An investigation of the controversies surrounding human rights of patients with ADHD

1
An investigation of the controversies
surrounding human rights of patients with ADHD

• Dr. Pooria Sarrami Foroushani M.D.
• School of Sociology Social Policy
• University of Nottingham
• lqxps_at_nottingham.ac.uk

1 of 16
2
Attention Deficit Hyperactivity Disorder (ADHD)

• A common psychiatric disorder

• Children and adults

• 3-5 (potentially 3,000,000 in UK)

• Attention difficulties, hyperactivity and
  impulsivity

• Increase in diagnosis and treatment rate

2 of 16
3
3 of 16
4
Why ADHD is controversial?

• Drug treatment of children

• Diagnosis demanded by others

• No start and end

• Sign and symptoms could be found in everybody

• It has a biological treatment the basis (cause)
  is also claimed to be biological, but no
  biological diagnosis method has established yet

4 of 16
5
Why ADHD is controversial? (continue)

• Stimulant drugs are claimed to be safe, but are
  classified as schedule II drugs

• Stimulant drugs are symptomatic treatment

• Sign and symptoms of this disorder might be an
  advantage for patients

• Sign and symptoms of this disorder might decrease
  and even disappear.

5 of 16
6
6 of 16
7
The right to access psychiatric evaluation
It is the formal approach and is based on medical
model

• Patients should have access to medical
  evaluation, to achieve welfare and proper
  education

• Patients could have the right to choose their
  doctors

• Patients have the right to negotiate the offered
  treatment however, parents are sometimes legally
  forced to treat their children (Charatan, 2000).

•   in this perspective, medical
  organizations are providers of human right.

7 of 16
8
The right to avoid drugs
It is the idea of opponents of medical model of
ADHD (e.g. Church of scientology, etc)

• Labelling and medicating of ADHD patients is
  inappropriate

• Health care organizations are scarifying rights
  of people in favour
• of drug companies

• There are better ways to provide welfare and
  proper education for people.

• in this perspective, human right of
  people is violated by medical organizations

8 of 16
9
Controversies surrounding human right of ADHD
patients

• Both sides agree with articles of universal
  declaration of human rights on importance of
  welfare, liberty, and proper education.

• However, different interpretation of ADHD and
  related phenomena lead to opposite conclusions.

9 of 16
10
A third perspective

• At  present, patients could have access to drugs,
  only if they are diagnosed and labelled by health
  care professionals.

• There are histories of cases, who desperately
  demand these drugs and it seems that drugs could
  benefit them, but their doctors do not agree with
  their diagnosis (Wender, 2000).

• It is possible to accept the efficacy of drugs
  like the medical model, and challenge the control
  of health care professionals on them similar to
  opponents of medical model.

10 of 16
11
(No Transcript)
12
Why labeling is used? A historical perspective
(Conrad Schneider, 1992)

• Opiates were regularly available in pharmacies
  in USA till 19th century. Addiction was
  prevalent, but harmless.

• In 1920, definition and moral concepts of opiate
  addiction changed as a result, opiates were not
  available in pharmacies, prevalence of addiction
  reduce since then, but it become a social problem.

• In 1937, usefulness of amphetamines for some
  people was discovered, but they could not be
  distributed freely, as the moral concepts were
  against a drug that could be potentially
  addictive.

• In 1957, a label was introduced for ADHD
  (hyperkinetic impulse disorder),

• In 1961, FDA approved use of amphetamines as a
  drug for treatment of a disorder in children
  (ADHD).

12 of 16
13
Some reasons against the necessity of labeling

• 1. Practically in many cases labeling do not
  provide any help other than access to drugs.

2. Health care professionals have not a
biological method for diagnosis.
3. Distribution of similar substances is done
without prescriptions.

• 4. People can potentially access the drugs via
  other routes (role playing and black market)

13 of 16
14
Some reasons against the necessity of
labeling(continue)
5. There is a huge financial burden on health
care system (NHS spend annually 247 million is
for treatment of ADHD) (National Institute for
clinical Excellence, 2000a in Blew and Kenny,
2006).
6. Labeling put the responsibility of drug
consumption on health care professionals, instead
of individuals.

• 7. There is a force in getting the label, if
  somebody is interested to use these drugs.

14 of 16
15
Freedom to access the drugs?

• Freedom of choice,

• Avoiding unnecessary labelling.

• People would be still free to get help and
  guidance, if they wish.

15 of 16
16
Suggestions for future studies

• Biological method for diagnosis of ADHD.

• Investigating safety and benefits of
  amphetamines for ordinary people.

16 of 16
17
Thank you!

• Dr. Pooria Sarrami Foroushani M.D.
• School of Sociology Social Policy
• University of Nottingham
• lqxps_at_nottingham.ac.uk