Topics Freedom

Question I work for a housing charity who deal with homeless clients. The local housing authority refues to consider heroin users or alcoholics as vulnerable enough for emergency accommodation because their drug use is a "lifestyle choice." Even if they have severe medical problems [deep vein thrombosis, liver disease, etc.] which in another case may be deemed serious enough to make them "vulnerable." My colleagues and I are confused. Can addictive behaviour seriously be described as an act of free will? I don't know if your rules forbid such qestions as being medical/psychological rather than philosophical, but I have worked in addictions services for nearly 15 years, and I have never seen a definitive answer to this question, therefore I suspect it may be one for the philosophers rather than the men in white coats! Please help us if you can.

Accepted:
November 3, 2006

Comments

Thank you very much for your contribution. I'm not a specialist on issues of free will, or on the psychology or neuroscience of addiction. I hope that other panelists will add their comments here as well. However, one thought that comes to mind in response to your question is that there is *a* sense in which drug addicts and alcoholics are in the condition they are in as a result of their own choice: With the exception of those who gained an addiction in utero (I have the impression that this is possible), these individuals made choices that resulted in their addictions. There would have to have been many such choices, since it is only in this way that an addiction can be created; and those choices might not have been made in the awareness that an addiction would likely result. Nevertheless, the housing authority perhaps would suggest that people can be expected to know that certain choices will likely result in an addiction over time.

Of course that will not satisfy you and your colleagues, since you might accept all this and feel that nonetheless, *now*, these addicted individuals hardly have a choice as to whether to continue their addictive behavior, at least in the short run. What is more, they clearly have severe medical problems that justify emergency accommodation. Is it not unjust to deprive them of such services? Furthermore, it will not be hard to find cases of individuals who do qualify for accommodation because of a medical condition that was also due in part to a choice or series of choices that they made at an earlier time : Diabetes due to obesity and lack of exercise, or for that matter a serious injury resulting from some bad driving, are examples. I'm guessing that the housing authority would probably accommodate these individuals. If it would, then that suggests a bit of a double standard.

If there is such a double standard, my guess is that the reason is more political than philosophical: Taxpayers might well chafe at the idea of paying to support addicts, whereas to them it might seem that aut0 accidents and even obesity are to a large extent a fact of life. It is easier for many people to have a "there but for the grace of God walk I" attitude toward someone whose bad driving results in a debilitating accident, than toward an addict. I'm not claiming that that difference of attitude is rational, but there it is.

Given my suspicion that philosophical reasoning is not going to change policy here, how about a practical suggestion: Might your charity approach the housing authority with the suggestion that addicts get accommodation on the condition of being involved in some kind of rehab? (A reminder of the social costs of *not* responding to addiction might also strengthen your case.)

For more information about the science of addiction and recovery, you might wish to consult some of the work of Prof. Bankole Johnson. The link below is to an article about his work. (http://www.virginia.edu/uvatoday/newsRelease.php?id=310).