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  1. Addiction: choice or compulsion?Edmund Henden, Hans Olav Melberg & Ole Rogeberg - 2013 - Frontiers in Psychiatry 4 (77):11.
    Normative thinking about addiction has traditionally been divided between, on the one hand, a medical model which sees addiction as a disease characterized by compulsive and relapsing drug use over which the addict has little or no control and, on the other, a moral model which sees addiction as a choice characterized by voluntary behaviour under the control of the addict. Proponents of the former appeal to evidence showing that regular consumption of drugs causes persistent changes in the brain structures (...)
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  • Three arguments against prescription requirements.Jessica Flanigan - 2012 - Journal of Medical Ethics 38 (10):579-586.
    In this essay, I argue that prescription drug laws violate patients' rights to self-medication. Patients have rights to self-medication for the same reasons they have rights to refuse medical treatment according to the doctrine of informed consent (DIC). Since we should accept the DIC, we ought to reject paternalistic prohibitions of prescription drugs and respect the right of self-medication. In section 1, I frame the puzzle of self-medication; why don't the same considerations that tell in favour of informed consent also (...)
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  • The Purpose in Chronic Addiction.Hanna Pickard - 2012 - American Journal of Bioethics Neuroscience 3 (2):40-49.
    I argue that addiction is not a chronic, relapsing, neurobiological disease characterized by compulsive use of drugs or alcohol. Large-scale national survey data demonstrate that rates of substance dependence peak in adolescence and early adulthood and then decline steeply; addicts tend to “mature out” in their late twenties or early thirties. The exceptions are addicts who suffer from additional psychiatric disorders. I hypothesize that this difference in patterns of use and relapse between the general and psychiatric populations can be explained (...)
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  • Addiction is not an affliction: Addictive desires are merely pleasure-oriented desires.Bennett Foddy & Julian Savulescu - 2007 - American Journal of Bioethics 7 (1):29 – 32.
    The author comments on the article “The neurobiology of addiction: Implications for voluntary control of behavior,‘ by S. E. Hyman. Hyman presents that addiction is a brain disease or a moral condition. The authors present that addiction is a strong preference, similar to appetitive preferences. They state that addiction is merely a form of pleasure-seeking. The authors conclude that the problem of addiction is the problem of the management of pleasure, not treatment of a disease. Accession Number: 24077914; Authors: Foddy, (...)
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  • Autonomy and addiction.Neil Levy - 2006 - Canadian Journal of Philosophy 36 (3):427-447.
    Centre for Applied Philosophy and Public Ethics University of Melbourne, Parkville, 3010, Australia and.
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  • Anti-Love Biomedical Intervention and the Necessity of Consent.Kiichi Inarimori, Haruna Ichiki & Kengo Miyazono - 2025 - Neuroethics 18 (1):1-16.
    This paper is an investigation into the conditions under which anti-love biomedical intervention is justified. Our central claim is that anti-love biomedical intervention can be justified without the “simultaneous consent” of recipients (where the simultaneous consent of a person S is understood as S’s consent at time t to an intervention at t) when it contributes to increased autonomy. We begin with an overview of earlier discussions of the ethics of anti-love biomedical intervention, focusing on the pioneering work of Earp (...)
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  • Advance Medical Decision-Making Differs Across First- and Third-Person Perspectives.James Toomey, Jonathan Lewis, Ivar R. Hannikainen & Brian D. Earp - 2024 - AJOB Empirical Bioethics 15 (4):237-245.
    Background Advance healthcare decision-making presumes that a prior treatment preference expressed with sufficient mental capacity (“T1 preference”) should trump a contrary preference expressed after significant cognitive decline (“T2 preference”). This assumption is much debated in normative bioethics, but little is known about lay judgments in this domain. This study investigated participants’ judgments about which preference should be followed, and whether these judgments differed depending on a first-person (deciding for one’s future self) versus third-person (deciding for a friend or stranger) perspective. (...)
