title: Cognitive enhancement in children and adolescents: is it in their best interests?
abstract: Evidence suggests children and adolescents are consuming stimulants and nonstimulants in the hopes of improving academic performance through cognitive enhancement. As such, clinicians may be faced with requests to prescribe enhancers for their paediatric patients. In this article, we analyse the ethics of cognitive enhancement in paediatrics in the light of the best interests standard, a guiding principle, often used to make decisions for minors in moral, legal, social and medical contexts.
  
  
  CONCLUSIONS
  Cognitive enhancement in children and adolescents does not represent an ethical ideal that societies should strive for. Furthermore, paediatric cognitive enhancement does not meet the criteria for a minimally acceptable practice, given the health-related risks posed by these medications and the coercive environments such a practice creates. In line with a recent policy statement by the American Academy of Neurology, ethical and clinical arguments based on the best interests of paediatric patients encourage clinicians to refrain from engaging in this practice.
authors.affiliation: Pediatric Clinical Ethics Unit, Department of Pediatrics, Université de Montréal, Montreal, QC, Canada; Division of Emergency Medicine, Department of Pediatrics, Université de Montréal, Montreal, QC, Canada; CHU Sainte-Justine Research Center, Department of Pediatrics, Université de Montréal, Montreal, QC, Canada. Nathalie.orr.gaucher@umontreal.ca.
authors.forename: N
authors.initials: N
authors.lastname: Gaucher
authors.forename: A
authors.initials: A
authors.lastname: Payot
authors.forename: E
authors.initials: E
authors.lastname: Racine
mesh_terms: D000293:Adolescent; D000697:Central Nervous System Stimulants; D002648:Child; D006801:Humans; D018697:Nootropic Agents; D010372:Pediatrics / Q000941:ethics* / Q000592:standards
chemical_list: D000697:Central Nervous System Stimulants; D018697:Nootropic Agents
keywords: Attention-deficit hyperactivity disorder (ADHD); Best interests; Cognitive enhancement; Ethics; Neuroenhancement; Stimulants