Medical Ethics: In Support of Providing Stimulants as a Work Aid

Prescription stimulants such as Ritalin and Modafinil are used for medical purposes to treat attention deficit hyperactivity disorder commonly referred as the ADHD. The stimulants increase the ability of the patients to be more focused. Attention, deficit hyperactivity disorder, is a condition linked to neurobehavioral, and the patient is characterized by persistent hyperactivity and inability to focus his/her attention (Taba et al. 2015, 45). However, the ability of prescription stimulants to increase the level of focus to patients who have ADHD has led to its use for non-medicinal purposes.

Ethical Dilemma in Prescription

In this case, the request from my patient to provide her with the drug is purely non-medical as her main reason to ask for the prescription is to increase her level of concentration in a busy workplace. On a social perspective, I am required to provide her with the drug since the increase in the level of attention will increase productivity. On the other hand, it is illegal to offer the drug to the patient since she does not have ADHD. According to various records on the number of accidents that take place at work, there has been an increase in the number of cases as a result of poor concentration. Taking into consideration on what happens to most patients who have shown a reduced level of intensity and did not take stimulant-related drugs, it begs for only one option which is the provision of the prescribed stimulant drugs. The principle of autonomy gives the patient the right to self-determination and is rooted in every society that indeed every individual has the right to make an informed decision on personal matters. However, it is unethical if the doctors do not give a prescription that serves the best interest of their patients (Merino 2015, 30). The situation places the doctor in an ethical dilemma of whether to provide the medicine with stimulants to her or not as both choices seem to be the right choice. Therefore, providing the patient with the stimulant will not harm her but instead will increase the concentration at work and enhance her social interaction. In this regard, I agree with the provision of stimulants to patients.

Motivational Effects of Prescription Stimulants

The use of prescription stimulants has a motivational effect on an individual. According to Dr. Stephen Ross of NYU Langone Medical Center, he points that there is clear evidence that shows the use of prescriptive stimulants increases the level of concentration and fights fatigue. In this regard, the healthy individual tends to take prescribed drugs for the sole purpose of improving their performance level at work or in an academic field. According to various qualitative research, they have shown that most people enhance their motivation level through the use stimulant-related drugs to boost their concentration. The general outcome to enhance motivation through the use of prescription stimulant is increase productivity. However, bioethicists have so far not appreciated the fact that prescribed drugs have motivational enhancement hence they haven’t given special attention to it.

Academic Research on Motivational Enhancement

The issue of motivational enhancement has been a subject of interest in the academic literature for the past ten years. The increase in the level of stress and depression among individuals contribute to the use of stimulant-related drugs to booster their motivation. According to a survey conducted on some students on the effects of consumption of stimulants on their motivation, a majority of them responded that the drugs had positive effects on their state of alertness and willingness to do their homework. Moreover, two surveys were further conducted to determine the effectiveness of the drugs on the motivation of the students about class work (Currie et al 2013, 20). The first survey included the statement “to make work more interesting” as a reason when asked why they use prescribed drugs. The second survey conducted included the statement “to make studying more enjoyable” as a reason when asked why they use prescribed drugs. Out of all respondents in both surveys, 58% gave the two answers as the reasons why they use prescribed drugs. The surveys are clear indication that indeed prescription stimulants have useful results on the motivation of an individual. Stress and depression are always accompanied with poor judgment, and an individual under enormous stress can eventually commit suicide. Therefore, there is need to prescribe the drugs to such individuals to prevent such cases as suicide from taking place. Moreover, various studies conducted on users of prescription stimulants have shown that the drugs have motivational effects through positive influence on the moods of an individual, and acquisition of energy that enables them to do their work effectively. However, the effectiveness of these drugs last for a specified period and then cease to provide the high level of concentration, motivation and the state of alertness. This is because the drugs are designed to be used continually and not on a short-term basis.