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  • Addiction and autonomy: Why emotional dysregulation in addiction impairs autonomy and why it matters.Edmund Henden - 2023 - Frontiers in Psychology 14:1081810.
    An important philosophical issue in the study of addiction is what difference the fact that a person is addicted makes to attributions of autonomy (and responsibility) to their drug-oriented behavior. In spite of accumulating evidence suggesting the role of emotional dysregulation in understanding addiction, it has received surprisingly little attention in the debate about this issue. I claim that, as a result, an important aspect of the autonomy impairment of many addicted individuals has been largely overlooked. A widely shared assumption (...)
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  • Patient Autonomy, Clinical Decision Making, and the Phenomenological Reduction.Jonathan Lewis & Søren Holm - 2022 - Medicine, Health Care and Philosophy 25 (4):615-627.
    Phenomenology gives rise to certain ontological considerations that have far-reaching implications for standard conceptions of patient autonomy in medical ethics, and, as a result, the obligations of and to patients in clinical decision-making contexts. One such consideration is the phenomenological reduction in classical phenomenology, a core feature of which is the characterisation of our primary experiences as immediately and inherently meaningful. This paper builds on and extends the analyses of the phenomenological reduction in the works of Husserl, Heidegger, and Merleau-Ponty (...)
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  • Understanding Addiction.Robert M. Kelly - 2021 - Dissertation, University at Buffalo
    The addiction literature is fraught with conceptual confusions, stalled debates, and an unfortunate lack of clear and careful attempts to delineate the phenomenon of addiction in a way that might lead to consensus. My dissertation has two overarching aims, one metaphysical and one practical. -/- The first aim is to defend an account of addiction as the systematic disposition to fail to control one’s desires to engage in certain types of behaviors. I defend the inclusion of desires and impaired control (...)
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  • Denial in Addiction.Hanna Pickard - 2016 - Mind and Language 31 (3):277-299.
    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 (...)
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  • Doping as addiction: disorder and moral responsibility.Carwyn Jones - 2015 - Journal of the Philosophy of Sport 42 (2):251-267.
    D’Angelo and Tamburrini invited readers to consider doping in sport as a health issue and dopers as potential addicts who need therapy rather than offenders who need punishing. The issue of addiction in sport is important and very much under researched. In this essay I explore the extent to which addiction can be justifiably used as an excuse for offending behaviour. The favoured argument is that addicts experience a craving or compulsion to use over which they have no control. I (...)
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  • Addiction, responsibility and moral psychology.A. M. Viens - 2007 - American Journal of Bioethics 7 (1):17 – 19.
    The author comments on several articles on addiction. Recent developments in neuroscience suggest that addicted individuals have substantial impairments in the cognitive control of voluntary behavior. The author differs on the observations that addicts either act on desires that are not conducive to rational action. The author also states that addiction seems to be a prime manifestation of akrasia, in which one fails to be motivated to act in accordance with what one judges ought to be done. Accession Number: 24077920; (...)
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  • The social: A missing term in the debate over addiction and voluntary control.Neil Levy - 2007 - American Journal of Bioethics 7 (1):35 – 36.
    The author comments on the article “The Neurobiology of Addiction: Implications for Voluntary Control of Behavior,‘ by S. E. Hyman. Hyman’s article suggests that addicted individuals have impairments in cognitive control of behavior. The author agrees with Hyman’s view that addiction weakens the addict’s ability to align his actions with his judgments. The author states that neuroethics may focus on brains and highlight key aspects of behavior but we still risk missing explanatory elements. Accession Number: 24077912; Authors: Levy, Neil 1,2; (...)
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  • What ethical resources are available to Alcohol and Other Drug practitioners? A systematic review.David Silkoff, Marilys Guillemin, Richard Chenhall & Rosalind McDougall - 2018 - Clinical Ethics 13 (1):34-52.
