From Fidgeters, Footerers and Flibbertigibbets to the Medicalisation of Childhood Behaviour

Abstract

This article considers the best interests of young children diagnosed with attention deficit/hyperactivity disorder (adhd). It discusses the situation in the uk where adhd is diagnosed with increasing frequency in school age and pre-school age children. When children are too young to have decision-making capacity, those with parental responsibility may consent to treatment which is in the child’s best interests. The article highlights that such parental decisions are difficult to make when the causes of adhd are unknown and the criteria for the diagnosis of the condition have been changing over time. The risk is that their child may be treated unnecessarily. When parents are asked to consent to treatment, they must be given sufficient information about the treatment options to decide what is in their child’s best interests. The mainstay of treatment for adhd is drugs such as Ritalin. In order for parents to make a decision, they need to weigh up the apparent efficacy of these drugs in treating the symptoms of adhd with the fact that they are controlled substances with the potential to cause considerable adverse reactions. They also need to be informed that these drugs have largely not been tested in clinical trials in children and thus their use is off-label. Current treatment of adhd in a child’s best interests therefore presents legal and ethical challenges. It raises the question as to whether there is a general duty to protect children from harm, sparing them from non-therapeutic drug treatment and, where drug treatment is necessary, to ensure safe and effective treatment which has been researched and tested for its efficacy and safety in children.