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Sept. 13, 2000
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Can a judge constitutionally order a controversial drug to be
given to a child over the opposition of his parents? Such action by a
Family Court Judge in Albany, NY has touched off a national debate
pitting public schools and the courts against parental rights.
Seven-year-old Kyle Carroll of Berne, NY, was diagnosed by a
psychologist as having ADHD (Attention Deficit/Hyperactivity Disorder)
and a physician prescribed the psychotropic drug Ritalin. The boy soon
exhibited two of the drug's common side effects, sleeplessness and
appetite loss.
When Kyle's parents told school officials they wanted to
temporarily discontinue the medication, they got a visit from the
Albany County Child Protective Services and a petition to appear in
court. The school district accused the Carrolls of "educational
neglect" and they received what amounted to an order from Judge Gerard
E. Maney to start using Ritalin again.
Under what was described as "at least the theoretical threat of
having their child removed from their custody," the Carrolls agreed to
"an adjournment in contemplation of dismissal (ACOD)." There was no
fact-finding hearing before Judge Maney, no testimony taken, and no
written decision rendered.
According to law guardian Pamela J. Joern of Albany, who supported
the school's position, "The consent ACOD directed the parents to comply
with the doctor's treatment regimen, which was a prescription for
Ritalin. They could get a second opinion, but they couldn't ignore the
problem."
This case underscores the need for better medical privacy
protection in order to safeguard against government intervention in
personal medical decisions. A family's decision whether or not to use
Ritalin is not the government's business.
In order to avoid a prolonged court battle, the Carrolls
compromised, which is usually what happens when parents are subjected
to intimidation by state child protection agencies. The injustice of
Judge Maney's decision will go unreviewed by higher courts, but the
Kyle Carroll case has kicked up a storm of protest on the internet.
This case is a good example of judicial activism that would never
be known outside of the local community if it were not for the free
flow of news and information on the internet. Hundreds of criticisms
of this decision appeared on internet message boards within days.
In traditional channels of communication, many disputes degenerate
into both sides reciting hearsay and bogus facts, with no hope of
resolution. On the internet, it is so easy to include checkable hard
facts in the discussion, and one side can actually persuade the other.
A quick search on Yahoo yields a variety of sites that are
critical of Ritalin, including support groups, pharmacies and
alternative medications. The case against Napster, soon to be heard by
the Ninth Circuit Court of Appeals, has ominous implications for this
exchange of information about Ritalin on the internet.
The same reasoning behind the injunction recently issued against
Napster would chill or even require shutting down web sites that
provide medical information to internet users. Since "Ritalin" is a
registered trademark and some of the official information on it and
ADHD is copyrighted, the arguments behind the anti-Napster injunction
could enable the owner of Ritalin to demand that Yahoo provide only
authorized links about Ritalin.
Ritalin does not treat an objective physical illness as, for
example, insulin treats diabetes. Ritalin is a serious drug used to
control behavior problems and is very attractive to the schools because
it makes the child more likely to shut up, sit down, and do what he's
told.
There are some 3.8 million schoolchildren, mostly boys, who are
said to have ADHD, according to the American Academy of Pediatrics.
Estimates are that most of them are on Ritalin or similar psychotropic
drugs.
The number of children labeled ADHD and taking Ritalin has greatly
increased since 1991 when ADHD was covered under the Individuals with
Disabilities Education Act (IDEA), a federal program that brings more
funding to public schools in order to provide extra services. Under
IDEA, the school is required to craft an Individualized Education Plan
(IEP) to accommodate each child, which may include drugs prescribed by
a medical doctor, and that's how Kyle happened to be given Ritalin.
In May this year, the Dallas law firm Waters and Kraus filed a
class action suit alleging fraud and conspiracy against the Swiss-owned
manufacturer of Ritalin, Novartis, as well as the private ADHD support
group Children and Adults with Attention Deficit/Hyperactivity Disorder
(CHADD) and the American Psychiatric Association. The suit charges
that the three defendants committed fraud in conspiring to over-promote
the diagnosis of ADHD and its treatment with the stimulant drug
methylphenidate (Ritalin).
Information about Ritalin's side effects, withdrawal symptoms,
manufacturer warnings, and interactions with other drugs is now very
accessible on the internet. The public needs the internet to sort out
the facts about Ritalin, ADHD, and medical privacy rights.
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