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 (...) with lived experience of addiction, clinicians with experience treating addiction, and members of the public without lived experience of addiction. We notably examine whether three paradigms, i.e., three philosophical sets of understandings about the nature of reality and knowledge (realism, relativism, pragmatism) reflect how stakeholders envision addiction and volition in the context of addiction. The use of these paradigms allows for the characterization of different stances on addiction and volition and an assessment of the coherence of beliefs about these matters. Our findings demonstrate that few participants relied on a single epistemic paradigm when describing their views. Furthermore, there were notable differences in understandings of volition between the clinician group, who were more oriented toward pragmatism, and people with lived experience of addiction, who were less oriented toward realism. Despite its limitations, our study suggests that a greater appreciation for the complexity of views held by different stakeholders about addiction and volition could help critically assess the search for coherence expressed in academic and policy debates. (shrink)

Environmental pragmatism has faced numerous criticisms for relativism and crude instrumentalism as well as for sidestepping the fundamental concerns of environmental ethics. Recently, Andre Santos Campos and Sofia Guedes Vaz have proposed a new ‘method’ of environmental pragmatism, justificatory moral pluralism, with the aim of overcoming these criticisms. It is argued that this new approach is plagued by the traditional concerns. Instead, the pitfalls of pragmatism can be avoided by adopting the central insight of the classical pragmatists that values may (...) be revised in light of experience in a process that resembles scientific inquiry. The resulting view may not be satisfying for those who expect pragmatism to live up to its periodic promise of immediate and concrete results. Nevertheless, pragmatism presents the environmental ethicist with a range of promising tasks. (shrink)