrete the endorphins necessary for proper mood maintenance. Endorphins are chemicals that a healthy brain will naturally secrete when a person is in a good mood, is happy, is exercising and is thinking positively (and I must add, making love). These are extremely salubrious chemicals that are essential to a person’s healthy thought process. The opposite occurs when someone thinks negatively or is depressed-the brain produces harmful chemicals that cause a vicious cycle of bad feelings. These are extremely deleterious chemicals that are destructive to a person’s healthy thought process and are destructive to a person’s whole body.

With the average child’s diet, completely deficient of proper nutrition, it’s no wonder kids can’t think when they go to class in the morning. Try thinking straight after eating a bowl of processed, sugar coated, artificially colored, artificially flavored, enzymatically denatured, puffs of empty calories, seeped in pasteurized, homogenized, puss contaminated, genetically modified bovine mammary secretions. Now, top that off with the amount of time kids spend getting fat, watching television and it’s no wonder they’re drowsy and depressed. Who wouldn’t be?

Also the type of movies and video games most kids are exposed to these days, cause the secretion of negative endorphins. The continued viewing of horror movies or movies with a lot of violence and suspense, or video games of armed warriors slaying their vicious opponents, which all illicit feeling a fear or rage, can increase the levels of negative endorphins a child’s brain secretes.

Dr. Norman Cousins in his book An Anatomy of An Illness, showed that watching love stories and happy movies or comedies, which make a person laugh and smile, helped increase the levels of positive endorphins in his patients and helped increase the working of their immune systems, helping them overcome their illnesses.

Isn’t it unethical that doctors in the west get little to no education in what constitutes a healthy diet (one of the greatest causes of both sickness and health) in medical schools, without which, they have little chance of teaching patients how to stay healthy? Under these circumstances, should their profession really be called, “healthcare?” Some believe this label should only be reserved for dieticians and fitness trainers. Shouldn’t doctor’s professions be called “sick care” or rather, “sick maintenance,” since maintaining the sickness is the best one could often hope for with such drugs as Ritalin, Prozac and other synthetic drugs?

This topic seems to touch upon most of the ethical perspectives we’ve studied so far this year in our class entitled “Ethical Frameworks in a Changing World.” If we look at this issue from an Aristotelian perspective, “We become virtuous by performing virtuous acts repeatedly, until such acts become ‘second nature’ (570),” one could say that the doctor, who cares about his or her patient and feels he or she is helping children, is doing a virtuous act. The more that doctor does, in this virtuous way, the more it becomes “second nature.” However, others feel children are not learning such virtuous acts, as what constitutes a healthy diet from their doctors, their schools (which often have the most unhealthy cafeteria food, Soka’s is just a little healthier than some, though each year at the request of students, it is becoming healthier), their parents, nor their commercial television culture, which often teach them just the opposite. The kids in this case are not being virtuous and neither are others who support their bad habits.

We might be able to argue that the doctors who are prescribing drugs to kids are unaware that they are not doing the best thing for their patients; they may believe the research of pharmaceutical companies is always legitimate and that profit is not their sole motive. However, in the case of many pharmaceutical companies, which are deliberately trying to profit off of this problem, we can say the people who own those companies suffer from an “excess” of greed and a “deficiency” of compassion, as Aristotle would say. We can also say that the doctors are suffering from a “deficiency” in awareness or enlightenment of the true causes of depression and an “excess” of gullibility. However, in this case, ignorance would not equate to innocence. The doctor’s Hippocratic oath requires them to know more about health than their patients and to advise their patients correctly.

From Aristotle’s point of view, both the doctors and the people from the pharmaceutical companies are nowhere near a happy mean between excesses and deficiencies. Therefore they are all unhappy people. For Aristotle, a happy person is one who brings out their full creative potential and excellence, while balancing excesses. For him, happiness is the expression of virtuous activities, which neither the doctor, nor the drug maker manifests when they are drugging kids or making drugs for kids for the sake of profit. Therefore, under these circumstances, we can say neither is fully happy from Aristotle’s perspective.

