Ethics and the Prescription Pad

• Published in: Child and adolescent psychiatric clinics of North America Vol. 17; no. 1; pp. 93 - 111
• Main Authors: Dell, Mary Lynn, MD, MTS, ThM, Vaughan, Brigette S., APRN, Kratochvil, Christopher J., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2008
• Subjects: Adolescent; Adolescent Psychiatry - education; Adolescent Psychiatry - ethics; Child; Child Psychiatry - education; Child Psychiatry - ethics; Drug Prescriptions; Education, Medical, Continuing - ethics; Evidence-Based Medicine - ethics; Humans; Informed Consent - ethics; Informed Consent - legislation & jurisprudence; Internship and Residency - ethics; Patient Participation - psychology; Pediatrics; Personal Autonomy; Physician-Patient Relations - ethics; Psychiatric/Mental Health; Psychotropic Drugs - administration & dosage; Psychotropic Drugs - adverse effects; United States; United States
• ISSN: 1056-4993; 1558-0490
• DOI: 10.1016/j.chc.2007.08.003

This article reviews the considerations that inform ethical psychotropic medication prescription processes at the clinical level with child and adolescent patients and their families or guardians. Physician attributes, cultural and religious factors, and the psychodynamic aspects of psychopharmacology are reviewed, in addition to the applications of basic ethical principles and concepts to the act of dispensing psychotropic medications. Attention is given to the processes of informed consent, assent, and challenges encountered to ethical prescribing for special populations such as children in foster care and juvenile justice systems. Ramifications of black box warnings and off label prescribing are discussed. Finally, the authors offer practical tips to guide clinicians in ethical psychopharmacologic management of their child and adolescent patients.