Transcript Goodin and Shapiro on Addiction

Philosophy 220
Focusing on Addiction Through a
Haze of Cigarette Smoke: Goodin
and Shapiro
Goodin on Paternalism and
Rights
• Project: “carve…out a substantial sphere of
morally permissible paternalism” (199c1).
• One obvious obstacle: Rights. If we think
about rights primarily in terms of freedom of
choice (à la Boaz) then paternalism is in
conflict with rights.
• If we think about rights as protected
interests, then there is no necessary conflict.
Interests and
Preferences
• Clearly, not every understanding of interest
is going to mollify the rights theorists.
• Attempts to define interests ‘objectively’ and
then use these definitions as grounds for
paternalistic purposes is not going to be
acceptable to many.
• Linking the concept of interest to that of
preference helps, because then an interest
looks like a type of choice.
What about that
Sphere?
• The upshot of the link between interests and
preferences is that the sphere of morally permissible
paternalism is defined by reference to what people
value.
o “In paternalistically justifying some course of action on
the grounds that it is in someone’s interest, I shall always
been searching for some warrant in that person’s own
value judgments for saying that it is in the person’s
interest” (200c1).
• It is important to recognize that it is certainly
possible that a person’s actions or statements may
not always be consistent with specific value
judgments.
The Importance of Context
• Goodin makes one more contribution to
our understanding of morally permissible
paternalism.
• He insists that paternalism is only an
option when the stakes are high.
o Threat of serious harm.
o Significant life-shaping potential.
Preferences and
Paternalism
•
Review of preference-focused justifications for
the employment of moral paternalism reveals
that such employment is appropriate only
when policy makers are correctly convinced
that your preferences are:
1.
2.
3.
4.
Relevant
Settled
Preferred
Yours
Relevant Preferences
• The general assumption is that people should be free to
act on their preferences.
• However, it is not always that case that specific
preferences are relevant to a particular choice.
• In the example of Ms. Cipollone (201), her preference for
a particular brand of cigarettes based on the (false) belief
that it was safer than other brands is irrelevant because it
is false.
• On the assumption that a relevant preference is desire
for health and well-being, paternalistic prohibition could
be morally acceptable, or at least minimally offensive.
Settled Preferences
• Some preferences express long term
commitments or considerations; others are
more transitory, rooted in immediate
circumstance.
• Paternalism may be justified in a potential
conflict between these two orders of preference.
• Ms. Cipollone thought smoking was glamorous
when she was young but this was not
necessarily her settled position.
Preferred Preferences
• We often rank our preferences in terms of our perception
of their importance to us.
• Not uncommonly, conflicts of preferences can emerge
between preferences of different rank and typically we
choose to satisfy the preference that ranks higher.
• This approach can justify paternalism in the name of the
higher ranked preferences.
• Ms. Cipollone smoked while pregnant even though her
preference for the health of her fetus was of a higher
rank than her preference for smoking.
Your Preferences
• Relying on something like the analysis of
dispositional coercion we saw from Mapes
(sexual morality), Goodin highlights that
some preferences we have are not really
ours, but are shaped by the will of others.
• In these cases, paternalism may be
justified to protect our own preferences
from being trampled by those that come
from elsewhere.
Smoking Policy
• The practical implication of all of this is that a
range of paternalistic limitations on tobacco
use seem justifiable.
• This is true from a consideration of the
preferences (and thus interests) of smokers,
even when a stated preference of theirs is to
continue to smoke.
• Of course, there are implications for the
analysis of the moral status of paternalistic
control of the use of other drugs.
Shapiro on Addiction and
Criminalization
• Shapiro links arguments like those of De
Marneffe and Goodin in favor of prohibition of
certain forms of drug markets or use to their
acceptance of the standard model of addiction.
o The pharmacological properties of drugs and their effects on the
brain account for why some drugs are (highly) addictive.
• Shapiro argues that the standard model fails and
thus that the arguments based on it fail as well,
before offering another model with different
policy implications.
Problems with the Standard
View
• The central claim of the standard view is that
the obsessive behavior displayed by the addict
is ultimately to be accounted for in terms of the
pharmacological effects of the drug.
• Central concepts of this account include:
cravings, tolerance, and withdrawal symptoms.
o What kind of explanatory mechanism do these
concepts provide?
• Most drug users do not become addicts and
many addicts do not consistently use (205c1).
Another View on Addiction
•
•
Shapiro advocates a competing view of addiction
developed by Norman Zinberg.
Two concepts that it adds to the mix are “set” and
“setting.”
o Set: the mindset of the individual
o Setting: social context of drug use.
•
A virtue of this approach is that it coheres with our
common-sense conviction that explanations of
human behavior are never simple causal claims;
neither are accounts of human valuing.
Setting
• Drug use in hospitals rarely leads to
addiction. This suggests that
quantity/dosage and duration of use are
much less significant than setting.
• Vietnam (206c2).
• Alcohol and social control
o Example of middle-class cocaine use (207c1).
Set
• Foci of evaluation of set’s effects on drug use
are expectations, personality and values.
• Expectations: “interpretation of a drug’s effects
depends on expectations” (207c2).
• Personality and Values. Common sense
predictions turn out to be most accurate.
o Psychologically healthy people are likely to engage in
controlled, moderate drug use (207c2).
o Strongly motivated people make drug use a
component of life, not the dominant factor (Ibid.).
Case Study: Cigarette
Smoking
• Why is it so hard to stop smoking
cigarettes?
o Pharmacology.
o Setting.
o Set.
• Conclusion: arguments that criticize
legalization on the basis of feared
explosion of addiction are based on an
inadequate theory of addiction; a more
adequate theory undercuts this fear.