Looking at this situation from Christian ethics, according to St. Augustine, “Happiness is in the enjoyment of man’s chief good (296).” According to Augustine, an ethical person desires to do the just and good thing. This may be the case with the doctor, who is just ignorant of what is the “good thing” to do for an unhealthy child. However, this is clearly not the case for the pharmaceutical producer, who is mostly interested in profit, who makes health secondary, especially under a capitalist system, where often the bottom line (money) overrides other, more important considerations. St. Augustine says, “One who seeks what he cannot obtain suffers torture (297).” We can relate this to the drugged child, who seeks to be healthy, but under the misdirection of his doctor and the greed of the pharmaceutical companies, is often only made to be more unhealthy.

St. Augustine writes, “One who has got what is not desirable is cheated (297).” For the doctor who believes his or her prescriptions are truly helping a child get better, which in some case is so, that doctor is not cheated. However, the profits that pharmaceutical companies get for selling and producing their drugs really make the directors and share holders (along with their employees) of these drug companies cheated, according to Augustine’s definition. Even though they think they are benefiting from profits-except in those rare cases where taking drugs in fact cures some patient-they are not really benefiting their selves or anyone else.

Further St. Augustine writes, “The title happy cannot… belong… to him who has what he loves if it is hurtful (296-297).” In the case of the pharmaceutical producers, who gain profit (what they love) by hurting young kids with the terrible side effects of their drugs, they cannot be called happy. These companies are often doing what St. Augustine warns against, seeking “mutable goods,” those Earthly desires of wealth and profit, at the expense of “immutable goods,” those eternal and unchanging goods, like fairness, compassion and honesty. If they truly had compassion, they wouldn’t need to patent their drugs and they wouldn’t sell them at such exorbitant prices; they would sell them closer to the cost of production, thus they wouldn’t be making such an extraordinary and unwarranted profit.

If we look at these issues from a Hobbsian point of view, we’ll see that according to Thomas Hobbs, everything people do is based on selfish motives. He says, “All human beings seek to preserve and to gratify themselves (442).” All of us, out of fear, according to him, also possess a desire to dominate and hurt others, lest we be dominated or hurt by others. Perhaps this is the perspective of some of the pharmaceutical companies, maybe even some to the realist doctors. Perhaps they are trying to get the best out of the younger generation, before they are harmed by these “out of control, depressed, hyperactive children,” who will end up hurting them and others, if doctors don’t first sedate them with drugs (this is the “Clockwork Orange” remedy).

Hobbs says, “If you have nothing to restrain you, you will do what is good for your selfish desire.” This is often true for the pharmaceutical companies. For this reason, Hobbs states that we must have social contracts to keep us from acting solely on our selfish desires. He says that social contracts are a negative restriction that we couldn’t live without. As of now, however, the only social contract patients and doctors have is the doctors’ “Hippocratic oath,” which thanks to the pressure from pharmaceutical companies and organizations such as Health Maintenance Organizations (HMOs), it is often violated.

Many progressives, including Ralph Nader, have been pushing for a “Patients Bill of Rights,” which HMOs and pharmaceutical companies have been fighting against tooth and nail. This type of social contract is badly needed by patients. The doctor’s Hippocratic oath isn’t sufficient enough to stop the abuse of drugs that is so prevalent in western “healthcare.”

According to Kant, the goods of the world are not good without a good will. If pharmaceutical companies are acting out of greed or as in the above hypothetical (Clockwork Orange) case, out of fear, they can’t be said to be acting out of their good will. Also, if doctors are acting out of ignorance, they too can’t be said to have a good will. Although many doctors ignorantly believe they have a good will, because they believe what they are doing is right, Kant postulates a concept called “pure reason,” which he claims is available to everyone. It is a universal reason. This is, according to Kant, one of the ways the mind understands cause and effect. Humans, unlike other animals, get to legislate who they are. They get to decide, through their actions and through their use of reason, whether they are moral or not. He says that humans are not means to an end, but ends in and of themselves. Or as Kant says, they are a “Kingdom of Ends.”

