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Published online before print September 23, 2009, doi:10.1212/WNL.0b013e3181beecfe)
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Volume 73, Number 17, October 27, 2009
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Received May 28, 2009
Accepted August 10, 2009

Responding to requests from adult patients for neuroenhancements. Guidance of the Ethics, Law and Humanities Committee

Dan Larriviere MD, JD*, Michael A. Williams MD, FAAN, Matt Rizzo MD, FAAN, Richard J. Bonnie LLB, On behalf of the AAN Ethics, Law and Humanities Committee

From the Department of Neurology and School of Law (D.L.) and Schools of Medicine and Law (R.J.B.), University of Virginia, Charlottesville; Sandra and Malcolm Berman Brain & Spine Institute (M.A.W.), Department of Neurology, Sinai Hospital of Baltimore, MD; and Department of Neurology (M.R.), Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA.


* To whom correspondence should be addressed. E-mail: dgl6t{at}virginia.edu.

In the last decade, persons who have no diagnosed medical or mental health condition are increasingly seeking and utilizing, for the ostensible purpose of enhancing their memory or cognitive skills, prescription drugs that were originally developed to improve executive function or memory in persons diagnosed with disorders such as attention deficit hyperactivity disorder or Alzheimer disease. Evidence suggests that this practice, now known as neuroenhancement, is gathering momentum. As a result, neurologists may be encountering patients without a diagnosed illness asking for medications with the goal of improving their memory, cognitive focus, or attention span. Strong arguments have been made for and against this practice, often reflecting strongly held convictions concerning the appropriate practice of medicine. The purpose of this report is to provide neurologists with an overview of the ethical, legal, and social issues surrounding the use of pharmaceuticals prescribed to enhance or augment normal cognitive or affective functioning, as well as practical guidance for responding to an adult patient's request for neuroenhancement.







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