| Abstract |
Purpose: The purpose of this thesis is: 1) To investigate and indicate the gaps that appear in the diagnostic protocols of neurodevelopmental diseases based on the DSM-V manual and new scientific data. 2) To examine and summarize the data involving the use of psychotropic substances during childhood and adolescence as well as their effect on the developmental process and the formation of the brain, highlighting the potential risks that exist for immediate as well as prolonged side effects that can be caused from taking psychotropic substances throughout these critical age periods. 3) To examine whether there is a consistent valuation process of reasoning that we can follow in order to lead us to a safe and ethically acceptable use of these substances. By combining all the above factors, the appliance of scientific knowledge and taking into account the vulnerability of the pediatric patient, basic ethical questions and dilemmas are examined. They emerge when two or more values collide during the process of making a decision about minors΄ mental health. The final goal is to re-evaluate the criteria and the necessity of psychotropic substance use in minors. Research methodology: The methodology followed included a search for reviews, clinical studies and scientific literature in general, that examine the effects of psychotropic substances in childhood and adolescence from PubMed database as well as from the DSM-V manual. Additional literature was searched for the bioethical part of the thesis, from Stanford Encyclopedia of Philosophy website and from philosophers’ writings. Keywords: Psychotropic Substances, Psychiatric Disorders, Neurodevelopment, Kantian Ethics, Human nature, Consent and Autonomy. In summary: In chapter one, the neurodevelopmental factors concerning the diversity of the child and adolescent brain are analyzed, focusing on their structural and functional differences. Juvenile pharmacodynamics are reviewed and the problematic application of the generalization of adult data upon child psychiatric pharmacology is also examined. In chapter two , five of the main psychiatric disorders are studied with the indications for their pharmacotherapy. Specifically, the disorders that are examined are: - Attention deficit hyperactivity disorder - Obsessive compulsive disorder - Gilles de la Tourette syndrome - Schizophrenia - Epilepsy In chapter three, there is an extensive reference to psychotropic drugs in use during childhood and adolescence. In chapter four, the concept of human nature according to Kant and Kant's formulation of the Categorical Imperative are analyzed. In chapter five, the concept of autonomy according to Kant is examined. In chapter six, Kant's belief in the human status of children is presented, as well as their ability to acquire it. Finally, the importance of raising children by their parents according to Kant is emphasized and analyzed. In chapter seven, children’s medication is considered under light of Kantian Ethics. The role of parents in administering medication to children, the impact of medication on children's development into autonomous beings and the limits of parental autonomy in administering medication to children are investigated in more detail. Emphasis is also placed on the responsibility of health care providers in administering medication to children. Finally, the conclusions obtained are analyzed, taking into account both biological and bioethical options concerning the matter.
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