A doctor has a choice as to whether he or she will blindly follow the advise of drug companies or whether he or she will seek alternatives to drugging kids. In many cases, both the doctors and the drug companies can be said to be lacking pure reason. They do not see the cause and effect relation between children’s bad diets, their lack of exercise and their cases of depression, nervousness, hyperactivity and lack of mental clarity. Also, they often don’t see how the drugs they give kids don’t always help, but actually, more often than not, contribute adversely to the mental and physical conditions of these children.

In order for someone to determine if his or her actions are moral, according to Kant, that person must first try to universalize his or her actions. One’s actions are only moral, according to Kant, if one can make his or her actions universal for everyone to do the same thing. I wonder if all the people involved in the making and selling of drugs would make it universal that everyone’s kids, including their own, take these drugs, if their kids are feeling depressed or if their kids have feelings of hyperactivity? I wonder if a maxim could be invented that all doctors and druggists who prescribe drugs to children with adverse mental conditions, could consciously will to everyone, including their own children.

In Mill’s Ethics of Benevolence, one should not be concerned for his or her own welfare, but instead for “the greatest happiness for the greatest number of people.” Perhaps we can argue that doctors and drug makers may be using Mill’s “utilitarian” arguments to say they are helping as many kids as they can who are suffering from mental illness. However, if they were willing to look seriously at the realities of the situation, they would see that they are hurting more kids than they are helping. A better utilitarian argument would be that getting kids on healthy diets, getting them away from their TVs and instead getting them on an exercise program, would help more kids than the current drugging programs many kids are on. However, this kind of reasoning almost never takes place in the western medical establishment, as fixing the problem would reduce the amount of patients that the establishment could profits from. This is one of the biggest reasons we need not-for-profit, universal healthcare.

According to Bentham’s utilitarianism, a community is just a bunch of individuals. According to him, you have to appeal to the majority of the individuals. Bentham believes there are “two masters” that control people’s behavior: pain and pleasure. He says, to decide if a pain or pleasure has the most utility, one must take into consideration seven factors, which he calls his “felicity calculus,” or a calculation of how much happiness (felicity) is gained by an act. These seven factors are: “Intensity, duration, certainty, remoteness, fecundity, purity and extent.” (According to Hume’s “Skepticism,” pain and pleasure condition people, they make impressions on one’s mind. The more pain the stronger the impression).

The pleasure gained from taking drugs is very intense, but the duration is very short lived, and usually one who takes drugs ends up being more depressed afterward. Therefore, we can say there is a low fecundity of pleasure under this circumstance. Also, it is not pure pleasure. If it was, it would only bring about more pleasure and that pleasure would be compounding. The certainty for pleasure is also very low.

From personal experience with a person I know, who was diagnosed first for manic depression and then with bi-polar disorder (now they are both labeled as the same disorder. However, that wasn’t the case at the time, or at least it wasn’t understood as such by all doctors, including hers). It seemed her doctors had her trying every new drug available. She was their guinea pig. Often, they felt they didn’t know exactly what she had. In fact, with most people I’ve read about, doctors often don’t know precisely what their patients suffer from; it’s often a guessing game. They assume it’s some kind of depression, but everybody experiences depression differently. In addition, everyone responds to drugs differently. What the cause of this depression is, they don’t often know. With my friend, her depression was most likely caused by either an extremely traumatic life, from many depressing things that happen to her, and/or from her many years of illicit drug use. What she needed desperately was a healthier diet. (She was bulimic and anorexic, and most people with those disorders suffer from depression due to lack of proper nutrition). She also needed to get more moderate and regular exercise.

