ࡱ> ;=:@ FbjbjFF 0,,F hhhhhhh  aD        $RJh     hh   ^h h  hh  {dg~10aA  A |hhhhA h   " " Dr. Giovanni Frazzetto Branco Weiss Fellow BIOS Centre, London School of Economics and Political Science European Molecular Biology Laboratory  HYPERLINK "mailto:g.frazzetto@lse.ac.uk" g.frazzetto@lse.ac.uk I Bambini e le Droghe: The Right to Ritalin vs. the Right to Childhood in Italy In the psychopharmacological enhancement debate and in the difficult distinction between treatment and enhancement, distributive justice is one of the most salient issues. While a drug for treatment is meant to grant and restore normal functioning and mental health, enhancement drugs are viewed as an intervention improving human performance and behaviour beyond normality, and are therefore judged as unnecessary, excessive or artificial. The confusion especially surfaces when psychotropic drugs are used to treat disorders with ambiguous diagnostic criteria and individuals without appropriate diagnoses or with mild and negligible symptoms. This is true for methylphenidate, Ritalin, the first-line psychotropic drug used for the treatment of Attention-Deficit Hyperactivity Disorder (ADHD) in children. Emerging from the countrys child neuropsychiatry tradition, mental health system and attitudes about mental illness, the current Italian regulations deny the commercialisation of the medication and universal access to it. I have collected narratives emplotting moral choices behind giving or not the drug to children from both parents of ADHD children in favour of Ritalin and from opponents of it. The current restrictions in the regulation of Ritalin inscribe those choices in civil ideals of right to health and right to medication. The right to health is ambivalently adopted both in favour of or against the use of Ritalin. For parents of children with ADHD who have decided to administer Ritalin to them, the right to health becomes the right to cure and the right to medication. The majority of them feel that their denied access to the drug or a deprivation of a right to medication and a failure to grant their children a cure they deserve. For opponents of Ritalin it is exactly the right to medication that compromises the right to health. Properties and capabilities of Ritalin, therefore, assume opposing features which are advocated or condemned for the sake of childrens health and to guide mental health policies and governmental choices. j' FԯÜ$h3kvh3kv0JCJOJQJmH sH 'jh3kvh3kvCJOJQJU!jh3kvh3kvCJOJQJU h3kvh3kvCJOJQJmH sH h3kvh3kv5CJOJQJh3kvh3kvCJOJQJ ,j' ( ) * Fl l l l l l l l l l l l (.^ $dha$gd3kv$a$gd3kv $dha$gd3kv$a$gd3kv F.:p3kv|. A!"#$% DyK yK :mailto:g.frazzetto@lse.ac.ukD@D NormalCJOJQJaJmH sH tH DA@D Default Paragraph FontRiR  Table Normal4 l4a (k(No List0U@0  Hyperlink>*B*F F ,j'()*H 0ʀ0ʀ0ʀ0ʀ0ʀ0ʀ0ʀ0ʀ0ʀ0ʀ0ʀ0`,jH @0@0@0@0@0 0F F F F XjOYH H 3H H 3kvjH @`0O;;F @UnknownGz Times New Roman5Symbol3& z Arial9GaramondS PalatinoBook Antiqua qh{\Fbdf bb24B B  ` {|DrGiovanniasseafOh+'0P(   $ 0<DLT\Dr GiovanniNormalasseaf2Microsoft Word 10.0@d@Jm@4AgbG&Qti e  ld."Systemd$U02 d-@Garamond-  2 ^i (-@Garamond--,2 ^iDr. Giovanni FrazzettoN"I4.077>"0///4- 2  ^i (.(2 ^iBranco Weiss Fellowt=!)3*3Y*$$8*3C 2 G ^i (-g2 =^iBIOS Centre, London School of Economics and Political Science=#N0@*3!*9332330*3333 B*333M*$)3283*)0**3** 2 ^i (,C2 p%^iEuropean Molecular Biology LaboratoryyB1!33*)3S3**1)!=33-*9)33!)3!* 2 p ^i (-@Garamond-- +2 ^ig.frazzetto@lse.ac.uko- !)++*3\$*(*1/- @ !9-  2 K ^i (, 2 ^i (--L2 +^iI Bambini e le Droghe: The Right to Ritaln(D0T77//N"467/E7/F674F0D2 5 &^iin vs. the Right to Childhood in Italy7.*7/F674D7774487(0/ 2 C^i (6- 2 j^i (- 2 ^i (- 2 K^i (-2 Q^iIn the psychopharmacological enhancement debate and in the difficult distinction #3:3*:3$**3333)!M)*33-*):*32)3**M*3:2*2)*:)32:3:3*:2 *1:2$3*322 e[^ibetween treatment and enhancement, distributive justice is one of the most salient issues. 