High-Level Feud Bares Tensions in Iran

TEHRAN — President Mahmoud Ahmadinejad escalated a bitter political fight this week with Iran’s most influential political family by disclosing secret film recordings of what he purported were fraudulent business deals.

During a Sunday session of Parliament, broadcast on state radio, Mr. Ahmadinejad singled out the head of the Parliament, Ali Larijani, a political rival with strong links to influential Shiite Muslim clerics and one of several brothers who have held top positions in the Iranian government.

His younger brother Sadegh, 52, heads Iran’s judiciary, while his oldest brother, Mohammad Javad, a Berkeley-educated mathematician, is also a judiciary official.

On Monday, a conservative newspaper, Kayhan, hinted that the nation’s supreme leader, Ayatollah Ali Khamenei, had been forced to step in to prevent both men from giving potentially damaging news conferences, which were both canceled at the last minute.

This was not the first time Ayatollah Khamenei has been forced to intervene in this feud. In October, he issued an edict aimed at stopping the infighting, saying that those creating divisions before the June 14 presidential elections “betray” the country.

Mr. Ahmadinejad, who went to the Parliament in a failed attempt to head off the impeachment of his labor minister, Abdolreza Sheikholeslami, said Mr. Larijani and his fellow lawmakers had obstructed the government, stepped beyond their constitutional boundaries and written letters ordering the annulment of government decisions.

Instructed by Mr. Larijani to stick to the subject of the impeachment, Mr. Ahmadinejad said, “Don’t order me to close my mouth because you say it’s the law.”

With that, Mr. Ahmadinejad, who for years has threatened to reveal the names of corrupt officials, played a video clip of a conversation in which another of Mr. Larijani’s brothers, Fazel, appeared to discuss the purchase of a state company under favorable terms, the semiofficial Tabnak Web site reported. While Fazel Larijani used to head a medical association in Iran, his current position is unclear.

The public accusation, rare in Iran, could signal a new phase in an already intense conflict between Mr. Ahmadinejad, who represents a powerful group of young, ambitious politicians, and Mr. Larijani, who is the official representative of the holy city of Qum, the center of Shiite scholarship in Iran.

Mr. Ahmadinejad said his associate, Saeed Mortazavi, 45, was also at the taped meeting. In January, Mr. Mortazavi was dismissed as the head of Iran’s enormous social welfare organization under pressure from Parliament. Some days later, however, he was rehired by the president in the same position, this time as official caretaker.

During the conversation, read out in part by Mr. Ahmadinejad to astonished lawmakers, Fazel Larijani appears to try to use his family connections to buy a factory from the social welfare organization. He promises leniency for Mr. Mortazavi, the former Tehran prosecutor who faces several criminal proceedings over accusations that he played a role in the deaths of three protesters in a substandard prison in 2009.

Mr. Mortazavi was arrested Monday evening, the Fars news agency reported, though no reason was given.

“These are audio and video, and the tape is clear,” Mr. Ahmadinejad is quoted as saying by the Iranian Students’ News Agency. “If the honorable Parliament speaker sees fit, we can turn over the 24 to 25 hours to you,” he said of the recordings. On Monday, Iran’s Islamic Republic News Agency, a mouthpiece for Mr. Ahmadinejad, deepened the split by publishing the audiotape on its Web site.

Ali Larijani, cheered on by the Parliament, which has lost nearly every serious political battle with the president, silenced the room, saying: “Let him tell his words. If there is anything about my family, then let him talk about it.”Mr. Larijani said it was a “mafia film” and recalled how he had a meeting with Mr. Ahmadinejad’s estranged brother, Davoud. “He said many things against you,” Mr. Larijani told the president, “about economic corruption, about your inner circle and your relations with foreign countries.”

For his part, Fazel Larijani strongly denied any wrongdoing, saying that while he did appear in the clip, the words were not his, but rather had been added in a voiceover. Calling Mr. Ahmadinejad and Mr. Mortazavi “mafialike individuals,” he said he would sue them both for “spreading lies and disturbing public opinion.”

On Monday, several officials criticized Mr. Ahmadinejad and Ali Larijani, accusing them of lacking self-control and bringing shame on the country. “They broke the leader’s heart and gave the friends of the Islamic republic almost a seizure,” said Mojtaba Zolnour, a special consultant to the supreme leader, Ayatollah Khamenei, the semiofficial Iranian Labor News Agency reported. “They provided ammunition for the foreign media on the eve of our election.”

This article has been revised to reflect the following correction:

Correction: February 5, 2013

An earlier version of this article misstated the birth order of Ali Larijani and his brother Sadegh Larijani. Sadegh is younger than Ali, not older.

