Addiction, autonomy and ego-depletion: A response to Bennett Foddy and Julian Savulescu

Bioethics

Volumn 20, Issue 1, 2006, Pages 16-20

  Levy, Neil ^a  

^a UNIVERSITY OF MELBOURNE   (Australia)

Author keywords

[No Author keywords available]

Indexed keywords

COCAINE; DIAMORPHINE;

APPETITE; COCAINE DEPENDENCE; COMPULSION; CONFERENCE PAPER; CONSCIOUSNESS; DRUG DEPENDENCE; DRUG WITHDRAWAL; EGO; FATIGUE; HEROIN DEPENDENCE; HUMAN; SELF CONTROL; SELF EVALUATION; TASK PERFORMANCE; WITHDRAWAL SYNDROME;

BIOMEDICAL AND BEHAVIORAL RESEARCH; MENTAL HEALTH THERAPIES;

BEHAVIOR CONTROL; CLINICAL TRIALS; COMPULSIVE BEHAVIOR; CONTROL GROUPS; EMPIRICAL RESEARCH; HEROIN; HEROIN DEPENDENCE; HUMANS; INFORMED CONSENT; MENTAL COMPETENCY; PERSONAL AUTONOMY;

EID: 31544471792     PISSN: 02699702     EISSN: 14678519     Source Type: Journal    
DOI: 10.1111/j.1467-8519.2006.00471.x     Document Type: Conference Paper

References (23)

1. The OED gives as one of its definitions of addiction 'a compulsion and need to continue taking a drug as a result of taking it in the past'.
2. Louis C. Charland. Cynthia's Dilemma: Consenting to Heroin Prescription. Am J Bioeth 2002; 2(2): 37-47.
3. Bennett Foddy & Julian Savulescu. Addiction and Autonomy: Can Addicted People Consent to the Prescription of Their Drug of Addiction? Bioethics 2006; 20(1): 1-15.
4. For an example of the latter, see, for instance, Alan Leshner. Science-Based Views of Drug Addiction and Its Treatment. JAMA 1999; 282: 1314-1316.
5. William James. 1890. Principles of Psychology. New York: Henry Holt & Company: 543.
6. Charland, op. cit. note 2, pp. 37, 43.
7. For a review of the literature on the recovery of untreated addicts, see Linda C. Sobell, Timothy P. Ellingstad & Mark B. Sobell. Natural recovery from alcohol and drug problems: methodological review of the research with suggestions for future directions. Addiction 2000; 95: 749-764.
8. Jon Elster. 1999. Strong Feelings: Emotion, Addiction and Human Behavior. Cambridge, Mass.: The MIT Press;
9. Joanne Neale. 2002. Drug Users in Society. New York: Palgrave.
10. Price sensitivity is also a feature of alcoholism: see Herbert Fingarette. 1988. Heavy Drinking: The Myth of Alcoholism as a Disease. Berkeley: University of California Press: 36-42. Consumption is price sensitive both within and outside the laboratory; moreover, alcoholics are sensitive to cost even after consuming an initial priming drink.
11. George Ainslie. A Research-Based Theory of Addictive Motivation. Law Philos 2000; 19: 82.
12. At least this seems true of between-episode behavior. Within episodes, the behavior of those addicted to some drugs - most notably cocaine - seems sometimes to be genuinely compulsive. See Elster, op. cit. note 8, pp. 167-169.
13. Foddy & Savulescu, op. cit. note 3, p. 11.
14. George Loewenstein. Willpower: A Decision Theorist's Perspective. Law Philos 2000; 19: 51-76;
15. George Ainslie. 2001. Breakdown of Will. Cambridge: Cambridge University Press.
16. The ego-depletion hypothesis has been outlined and refined by Roy Baumeister and his collaborators. See, for instance, R.F. Baumeister et al. Ego-depletion: Is the active self a limited resource? J Pers Soc Psychol 1998; 74: 1252-1265,
17. and R.F. Baumeister. Ego Depletion and Self-Control Failure: An Energy Model of the Self's Executive Function. Self and Identity 2002; 1: 129-136.
18. K.D. Vohs & T.F. Heatherton. Self-regulatory failure: A resource-depletion approach. Psychol Sci 2000; 11: 249-254.
19. B.J. Schmeichel & R.F. Baumeister. 2004. Self-regulatory Strength. In Handbook of Self-Regulation. Roy F. Baumeister & Kathleen D. Vohs, eds. New York: The Guilford Press: 84-98.
20. See J. Zhu. Locating Volition. Conscious Cogn 2004; 13: 302-322, for a review of these studies.
21. K.D. Vohs et al. Self-Regulation and Choice. Unpublished.
22. It is worth pointing out that there may be more than an analogy between self-control and muscular exhaustion. Recent research seems to show that depletion of physical resources is also controlled by neural mechanisms: when athletes feel themselves unable to continue, their feeling is not a veridical reflection of the state of resources available to their muscles, but is instead a feeling produced by brain mechanisms designed to ensure that physical resources are preserved. See T.D. Noakes et al. From catastrophe to complexity: a novel model of integrative central neural regulation of effort and fatigue during exercise in humans. Br J Sports Med 2004; 38: 511-514.
23. See Loewenstein, op. cit. note 12. Loewenstein notes that Vietnam veterans with heroin addictions found it relatively easy to kick the habit: since it was developed and maintained in a very different environment from that in which they attempted to give up, they encountered the cues that trigger cravings only rarely.