    Clinical work in Alcohol and Other Drugs has not generally been an area of focus for ethicists. Likewise, ethics is not usually part of Alcohol and Other Drugs training or practice. This means that resources available to Alcohol and Other Drugs clinicians navigating ethical challenges are not widely available. This paper describes a systematic review of literature at the intersection of ethics and clinical practice in Alcohol and Other Drugs. The review will potentially benefit Alcohol and Other Drug practitioners by (...)
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  • Simply Irresistible: Addiction, Responsibility, and Irresistible Desires.Marcela Herdova - 2015 - Journal of Cognition and Neuroethics 3 (1):196-216.
    In this paper I set out to investigate the claim that addicts lack su cient control over their drug-taking and are thus not morally responsible for it. More speci cally, I evaluate what I call the Simply Irresistible Argument, which proceeds from the claim that addictive desires are irresistible to the conclusion that addicts are not responsible for acting on such desires. I rst propose that we have to disambiguate the notion of an irresistible desire according to temporal criteria, and (...)
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  • Addiction and Volitional Abilities: Stakeholders’ Understandings and their Ethical and Practical Implications.Marianne Rochette, Matthew Valiquette, Claudia Barned & Eric Racine - 2023 - Neuroethics 16 (3):1-22.
    Addiction is a common condition affecting millions of people worldwide of which only a small proportion receives treatment. The development and use of healthcare services is influenced by how addiction is understood (e.g., a condition to treat, a shameful condition to stigmatize), notably with respect to how volition is impacted (e.g., addiction as a choice or a disease beyond one’s control). Through semi-structured qualitative interviews, we explore the implicit views and understandings of addiction and volition across three stakeholder groups: people (...)
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  • Revive and Refuse: Capacity, Autonomy, and Refusal of Care After Opioid Overdose.Kenneth D. Marshall, Arthur R. Derse, Scott G. Weiner & Joshua W. Joseph - 2023 - American Journal of Bioethics 24 (5):11-24.
    Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient’s interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians (...)
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  • Responsibility without Blame for Addiction.Hanna Pickard - 2017 - Neuroethics 10 (1):169-180.
    Drug use and drug addiction are severely stigmatised around the world. Marc Lewis does not frame his learning model of addiction as a choice model out of concern that to do so further encourages stigma and blame. Yet the evidence in support of a choice model is increasingly strong as well as consonant with core elements of his learning model. I offer a responsibility without blame framework that derives from reflection on forms of clinical practice that support change and recovery (...)
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  • Psychopathology and the Ability to Do Otherwise.Hanna Pickard - 2013 - Philosophy and Phenomenological Research 90 (1):135-163.
    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 (...)
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  • Intertemporal disagreement and empirical slippery slope arguments.Thomas Douglas - 2010 - Utilitas 22 (2):184-197.
    One prevalent type of slippery slope argument has the following form: (1) by doing some initial act now, we will bring it about that we subsequently do some more extreme version of this act, and (2) we should not bring it about that we do this further act, therefore (3) we should not do the initial act. Such arguments are frequently regarded as mistaken, often on the grounds that they rely on speculative or insufficiently strong empirical premises. In this article (...)
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  • Giving addicts their drug of choice: The problem of consent.Tom Walker - 2008 - Bioethics 22 (6):314–320.
    Researchers working on drug addiction may, for a variety of reasons, want to carry out research which involves giving addicts their drug of choice. In carrying out this research consent needs to be obtained from those addicts recruited to participate in it. Concerns have been raised about whether or not such addicts are able to give this consent. Despite their differences, however, both sides in this debate appear to be agreed that the way to resolve this issue is to determine (...)
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  • Ameliorating and exacerbating: Surgical "prosthesis" in addiction.Paul J. Ford & Cynthia S. Kubu - 2007 - American Journal of Bioethics 7 (1):32 – 34.