Medical Ethics and Prescription Stimulants

The medical ethics play a major role in giving clear reasons to support the provision of prescription stimulants to patients who do not have ADHD. The principle of autonomy provides the patient with a right to determine the right prescription and be able to make independent and un-influenced decisions. This places the doctor in a position to prescribe the drug to the patient to uphold medical ethic that emphasizes the need to respect the autonomy of the patient. In this case, the patient understands that the doctor must adhere to his/her preference. If the doctor does not give in to the patient’s demand, he/she will break the ethical values which should guide him/her. In addition to patient’s autonomy, another medical ethic that advocates for the support of the provision of prescription stimulants to a patient is beneficence (Mcfadden 2017, 44). The term beneficence can often be misunderstood when applied to patients. In the context of medicine, beneficence involves taking decisions that champion for the best interest of your patient. In support of my argument that patients should be provided with the prescription of stimulants for non-medicinal purposes, consider the patient working in an area that requires a lot of concentration and focus. The possibility of this patient endangering her life and those of others is so high due to lack of attention compared to the effects that come along as a result of drug prescription. Therefore, as a doctor, it is of the best interest of the patient to be provided with the drug to increase her focus and concentration. Moreover, when an individual is more focused on a particular issue, there is a likelihood of increasing the productivity in the company which in return translates to a rise in living standard. Although some prescription may do more harm than good, prescribing stimulants to depressed individuals do more good than harm to the patient. The term non-maleficence may differ from one nation to another, and its legal definition may vary depending on the conditioning of the cultural consensus. The prescription of stimulant drugs to patients is justified despite the high chances of harming the patient for his/her best interest.

The Ethic of Double Effect

The medical ethic of double effect provides the doctor with an alternative of prescribing the patient with the drug even though it may produce negative effects (Campbell et al 2012, 47). However, in this case, the doctor should prescribe the drug as it will prevent the patient from losing focus and concentration at work which may lead to more unfortunate events compared to the effects that come along as a result of its consumption. For example, an individual working in a construction company is likely to lose concentration along the way which may result in accidents. Therefore, in such a condition, the doctor should prescribe the patient with the drug as the best option to keep him/her on track back at the company. Although there is an unclear circumstance on the effects of prescriptive stimulants on people free from ADHD, there is a possibility that indeed the drugs have positive effects on the cognitive performance of work and academic field. According to research conducted by Looby and Earleywine, participants reported a positive outcome on the use of prescription stimulants to enhance their focus and persevere. The fact that the patient has asked for a prescription of the stimulant drug implies that she understands well the effects it has on her state of poor concentration. Therefore, this indicates that the patient is informed of the possible consequences that may come along as a result of consumption of the drug and thus the doctor should prescribe the stimulant to her. According to medical ethic on human rights, it gives an account for the protection of individual that may pose signs of special vulnerability (Henningfeld 2011, 53). Also, international law on human rights advocates for the doctor to fight and recognize the patient's nature of weakness and take the best course of action. In this case, if the doctor sees that the patient's lack of focus and concentration may make her vulnerable to other dangers such as work accidents, and social misunderstanding that might come along, prescription of the drug could be the only option to respect her human rights and upholding the medical ethics at the same time.

Historical Perspective and Future Considerations

However, taking into consideration the increase in numbers of people consuming prescription stimulants with no adverse effects on their overall health, it is clear that indeed most medical practitioners fail to see the bigger picture of how the drugs can enhance the attention and focus of the patient at the workplace and academic institutions. On a historical perspective, long before international community realized the positive effects prescriptive stimulant had on patients, athletes used to experience a sense of motivation on prescriptive stimulants and they would eventually win in most of the races. This led to the introduction of doping agency that test for any kind of stimulant in athletes’ blood. The test set a fair ground for each participant as the effectiveness of the stimulant is visible. There is no considerable amount of proof that prescription stimulants can cause any harm to our body, which calls for more research on that particular topic. Moreover, the various numbers of patients who consume these drugs for the non-medical purpose have registered a positive result in their level of attention indicating that indeed providing stimulants to non-affected patients does more good than harm. The claim is supported by the astonishing statistics from DEA showing that the aggregate production of Ritalin in the US rose from 1768 to 14957 kilograms within ten years. This is a significant rise in consumption taking into consideration that a small percentage of the stimulant is used for medicinal purposes.

