A Focus On: Addiction
Image: Front cover of Confessions of an English Opium-Eater, Second Edition, by Thomas de Quincy (London, 1823). Reproduced from http://commons.
Discussions of responsibility for addiction often follow either a medical, or a criminal model. According to the first, a degree of compulsion is a defining feature of addiction. Since compulsion diminishes control over one’s actions, addictive behaviours are not fully responsible, if at all. According to the second model, addictive cues are rarely irresistible; moreover, addiction is compatible with successful planning. Addictive behaviours are therefore fully responsible.
The coexistence of these two contrasting models leads to an apparent dilemma in societal responses to addiction: to treat, endorsing the medical model, or to punish, endorsing the criminal model. The two options are not mutually exclusive: in some cases, treatment might be deemed to fulfil an additional punitive function; in others, sentencing might pursue rehabilitating, if not explicitly therapeutic objectives.
The medical and criminal models have a lot in common. For instance, they share the assumption that in so far as addiction is an illness rather than a personal choice, no responsibility attaches to it. Another shared assumption is that responsibility for addiction should be captured, whenever possible, in non-evaluative terms. While the underlying ambition is understandable, to avoid further stigmatising people with addiction, the strategy seems nevertheless counterproductive. This is because both medical and criminal models imply that responsibility for addiction can be assessed from the third-personal perspective of an impartial and expert observer. In this respect, both models inadvertently underwrite objectifying as opposed to reactive, participatory attitudes toward people with addiction. An ethical model of responsibility for addiction offers a better alternative, for it enables us to re-engage with people with addiction as full members of the moral community, whose first-personal perspective is just as important in understanding and evaluating addiction.
Lubomira Radoilska, MA, MPhil, PhD is Lecturer in Philosophy at the University of Kent, Canterbury, Kent, UK, and Affiliated Lecturer in Philosophy at the University of Cambridge, Cambridge, UK.
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