Autonomy and Addiction: An Overview of Relevant and Confounding Factors

Open Access
Author:
Al-Mondhiry, Jafar Hamid
Graduate Program:
Philosophy
Degree:
Master of Arts
Document Type:
Master Thesis
Date of Defense:
None
Committee Members:
  • Vincent M Colapietro, Thesis Advisor
  • John Philip Christman, Thesis Advisor
  • Jesse F Ballenger, Thesis Advisor
Keywords:
  • Addiction
  • Autonomy
  • Medicalization
  • Mental Helth
  • Bioethics
Abstract:
The accurate assessment of drug addiction is a widely debated issue across academic disciplines and a hotly contentious subject in society at large. While legal institutions largely recognize addicts as rational, moral agents, an emerging understanding of addictive cravings in the social and neurological sciences seems to challenge this view. In a complementary manner, medicine has traditionally viewed addiction as a disease, leading some addiction theorists to conceptualize addictive behavior as the product of a symptomatic physiological condition. Consistency on this issue has become of paramount importance, as disparities between punitive and rehabilitative programs create a confused and deleterious environment for addicts. It is the purpose of this paper to survey and critique the claims made by different groups about the questionable autonomy of those in a drug-addicted state, and to bring up through critical interpretation a strong base for understanding autonomy in both its particularly relevant and most general character. Through an examination of relevant concepts in mental health, physiology, medicine, sociology, law, and philosophy, tensions between competing explanations of the addictive experience will reveal gaps that demand mediation. Relating these different insights to a basic and non-normative definition of autonomy will show how explanations that deny or severely challenge the call for responsibility in addiction fail to address the vicissitudes of autonomy in its lived experience. I will argue that the practical, theoretical and therapeutic challenges of denying addicts status as autonomous agents compels us to retain a strong but nuanced notion of accountability in addiction, and structure our social response to chemical addictions around these lines of responsibility. In particular, I embrace a global and diachronous understanding of autonomy that places accountability on the chemically addicted to confront the challenges of addictive cravings, and plan their lives with insight into the very real compromises such cravings place on the exercise of self-rule. By debunking the popular and exaggerated representations of addiction, it is my goal to reinstitute addictive processes within the vagaries and allowances of autonomy as it is tenuously achieved by embodied agents. Situated as such, I argue that addicts be understood as autonomous in this very basic sense that protects their status as moral agents, with the rights, respects, and responsibilities due to such agents.