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  • Beyond Cognition and Affect: An Analysis of Anorexia Nervosa within the Framework of Addiction.Nevia Dolcini - 2024 - Review of Philosophy and Psychology 15 (3):817-835.
    Anorexia Nervosa is widely recognized as having both cognitive and affective dimensions. Current accounts typically explain the perplexing behaviors associated with this eating disorder by emphasizing either its cognitive components—particularly false beliefs related to the denial of the patient’s actual conditions—or its affective components, such as the intense fear of gaining weight. I will argue that neither approach is sufficient to fully capture the complexity of Anorexia Nervosa. This paper explores a more comprehensive approach that goes beyond the cognition-affect dichotomy, (...)
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  • Voluntary decision-making in addiction: A comprehensive review of existing measurement tools.Claudia Barned, Marianne Rochette & Eric Racine - 2021 - Consciousness and Cognition 91 (C):103115.
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  • On Addicts' Moral Responsibility and Action.Susanne Uusitalo - 2011 - Res Cogitans 8 (1).
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  • Threats and offers in community mental healthcare.Michael Dunn, Daniel Maughan, Tony Hope, Krysia Canvin, Jorun Rugkåsa, Julia Sinclair & Tom Burns - 2012 - Journal of Medical Ethics 38 (4):204-209.
    Next SectionMaking threats and offers to patients is a strategy used in community mental healthcare to increase treatment adherence. In this paper, an ethical analysis of these types of proposal is presented. It is argued (1) that the primary ethical consideration is to identify the professional duties of care held by those working in community mental health because the nature of these duties will enable a threat to be differentiated from an offer, (2) that threatening to act in a way (...)
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  • Addiction, autonomy and ego-depletion: A response to Bennett Foddy and Julian Savulescu.Neil Levy - 2005 - Bioethics 20 (1):16–20.
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  • Autonomy, addiction and the drive to pleasure: Designing drugs and our biology: A reply to Neil Levy.Bennett Foddy & Julian Savulescu - 2005 - Bioethics 20 (1):21–23.
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  • Prescribing safe supply: ethical considerations for clinicians.Katherine Duthie, Eric Mathison, Helgi Eyford & S. Monty Ghosh - 2023 - Journal of Medical Ethics 49 (6):377-382.
    The COVID-19 pandemic has exacerbated the drug poisoning epidemic in a number of ways: individuals use alone more often, there is decreased access to harm reduction services and there has been an increase in the toxicity of the unregulated drug supply. In response to the crisis, clinicians, policy makers and people who use drugs have been seeking ways to prevent the worst harms of unregulated opioid use. One prominent idea is safe supply. One form of safe supply enlists clinicians to (...)
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  • Addiction and Voluntariness: Five “Challenges” to Address in Moving the Discussion Forward.Eric Racine & Claudia Barned - 2019 - Cambridge Quarterly of Healthcare Ethics 28 (4):677-694.
    Abstract:The question as to whether people with an addiction have control (and to what extent) over their addiction, and voluntarily decide to use substances is an ongoing source of controversy in the context of research on addiction, health policy and clinical practice. We describe and discuss a set of five challenges for further research into voluntariness (definition[s], measurement and study tools, first person perspectives, contextual understandings, and connections to broader frameworks) based on our own research experiences and those of others.
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  • Mandatory neurotechnological treatment: ethical issues.Farah Focquaert - 2014 - Theoretical Medicine and Bioethics 35 (1):59-72.
    What if neurofeedback or other types of neurotechnological treatment, by itself or in combination with behavioral treatment, could achieve a successful “rewiring” of the psychopath’s brain? Imagine that such treatments exist and that they provide a better long-term risk-minimizing strategy compared to imprisonment. Would it be ethical to offer such treatments as a condition of probation, parole, or prison release? In this paper, I argue that it can be ethical to offer effective, non-invasive neurotechnological treatments to offenders as a condition (...)
