By Michael LaBossiere
In 2017, the World Health Organization released as six question “test” for adult attention deficit hyperactivity disorder (ADHD). While even proponents of the questions warn that people should not self-diagnose with the “test”, there is the obvious question about the effectiveness of such a diagnostic method. After all, as others have noted, almost every adult seems to exhibit the symptoms that the questions ask about. For example, difficulty in concentrating, unwinding and relaxing seem to be the plight of most people. I first learned of a similar sort of diagnostic tool at a mandatory training session on learning disabilities and another faculty member commented on this tool by saying “by those standards, I think we all have ADHD.” Everyone agreed. Because of these concerns, doctors tend to agree that the simple screening test is not sufficient to diagnose adult ADHD. While using an unreliably method of diagnosing adult ADHD would be problematic, there are also important moral concerns about this matter.
Coincidentally enough, many of the doctors who served on the advisory panel for developing the screening method have enjoyed the financial support of the pharmaceutical companies who produce the drugs used to “treat” adult ADHD. Such payments to doctors by pharmaceutical companies is standard practice and drives much of how treatment works in the United States. Doctors who are not influenced by pharmaceutical companies as less inclined to prescribe the brand name products of companies, which is hardly surprising.
It is important to note that the fact that doctors are enriched financial by pharmaceutical companies that profit from ADHD drugs does not prove that the questions are not useful nor does it prove that they are wrong in expanding the number of people on ADHD drugs. After all, the possibility that a person making a claim is biased does not entail that the claim is false and to think otherwise would be an error of logic. That said, if a person is an interested party and stands to gain, then the relevant claims should be considered with due skepticism. As such, the doctors who are pushing the agenda of the pharmaceutical companies that enrich them should be regarded as lacking in credibility to the degree they are likely to be influenced by this enrichment. Which, one would infer, would be significant. As is always the case in such situations, what is needed are more objective sources of information about ADHD. As should not be surprising, those who are not being enriched by the industry are not as enthusiastic about expanding the ADHD drug market. This raises reasonable ethical concerns about whether the industry is profiting at the expense of people who are being pushed to use drugs they do not actually need. Given the general track record of these companies, this sort of unethical behavior does seem to be the case.
Since I am not a medical doctor specializing in ADHD, I lack the expertise to properly assess the matter. However, I can offer some rational consideration of adult ADHD and its treatment with pharmaceuticals. The diagnostic questions focus on such factors as concentration, ability to remain seated, ability to relax, ability to let people finish sentences, ability to not procrastinate, and independence in regards to ordering one’s life. As noted above, these are all things that all humans have difficulty with at one time or another. Of course, even the proponents of medicating people do note that it takes more than the usual problems to make a person a candidate for medication. But, of course, these proponents do have a fairly generous view of who should be medicated.
One reasonable concern is that there are non-pharmaceutical methods of addressing problematic behaviors of this sort. While, as noted above, I am not an ADHD specialist, I do have extensive training in methods of concentration (thanks to running, martial arts and academics). As such, I know that people can be trained to have better focus without the use of profitable chemicals. Since these drugs have side effects and cost money, it would be morally and practically preferable to focus on non-chemical methods of developing positive traits. Aristotle developed just such a method long ago: training in virtue by habituation. But, it can be objected, there are people who cannot or will not use such non-pharmaceutical methods.
This is a reasonable reply. After all, while many medical conditions can be addressed without drugs, there are times when drugs are the only viable options—such as in cases of severe bacterial infections. However, there is still an important concern: are the drugs merely masking the symptoms of an underlying problem?
In the United States, most adults do not get enough sleep and are under considerable stress. This is due, largely, to the economic system that we accept and tolerate. It is well known that lack of sleep and stress cause exactly the sort of woes that are seen as symptoms of adult ADHD. As such, it seems reasonable to think that problematic adult ADHD is largely the result of the American way of life. While the drugs mask the real problems, they do not solve them. In fact, these drugs can be seen as analogous to the soma of Aldous Huxley’s Brave New World. If this is true, then the treatment of ADHD with drugs is morally problematic in at least two ways. First, it does not really treat the problems—it merely masks them and leaves the real causes in place. Second, drugging people in this manner makes it easier for them to tolerate a political, social and economic system that is destroying them which is morally wrong. In light of the above discussion, the pushing of ADHD drugs on adults is morally wrong.