The use of prescription stimulants to enhance the level of concentration and increase the ability to focus in our ever busy academic life as well as strenuous activities at the workplace is often misinterpreted to be a misuse of stimulant medication (Canadian Agency for Drugs and Technologies in Health 2013, 31). The fact that I stand with my argument and refute the claims that use of stimulants may have adverse effects on an individual is because no established evidence has been shown to support their argument. Taking into consideration the harmful effects of ignoring individuals undergoing a sheer amount of stress as a result of poor concentration at work and school, it gives more reasons why I support the prescription of stimulant drugs. The weight and responsibilities that come along on our day to day life do not provide time for relaxation or relieve stress, thus the need to support the doctor's decision to administer the drug to a patient who does not have ADHD. On the other hand, there is no evidence of adverse side effects of consumption of stimulant drugs by patients who have ADHD, but instead, it shows a significant progress on the level of their concentration and focusing ability. Although studies have shown that continuous use of these drugs will result in a positive change in patients who have ADHD, it is my concern that more resources should be directed towards the establishment of the effects of continuous consumption of stimulant drugs on healthy individuals. Given my argument to support the provision of stimulants to patients for non-medical purposes, I do not think I have approached the issue from all angles, and there is always room for improvement and have a more diverse and more in-depth approach on the same. The use of stimulants to enhance performance has been applied to various disciplines including sports, although its use on such fields comes in handy with its legal consequences. There are some cases where athletes confirm to have used prescription stimulants and have seen a lot of difference in their morale and spirit during the competition. This is a clear demonstration that indeed the consumption of prescribed stimulants may revolutionize our means of motivation and focus concentration.

Conclusion

There is need to accept and appreciate prescription stimulants in both medical and non-medical way. The various studies conducted on both cases serve a common denominator which is increased motivation and level of concentration. In both cases, no adverse effects have been proven which begs for the question on why most people oppose its application in non-medical situations (Dussault 2011, 61). Moreover, with the closer look of the ethical issues in medicine, it is clear that most of those issues can be tackled in a manner that benefits the patient by deciding on the best approach. Also, the observation of various cases and how they unfold defines the current decision on providing the patient with a prescription drug to enhance her concentration level. The debate on how justified a medical practitioner is to prescribe a stimulant to the patient will still be around for some time.

References

Campbell, A. V., Gillett, G. R., & Jones, D. G. (2012). Medical ethics. South Melbourne, Vic, Oxford University Press.

Canadian Agency for Drugs And Technologies In Health. (2013). Abuse and misuse potential of drugs for attention deficit/hyperactivity disorder: a review of the clinical evidence. Ottawa :

Canadian Agency for Drugs and Technologies in Health, Beaconsfield, Quebec : Canadian Electronic Library.

Currie, J., Stabile, M., & Jones, L. E. (2013). Do Stimulant Medications Improve Educational and Behavioral Outcomes for Children with ADHD? Cambridge, Mass, National Bureau of Economic Research.

Dussault, C. (2011). Non-medical prescription stimulant use among sorority and fraternity college populations: relationship with psychological variables.

Henningfeld, D. A. (2011). Medical ethics. Detroit, Greenhaven Press

Mcfadden, C. J. (2017). Medical ethics. New York, William S. Hein & Company.

Merino, N. (2015). Medical ethics. Farmington Hills, Mich.: Greenhaven

Taba, P., Lees, A., & Sikk, K. (2015). The neuropsychiatric complications of stimulant abuse Amsterdam : Academic Press.