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DealBook: U.S. and States Prepare to Sue S.&P. Over Mortgage Ratings

The Justice Department, along with state prosecutors, plans to file civil charges against Standard & Poor’s Ratings Service, accusing the firm of fraudulently rating mortgage bonds that led to the financial crisis, people briefed on the plan said Monday.

Up until last last week, the Justice Department had been in settlement talks with S.&P., these people said. But the negotiations broke down after the Justice Department said it would seek a settlement in excess of “10 figures,” or at least $1 billion, these people said, which would wipe out the profits of S.&P.’s parent, the McGraw-Hill Company, for an entire year.

McGraw-Hill earned $911 million last year.

A suit against S.&P. would be the first the government has brought against the credit ratings agencies related to the financial crisis, despite continued questions about the agencies’ conflicts of interest and role in creating a housing bubble.

By bringing a civil suit, as opposed to a criminal case, the Justice Department’s burden of proof will be less, perhaps lowering the bar for a successful prosecution.

In a statement on Monday, S.&P. said it had received notice from the Justice Department over a pending lawsuit.

The ratings agency argued any such legal action would be baseless, since it downgraded plenty of mortgage-backed investments, including in the two years leading up to the financial crisis. It also contended that other observers of the debt markets, including government officials, believed at the time that any problems within the housing sector could be contained.

“A D.O.J. lawsuit would be entirely without factual or legal merit,” the agency said in its statement. “With 20/20 hindsight, these strong actions proved insufficient – but they demonstrate that the D.O.J. would be wrong in contending that S.&P. ratings were motivated by commercial considerations and not issued in good faith.”

Shares in McGraw-Hill were down 3.8 percent in midafternoon trading on Monday, at $56.07.

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Well: A Doctor's Struggle With Numbers

My youngest child has been struggling with numbers.

This all started around the time of his 4th birthday, in mid-November. He knew he was getting older and asked a lot of questions about babies, who were “too little to have a number,” being less than 1 year old. Then, on the day of his birthday, he wanted to know when he was turning 4.

I told him that today was his birthday, that he turned 4 today.

“But when do I turn 4?” He had recently learned to emphasize certain words in an effort to assist his dim parents in getting his questions answered.

I told him at 8 in the morning, the time he was born.

“No, no, when do I turn 4?”

I looked at him helplessly, wondering whether he was expecting some pivotal moment when he would suddenly gain five inches in height. He decided that the anointed time occurred later that day, after he received his presents.

A week later, his mother and I went for a car ride with her parents, both in their mid-70s. In a rare quiet moment amid the usual barrage of instructions on how to navigate the rural western Pennsylvania roads, our son spoke up.

“When is Pappy going to die?”

The adults fell over themselves responding, trying to both reassure him and ourselves, as if the faster and louder we answered his question, the more we would negate it: A lot of years. Not for a long, long time. We hope he never does.

This satisfied him for the moment, but much like his father, he broods about these types of important topics. A couple of hours later, back at the house, he asked as if in mid-thought: “But, what is the last number?”

I repeated his question, stalling.

“Yes, what is the last number? What’s my last number?” he asked. His mother and I glanced at each other, in a quick game of chicken to see who would answer first.

“We don’t know, honey,” I finally said. He looked up at my wife, who nodded in agreement.

My son’s words came back to me the following Monday when I saw my first patient, a man in his 70s whose leukemia didn’t get worse on chemotherapy, but unfortunately also didn’t get better. We had run out of options, aside from supportive care.

“How long does he have?”

My patient’s son asked the question that was on everyone’s mind, and when he did, the wave of emotion that washed across the room was almost palpable. My patient’s daughter crossed her legs, and his wife started to cry. So did my patient, though he tried to hide it, glancing up at the fluorescent ceiling lights of the clinic room. Guys in his generation, I’ve found, don’t like to appear weak in front of their family.

I turned to my patient and asked him if he wanted me to talk about this, about his prognosis. My first responsibility in this type of situation is always to my patient and what he wants to hear. Some people want to know specifics, down to the half-month of predicted survival; others want no information at all, as if hearing a number will seal their fate.

“Sure, I guess so,” he answered. He did want to know, but he didn’t want to know.

Oncologists are notoriously bad at predicting survival, and none of us wants to be known as “the doctor who told me I would be dead by now,” the doctor who made a prediction of imminent demise, sending a family into a terrifying tailspin of goodbyes, only to be proven wrong and subsequently mocked for years to come. One of my patients, upon being told by another doctor that she had two months to live, held Christmas in April so she could spend one last holiday with her grandchildren. She survived to see two more Christmases.

At the same time, we need to be truthful and give guidance to people who want time to prepare, time to write wills and pay off debts, to say goodbyes and to leave instructions, to tie up the loose ends of a life now heavy with meaning.

