I argue that denial plays a central but insufficiently recognized role in addiction. The puzzle inherent in addiction is why drug use persists despite negative consequences. The orthodox conception of addiction resolves this puzzle by appeal to compulsion; but there is increasing evidence that addicts are not compelled to use but retain choice and control over their consumption in many circumstances. Denial offers an alternative explanation: there is no puzzle as to why drug use persists despite negative consequences if these (...) consequences are not straightforwardly known. I describe the nature of the causal knowledge that one's drug use is causing negative consequences; map the conceptual landscape of denial and explain how it can block such knowledge; and explore some of the processes and mechanisms that have been studied by philosophy and the cognitive sciences and which may underpin denial in addiction, including well-established information-processing biases, motivational influences on belief formation and self-deception, and cognitive deficits with respect to insight and self-awareness. I conclude by suggesting that addiction is as much a disorder of cognition as a disorder of conation. (shrink)

Centre for Applied Philosophy and Public Ethics University of Melbourne, Parkville, 3010, Australia and.

It is often assumed that, except perhaps in a few rare cases, people with addiction can be aptly held responsible for having acquired the condition. In this chapter, I consider the argument that supports this view and draw attention to a number of challenges that can be raised against it. Assuming that early decisions to use drugs were made in possession of normal-range psychological capacities, I consider the key question of whether drug users who later became addicted should have known (...) that addiction was a likely outcome of their decisions to use drugs in a way that makes them blameworthy for their lack of foresight. I focus on three different points of contention surrounding this claim: how likely the outcome to be predicted was, how tolerable risk should be weighed against the expected value of decisions to use, and how reliable the relevant predictive abilities of the average person are. Once we consider in some detail what would have to be true in order for someone to be aptly held responsible for becoming addicted, the prospects for making a convincing case to that effect look, I argue, somewhat more uncertain than they might at first appear. (shrink)

Can addiction be credibly invoked as an excuse for moral harms secondary to particular decisions to use drugs? This question raises two distinct sets of issues. First, there is the question of whether addiction is the sort of consideration that could, given suitable assumptions about the details of the case, excuse or mitigate moral blameworthiness. Most discussions of addiction and moral responsibility have focused on this question, and many have argued that addiction excuses. Here I articulate what I take to (...) be the best argument for this view, based on the substantial difficulty that people with severe addiction experience in controlling drug-related behavior. This, I argue, may in some cases be sufficient to ground a mitigating excuse, given the way in which addiction undermines agents’ responsiveness to relevant moral reasons to do otherwise. Much less attention has been devoted to a second set of issues that critically affect the possibility of applying this mitigating excuse in particular cases, derived from the ambivalent nature of agential control in addiction. In order to find a fitting response to moral harm, the person with the right standing to blame must make a judgment about the extent to which the agent possessed certain morally relevant capacities at the time of the act. In practice, this will often prove tremendously difficult to assess. The ethical challenge for the person with the right standing to blame is fundamentally one of making a judgment about matters that seem underdetermined by the available evidence. (shrink)

While some form of loss of control is often assumed to be a common feature of the diverse manifestations of addiction, it is far from clear how loss of control should be understood. In this paper, I put forward a concept of decrease in control in addiction that aims to fill this gap and thus provide a general framework for thinking about addictive behavior. The development of this account involves two main steps. First, I present a view of degrees of (...) control as the degree to which an agent would be responsive to potential or counterfactual sufficient reasons to do otherwise. Second, I sketch an account of the relevant control-undermining factors in addiction that is consonant with my proposed view of degrees of control. Being a high-level functional property, reasons-responsiveness is particularly well suited to frame an account of control-undermining factors that is doubly pluralistic: it encompasses the contribution of factors both internal and external to the agent, and it is consistent with various proposals as to the precise nature of the anomaly taking place in the psychology of addiction. (shrink)

The landscape of addiction is dominated by two rival models: a moral model and a model that characterizes addiction as a neurobiological disease of compulsion. Against both, I offer a scientifically and clinically informed alternative. Addiction is a highly heterogenous condition that is ill‐characterized as involving compulsive use. On the whole, drug consumption in addiction remains goal directed: people take drugs because drugs have tremendous value. This view has potential implications for the claim that addiction is, in all cases, a (...) brain disease. But more importantly, it has implications for clinical and policy interventions. To help someone overcome addiction, you need to understand and address why they persist in using drugs despite negative consequences. If they are not compelled, then the explanation must advert to the value of drugs for them as an individual. What blocks us from acknowledging this reality is not science but fear: that it will ignite moralism about drugs and condemnation of drug users. The solution is not to cleave to the concept of compulsion but to fight moralism directly. (shrink)

