Withdrawal involves emotional pain that motivates much addictive behavior. In this paper, I argue that the emotional pain of withdrawal compels much addictive behavior. Researchers have noticed this possibility but it is widely underappreciated. Among philosophers, only Hanna Pickard has discussed emotional compulsion in addiction, and the emotional aspect of withdrawal has been almost completely neglected. Accounts of emotional compulsion in the philosophical literature (from Tappolet, Elster, and Furrow) probably do not capture how the distress of withdrawal compels, so I (...) propose a more suitable account of “pathodoxastic” compulsion in addiction. On this account, the emotional pain of withdrawal compels when it undermines the ability to believe that one can continue to endure it, and therefore the ability to intend abstinence. (shrink)

How does character information inform judgments of blame? Some argue that character information is indirectly relevant to blame because it enriches judgments about the mental states of a wrongdoer. Others argue that character information is directly relevant to blame, even when character traits are causally irrelevant to the wrongdoing. We propose an empirical synthesis of these views: a Two Channel Model of blame. The model predicts that character information directly affects blame when this information is relevant to the wrongdoing that (...) elicits blame. Further, the effect of character information on blame depends on judgments about the true self that are independent of judgments of intentionality. Across three pre-registered studies (N = 662), we found support for all three predictions of the Two Channel Model. We propose that this reflects two distinct functions of blame: a social regulatory function that encourages norm compliance and a pedagogical function that encourages personal improvement. (shrink)

Various philosophers authors have argued—on the basis of powerful examples—that we can have compelling moral or practical reasons to believe, even when the evidence suggests otherwise. This paper explores an alternative story, which still aims to respect widely shared intuitions about the motivating examples. Specifically, the paper proposes that what is at stake in these cases is not belief, but rather acceptance—an attitude classically characterized as taking a proposition as a premise in practical deliberation and action. I suggest that acceptance’s (...) theoretical usefulness in the ethics of belief has been hidden by its psychological obscurity. I thus aim to develop an empirically adequate and mechanistically specific psychological profile of acceptance. I characterize acceptance as centrally involving a cognitive gating function, in which we prevent a target belief state from having its characteristic downstream effects on reasoning, cognition, and action, and restructure those downstream processes. I then argue that there is substantial empirical support for the existence of the cognitive mechanisms needed to instantiate this view, coming from the science of emotion regulation. I argue that acceptance involves deploying the same mechanisms used in emotional response modulation to belief states: acceptance is doxastic response modulation. I then propose that having a better understanding of the psychological profile of acceptance leaves us better positioned to appreciate its potential usefulness for making progress on various puzzles within the ethics of belief. (shrink)

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 (...) in the philosophical literature is that for addiction to impair a person’s autonomy it has to make them (in some sense) take drugs against their will. So-called “willing addicts” are therefore usually seen as exempted from the autonomy impairment believed to characterize “unwilling addicts”, the latter being those who ‘truly want’ to stop using drugs but find their attempts repeatedly derailed by failures of self-control. In this article, I argue that the association between addiction and emotional dysregulation shows why this assumption is false. Emotional dysregulation is not only consistent with the possibility that many addicts take drugs ‘willingly’, it supports the hypothesis that they use drugs because they truly want to. The article proposes an explanation for why emotional dysregulation should nevertheless be seen as an aspect of their loss of control and an important reason why they have impaired autonomy. I end by exploring some implications of this account for addict’s decision-making capacity when they are prescribed the drugs to which they are addicted. -/- . (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)

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)

Any ethical inquiry into addiction research is faced with the preliminary challenge that the term “addiction” is itself a matter of scientific and ethical controversy. Accordingly, the chapter begins with a brief history of the term “addiction.” The chapter then turns to ethical issues surrounding consent and decision-making capacity viewed from the perspective of the current opioid epidemic. One concern is the neglect of the cyclical nature of addiction and the implications of this for the validity of current psychometric instruments (...) used to evaluate decision-making capacity in addiction. Another is the apparent discrepancy—possibly an ethical double standard—in the manner in which society and addiction researchers view the mental capacity and vulnerability of individuals who suffer from severe addiction. On the whole, the main ethical concern of the chapter is the puzzling lack of clinical research on decision-making capacity in research on addiction. (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)

A restrictive view of self-control identifies exercises of self-control with synchronic intrapsychic processes, and pictures diachronic and externally-scaffolded strategies not as proper instances of self-control, but as clever ways of avoiding the need to exercise that ability. In turn, defenders of an inclusive view of self-control typically argue that we should construe self-control as more than effortful inhibition, and that, on grounds of functional equivalence, all these diverse strategies might be properly described as instances of self-control. In this paper, I (...) take a fresh look at this debate by focusing on cases of addiction. I argue that addicted agents face a paradigmatic sort of self-control challenge, which makes addiction an important test case for theories of self-control. And I discuss evidence that highlights both the unreliability of synchronic intrapsychic strategies and the crucial role that is played by diachronic and externally-scaffolded strategies in successful attempts at achieving abstinence by addicted individuals. Abstaining addicts are a paradigmatic case of agents who successfully exercise self-control, and they mostly do so by relying on diachronic and externally-scaffolded strategies. This, I argue, lends further support to an inclusive view of self-control. (shrink)

Charland's article suggests that we need to think more about whether decision-making capacity is impaired in severe addiction, working from the idea that drug dealers rely on this understanding of addiction to draw in their clients. Charland argues that it is possible to make a choice without being in control (to make decisions without having decision-making capacity). I argue in support of Charland's ideas by examining the reasons supporting a medical model of addiction and its importance. (For Charland's article and (...) the full set of commentaries, please see the Research Gate link). (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)

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 (...) an approach to addressing addiction that is humane and heterogeneous, moving beyond strategies that are fundamentally controlling. (shrink)

:Reasons-responsiveness theories of moral responsibility are currently among the most popular. Here, I present the fallibility paradox, a novel challenge to these views. The paradox involves an agent who is performing a somewhat demanding psychological task across an extended sequence of trials and who is deeply committed to doing her very best at this task. Her action-issuing psychological processes are outstandingly reliable, so she meets the criterion of being reasons-responsive on every single trial. But she is human after all, so (...) it is inevitable that she will make rare errors. The reasons-responsiveness view, it is claimed, is forced to reach a highly counterintuitive conclusion: she is morally responsible for these rare errors, even though making rare errors is something she is powerless to prevent. I review various replies that a reasons-responsiveness theorist might offer, arguing that none of these replies adequately addresses the challenge. (shrink)

Recent work by Alfred Mele, Romy Jaster and Chandra Sripada recognizes that abilities come in degrees of fallibility. The rough idea is that abilities are often not surefire. They are liable to fail. The more liable an ability is to fail, the more fallible it is. Fallibility is plausibly significant for addiction, responsibility, and normative theorizing. However, we lack an adequate account of what fallibility consists in. This article addresses that problem. Perhaps the most natural approach is to say (roughly) (...) the fallibility of your ability to F is the proportion of scenarios in which you do not F, among those in which you try to F. I argue that this approach (in all plausible versions) is mistaken. I then introduce the notion of an action’s “fragility,” and propose that we use that new notion to understand fallibility. (shrink)