We try to provide hope, but not false hope.

So we give ranges, starting with the best estimate of survival, because my patients have told me they shut down after they hear the worst estimate. We talk about setting goals, about maximizing quality of life, because we don’t have much leverage with quantity of life. We emphasize spending as much time as possible with family and friends, and as little time as possible with people wearing white coats. We tell them we’re not going to give up if they don’t give up.

But the truth is, we don’t know.

---

Dr. Mikkael Sekeres is director of the leukemia program at the Cleveland Clinic.

Read More..

Well: A Doctor's Struggle With Numbers

My youngest child has been struggling with numbers.

This all started around the time of his 4th birthday, in mid-November. He knew he was getting older and asked a lot of questions about babies, who were “too little to have a number,” being less than 1 year old. Then, on the day of his birthday, he wanted to know when he was turning 4.

I told him that today was his birthday, that he turned 4 today.

“But when do I turn 4?” He had recently learned to emphasize certain words in an effort to assist his dim parents in getting his questions answered.

I told him at 8 in the morning, the time he was born.

“No, no, when do I turn 4?”

I looked at him helplessly, wondering whether he was expecting some pivotal moment when he would suddenly gain five inches in height. He decided that the anointed time occurred later that day, after he received his presents.

A week later, his mother and I went for a car ride with her parents, both in their mid-70s. In a rare quiet moment amid the usual barrage of instructions on how to navigate the rural western Pennsylvania roads, our son spoke up.

“When is Pappy going to die?”

The adults fell over themselves responding, trying to both reassure him and ourselves, as if the faster and louder we answered his question, the more we would negate it: A lot of years. Not for a long, long time. We hope he never does.

This satisfied him for the moment, but much like his father, he broods about these types of important topics. A couple of hours later, back at the house, he asked as if in mid-thought: “But, what is the last number?”

I repeated his question, stalling.

“Yes, what is the last number? What’s my last number?” he asked. His mother and I glanced at each other, in a quick game of chicken to see who would answer first.

“We don’t know, honey,” I finally said. He looked up at my wife, who nodded in agreement.

My son’s words came back to me the following Monday when I saw my first patient, a man in his 70s whose leukemia didn’t get worse on chemotherapy, but unfortunately also didn’t get better. We had run out of options, aside from supportive care.

“How long does he have?”

My patient’s son asked the question that was on everyone’s mind, and when he did, the wave of emotion that washed across the room was almost palpable. My patient’s daughter crossed her legs, and his wife started to cry. So did my patient, though he tried to hide it, glancing up at the fluorescent ceiling lights of the clinic room. Guys in his generation, I’ve found, don’t like to appear weak in front of their family.

I turned to my patient and asked him if he wanted me to talk about this, about his prognosis. My first responsibility in this type of situation is always to my patient and what he wants to hear. Some people want to know specifics, down to the half-month of predicted survival; others want no information at all, as if hearing a number will seal their fate.

“Sure, I guess so,” he answered. He did want to know, but he didn’t want to know.

Oncologists are notoriously bad at predicting survival, and none of us wants to be known as “the doctor who told me I would be dead by now,” the doctor who made a prediction of imminent demise, sending a family into a terrifying tailspin of goodbyes, only to be proven wrong and subsequently mocked for years to come. One of my patients, upon being told by another doctor that she had two months to live, held Christmas in April so she could spend one last holiday with her grandchildren. She survived to see two more Christmases.

At the same time, we need to be truthful and give guidance to people who want time to prepare, time to write wills and pay off debts, to say goodbyes and to leave instructions, to tie up the loose ends of a life now heavy with meaning.

We try to provide hope, but not false hope.

So we give ranges, starting with the best estimate of survival, because my patients have told me they shut down after they hear the worst estimate. We talk about setting goals, about maximizing quality of life, because we don’t have much leverage with quantity of life. We emphasize spending as much time as possible with family and friends, and as little time as possible with people wearing white coats. We tell them we’re not going to give up if they don’t give up.

But the truth is, we don’t know.

---

Dr. Mikkael Sekeres is director of the leukemia program at the Cleveland Clinic.

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TIMESCAST: Super Bowl Ads Recall Days Gone By

February 4, 2013By Fritzie Andrade, Zena Barakat, Emily B. Hager, Erica Berenstein and Pedro Rafael Rosado

TimesCast Media+Tech: The successes and failures of this year’s Super Bowl ads. | Ang Lee on the technology behind “Life of Pi.” | An interactive project encourages action against human trafficking.

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High-Level Feud Bares Tensions in Iran

TEHRAN — President Mahmoud Ahmadinejad escalated a bitter political fight this week with Iran’s most influential political family by disclosing secret film recordings of what he purported were fraudulent business deals.

