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Medicine and morals, craving and compulsion.

Stephen J Morse1

  • 1Law School, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6204, USA. smorse@law.upenn.edu

Substance Use & Misuse
|April 20, 2004
PubMed
Summary

Addiction is viewed as either a disease (medical model) or moral failing (moral model). This analysis suggests diminished rationality, not compulsion, may excuse addict behavior, though most remain responsible. Public policy should integrate both models.

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Area of Science:

  • Addiction studies
  • Moral philosophy
  • Criminal justice

Background:

  • Addiction conceptualization is dominated by the medical model (disease) and the moral model (failure).
  • The moral model views addiction-related behaviors as indicative of personal failing.
  • The medical model frames addiction as a disease with observable signs and symptoms.

Purpose of the Study:

  • To analyze the implications of the moral model of addiction.
  • To explore the concept of compulsion and its relation to moral and legal responsibility in addicts.
  • To determine if diminished rationality or compulsion better explains excusable behavior in addiction.

Main Methods:

  • Conceptual analysis of addiction models.
  • Examination of psychological states like craving and their impact on behavior.
  • Ethical and legal reasoning regarding responsibility.

Main Results:

  • Diminished rationality is proposed as a better explanation for potential excuses in addiction than compulsion.
  • Most individuals with addiction can be held responsible for the majority of addiction-related behaviors.
  • Neither the medical nor the moral model alone is sufficient for sound public policy.

Conclusions:

  • A balanced approach, integrating aspects of both medical and moral models, is recommended for public policy.
  • The criminal justice system should consider implications from both perspectives when formulating policies.
  • Understanding the nuances of responsibility in addiction is crucial for effective interventions and legal frameworks.

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