Due to the incredibly high cost of drugs, it is a far more remote cure than eating healthy and exercising. The extent of people that become happy and stay happy by taking synthetic drugs is also very low. Therefore, taking prescription drugs for depression or other psychological problems seems to fail all measurements of Bentham’s “felicity calculus.”

Looking at this problem from a Buddhist ethical perspective, we can say that the drug makers and the doctors can be basing their decision on greed, which in Buddhism is one of the three poisons, the elimination of which is one of the goals of Buddhism. However, there are those doctors, as I said, who do believe they are doing the right thing for their patients. Therefore, for them, they may think they are acting out of compassion, which is the practice of a Bodhisattva. However, true compassion in Buddhism is not at odds with true wisdom. In addition, if they are ignorant of the negative consequences of the drugs they are prescribing, or if they are just purposely overlooking those negative consequences, and if they are ignorant of the alternative, more healthy treatments for depression, like natural herbs, exercise and a healthy diet, they are not really compassionate, from a Buddhist perspective. Rather, the third poison, according to Buddhism, Ignorance, is poisoning them.

The golden rule in Buddhism is “never do harm.” If a doctor followed this rule, he or she would almost never be able to prescribe synthetic drugs, unless he or she absolutely knows, 100% that the drugs he or she is prescribing could have no side effects. However, there is no synthetic drug on the market, that doesn’t have a long warning label of all the possible side effects of the drug-in other words the “harms” of the drug. There are many natural remedies for depression, such as the herb, St. Johns Wort, which have little to no side effects. Usually the only side effects are only when these natural herbs are mixed with unnatural, synthetic drugs.

In the end, we can see from fully examining the many ethical controversies associated with drugging kids, that drugging kids is definitely not the best answer and should only be used as an absolute last resort, if we are to claim to be ethical. We need to start teaching children the negative consequences of lack of exercise and bad diet. Also, we need to teach them the negative effects of negative emotions such as fear and anger. We also need to start teaching kids about alternative medicines, like herbs and about the negative consequences of the three poisons, according to Buddhism, which are, greed, hostility and ignorance.

In order to cure kids of their mental ailments, we need to get them to start turning off their TVs, to start getting them out into nature and to help them relax and have fun. We need to teach children that laughing is not only enjoyable, but it is extremely good for their physical and mental health. Laughing is a great way to have your brain produce positive, salubrious endorphins. Only then will we be able to start curbing the problems of ADD, ADHD and depression in kids. Drugs are definitely not the best answer.

End Notes

(1) Timothy’s wife worked in a doctor’s office in Niigata, and the pharmacist that worked across the parking lot took out the entire doctor’s staff at least once a month to the finest sushi restaurants in her city, Niigata, for the most expensive dinners and the most expensive sake in Niigata. Of course, Timothy and his wife have never had the money to go to these restaurants on their own. Similar bribery probably occurs between doctors in the US and their pharmacists, to induce doctors to prescribe more and more drugs to their patients.

(2) http://autarchic.tripod.com/files/drugging.html

(3) http://jama.ama-assn.org/issue/v238n8/full/joc91250.html

(4) http://www.pslgroup.com/dg/fb256.htm

(5) http://www.mcmanweb.com/article-103.htm

(6) http://www.theage.com.au/news/2001/03/12/FFXLO8ZL5KC.html

(7) Not getting enough fat, or rather enough good fats, has been shown to put the human body into a “starvation mode,” which causes the body to retain fat and store more fat and/or to convert carbohydrates, and under severe circumstances even proteins, into fat. Also, “Restricting your daily fat intake to less than 30 grams per day can generate serious health consequences. Our bodies NEED fat for healthy skin, healthy hair, healthy nails, and to assist in breaking down the foods we eat (http://www.dietbites.com/diet-fat-cut.html).”

(8) http://www.maui.net/~jms/gloss.html

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