During a Sunday session of Parliament, broadcast on state radio, Mr. Ahmadinejad singled out the head of the Parliament, Ali Larijani, a political rival with strong links to influential Shiite Muslim clerics and one of several brothers who have held top positions in the Iranian government.

His older brother, Sadegh, 52, heads Iran’s judiciary, while another brother, Mohammad Javad, a Berkeley-educated mathematician, is also a judiciary official.

On Monday, Iran’s state newspaper, Kayhan, which is run by an editor appointed by the supreme leader, Ayatollah Ali Khamenei, hinted that Ayatollah Khamenei had been forced to step in to prevent both men from giving potentially damaging news conferences, which were both canceled at the last minute.

This was not the first time Ayatollah Khamenei has been forced to intervene in this feud. In October, he issued an edict aimed at stopping the infighting, saying that those creating divisions in the leadup to the June 14 presidential elections “betray” the country.

Mr. Ahmadinejad, who went to the Parliament in a failed attempt to head off the impeachment of his labor minister, Abdolreza Sheikholeslami, said Mr. Larijani and his fellow lawmakers had obstructed the government, stepped beyond their constitutional boundaries and written letters ordering the annulment of government decisions.

Instructed by Mr. Larijani to stick to the subject of the impeachment, Mr. Ahmadinejad said, “Don’t order me to close my mouth because you say it’s the law.”

With that, Mr. Ahmadinejad, who for years has threatened to reveal the names of corrupt officials, played a video clip of a conversation in which another of Mr. Larijani’s brothers, Fazel, appeared to discuss the purchase of a state company under favorable terms, the semiofficial Tabnak Web site reported. While Fazel Larijani used to head a medical association in Iran, his current position is unclear.

The public naming, rare in Iran, could signal a new phase in an already intense scrum between Mr. Ahmadinejad, who represents a powerful group of young, ambitious politicians, and Mr. Larijani, who is the official representative of the holy city of Qum, the center of Shiite scholarship in Iran.

Mr. Ahmadinejad said his associate, Saeed Mortazavi, 45, was also present at the taped meeting. In January, Mr. Mortazavi was dismissed as the head of Iran’s enormous social welfare organization under pressure from Parliament. Some days later, however, he was rehired by the president in the same position, this time as official caretaker.

During the conversation, read out in part by Mr. Ahmadinejad to astonished lawmakers, Fazel Larijani appears to try to use his family connections to buy a factory from the social welfare organization. He promises leniency for Mr. Mortazavi, who faces several criminal proceedings over assertions that he played a role in the deaths of three protesters in a substandard prison in 2009.

“These are audio and video, and the tape is clear,” Mr. Ahmadinejad is quoted as saying by the Iranian Students’ News Agency. “If the honorable Parliament speaker sees fit, we can turn over the 24 to 25 hours to you,” he said of the recordings. On Monday, Iran’s Islamic Republic News Agency, a mouthpiece for Mr. Ahmadinejad, deepened the split by publishing the audio tape on its Web site.

Ali Larijani, cheered on by the Parliament, which has lost nearly each serious political battle with the president, silenced the room, saying, “Let him tell his words. If there is anything about my family, then let him talk about it.”

Mr. Larijani said it was a “mafia film” and recalled how he had a meeting with Mr. Ahmadinejad’s estranged brother, Davoud. “He said many things against you,” Mr. Larijani told the president, “about economic corruption, about your inner circle and your relations with foreign countries.”

For his part, Fazel Larijani strongly denied any wrongdoing, saying that while he did appear in the clip, the words were not his, but rather had been added in a voiceover. Calling Mr. Ahmadinejad and Mr. Mortazavi “mafialike individuals,” he said he would sue them both for “spreading lies and disturbing public opinion.”

On Monday, several officials criticized Mr. Ahmadinejad and Ali Larijani, accusing them of lacking self-control and bringing shame on the country. “They broke the leader’s heart and gave the friends of the Islamic republic almost a seizure,” said Mojtaba Zolnour, a special consultant to the supreme leader, Ayatollah Khamenei, the semiofficial Iranian Labor News Agency reported. “They provided ammunition for the foreign media on the eve of our election.”

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Iceland, Prosecutor of Bankers, Sees Meager Returns

Ilvy Njiokiktjien for The New York Times

"Greed is not a crime. But the question is: where does greed lead?" said Olafur Hauksson, a special prosecutor in Reykjavik.

REYKJAVIK, Iceland — As chief of police in a tiny fishing town for 11 years, Olafur Hauksson developed what he thought was a basic understanding of the criminal mind. The typical lawbreaker, he said, recalling his many encounters with small-time criminals, “clearly knows that he crossed the line” and generally sees “the difference between right and wrong.”

