2014_06_10_Regulation of Pharmacological Substances Enhancing Cognition_Helsinki
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This document proposes a policy on regulating pharmacological cognitive enhancement (PCE) substances. It summarizes surveys conducted in Lithuania in 2008 and 2011 that found 34-41% of respondents used food supplements marketed as cognitive enhancers. While some reported benefits, many noted no effects or side effects. The document reviews PCE usage and attitudes in other countries and outlines arguments for and against PCE use. It proposes a reasoned pro-enhancement approach that allows research while promoting safety, efficacy, transparency and public discussion to establish standards and address issues of fairness, coercion and inequality.
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Opioids are substances extracted from opium poppy, they are a sophisticated group of prescribed drugs that are used in pain management, especially after significant surgeries. Unfortunately, when these medications are used in an uncontrolled manner, they have adverse addictive effects. These drugs are specifically designed to treat severe pain and are often prescribed following surgery or injury or for health conditions that cause extensive chronic illness such as cancer. At times, when taken in a way other than prescribed by a licensed practitioner, they can cause euphoric and pleasurable effects, making them a high demand on the streets. The death statistics resulting from opioid overdose in the United States between 1999 and 2010 increased exponentially, and it was recorded that in 2010 alone, the number of deaths recorded from opioid overdose was 16,651 deaths (Volkow, Frieden, Hyde, P. & Cha, S., 2014).
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BUSI 230Project 1 InstructionsBased on Larson & Farber sectio.docx
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Based on Larson & Farber: section 2.1
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International Journal o f Clinical and Health Psychology (2014) 14, 216-220
International Journal
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w w w .elsevier.es/ijchp
THEORETICAL ARTICLE
The end of mental illness thinking?
Richard Pemberton3 *, Tony Wainwrightb
<DCrossMark
ELSEVIER
DOYMA
a University o f Brighton, United Kingdom
b University o f Exeter, United Kingdom
Received 26 May 2014; accepted 15 June 2014
A vailable on lin e 9 July 2014
KEYWORDS A b s tra c t M ental he alth th e o ry and p ra ctice are in a s ta te o f sig nifica nt flu x . This th e o re t-
Diagnosis; ic a l a rtic le places th e position taken by th e British Psychological Society Division o f C linical
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Dissertation Prospectus
Factors Influencing Individuals' Decision to Utilize Mental Health in South Texas
Submitted by:
James Dada
April 5, 2020
The Prospectus Overview and Instructions
Prospectus Instructions:
1. Read the entire Prospectus Template to understand the requirements for writing your prospectus. Each section contains a narrative overview of what should be included in the section and a table with required criteria for each section. WRITE TO THE CRITERIA, as they will be used to assess the prospectus for overall quality and feasibility of your proposed research study.
2. As you draft each section, delete the narrative instructions and insert your work related to that section. Use the criterion table for each section to ensure that you address the requirements for that particular section. Do not delete/remove the criterion table as this is used by you and your committee to evaluate your prospectus.
3. Prior to submitting your prospectus for review by your chair or methodologist, use the criteria table for each section to complete a realistic self-evaluation, inserting what you believe is your score for each listed criterion into the Learner Self-Evaluation column. This is an exercise in self-evaluation and critical reflection, and to ensure that you completed all sections, addressing all required criteria for that section.
4. The scoring for the criteria ranges from a 0-3 as defined below. Complete a realistic and thoughtful evaluation of your work. Your chair and methodologist will also use the criterion tables to evaluate your work.
5. Your Prospectus should be no longer than 6-10 pages when the tables are deleted.
Score
Assessment
0
Item Not Present
1
Item is Present. Does Not Meet Expectations. Revisions are Required: Not all components are present. Large gaps are present in the components that leave the reader with significant questions. All items scored at 1 must be addressed by learner per reviewer comments.
2
Item is Acceptable. Meets Expectations.Some Revisions May Be Required Now or in the Future. Component is present and adequate. Small gaps are present that leave the reader with questions. Any item scored at 2 must be addressed by the learner per the reviewer comments.