3*C**3!*)L*3)32*23)3**M*32$!31/*0$**$33*3 3*M3$$)*3$$1*$J2 *^iWhile a drug for treatment is meant to graY3*)2!1- 3!!*)M*4$M*)34-!)O2 q -^int and restore normal functioning and mental t3)32!+$3!*33"M) 13*333-)32M*3(2 T^ihealth, enhancement drugs are viewed as an intervention improving human performance 3*)3*32)3**M*32!1,$)!*/*C*1)$)33*!/)333M3!3/3-31M)33*! 3!M)3))2 _ V^iand behaviour beyond normality, and are therefore judged as unnecessary, excessive or )32"3*3)/31!"3**332"33!M)*")32")!*"3*!* 3!*"12-*2")$"133***$$)!*"*.**$$/*"3 I2  )^iartificial. The confusion especially surft)! *)(=3*(*33 1$33'*$3**)*($1! R2  /^iaces when psychotropic drugs are used to treat )**$(C3*3'3$**33!33*(2!1-$()!*(1$*2(3(!*)2 Q^idisorders with ambiguous diagnostic criteria and individuals without appropriate e2$3!2*!$EC3E)M3-141$E2)-33$*E*!*!)E)32E32/21)$EC331E)33!33!))2 Y R^idiagnoses or with mild and negligible symptoms. This is true for methylphenidate, 2)-33$*$33!3C33M23)3233*--3*3$*M33M$3=3$3$3!1*3 3!3M*3+33*32))&2  ^iRitalin, the first?)342*4 !$ 2  {^i-(42  ^iline psychotropic drug usedt3*43$**33!33*42!1-41$*2:2   ^i for the treatment of Attention4 3!43*4!*)M*343 3D*233 2  F^i-(2  e^iDeficit M* *2 M^iHyperactivity Disorder (ADHD) in children. Emerging from the countrys child L*3*!)*/*AM$3!2*!ADMLMA3A*32!*3ABM*!-3-A !3MA3*A*313!*$A*322 SX^ineuropsychiatry tradition, mental health system and attitudes about mental illness, the 3*1!33$**3)!*(!)233(M*3)(3))3($*$*M()22()12*$()331(M*3)'3*$$(3*X2 3^icurrent Italian regulations deny the commercialisath*1!!*3&#))3&!*-1)33$&2*3*&3*&*3MM*!*)$)A2  $^iion of the medication and universal 33&3 &3*&M*2*)33&)32&13/*!$)2 Z^iaccess to it. I have collected narratives emplotting moral choices behind giving or not )***$$"3""#"3).*"*3*)*2"3)!!)/*$"*M333,"M3!)"*33)*$"3*332"-/3-"3!"332 NV^ithe drug to children from both parents of ADHD children in favour of Ritalin and from 3*2!1-4*32!*3 !3N3333)!*3%3!DMLM*32!*33 )/31!3!?)3)32 !3NM2 ,^iopponents of it. The current restrictions in33333*3$23 22=3*2*1!!*32!*$!*33$23J2  *^i the regulation of Ritalin inscribe those 23*3!*-1)3323 2?)323$)!3*233$)2 _^ichoices in civil ideals of right to health and right to medication. The right to health is *33**$3*/2))$3 !-333*)3)32!-33M*2*)33=3*!-333*)3#2 HU^iambivalently adopted both in favour of or against the use of Ritalin. For parents of )M3/)*3*+)233*2+333+3+ )/31!+3 +3!+)-)3$+3*+1$*+3 +?)3+83 +3)!*3$+3 >2 "^ichildren with ADHD who have decide*32!*3C2DMLMC233)/)2**1*[2 5^id to administer Ritalin to them, the right to health 22)2M3#*!?)233*M3*!,333*)22 Z^ibecomes the right to cure and the right to medication. The majority of them feel that 3**3M*$3*!-33*1 *)323*!-33L*2))33=3*M)3!*3 2*M **3)2 B[^itheir denied access to the drug or a deprivation of a right to medication and a failure to 3*!2*3*2)*)*$$33*2!1-3!)1*3!/)333 )!-33M*2*)33)31) )1!)2,2 ^igrant their children a-!)33*!*32!*3)w2 H^i cure they deserve. For opponents of Ritalin it is exactly the right to *1!*3**2*$*!/*83!33334*3$3 ?)3$*.)**3*!-332 Y^imedication that compromises the right to health. Properties and capabilities of Ritalin, oM*2*)33$3)$*3M3!3M$*$$3*$!-3$3$3*)3$8!33*!*%$)32$*)3)3*$$3 $?)32 <U^itherefore, assume opposing features which are advocated or condemned for the sake of 3*!* 3!*)$$1M*3333$3- *)1!*$C3*3)!*)1.3*)*23!*331*M3*2 3!3*$)/*32  ^ichildrens*32!*3$s2 cE^i health and to guide mental health policies and governmental choices.t3*)3)323,12*M*3)3))333*)$)32-3/*!3M*3)*33)*$ 2 ^i (--ii^^hh]]gg\\ff[[eeZZddYYccXXbbWWaaVV ` `U U  _ _T T  ^ ^S S  ] ]R R  \ \Q Q [[PPZZOOYYNNXXMMWWLL՜.+,D՜.+,D hp  ýB  Dr Title 8@ _PID_HLINKSAtvNmailto:g.frazzetto@lse.ac.uk  !"#$%&'()*+,-./013456789<Root Entry Fdg>Data  1TableWordDocument0SummaryInformation((DocumentSummaryInformation82CompObjj  FMicrosoft Word Document MSWordDocWord.Document.89q