Today, the burly, 48-year-old former policeman is struggling with a very different sort of suspect. Reassigned to Reykjavik, the Icelandic capital, to lead what has become one of the world’s most sweeping investigation into the bankers whose actions contributed to the global financial crisis in 2008, Mr. Hauksson now faces suspects who “are not aware of when they crossed the line” and “defend their actions every step of the way.”

With the global economy still struggling to recover from the financial maelstrom five years ago, governments around the world have been criticized for largely failing to punish the bankers who were responsible for the calamity. But even here in Iceland, a country of just 320,000 that has gone after financiers with far more vigor than the United States and other countries hit by the crisis, obtaining criminal convictions has proved devilishly difficult.

Public hostility toward bankers is so strong in Iceland that “it is easier to say you are dealing drugs than to say you’re a banker,” said Thorvaldur Sigurjonsson, the former head of trading for Kaupthing, a once high-flying bank that crumbled. He has been called in for questioning by Mr. Hauksson’s office but has not been charged with any wrongdoing.

Yet, in the four years since the Icelandic Parliament passed a law ordering the appointment of an unnamed special prosecutor to investigate those blamed for the country’s spectacular meltdown in 2008, only a handful of bankers have been convicted.

Ministers in a left-leaning coalition government elected after the crash agree that the wheels of justice have ground slowly, but they call for patience, explaining that the process must follow the law, not vengeful passions.

“We are not going after people just to satisfy public anger,” said Steingrimur J. Sigfusson, Iceland’s minister of industry, a former finance minister and leader of the Left-Green Movement that is part of the governing coalition.

Hordur Torfa, a popular singer-songwriter who helped organize protests that forced the previous conservative government to resign, acknowledged that “people are getting impatient” but said they needed to accept that “this is not the French Revolution. I don’t believe in taking bankers out and hanging them or shooting them.”

Others are less patient. “The whole process is far too slow,” said Thorarinn Einarsson, a left-wing activist. “It only shows that ‘banksters’ can get away with doing whatever they want.”

Mr. Hauksson, the special prosecutor, said he was frustrated by the slow pace but thought it vital that his office scrupulously follow legal procedure. “Revenge is not something we want as our main driver in this process. Our work must be proper today and be seen as proper in the future,” he said.

Part of the difficulty in prosecuting bankers, he said, is that the law is often unclear on what constitutes a criminal offense in high finance. “Greed is not a crime,” he noted. “But the question is: where does greed lead?”

Mr. Hauksson said it was often easy to show that bankers violated their own internal rules for lending and other activities, but “as in all cases involving theft or fraud, the most difficult thing is proving intent.”

And there are the bankers themselves. Those who have been brought in for questioning often bristle at being asked to account for their actions. “They are not used to being questioned. These people are not used to finding themselves in this situation,” Mr. Hauksson said. They also hire expensive lawyers.

The special prosecutor’s office initially had only five staff members but now has more than 100 investigators, lawyers and financial experts, and it has relocated to a big new office. It has opened about 100 cases, with more than 120 people now under investigation for possible crimes relating to an Icelandic financial sector that grew so big it dwarfed the rest of the economy.

To help ease Mr. Hauksson’s task, legislators amended the law to allow investigators easy access to confidential bank information, something that previously required a court order.

Parliament also voted to put the country’s prime minister at the time of the banking debacle on trial for negligence before a special tribunal. (A proposal to try his cabinet failed.) Mr. Hauksson was not involved in the case against the former leader, Geir H. Haarde, who last year was found guilty of failing to keep ministers properly informed about the 2008 crisis but was acquitted on more serious charges that could have resulted in a prison sentence.

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Concerns About A.D.H.D. Practices and Amphetamine Addiction

Before his addiction, Richard Fee was a popular college class president and aspiring medical student. "You keep giving Adderall to my son, you're going to kill him," said Rick Fee, Richard's father, to one of his son's doctors.

VIRGINIA BEACH — Every morning on her way to work, Kathy Fee holds her breath as she drives past the squat brick building that houses Dominion Psychiatric Associates.

Matt Eich for The New York Times

MENTAL HEALTH CLINIC Dominion Psychiatric Associates in Virginia Beach, where Richard Fee was treated by Dr. Waldo M. Ellison. After observing Richard and hearing his complaints about concentration, Dr. Ellison diagnosed attention deficit hyperactivity disorder and prescribed the stimulant Adderall.

It was there that her son, Richard, visited a doctor and received prescriptions for Adderall, an amphetamine-based medication for attention deficit hyperactivity disorder. It was in the parking lot that she insisted to Richard that he did not have A.D.H.D., not as a child and not now as a 24-year-old college graduate, and that he was getting dangerously addicted to the medication. It was inside the building that her husband, Rick, implored Richard’s doctor to stop prescribing him Adderall, warning, “You’re going to kill him.”