3
Item Exceeds Expectations. No Revisions Required. Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions. No changes required.
Dissertation Prospectus
Introduction
This research study will examine the factors according to mental health providers that influence an individuals' decision to utilize mental health services in South Texas. This research will help us understand why individuals choose to utilize or reject mental health services in the state. Researchers (AUTH YEAR) have expressed a need for further research on the reasons why people decide to utilize or reject mental health services. In South Texas this research is needed because XXXXXXX. There is a ...
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2014_06_10_Regulation of Pharmacological Substances Enhancing Cognition_Helsinki
- 1. Regulation of Pharmacological Substances Enhancing Cognition: Policy Proposal Alma LINKEVICIUTE PhD stude t i Fou datio s of Life Sciences and their Ethical Co se ue ces P og a e
- 2. OUTLINE Usage and attitudes to pharmacological cognitive enhancement (PCE) among Lithuanians (food supplements). PCE usage and attitudes in other countries. Reasons for and against the use of PCE. Values to be protected. Policy proposal.
- 3. PCE usage among Lithuanians 2008 2011 N=531 Paper questionnaire Students of 7 universities 3 non-university higher education colleges 40,9% used food supplements Only 2 respondents used prescriptions drugs N=61 23 students Online questionnaire 30 academics 8 physical work/unemployed 34,4 % used food supplements to enhance cognition
- 4. Substance 2008 (%) Food supplements, vitamins Medicinal drugs under prescription Energy drinks Coffee, tea Recreational drugs Over the counter drugs Alcohol, nicotine Other 61 54,4 36,3 29,8 26,2 18,6 13,2 1,9 What respondents considered to be pharmacological cognitive enhancement (N=531). Respondents could choose few answers. Food supplements, vitamins Medicinal drugs under prescription 61 54,4
- 5. Effect 2008 (%) 2011 (%) My concentration became better I felt more awake I could memorize new information faster I had energy boost I did not notice any effect I experienced some side effects I could finish my tasks faster 39,7 35,8 30,9 29,1 26,5 14,8 14,7 33,3 42,9 33,3 28,6 28,6 9,2 28,6 Effects respondents experienced while taking food supplements which were described as enhancing cognition by distributor (N=217 in 2008; N=21 in 2011). Respondents could choose few answers. My concentration became better I felt more awake I could memorize new information faster I did not notice any effect
- 6. Both surveys at glance 2008 NEUROZAN, GERIMAX, MEMOREX, BILOBIL Using or used in the past: 40,9% Main source of information: TV adverts – 80,4% PCE is cheating – 5,6% 2011 NEUROZAN, GERIMAX, MEMOREX, BILOBIL Using or used in the past: 34,4% Main source of information: Scientific articles 66,6% TV adverts – 60,7% Consultation with doctor/pharmacist 49,1% PCE is cheating – 14,7%
- 7. Situation 2008 (%) 2011 (%) Degenerative illness affecting cognition During the exams During intensive work Being in a job requiring attentiveness Going for an important interview Serving at the military 60,6 57,1 54,6 28,4 3,4 2,6 67,2 39,3 50,8 19,7 3,3 4,9 Situations in which respondents would justify the usage of pharmacological cognitive enhancement (N=531 in 2008; N=61 in 2011).Respondents could choose few answers. Degenerative illness affecting cognition During the exams During intensive work
- 8. Expectation 2008 (%) 2011 (%) Effectiveness in short time Limited side effects Safety Self-confidence 70 37,4 27,1 17,2 85,7 33,3 49,9 28,6 Expectations influencing the decision to use cognition enhancing food supplements (N=217 in 2008; N=21 in 2011). Respondents could choose few answers. Effectiveness in short time
- 9. Key points: • Confusion in distinguishing medicinal drugs and food supplements (advertising violations) • Liberal attitude to usage (especially among individuals doing intellectual work) • Scepticism about the effectiveness (emphasis on effort) • Only small numbers agreed that the usage of PCE is cheating or promotes social inequalities
- 10. PCE usage in other countries: • US estimates of PCE usage differ between 1.5% and 31% which makes research techniques questionable (Hall et Lucke, 2010). • Ragan et al., 2013; provides an international PCE prevalence overview for prescription drugs: Germany <2%, Belgium – 4%, Denmark – 7%, the UK – up to 10%, Iran – 7,7%
- 11. Attitudes towards PCE in other countries: Australia and Canada (student surveys): could lead to unfair advantage, coercion to take enhancement if majority is doing that and limit individual freedom to choose how to study (Bell et al., 2012; Forlini et Racine, 2009). Sweden: general public finds it acceptable to enhance human capacities by using natural remedies but only small minorities of general public and medical practitioners agree to allow the use of pharmaceuticals (Bergstrom et Lynoe, 2008).
