Ethical considerations in the framing of the cognitive enhancement debate

Over the past few years the use of stimulants such as methylphenidate and modafinil among the student population has attracted considerable debate in the pages of bioethics journals. Under the rubric of cognitive enhancement, bioethicists have discussed this use of stimulants—along with future technologies of enhancement—and have launched a sometimes forceful debate of such practices. In the following paper, it is argued that even if we focus solely upon current practices, the term cognitive enhancement encompasses a wide range of ethical considerations that can usefully be addressed without the need for speculation. In taking this position it is suggested that we divide cognitive enhancement into a series of empirically-constructed frameworks—medical risks and benefits, self-medication and under-prescription, prescription drug abuse and over-medication, and finally, the intention to cognitively enhance. These are not mutually exclusive frameworks, but provide a way in which to identify the scope of the issue at hand and particular ethical and medical questions that may be relevant to enhancement. By a process of elimination it is suggested that we can indeed talk of cognitive enhancement as an observable set of practices. However, in doing so we should be aware of how academic commentaries and discussion may be seen as both capturing reality and reifying cognitive enhancement as an entity

Detection of feigned attention deficit hyperactivity disorder

In recent years, there is an increasing awareness that individuals may purposely feign or exaggerate symptoms of attention deficit hyperactivity disorder (ADHD) to gain external incentives, including access to stimulant drugs or special academic accommodations. There are vast consequences of undetected feigned ADHD such as substantial costs covered by society for unnecessary assessments and treatments, unjustified occupation of limited medical resources and undermining society's trust in the existence of the disorder or the effectiveness of treatment. In times of economic crisis and cost savings in the medical sector, the detection of feigned ADHD is of importance. This review briefly describes the research on this topic with an emphasis on the approaches available for detection of feigned ADHD (i.e., self-report questionnaires, personality inventories, cognitive tests used in routine neuropsychological assessment and tests specifically designed for detecting feigned cognitive dysfunction). Promising approaches and measures are available for identifying feigned ADHD but there is an immediate need for further research