It was where, after becoming violently delusional and spending a week in a psychiatric hospital in 2011, Richard met with his doctor and received prescriptions for 90 more days of Adderall. He hanged himself in his bedroom closet two weeks after they expired.

The story of Richard Fee, an athletic, personable college class president and aspiring medical student, highlights widespread failings in the system through which five million Americans take medication for A.D.H.D., doctors and other experts said.

Medications like Adderall can markedly improve the lives of children and others with the disorder. But the tunnel-like focus the medicines provide has led growing numbers of teenagers and young adults to fake symptoms to obtain steady prescriptions for highly addictive medications that carry serious psychological dangers. These efforts are facilitated by a segment of doctors who skip established diagnostic procedures, renew prescriptions reflexively and spend too little time with patients to accurately monitor side effects.

Richard Fee’s experience included it all. Conversations with friends and family members and a review of detailed medical records depict an intelligent and articulate young man lying to doctor after doctor, physicians issuing hasty diagnoses, and psychiatrists continuing to prescribe medication — even increasing dosages — despite evidence of his growing addiction and psychiatric breakdown.

Very few people who misuse stimulants devolve into psychotic or suicidal addicts. But even one of Richard’s own physicians, Dr. Charles Parker, characterized his case as a virtual textbook for ways that A.D.H.D. practices can fail patients, particularly young adults. “We have a significant travesty being done in this country with how the diagnosis is being made and the meds are being administered,” said Dr. Parker, a psychiatrist in Virginia Beach. “I think it’s an abnegation of trust. The public needs to say this is totally unacceptable and walk out.”

Young adults are by far the fastest-growing segment of people taking A.D.H.D medications. Nearly 14 million monthly prescriptions for the condition were written for Americans ages 20 to 39 in 2011, two and a half times the 5.6 million just four years before, according to the data company I.M.S. Health. While this rise is generally attributed to the maturing of adolescents who have A.D.H.D. into young adults — combined with a greater recognition of adult A.D.H.D. in general — many experts caution that savvy college graduates, freed of parental oversight, can legally and easily obtain stimulant prescriptions from obliging doctors.

“Any step along the way, someone could have helped him — they were just handing out drugs,” said Richard’s father. Emphasizing that he had no intention of bringing legal action against any of the doctors involved, Mr. Fee said: “People have to know that kids are out there getting these drugs and getting addicted to them. And doctors are helping them do it.”

“...when he was in elementary school he fidgeted, daydreamed and got A’s. he has been an A-B student until mid college when he became scattered and he wandered while reading He never had to study. Presently without medication, his mind thinks most of the time, he procrastinated, he multitasks not finishing in a timely manner.”

Dr. Waldo M. Ellison

Richard Fee initial evaluation

Feb. 5, 2010

Richard began acting strangely soon after moving back home in late 2009, his parents said. He stayed up for days at a time, went from gregarious to grumpy and back, and scrawled compulsively in notebooks. His father, while trying to add Richard to his health insurance policy, learned that he was taking Vyvanse for A.D.H.D.

Richard explained to him that he had been having trouble concentrating while studying for medical school entrance exams the previous year and that he had seen a doctor and received a diagnosis. His father reacted with surprise. Richard had never shown any A.D.H.D. symptoms his entire life, from nursery school through high school, when he was awarded a full academic scholarship to Greensboro College in North Carolina. Mr. Fee also expressed concerns about the safety of his son’s taking daily amphetamines for a condition he might not have.

“The doctor wouldn’t give me anything that’s bad for me,” Mr. Fee recalled his son saying that day. “I’m not buying it on the street corner.”

This article has been revised to reflect the following correction:

Correction: February 3, 2013

An earlier version of a quote appearing with the home page presentation of this article misspelled the name of a medication. It is Adderall, not Aderall.

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Concerns About A.D.H.D. Practices and Amphetamine Addiction

Before his addiction, Richard Fee was a popular college class president and aspiring medical student. "You keep giving Adderall to my son, you're going to kill him," said Rick Fee, Richard's father, to one of his son's doctors.

VIRGINIA BEACH — Every morning on her way to work, Kathy Fee holds her breath as she drives past the squat brick building that houses Dominion Psychiatric Associates.

Matt Eich for The New York Times

MENTAL HEALTH CLINIC Dominion Psychiatric Associates in Virginia Beach, where Richard Fee was treated by Dr. Waldo M. Ellison. After observing Richard and hearing his complaints about concentration, Dr. Ellison diagnosed attention deficit hyperactivity disorder and prescribed the stimulant Adderall.

