Pediatric neuroenhancement: ethical, legal, social, and neurodevelopmental implications.

The use of prescription medication to augment cognitive or affective function in healthy persons-or neuroenhancement-is increasing in adult and pediatric populations. In children and adolescents, neuroenhancement appears to be increasing in parallel to the rising rates of attention-deficit disorder diagnoses and stimulant medication prescriptions, and the opportunities for medication diversion. Pediatric neuroenhancement remains a particularly unsettled and value-laden practice, often without appropriate goals or justification.

Upholding professionalism: the disciplinary process of the American Academy of Neurology.

Objective: To review the disciplinary process by which the American Academy of Neurology (AAN) enforces its formalized standards of professional conduct.

Methods: We reviewed the AAN's Disciplinary Action Policy. We tracked the elapsed time from receipt to final decision of all allegations ("complaints") of improper conduct by AAN members submitted from 2004 to 2009.

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

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.

Invited article: professionalism in neurology: the role of law.

Professionalism may be defined as the obligation of the physician to uphold the primacy of patients' interests, to achieve and maintain medical competency, and to abide by high ethical standards. Recent commentary has suggested that medical professionalism is being threatened by commercialism and the legal system. Consideration of judicial rulings centered on primacy of patients' interests (informed consent, end-of-life care, and conflicts of interest), medical competence (standard of care in medical malpractice cases, medical futility cases, and confidentiality of peer review), and enforcement of ethical standards (peer review by professional organizations) demonstrates that the law generally defers to standards set by the medical profession, but competing views over what health care model is operative may generate non-deferential outcomes.

Residents' perceptions of professionalism in training and practice: barriers, promoters, and duty hour requirements.

Background: The Accreditation Council for Graduate Medical Education duty hour requirements may affect residents' understanding and practice of professionalism.

Objective: We explored residents' perceptions about the current teaching and practice of professionalism in residency and the impact of duty hour requirements.

Design: Anonymous cross-sectional survey.