Introduction
Ever since Prozac (fluoxetine) was launched in the late1980s, a variety of ‘selective serotonin reuptake inhibitors’ (SSRIs), ‘new antidepressants’ have been developed and launched in the market for use. These anti-depressants were originally developed to treat severe mental diseases including depression and other psychiatric troubles, but nowadays these kinds of mood-enhancers are regularly being recommended to persons with not-so-severe problems. (President’s Council on Bioethics, 2003).
A majority of persons using SSRIs do not have any severe type of depression but only a mild psychiatric problem, which may be a societal fear reflected by extreme shyness, or a natural negative mood associated with PMS, or even eating disorders, all of which are known to react ably to SSRIs (Farah & Wolpe, 2004). Persons using Prozac or any other SSRIs statethat they experience a new form of energy, enhanced alertness and feel more capable to cope-up with life by being able to perceive themselves better than before. (Elliott, 1999).
‘Prozac As A Way of Life’, is a collection of eleven essays by Carl Elliott and Tod Chambers, with the purpose of investigating the philosophical as well as the cultural repercussions of the escalating use of ‘Selective Serotonin Reuptake Inhibitors’ (SSRIs), in America. Elliott introduces the topic fantastically, and has divided the book into three sections, each, relating to with a specific topic.
Elliott (2003) states that the principle of genuineness determines how people use pharmaceuticals and other tools to improve their performance. People use drugs like Prozac to sense a more genuine feeling, of ‘being themselves’. He mentions the instance of Jan Morris, who transformed from being a male to a female. After the completion of her sex surgery that she believed that she discovered her proper identity and was content by the transformation. She was ecstatic by the achievement, as ‘fulfillment requires being true to that inner voice.’ (Elliott 2003, p.37) Elliott states one more instance about persons who got their limb cut off at their own will: ‘I have always felt I should be an amputee’, It is a desire to see myself, be myself, as I ‘know’, or ‘feel’ myself to be.’
Tod Chambers too provides us with instances as to how religious existence of people has been transformed by the influence of Prozac. On consuming Prozac, a spiritual Christian sensed a feeling of ‘living again. And I began experience God like I never had before.’
The foremost section, is the longest, and revolves around ‘Listening to Prozac’, a book written by Peter Kramer. The subsequent section “Prozac and American Culture,” progresses to argue about the cultural context of SSRIs in America where the discussion centers on the cultural concerns arisen by the use of SSRI in the United States.
The final section evaluates the differences between the Western psychiatric approaches as opposed to the Eastern contemplative approach to self renovation.
The final section of the book, “Prozac and the East,” comprises of three treatises, about Prozac in the milieu of unconventional life of the people of United States. Susan Squire and Tod Chambers in their essays seek to confer the connection amid the ‘antidepressants’ and mysticism.
The first section one is labeled “Responses to Prozac from Philosophy and Psychiatry.” Kramer, a psychiatric specialist, was among the foremost famous writers to debate the SSRIs in the perspective of varying individual attributes including self-confidence, insolence, and responsiveness to societal rejection. He accounted the cases of slightly dejected patients who on taking Prozac, almost immediately experience a “better than well” feeling, and felt more positive, active, and attractive.
In fact, a majority of the patients stated that the drug facilitated their discovery their true personality. It is this discovery, of most people developing significantly diverse characteristic aspects whilst taking Prozac, that led Kramer along with the other authors of ‘Prozac As A Way of Life’, to inquire the correct meaning of individual personality along with morally suitable and unsuitable means of renovation. The authors are however, cautious to reveal that there are lawful uses of Prozac, incorporating the healing of acute depression; a majority of them are precautious about employing SSRIs for the purpose of producing transformations in individuality.
Ethical Issues
The employment of Prozac for mood elevation does bring to the fore a number of ethical concerns like safety of the patient or person using Prozac and the worth human life as it originally exists (Farah & Wolpe, 2004), which are associated with our self perception.
There are also additional concerns involving fairness, equality and impartiality.