It was there that her son, Richard, visited a doctor and received prescriptions for Adderall, an amphetamine-based medication for attention deficit hyperactivity disorder. It was in the parking lot that she insisted to Richard that he did not have A.D.H.D., not as a child and not now as a 24-year-old college graduate, and that he was getting dangerously addicted to the medication. It was inside the building that her husband, Rick, implored Richard’s doctor to stop prescribing him Adderall, warning, “You’re going to kill him.”

It was where, after becoming violently delusional and spending a week in a psychiatric hospital in 2011, Richard met with his doctor and received prescriptions for 90 more days of Adderall. He hanged himself in his bedroom closet two weeks after they expired.

The story of Richard Fee, an athletic, personable college class president and aspiring medical student, highlights widespread failings in the system through which five million Americans take medication for A.D.H.D., doctors and other experts said.

Medications like Adderall can markedly improve the lives of children and others with the disorder. But the tunnel-like focus the medicines provide has led growing numbers of teenagers and young adults to fake symptoms to obtain steady prescriptions for highly addictive medications that carry serious psychological dangers. These efforts are facilitated by a segment of doctors who skip established diagnostic procedures, renew prescriptions reflexively and spend too little time with patients to accurately monitor side effects.

Richard Fee’s experience included it all. Conversations with friends and family members and a review of detailed medical records depict an intelligent and articulate young man lying to doctor after doctor, physicians issuing hasty diagnoses, and psychiatrists continuing to prescribe medication — even increasing dosages — despite evidence of his growing addiction and psychiatric breakdown.

Very few people who misuse stimulants devolve into psychotic or suicidal addicts. But even one of Richard’s own physicians, Dr. Charles Parker, characterized his case as a virtual textbook for ways that A.D.H.D. practices can fail patients, particularly young adults. “We have a significant travesty being done in this country with how the diagnosis is being made and the meds are being administered,” said Dr. Parker, a psychiatrist in Virginia Beach. “I think it’s an abnegation of trust. The public needs to say this is totally unacceptable and walk out.”

Young adults are by far the fastest-growing segment of people taking A.D.H.D medications. Nearly 14 million monthly prescriptions for the condition were written for Americans ages 20 to 39 in 2011, two and a half times the 5.6 million just four years before, according to the data company I.M.S. Health. While this rise is generally attributed to the maturing of adolescents who have A.D.H.D. into young adults — combined with a greater recognition of adult A.D.H.D. in general — many experts caution that savvy college graduates, freed of parental oversight, can legally and easily obtain stimulant prescriptions from obliging doctors.

“Any step along the way, someone could have helped him — they were just handing out drugs,” said Richard’s father. Emphasizing that he had no intention of bringing legal action against any of the doctors involved, Mr. Fee said: “People have to know that kids are out there getting these drugs and getting addicted to them. And doctors are helping them do it.”

“...when he was in elementary school he fidgeted, daydreamed and got A’s. he has been an A-B student until mid college when he became scattered and he wandered while reading He never had to study. Presently without medication, his mind thinks most of the time, he procrastinated, he multitasks not finishing in a timely manner.”

Dr. Waldo M. Ellison

Richard Fee initial evaluation

Feb. 5, 2010

Richard began acting strangely soon after moving back home in late 2009, his parents said. He stayed up for days at a time, went from gregarious to grumpy and back, and scrawled compulsively in notebooks. His father, while trying to add Richard to his health insurance policy, learned that he was taking Vyvanse for A.D.H.D.

Richard explained to him that he had been having trouble concentrating while studying for medical school entrance exams the previous year and that he had seen a doctor and received a diagnosis. His father reacted with surprise. Richard had never shown any A.D.H.D. symptoms his entire life, from nursery school through high school, when he was awarded a full academic scholarship to Greensboro College in North Carolina. Mr. Fee also expressed concerns about the safety of his son’s taking daily amphetamines for a condition he might not have.

“The doctor wouldn’t give me anything that’s bad for me,” Mr. Fee recalled his son saying that day. “I’m not buying it on the street corner.”

This article has been revised to reflect the following correction:

Correction: February 3, 2013

An earlier version of a quote appearing with the home page presentation of this article misspelled the name of a medication. It is Adderall, not Aderall.

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Slipstream: Consumer Data Protection Laws, an Ocean Apart

OVER the years, the United States and Europe have taken different approaches toward protecting people’s personal information. Now the two sides are struggling to bridge that divide.

On this side of the Atlantic, Congress has enacted a patchwork quilt of privacy laws that separately limit the use of Americans’ medical records, credit reports, video rental records and so on. On the other side, the European Union has instituted more of a blanket regulatory system; it has a common directive that gives its citizens certain fundamental rights — like the right to obtain copies of records held about them by companies and institutions — that Americans now lack.

