title: Disagreements with implications: diverging discourses on the ethics of non-medical use of methylphenidate for performance enhancement.
abstract: BACKGROUND
  There is substantial evidence that methylphenidate (MPH; Ritalin), is being used by healthy university students for non-medical motives such as the improvement of concentration, alertness, and academic performance. The scope and potential consequences of the non-medical use of MPH upon healthcare and society bring about many points of view.
  
  
  METHODS
  To gain insight into key ethical and social issues on the non-medical use of MPH, we examined discourses in the print media, bioethics literature, and public health literature.
  
  
  RESULTS
  Our study identified three diverging paradigms with varying perspectives on the nature of performance enhancement. The beneficial effects of MPH on normal cognition were generally portrayed enthusiastically in the print media and bioethics discourses but supported by scant information on associated risks. Overall, we found a variety of perspectives regarding ethical, legal and social issues related to the non-medical use of MPH for performance enhancement and its impact upon social practices and institutions. The exception to this was public health discourse which took a strong stance against the non-medical use of MPH typically viewed as a form of prescription abuse or misuse. Wide-ranging recommendations for prevention of further non-medical use of MPH included legislation and increased public education.
  
  
  CONCLUSIONS
  Some positive portrayals of the non-medical use of MPH for performance enhancement in the print media and bioethics discourses could entice further uses. Medicine and society need to prepare for more prevalent non-medical uses of neuropharmaceuticals by fostering better informed public debates.
authors: Neuroethics Research Unit, Institut de recherches cliniques de Montréal, 110 avenue des Pins Ouest, Montréal, Québec, H2W 1R7, Canada. cynthia.forlini@ircm.qc.ca
authors: Cynthia
authors: C
authors: Forlini
authors: Eric
authors: E
authors: Racine
mesh_terms: D026688:Bioethical Issues; D000697:Central Nervous System Stimulants / Q000494:pharmacology; D003071:Cognition / Q000187:drug effects*; D034462:Dissent and Disputes; D018765:Dopamine Uptake Inhibitors / Q000494:pharmacology; D011307:Drug Prescriptions / Q000592:standards*; D006801:Humans; D008774:Methylphenidate / Q000494:pharmacology*; D011639:Public Opinion; D012107:Research Design
chemical_list: D000697:Central Nervous System Stimulants; D018765:Dopamine Uptake Inhibitors; D008774:Methylphenidate