Introduction: The Makings of a Responsible Addict

Poland, Jeffrey; Graham, George

doi:10.7551/mitpress/9780262015509.003.0001

Cited by 7 publications

(6 citation statements)

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“…Therefore, we discuss the thoughts of three critics of the disease model, who propose alternative views, and explicitly address this issue. The following is not meant to provide a complete discussion of addiction and moral responsibility, which would be far beyond the scope of this paper [See 59]. Rather, we seek to illustrate the ambiguity in whether or not alternative models of addiction involve re-moralization.…”

Section: Alternatives To the Disease Model And Their Treatment Of Mormentioning

confidence: 99%

Addiction and Moralization: the Role of the Underlying Model of Addiction

Frank

Nagel

2017

Neuroethics

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Addiction appears to be a deeply moralized concept. To understand the entwinement of addiction and morality, we briefly discuss the disease model and its alternatives in order to address the following questions: Is the disease model the only path towards a ‘de-moralized’ discourse of addiction? While it is tempting to think that medical language surrounding addiction provides liberation from the moralized language, evidence suggests that this is not necessarily the case. On the other hand non-disease models of addiction may seem to resuscitate problematic forms of the moralization of addiction, including, invoking blame, shame, and the wholesale rejection of addicts as people who have deep character flaws, while ignoring the complex biological and social context of addiction. This is also not necessarily the case. We argue that a deficit in reasons responsiveness as basis for attribution of moral responsibility can be realized by multiple different causes, disease being one, but it also seems likely that alternative accounts of addiction as developed by Flanagan, Lewis, and Levy, may also involve mechanisms, psychological, social, and neurobiological that can diminish reasons responsiveness. It thus seems to us that nondisease models of addiction do not necessarily involve moralization. Hence, a non-stigmatizing approach to recovery can be realized in ways that are consistent with both the disease model and alternative models of addiction.

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Section: Alternatives To the Disease Model And Their Treatment Of Mormentioning

confidence: 99%

Addiction and Moralization: the Role of the Underlying Model of Addiction

Frank

Nagel

2017

Neuroethics

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“…Classical approaches to akrasia avoid the stigmatising implications associated with a moralised attitude to failing in self-control. In this respect, they are well suited to address timely concerns about the ‘vindictiveness’ of attribution of responsibility in the context of substance misuse and substance dependence (Poland 2011). Arguably, the classical approaches fare better than recent attempts to sketch a secondary notion of responsibility, such as ‘responsibility without blame’ (Sinnott-Armstrong 2013).…”

Section: Discussionmentioning

confidence: 99%

Lessons from akrasia in substance misuse: a clinicophilosophical discussion

Radoilska

Fletcher

2016

BJPsych advances

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Substance misuse is an important public health problem as well as a major clinical challenge (Nuffield Council on Bioethics 2007). Arguably, these aspects are intimately related. In public discourse, substance misuse is routinely associated with increased burden on national health and social services, loss of productivity and the commission of often violent criminal offences. These uniformly negative connotations reinforce stigmatising attitudes towards substance misuse that might not only discourage people from seeking professional help in a timely fashion, but also stand in the way of successful recovery. In turn, relatively high relapse rates (Levy 2013) exacerbate the negative impact of substance misuse on public health. Philosophical work on the nature and scope of akrasia, or weakness of will (Arpaly 2000;Davidson 2001; Radoilska 2013a,b), offers a promising way of breaking out of this impasse by providing the conceptual resources required to challenge an implicit notion of control over one's actions that seems to be at root of the problem. This article focuses on variant models of akrasia, although it also acknowledges the potential role of other factors that could complement a holistic approach to a viable recovery plan. Substance misuse: three fictitious case vignettes Mr Miller: biological causationMr Robert Miller is a 65-year-old retired chief executive. His mother died at the age of 82 from 'old age'. His father died at the age of 58 from carcinoma of the oesophagus, having been a heavy drinker throughout his adult life. Mr Miller was an only child and described a happy and stable childhood despite his father's drinking. He excelled at school, enjoyed good peer relationships and obtained a first class honours degree at university. He married in his late 20s, had two children in his 30s and, in his mid-40s, became the chief executive of a national company. He was described by his family as a good husband and father, with a reputation for honesty, integrity and fairness. Throughout his working life he drank alcohol most days, attributing this to the stress of his job and frequent socialising. In his early 60s he developed a morning tremor of his hands, which he thought was due to anxiety. His wife and children became increasingly concerned about his drinking, especially as he was known on occasions to drink and drive. Under considerable family pressure he saw his general practitioner (GP) and was referred for cognitive-behavioural therapy (CBT) to treat anxiety, stress and depression. He attended these sessions regularly, but did not find them helpful and his drinking pattern did not change. Following a blood test to check thyroid function, his GP detected markedly deranged liver function and referred him to a consultant psychiatrist, who diagnosed moderate alcohol dependence. Mr Miller declined the offer of medication, believing that he was strong willed enough to reduce his drinking on his own, but he did accept two counselling sessions with a substance misuse liaison worker.Lessons from akrasia in ...

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“…Others are a matter of moral uncertainty, inconclusive research or prospective questions: the ‘what ifs’ of tobacco endgame policy. For example, the degree to which addictive behaviours are driven by ‘choice’ or ‘compulsion’ remains contested 8. This raises the moral question of whether policies should preserve a ‘choice’ to consume tobacco—even if tobacco is in itself a defective product that, when used as intended, kills half of its users—or protect tobacco users from their ‘compulsion’.…”

Section: Introductionmentioning

confidence: 99%

Development of an integrated tobacco endgame strategy

Eijk

2013

Tob Control

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In recent years, various tobacco 'endgame' strategies have been suggested as a means to phase out tobacco consumption. Using country examples, this paper discusses three potential strategies: replacing cigarettes with alternative products (harm reduction), denying tobacco sales to people born after a certain year (the tobacco-free generation proposal), and further implementing measures based on the WHO Framework Convention for Tobacco Control (FCTC) treaty. It is argued that all strategies have potential issues that could be avoided by combining them into an integrated, sequential endgame that, first, using measures recommended in the WHO FCTC, creates a climate that facilitates the phasing out of cigarettes; second, implements a generational phase out of cigarette sales; and third, simultaneously permits the regulated use of alternative nicotine products. Thus, integrating ideas from various endgame strategies will result in a more effective, resilient tobacco endgame policy.

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Introduction: The Makings of a Responsible Addict

Cited by 7 publications

References 0 publications

Addiction and Moralization: the Role of the Underlying Model of Addiction

Addiction and Moralization: the Role of the Underlying Model of Addiction

Lessons from akrasia in substance misuse: a clinicophilosophical discussion

Development of an integrated tobacco endgame strategy

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