Programs of drug testing welfare recipients are increasingly common in US states and have been considered elsewhere. Though often intensely debated, such programs are complicated to evaluate because their aims are ambiguous – aims like saving money may be in tension with aims like referring people to treatment. We assess such programs using a proportionality approach, which requires that for ethical acceptability a practice must be: reasonably likely to meet its aims, sufficiently important in purpose as to outweigh harms incurred, (...) and lower in costs than feasible alternatives. In the light of empirical findings, we argue that the programs fail the three requirements. Pursuing recreational drug users is not important in the light of costs incurred, while dependent users who may require referral are usually identifiable without testing and typically need a broader approach than one focussing on drugs. Drug testing of welfare recipients is therefore not ethically acceptable policy. (shrink)

The literature of Twelve Step groups such as Alcoholics Anonymous contains apparently contradictory implications regarding powerlessness and personal responsibility. In this essay I examine the treatment of these concepts in Twelve Step literature and their implications for the self-conception of people in these programs. In the first section, I examine the literature to demonstrate that addicts are presented as powerless over, yet responsible for, their addictive behaviors. In the second section, I outline two potential ways people in Twelve Step programs (...) might reconcile this contradiction within their self-conception, but I argue that neither is satisfactory. In the third section, I draw on Paul Ricoeur's theory of narrative identity to develop an account of how someone ni a Twelve Step group could coherently understand herself as both powerless and responsible. (shrink)

“Classic,” serotonergic psychedelic drugs such as LSD and psilocybin are the objects of renewed attention in science and psychiatry. A recent spate of research has produced evidence that psychedelics might be safe and effective adjuncts to the treatment of mood and addictive disorders, agents of positive psychological change in healthy subjects, and valuable tools for studying the neural mechanisms of perception and cognition. This chapter surveys three philosophical debates that have arisen in response to this “renaissance” of psychedelic research. The (...) first concerns the mechanisms of psychedelic-assisted psychotherapy (“psychedelic therapy”): How, exactly, does psychedelic administration in controlled conditions cause lasting psychological benefits? The second concerns the implications of psychedelic research for the philosophy of mind: Does psychedelic evidence show that there can be conscious mental states lacking all forms of self-consciousness? The third concerns the epistemic status of the psychedelic state: Is it possible that certain kinds of knowledge, or other epistemic benefits, could be gained by undergoing a psychedelic experience? (shrink)