Laura Hansen 08/07/16

Medicine for Malcolm

This article is about a young boy named Malcolm, unspecified age. His pediatrician Dr.
Hill refers him to a Psychiatrist by the name of Dr. DePaul for possible anxiety and depression.
The ethical issue is essentially that the parents of young Malcolm want him put on a medication
such as Prozac. It seems that Malcolm wasnt too keen on going to a psychiatrist in the first
place. After some time talking to Dr. DePaul, his answers to the doctor were short and his body
language presented as bored and irritated. Malcolm in fact stated, I thought you were going to
give me some Prozac.
Because of the fact that Malcolm and his parents seemed to want to immediately put him
on some of anti-depressant or other medication, the issue of excessive medication use in children
should be addressed. Although there have been no long-term studies of the safety or efficacy of
these agents in children, the use of anti-depressants in pre-schoolers approximately doubled
between 1991 and 1995. (Burke, Mary G. "AMA Journal of Ethics." VM. N.p., Oct. 2003.
Web. 03 Aug. 2016.)
Children are being medicated way too early, and for reasons that can be solved or helped
with other remedies of treatment. Prescription medication is not the only way to treat patients
ailments. Keep in mind though, at the beginning of the article, Malcolms pediatrician Dr. Hill
had considered putting Malcolm on anti-depressants. Dr. DePaul must take that into
consideration. Dr. Hill has known Malcolm since he was a little boy, therefore knows him more
than Dr. DePaul, a doctor that just met him. Dr. Hill may not have as much knowledge or

background on medication as Dr. DePaul; hence Dr. DePaul being a psychiatrist, specializing in
treating mental illness with medication.
In fact, its a Western Medicine medicines way of thinking. According to Cancer.gov,
Western Medicine is, A system in which medical doctors and other healthcare professionals
(such as nurses, pharmacists, and therapists) treat symptoms and diseases using drugs, radiation,
or surgery; also called allopathic medicine, biomedicine, conventional medicine, mainstream
medicine, and orthodox medicine. Traditional Chinese medicine (TCM) originated in ancient
China and has evolved over thousands of years. TCM practitioners use herbal medicines and
various mind and body practices, such as acupuncture and tai chi, to treat or prevent health
problems. In the United States, people use TCM primarily as a complementary health approach.
(NCI Dictionary of Cancer Terms. National Cancer Institute. N.p., n.d. Web. 03 Aug. 2016)
The previous quote is the definition of Eastern Medicine found no NIH.gov.
The article talks about how Dr. DePaul talks about how Malcolm shows signs of
Obsessive Compulsive Disorder (OCD); it also mentions mild to moderate anxiety as well as
depression. One important thing to note is that these disorders and diseases can run biologically,
and/or environmentally. Some people are born with the tendency to have depression or
something similar because its in their genes. But its also possible to get situational or
environmental depression, or anxiety. Salt Lake City, Utah has a high rate of depression because
of the fact the community is in a bowl. The sun does not reach society as much as some places;
so because of the lack of sunlight/vitamin D, the people become more depressed. Thats one
example of environmental/situational depression. An example of situational anxiety is in social
settings. There are a lot of people that get social anxiety; they dont do well around people.

Dr. DePaul mentioned in the article that he feels that Malcolm and his parents want to put
him on medication because they dont know much about OCD, anxiety, and depression. At this
point Dr. DePaul might take the opportunity to talk to Malcolm and his parents about the biology
of the limbic system, explaining that anxiety per se, is not a disease but a feeling that plays an
important biological role in the perception of, and response to, threat. (Burke, Mary G. AMA
Journal of Ethics. VM. N.p., Oct. 2013. Web. 03 Aug. 2016) Perhaps if Malcolm and his parents
knew there are other great ways of treating these illnesses, they will consider them.
Sometimes medicine is required. Clearly, there are psychiatric illnesses for which
medications play an essential treatment role. In the last 10 years we have seen a sophisticated
effort led by the pharmaceutical industry (Burke, Mary G. AMA Journal of Ethics. VM.
N.p., Oct. 2013. Web. 03 Aug. 2016) If the disease or disorder is truly hereditary and there is a
serious imbalance of hormones in the brain, medication may be necessary. Even if this is the case
however, other treatment options should be considered and possibly tried before medicating. If
Dr. DePaul does feel that after more sessions Malcolm would do the best on medication, he must
do what is best for the patient. Dr. DePaul first must practice Do No Harm. Do No Harm speaks
for itself, but it basically means that no matter which treatment option or intervention is
attempted, the doctor will do whatever is in the patients best interest; the patient is the doctors
primary consideration. If Malcolms quality of life will be better with medication vs. other
treatments, Dr. DePaul would be the best person to make that recommendation.
Attempting other treatment options is the best way to go. Children are too medicated in
our society today and that is affecting our way of living. Children are becoming more dependent
on medications; I just cant imagine our world in 20 years being run by pill poppers. However,
like mentioned above, if medication is truly in the patients best interest, then so be it.

From reading the article, it seems that the only reason Malcolms parents wanted him to
be medicated was because they werent aware of other treatments. And the reason Malcolm
wanted to be medicated was because thats what his parents wanted, and possibly because he felt
that it was the easiest thing to do. Hopefully after counsel from Dr. DePaul and his pediatrician
Dr. Hill, Malcolm and his parents came to realize that maybe they could try other options. There
is counseling, other methods of natural medicinal medication, meditation, etc. If these were
considered, perhaps Malcolm wouldnt need medication.
Another negative thing about medicating, and medicating so young, is addiction.
Prescription pill addictions are at an all time high. The National Institute on Drug Abuse states
that 25% of prescription drug abusers who began abusing earlier than age 13 ended up meeting
clinical criteria for addiction and prescription drug abuse treatment. (2015 Prescription Drug
Abuse Statistics. Talbott Recovery. N.p., n.d. Web. 03 Aug. 2016) These statistics are not known
by many. If more people knew how big of a problem prescription pill addiction is, more people
would avoid them at all costs. Especially if kids are involved; most parents would do whatever is
in the best interest of their kids; if that involved not exposing them to pill addiction at an early
age, thats the best option.
Hopefully as more information becomes more easily available to parents, less and less
children will be exposed to unnatural treatment options. In Malcolms case, a prescription should
not immediately be introduced especially since Dr. DePaul isnt sure if what he has requires
medication. In fact, Dr. DePaul does not currently know how to diagnosis Malcolm; perhaps in
the future, medication will be the best treatment action. Several follow up appointments with Dr.
DePaul and Dr. Hill will be necessary in deciding on how to best treat Malcolm. This should be
the case with all children possibly needing medication.

CITATIONS:
2015 Prescription Drug Abuse Statistics. Talbott Recovery. N.p. n.d. Web. 03 Aug. 2016
Burke, Mary G. "AMA Journal of Ethics." VM. N.p., Oct. 2003. Web. 07 Aug. 2016.
NCI Dictionary of Cancer Terms. National Cancer Institute. N.p., n.d. Web. 03 Aug. 2016