245086 Improving healthcare provision for children through pharmaceutical testing: The ethics of exposing a vulnerable community to unknown risks

Monday, October 31, 2011: 12:30 PM

Molly Deacutis, BS , School of Medicine, University of St Andrews, St Andrews, United Kingdom
Morven Shearer, PhD , School of Medicine, University of St Andrews, St Andrews, United Kingdom
Children can be viewed as a vulnerable community. Within medicine, the relatively new area of pediatric psychiatry has left children with mental illness as a particularly vulnerable population within healthcare provision, marginalised, and receiving sub-optimal treatment. Pharmaceutical companies have tended, and many would argue with good reason, to shy away from including children in clinical trials. However, the exclusion of children from pharmaceutical research leads pediatric mental health patients to be prescribed medication off-label, leaving them at risk as they are then treated with untested, potentially unsafe and/or unsuitable psychotropic medication. Despite the US Government's attempt to improve this deficit of pediatric treatment data through legislative procedures and to more strictly regulate pediatric pharmaceutical use, available data continues to fall far short of the ever-increasing prescription trends. With appropriate and effective treatments for this community lagging behind the adult population, mentally ill children find themselves on the margins of healthcare provision. Equal access to healthcare across the generations is of crucial import, hence the ethical question we face is: how can we improve access to the best possible medical treatment for this vulnerable community while still safeguarding their rights and not exposing them to undue risks or coercion?

Learning Areas:
Clinical medicine applied in public health
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Describe barriers to pharmaceutical research on children and adolescents. Explain why children are a vulnerable community, particularly in the frame of mental health. Evaluate strategies to improve children’s access to safe healthcare (in both the US and UK sector).

Keywords: Access to Health Care, Child and Adolescent Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a member of the Public Health research group at the University of St Andrews, and carry out research in the areas of neuroscience and ethics.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.