- 12. What are broader attitudes? Not clear what public opinion on PCE is (individual trends, societal tendencies, institutional promotions) No unity in the regulations across EU (enhancement tourism) No solid scientific evidence that PCE really works Laissez-fair approach in Europe
- 13. What are recommendations? 2004: enhancement projects suggested to be blocked politically (HLEG) 2007: healthcare concerns must be met first (EGE, Opinion 21) 2008: research aiming for non-therapeutic enhancement should not be undertaken (EC Recommendation) 2009: STOA study; 2012: Discussion in EP (CSC)
- 14. Institutional policies: Universities and business are reportedly ignoring the ethical challenges posed by the use of cognitive enhancement. The use of cognitive enhancement drugs is not discussed. Majority of university codes speak of drugs in a light of compromised work performance (Goodman, 2014).
- 15. Arguments for PCE: • Usage would reduce personal losses: lost keys, forgotten passwords, flooded bathrooms, etc. • Make work more effective, learning process faster. • Help to create welfare and avoid poverty. • Contribute to individual and society wide benefits.
- 16. Arguments against PCE: SAFETY: side-effects, addiction, too risky COERTION: pressure to perform better FAIRNESS: advantage in the competition INEQUALITY: not everybody can assess ALTERED PERSONALITY: boosted self-confidence HUMAN NATURE: changed radically PURPOSE OF MEDICINE: treat, prevent, enhance? ACCOMPLISHMENT ARGUMENT: pride of own work
- 17. What do European societies value? HUMAN RIGHTS and HUMAN DIGNITY Autonomy, justice, equality, bodily integrity, health, solidarity, freedoms, beauty... European values is political and ethical but not geographical concept. When and if values clash, they can be ranked (Hermeren, 2008).
- 18. Are we putting ban on PCE? REASONED PRO-ENHANCEMENT APPROACH REASONED RESTRICTIVE APPROACH CASE-BY-CASE APPROACH Economic Disincentives Model (Dubljevic, 2012) Temporary committee/working group (Coenen et al, 2012)
- 19. Reasoned pro-enhancement approach Meets demands and desires for individual life choices but not at public expense. Reflects on changing socioeconomic framework. Does not necessarily promote the use of PCE but encourage open public debate. Shifts from tacit PCE use to a culture of open use. Allowing research sets foundations for safety and quality standards.
- 20. Individual Institutions Society Research Safety Efficacy Quality Knowledge Clarified expectations Transparency Communication Public discussion Limits coercion Helps to establish fairness in usage and access Openness about usage Institutional PCE usage culture Addresses inequality issues Deliberation about the costs The points to address when drafting a policy on PCE:
- 21. Why clearer stand is beneficial? Ensures equal access for all Europeans Avoids enhancement tourism Sets up unified safety standards Safeguards safety and quality of technology Protects vulnerable (children, students, elderly) Helps to make informed choice Defines misuse and abuse
- 22. Acknowledgements: • P of. D . Osvaldas Rukšė as, D . G ita “kujie ė and Dr.Saulius Noreika at Vilnius University, Lithuania • Law, Philosophy and History Department at Mykolas Romeris University, Lithuania • Erasmus Mundus Master of Bioethics Programme at K.U.Leuven, Belgium • FOLSATEC team at European Institute of Oncology in Milan, Italy
- 23. Thank you for your enhanced attention!