Alexandre Erler

This article responds to Neil Levy's recent suggestion that: (1) the use of pharmaceutical enhancers can be understood as promoting our authenticity, no matter which of the two main contemporary conceptions of authenticity we adopt; and that (2) we do not need to decide between these two rival models (the ‘self-discovery’ and the ‘self-creation’ conception) in order to assess the common worry that enhancements will undermine our authenticity. Levy's core argument is based on a comparison between cases of people with ‘Gender Identity Disorder’ (GID) seeking sex reassignment surgery, and cases of enhancement via pharmaceuticals. While conceding the plausibility of Levy's claim (1), I offer reasons to resist (2), by pointing out structural differences between GID cases and some paradigmatic cases of pharmacological enhancement. I argue that these differences prevent the latter sort of cases from counting as authenticity-promoting on the self-discovery view. I conclude that Levy's proposed way of ‘breaking the stalemate’ in this debate is unsuccessful: we cannot avoid settling the dispute between the two models if we are to adequately address the authenticity worry about pharmacological enhancement

The treatment of children diagnosed with attention deficit/hyperactivity disorder with stimulant drugs has been a subject of controversy for many years, both within and outside bioethics, and the controversy is still very much alive. In her feature article , Ilina Singh, a major contributor to that debate in recent years, brings fresh empirical evidence to bear on it. She uses new data to deal with two key ethical concerns that have been raised about the practice. First, does medicating children with ADHD compromise their capacity for autonomous moral agency? And second, does it pose a threat to their ‘authentic self’? A related question is whether medication for ADHD is being used as an instrument of social control, forcing children to adapt to environments that they find oppressive.Whereas previous research by Singh examined the attitudes of parents of boys diagnosed with ADHD,1 this article draws from a series of interviews with children from the UK and USA, including those who were taking drugs for ADHD. The conclusions that Singh reaches can be characterised as cautiously optimistic. The data, she thinks, indicate that ‘a majority of children are not victims of stimulant drugs’. Rather than experiencing their use of such drugs as undermining their capacity for moral agency, children tend to report that the medication renders them better able to control their responses in potentially challenging situations. In addition, most of the children did not perceive the medication as a threat to their authenticity. Singh nevertheless accepts that such a threat might be real in certain cases, and suggests ways in which the threat might be mitigated. In particular, she suggests—plausibly, I think—that medical professionals could play a key role by spending more time listening to children in order to get …