Addiction, recovery and moral agency: Philosophical considerations

Aims: The purpose of this paper is to argue that it is important to recognize that addicts are morally accountable even for their addictive action, as moral agency is more generally an important factor in full-blown human agency. The challenge is to identify the problems that addicts have in their agency without discarding their potentially full-blown agency. Design: In philosophy of agency, moral responsibility and accountability, in particular, may refer to control over one’s action. I discuss this control as reason-responsiveness and, on a more general level, illustrate the importance of moral agency to human agency with a contrasting example of psychopaths and addicts as agents. Measures: A philosophical analysis is carried out in order to argue for the relevance and importance of moral accountability in therapeutic models of addiction. Findings: The example of psychopaths and addicts illustrates that moral agency is part of full-blown human agency, as psychopaths are generally believed to lack moral skills common to non-psychopathic individuals. I argue that addicts are not analogous to psychopaths in the framework of moral agency in this respect. Conclusions: By fleshing out the conceptual considerations in the framework of addiction therapies, I clarify the relevance and importance of moral accountability in therapeutic models of addiction. If evidence-based therapies attempt to restore the addict’s full-fledged agency at least in respect to addiction, then acknowledging addicts’ moral accountability for their action does matter. Philosophical interest in addiction is manifold. One area of interest lies in questions of agency. Philosophers of agency concentrate on issues relating to the moral and legal responsibility of addicts (e.g., Poland & Graham, 2011; Wallace, 1999; Watson, 1999). This may seem to differ from approaches within the sciences, which focus either on the etiological factors that cause addiction or the mechanisms involved in addiction that may cast more light on the prospects of therapeutic models, prevention measures, and public policies. The purpose of this paper is to argue that it is important to recognize that addicts are morally accountable even for their addictive actions. As moral agency is an important factor in full-blown human agency more generally, the consequences of recognizing addicts’ moral agency may be useful in recovery. The point is not to argue that addictive action is always morally relevant behavior, but that addicts are moral agents in the sense that, other things being equal, they are reasonresponsive to moral reasons, and if the addictive action involves a moral dimension—say, a morally wrong-making feature—the addict is morally accountable for that action. Analysis of moral agency and accountability, in particular, bears relevance to various therapeutic models developed on the basis of, and in line with, scientific research such as neuroscience. The paper begins with a rough characterization of addiction that draws on the different notions provided by academics in different fields and the self-reported experiences of addicts. I suggest that, despite the apparent differences in these views, they do agree on some aspects of addiction. There is, furthermore, an underlying aspect that affects these views—namely, the notion of moral agency. As moral responsibility is, in this article, considered to be dependent on the control the agent has over his action, I will have a closer look at a notion of moral agency in order to account for the forward-looking moral agency in the therapeutic framework. I suggest that moral accountability partly constitutes moral agency, without which full-blown human agency cannot be actualized, and addicts must be considered as apt candidates for full-blown human agency. The idea of moral agency being a necessary feature of fullblown human agency is argued for with a disanalogy between addicts and psychopaths. IJADR International Journal of Alcohol and Drug Research The Official Journal of the Kettil Bruun Society for Social and Epidemiological Research on Alcohol