Even so, United States officials maintain that the divergent approaches are equal. “The sum of the parts of U.S. privacy protection is equal to or greater than the single whole of Europe,” says Cameron F. Kerry, general counsel of the Commerce Department. He is overseeing an agency effort to help develop voluntary, enforceable codes of conduct for industry groups, like app developers, whose collection and use of consumer data are now unregulated.

Europe begs to differ.

“Yes, we share the basic idea of privacy,” says Peter Hustinx, Europe’s data protection supervisor. “But there is a huge deficit on the U.S. side.”

Alas, the data-control divide appears to be widening.

A year ago, the European Commission proposed comprehensive reforms to strengthen online privacy rights — changes that could have big repercussions for American technology companies and marketers that operate in the European Union. American officials, trade groups and tech executives have responded by taking frequent treks to Brussels and other cities, where they have urged regulators and legislators to reconsider the one-regulation-fits-all-data approach. What’s at stake, American industry representatives say, is nothing less than a free and commerce-friendly Internet.

“The ecosystem of the Internet is very delicate,” says Kevin Richards, senior vice president of federal government affairs at TechAmerica, a trade group that represents companies like Google and Microsoft. “It’s not wise to have an overly broad, prescriptive, one-size-fits-all approach that would hinder or undermine the ability of companies to innovate in a global economy.”

European Union members already have data protection laws in place, based on a directive from 1995 that laid out principles for the collection of personal information. The proposed new rules would strengthen some existing provisions. They would standardize data protections across the 27 member states. They would also provide some new rights, such as “data portability” — the right of consumers to easily transfer their text files, photographs and videos from one social network, or e-mail or cloud storage service, to another. And they would subject companies that violate the rules to penalties of up to 2 percent of their annual global revenue.

Asked for comment, Viviane Reding, the vice president of the European Commission and the architect of the proposed regulation, said in a statement: “The main problem is that our rules predate the digital age and it became increasingly clear in recent years that they needed an update.” She continued: “That is why I have proposed a root-and-branch reform of the E.U.’s data protection rules — currently under discussion in the European Parliament and the Council of the E.U. — that will both protect citizens’ rights and facilitate business in the digital age.”

BUT some provisions seem too rigid to United States officials and trade groups. They argue that the American approach — sector-specific privacy laws, in addition to industry self-regulation and enforcement by the Federal Trade Commission — is more nimble.

“We hope that Europe will move in the direction of those multistakeholder standards, and not standards which are not flexible and don’t move at Internet speed,” says Mr. Kerry, who has taken at least four trips to European cities in the last year to discuss these issues.

From the perspective of some European legislators, however, United States representatives seem more interested in protecting commerce than consumers. The full-court American effort may have backfired, they say, pushing some European officials toward even broader measures. Last month, Jan Philipp Albrecht, a representative of the European Parliament who reviewed the draft regulation, proposed additional rights for citizens — like the right not to be subject to consumer profiling.

“My impression is that the U.S. Chamber of Commerce and the Commerce Department are mostly just following the interests of Silicon Valley,” he says. “This leads to heavy pressure on the European regulator, I can say.”

But Mr. Kerry says the United States must make its views known if the systems are to work in concert.

“I know that some people have raised eyebrows at our involvement; I make no apologies,” Mr. Kerry says. “We in the United States and countries and businesses around the world are stakeholders in this process. This has an important impact on the global economy.”

The solution to this trans-Atlantic clash may simply be American ingenuity.

Last year, President Barack Obama proposed a “Consumer Privacy Bill of Rights” that would give Americans many of the same baseline protections that the draft European rule proposes to reinforce. These include the right of access to records that companies hold about them, the right to correct those records and the right to have limits on the personal data that companies collect and keep. Administration officials said they would work with Congress on legislation based on those rights and to extend oversight to industries not currently covered by federal privacy laws.

A coalition of more than a dozen American advocacy groups said it would send a letter on Monday to senior Obama administration officials, seeking a meeting to ensure that American policy makers’ efforts in Europe “are not averse to the views expressed by the president.” The coalition includes the Electronic Privacy Information Center and the Center for Digital Democracy.

“Does the Obama administration really want to be on the opposite side of the European effort to upgrade and modernize its privacy law which is at its core about the protection of a fundamental freedom?” asks Marc Rotenberg, executive director of the Electronic Privacy Information Center.

European officials hold out hope that Congress will enact baseline consumer privacy protections for Americans.

“This development — which is much welcomed in Europe — shows that we have much in common,” Ms. Reding of the European Commission said in her statement, speaking of the privacy bill of rights. “Convergence is springing up and synergies are possible.”

E-mail: slipstream@nytimes.com.

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