This study will answer the question, what do students expect to learn from philosophy teachers in the 21st century. by framing a response based on the following: The researcher’s teaching philosophy developed over 30 years, a survey conducted of UAEU students, and a discussion of the changing role and purpose of philosophy in the academy and current pedagogical philosophy in teaching. The study has focused on how philosophical questions have been changed over time, using new technology to teach philosophy, what (...) are the characteristics of philosophy teachers and students, the new direction for teaching philosophy, and career opportunities. The practical frame of this research will be analyzed students survey conducted on female students from United Arab Emirates University. I will use the method of content analysis to investigate and trace this phenomenon to determine its meaning, developing philosophical questions, and the new direction for teaching philosophy. Then I will examine the data taken from the theoretical and practical sources for the purpose of diagnosing and reaching conclusions a process which is called in philosophy synthesis, therefore the approach of the research would be analysis and synthesis. (shrink)

It is both common and natural to think of addiction as a kind of defect of the will. Addicts, we tend to suppose, are subject to impulses or cravings that are peculiarly unresponsive to their evaluative reflection about what there is reason for them to do. As a result of this unresponsiveness, we further suppose, addicts are typically impaired in their ability to act in accordance with their own deliberative conclusions. My question in this paper is whether we can make (...) adequate sense of this conception of addiction as a volitional defect. In particular, I want to focus on some philosophical assumptions, from the theory of action, that bear directly on the very idea that addiction might impair the agent’s volitional capacities. Understanding this idea, I shall argue, requires that we start out with an adequate conception of the human will. Only if we appreciate the kinds of volitional capacities characteristic of normal agents can we conceptualize properly the impairment of those capacities represented by addiction, and assess the implications of such impairment for questions of responsibility. (shrink)

Addiction is standardly characterized as a neurobiological disease of compulsion. Against this characterization, I argue that many cases of addiction cannot be explained without recognizing the value of drugs to those who are addicted; and I explore in detail an insufficiently recognized source of value, namely, a sense of self and social identity as an addict. For people who lack a genuine alternative sense of self and social identity, recovery represents an existential threat. Given that an addict identification carries expectations (...) of continued consumption despite negative consequences, there is therefore a parsimonious explanation of why people who identify as addicts continue to use drugs despite these consequences: they self‐identify as addicts and that is what addicts are supposed to do. I conclude by considering how it is nonetheless possible to overcome addiction despite this identity, in part by imagining and enacting a new one. Importantly, this possibility requires the availability of social support and material resources that are all too frequently absent in the lives of those who struggle with addiction. (shrink)

When philosophers want an example of a person who lacks the ability to do otherwise, they turn to psychopathology. Addicts, agoraphobics, kleptomaniacs, neurotics, obsessives, and even psychopathic serial murderers, are all purportedly subject to irresistible desires that compel the person to act: no alternative possibility is supposed to exist. I argue that this conception of psychopathology is false and offer an empirically and clinically informed understanding of disorders of agency which preserves the ability to do otherwise. First, I appeal to (...) standard clinical treatment for disorders of agency and argue that it undermines this conception of psychopathology. Second, I offer a detailed discussion of addiction, where our knowledge of the neurobiological mechanisms underpinning the disorder is relatively advanced. I argue that neurobiology notwithstanding, addiction is not a form of compulsion and I explain how addiction can impair behavioural control without extinguishing it. Third, I step back from addiction, and briefly sketch what the philosophical landscape more generally looks like without psychopathological compulsion: we lose our standard purported real-world example of psychologically determined action. I conclude by reflecting on the centrality of choice and free will to our concept of action, and their potency within clinical treatment for disorders of agency. (shrink)

Paradoxically, the profession whose primary mandate is to instruct and comment on matters of ethics spends inordinately little time reflecting on its own ethical practices. Consider the fact that while professional ethicists of all stripes crusade to expose and denounce conflicts of interests in all other branches of the health care system, they typically fail to pay much attention to their own potential ‘ethical’ conflicts of interest. Admittedly, there have been some efforts to address the problem. However, despite laudable intentions, (...) they are highly unsatisfactory. Unenforceable ‘model’ draft codes of ethics on professional websites,1 and obscure addenda to technical reports that are only available at a cost,2 do not constitute acceptable responses to this predicament. Th is is a problem of profound social importance, a matter that threatens the very foundation, integrity and accountability of one of the most powerful forces in the modern health care system. (shrink)