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  • Addiction, Autonomy, and Informed Consent: On and Off the Garden Path.Neil Levy - 2015 - Journal of Medicine and Philosophy 41 (1):56-73.
    Several ethicists have argued that research trials and treatment programs that involve the provision of drugs to addicts are prima facie unethical, because addicts can’t refuse the offer of drugs and therefore can’t give informed consent to participation. In response, several people have pointed out that addiction does not cause a compulsion to use drugs. However, since we know that addiction impairs autonomy, this response is inadequate. In this paper, I advance a stronger defense of the capacity of addicts to (...)
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  • Craving for drugs.Hanna Pickard - 2024 - Mind and Language 39 (5):598-626.
    The image of craving as a desire of unimaginable and irresistible force is poised to solve the puzzle of addiction: persistent drug use despite severe negative consequences. But the image is flawed. Drawing on science, philosophy, and first‐person testimony, I argue against irresistibility and develop a more nuanced, heterogeneous account of craving for drugs. Craving comes in three varieties, each corresponding to a kind of answer to the question why people crave drugs: cue‐induced, goal‐focused, and attachment‐based. This in turn grounds (...)
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  • Negotiating the Relationship Between Addiction, Ethics, and Brain Science.Daniel Z. Buchman, Wayne Skinner & Judy Illes - 2010 - American Journal of Bioethics Neuroscience 1 (1):36-45.
    Advances in neuroscience are changing how mental health issues such as addiction are understood and addressed as a brain disease. Although a brain disease model legitimizes addiction as a medical condition, it promotes neuro-essentialist thinking and categorical ideas of responsibility and free choice, and undermines the complexity involved in its emergence. We propose a “biopsychosocial systems” model where psychosocial factors complement and interact with neurogenetics. A systems approach addresses the complexity of addiction and approaches free choice and moral responsibility within (...)
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  • Our Life Depends on This Drug: Competence, Inequity, and Voluntary Consent in Clinical Trials on Supervised Injectable Opioid Assisted Treatment.Daniel Steel, Kirsten Marchand & Eugenia Oviedo-Joekes - 2017 - American Journal of Bioethics 17 (12):32-40.
    Supervised injectable opioid assisted treament prescribes injectable opioids to individuals for whom other forms of addiction treatment have been ineffective. In this article, we examine arguments that opioid-dependent people should be assumed incompetent to voluntarily consent to clinical research on siOAT unless proven otherwise. We agree that concerns about competence and voluntary consent deserve careful attention in this context. But we oppose framing the issue solely as a matter of the competence of opioid-dependent people and emphasize that it should be (...)
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  • Control and Responsibility in Addicted Individuals: What do Addiction Neuroscientists and Clinicians Think?Adrian Carter, Rebecca Mathews, Stephanie Bell, Jayne Lucke & Wayne Hall - 2013 - Neuroethics 7 (2):205-214.
    Impaired control over drug use is a defining characteristic of addiction in the major diagnostic systems. However there is significant debate about the extent of this impairment. This qualitative study examines the extent to which leading Australian addiction neuroscientists and clinicians believe that addicted individuals have control over their drug use and are responsible for their behaviour. One hour semi-structured interviews were conducted during 2009 and 2010 with 31 Australian addiction neuroscientists and clinicians (10 females and 21 males; 16 with (...)
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  • Creating an ethical culture to support recovery from substance use disorders.Laura Williamson - 2021 - Journal of Medical Ethics 47 (12):9-9.
    There is a long-standing failure to create an ethical culture around substance use disorders (SUDs) or dependence that actively supports people’s recovery efforts. Issues which impede the development of prorecovery environments are complex, but include the far-reaching effects of the social stigma that surrounds SUDs; and the failure to harness relational and social support that allows debates to transcend blaming individual substance users. As part of efforts to create prorecovery environments, it is important to acknowledge that bioethics debate on SUDs (...)
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