The concern relating to safety is permanent since drugs should not be taken over a long period of time as they can begin to interfere with the natural body processes and bring about changes or alterations over a longer period of time, which will eventually prove very disastrous and not much proof is available on the long-term effects of use of such drugs by healthy persons (Farah & Wolpe, 2004). Currently, there have been fresh apprehensions regarding the potential suicidal threats associated with the use of SSRIs, specifically among children and youngsters (Wong et al., 2004), and also in mature patients (Healy & Whitaker, 2003). Therefore the positive or negative long term use outcomes of these drugs remain to be concretely established.
Self-perception
The use of mood elevators for reasons other than medical has the potential to perpetually modify our theories of self acceptance individually and in the social order.
Authenticity
A grave anxiety pertaining to mood elevators is associated with individual honesty and authenticity. The employment of synthetic drugs to change consciousness and perception entails a sort of ‘taking over’. (President’s Council on Bioethics, 2003).
The worry exists in the fact that the taking of artificial drugs transform the psychological condition may possibly thwart the subject from being authentic and factual. A vital apprehension with the use of Prozac and such drugs is that they will psychologically alienate the persons using them from the realities of life consequently thwarting them from reacting appropriately to good or bad dealings and incidents. Another menace could be that mood elevators like Prozac will allow the persons using them to remain ‘bright’ or emotionless even in situations which are supposed to worry, depress, offend or motivate them.
Justice and fairness
The use of drugs such as Prozac as mood-elevators brings to the fore issues of unjust benefits by suggesting that if a single person is allegedly gaining an advantage of this type, there will be who may be obliged to use it (Blank, 1999). The employment of mood elevators essentially bestows a competitive benefit since the persons using Prozac or such drugs will tend to benefit from them in some way or the other thereby, generating a demand on those who do not use them to either become addicts, or to accept defeat from the competitors who use them (Whitehouse et al., 1997). Therefore this type of self prescription of the use of SSRIs could turn into a societal standard creating novel concerns relating to psychological wellbeing, producing fresh troubles in the sphere of communal justice.
David DeGrazia talks about Prozac and self-creation while arguing that legitimacy is not obtained from a specific manner of self-development, but actually from an individual’s sincere aspiration for transformation. He does not find much difference between the use of therapy ‘which works indirectly on the patient’s biochemistry’ and Prozac ‘which works directly on the patient’s biochemistry’. He elucidates that even though therapy may possibly have positive outcome over and above Prozac, it does necessitate a considerable investment of time and money. He goes on to argue that a well-read patient ought to be permitted to prefer Prozac as a means of self-alteration. Nonetheless, he rapidly mentions that significant moral apprehensions continue, most importantly the lack of availability to the needy.
In a new treatise, Erik Parens expresses the concern, that the use of Prozac may perhaps promote smugness, thereby thwarting the improvement of more gratifying way of life and grinding down principles such as independence.
David Healy discusses the therapeutic value of SSRIs where he questions the effectiveness along with the possible side effects including augmented propensity for suicide. He firmly believes that the social demand for Prozac is mostly due to the marketing strategies of pharmaceutical corporations, an observation that initiates critical queries concerning the preferred employment of Prozac along with the other SSRIs. Section one also includes an essay by Peter Kramer, which principally deals with Carl Elliott’s argument of ‘alienation’ in the final section.
References
Blank, R.H., Brain policy. How the new neuroscience will change our lives and our politics. Washington, D.C.: Georgetown University Press, 1999.
Elliott, C., A philosophical disease. Bioethics, culture and identity. New York/London: Routledge, 1999.
Elliott, C., Better than well. American medicine meets the American dream. New York: W.W. Norton & Company, 2003.
Farah, M.J. & Wolpe, P.R., New neuroscience technologies and their ethical implications. Hastings Center Report. 2004, 35-45.
Healy, D., Whitaker, C., Antidepressants and suicide: risk-benefit conundrums. Journal of Psychiatry and Neuroscience 2003; 28(5): 331-337.
President’s Council on Bioethics, Beyond therapy. Biotechnology and the pursuit of happiness. New York: ReganBooks, 2003.
Whitehouse, P.J., Juengst, E., Mehlman, M., Murray, T.H., Enhancing cognition in the intellectually intact. Hastings Center Report, 1997, 27(3):14-22.