Morality Question

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ronaldo23

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this is not asking for any medical advice, simply asking a theoretical moral question.

many people make the analogy that "steroids is to sports as adderall is to academics."

do you think that people who illegally take adderall are cheating liek athletes are cheating who take roids
 
Guilty feeling won't go away? Or are you just upset you got the second highest test grade? 😀
 
my friends were having a heated debate on teh topic.... i donno what my opinion is.
 
I'm not against it for that reason. Academics should not be primarily a "competition" (though OBVIOUSLY there is that element). If you learned the material, or demonstrated competency, then the institution should certify that you did. If you cheated by plagiarizing or copying someone's answers, etc., then you should be kicked out ... THAT is immoral/unethical.

I would never advise using adderall for academic "performance" mostly because of the risks to the user ... not an issue of "fairness" really. Do we ban coffee next?
 
I would never advise using adderall for academic "performance" mostly because of the risks to the user ... not an issue of "fairness" really. Do we ban coffee next?

Disagree. As a society, we are certainly capable of forming and exercising cutoffs of acceptable and unacceptable behavior (unless you're Rick Santorum...). It's perfectly rational for a society to ban a new dietary supplement or pharmaceutical, while accepting chemicals that have been with us for ages and intense physical training research, even though there is no objective reason to do so. The same is true for coffee vs amphetamine salts: we are perfectly capable of saying, "hey, everybody drinks coffee, but amphetamine is a drug!" even though any six year old can mock you and say "caffeine is a drug, too!"

If you have a disorder for which a psychostimulant is appropriate, it is ethical to take it. If not, it's a scummy thing to do. Of course, given the way we define these disorders, on mostly statistical and arbitrary bases, there is an obvious flaw to my reasoning.

Which isn't to say that other approaches to this topic aren't rational. I think ticket scalpers should be dragged through the streets and have their entrails strung through the bleacher seats, but I'm sure plenty of people on this forum see ticket scalpers as a necessary cog in a very inefficient wheel of product distribution. Whatever.

If you don't have a medical indication for a psychostimulant, then the provider who is writing a prescription is unethical. If you're obtaining amphetamines from a source other than a physician, then you're committing a crime. So whether you buy my weak argument for why taking amphetamines is scummy, it's clear that there is no way for a healthy college student to obtain amphetamines without somebody doing something wrong.

Of course, given how many of your healthy pre-med and medical student contemporaries take psychostimulants from their daddy's prescription pad because the bar was so much more tempting than the organic chemistry textbook, I'm probably filing a minority report here.
 
I had this same debate with one of my attendings.

Stimulants such as adderall can improve academic performance, even if a person doesn't have ADHD. If someone was in a situation where they were in one of the most intense academic pressures one can be (medschool, lawschool) the situation is similar to an athlete taking an enhancer.

I've seen several med & lawstudents doctor shop to get ADHD meds. The diagnosis despite its DSM criteria has room for subjectivity, and on top of that several journals mention that ADHD is often missed despite the DSM criteria--leading some doctors to give it out rather liberally.

And--here's a controversial problem, ADHD like several disorders exist on a spectrum. I've seen people able to hack college, but can't hack medschool unless given ADHD treatment. Is it possible they had ADHD on a much lesser scale--to the degree that the DSM wouldn't catch it? These were people who worked very very hard yet still struggled, but when given an ADHD med-they did considerably better. These people don't fit DSM criteria. What are you going to do? Not let them get these meds? These people ended up doing fine on the meds and ended up being fantastic doctors with no substance abuse.

My personal opinion is that "regular" clinical doctors should not be giving out any med of possible abuse liberally, and if they do so, only under very strict circumstances. I actually had a problem with doing my child psyche rotation because I felt more investigation was needed before prescribing a stimulant, but the current managed care infrastructure does not allow for it.

So in this situation I would not prescribe a stimulant with abuse potential, though yes I realize there are people that may actually need it in the situation I mentioned. I think at the most extreme, I'd prescribe bupropion or venlafaxine, because at that point, if that person is struggling that much, they probably have some associated sx of depression.
 
Taking the Stimmulant AND getting tons of extra time on Boards and tests is REALLY milking it I think.

Pick one or the other, would you please.
 
I've read studies showing that the number of students claiming to have a learning DO is dramatically increasing--which has lead some to believe that some students are milking it intentionally to manipulate the system.

I haven't read any recently (if I did I'd provide a link to one I just read). A number of buddies of mine are teachers & also mentioned how they get a number of students claming to have such a DO and then requesting several benefits the other students don't get, but in their opinion, the student doesn't have a learning DO.

Yes--those teachers aren't doctors, but then again, I've seen doctors prescribe stimulants & dx ADHD not following the DSM criteria. A buddy of mine doctor shopped (mentioned above) to get the dx so he could get extra free time in law school. Several of his law school colleagues asked him which doctor it was so they too could get stimulants & an ADHD dx.
 
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