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The July 8 editorial “Ethics of medical enhancement” (p. 27) ignores the possibility that people with mental illness who take psychotropic medications may be somewhat dysfunctional and unproductive without those supports precisely because of that mental disability. While I agree with the author’s skepticism about the significant upsurge in diagnoses of ADHD, it is possible that some of this increase has resulted from improved access to mental health resources and the better diagnosis of people with ADHD who might have previously gone undiagnosed.
To characterize ADHD diagnoses and accompanying access to needed medications as contributing to “medical enhancement” of performance is to oversimplify a more complex phenomenon. Richard Hegner Columbia, Md.