Making Sense of Bioethics
Addiction can be extremely harmful, and in some cases, fatal for those individuals ensnared by it. It can be seriously disruptive and damaging to those around them. Who is to blame when it comes to addiction? Family and friends may think to themselves, “Why can’t Jane just stop drinking?” Or, “Doesn’t Joe understand that his gambling addiction is bankrupting the family?” Or, “Can’t Bob see how his pornography habit is destroying his marriage and his relationships?” For those facing addiction, it seems they ought to be able to recognize their behavior as harmful and turn away from it by a resolute decision. Family and friends, however, can face years of frustration when they see their loved ones fall into a slow motion “crash and burn,” spiraling downward as they remain unwilling or unable to step away from their addiction.
Individuals caught in the web of addiction objectively fall prey to a loss of personal freedom. Their will becomes weakened, and they become enslaved in a way that limits their ability to recognize the right order of goods in life. By repetitively choosing the addictive behavior, it becomes ingrained, and the ability to choose better, alternative behaviors becomes enfeebled, if not seemingly impossible. For these reasons, there is almost always diminished personal responsibility in situations of addiction. To be accountable for our acts, we must freely choose those acts, but the internal pressure and downward spiral of the addiction may have already co-opted the individual’s ability freely to choose otherwise. Eventually, this bondage can appear to be permanent, and addicted individuals can imagine themselves pathetic and hopeless to such a degree that they almost give up. In the words of a formerly addicted individual:
“I believe that I did not have a choice to stop. ... It never became clear to me that I could live another way until a medical intervention from my physician and friends took place. Willpower plays a small role here, but it too cannot work if one has a malfunctioning brain. I speak for myself here … I could not stop. Period. Now, I have stopped. Not just because of the intervention, but because I have turned my life and my will over to the God of my understanding. That is something 12 step programs have taught me.”
This radical loss of freedom lies at the heart of the tragedy of addiction. Because we are creatures of habit, the choices we make, either for good or for evil, form us in one direction or the other, so we become individuals who are either capable or incapable of choosing the good freely. Virtue is a habit of good, while vice is a habit of evil. Early choices leading down the road toward addiction, freely made, can quickly snowball into vice, addiction and a loss of freedom. As one recovered addict graphically described it:
“My beef is with those who claim that they never chose to become an addict or never chose to hurt their families. ... While we likely didn’t intend to end up helpless, dysfunctional people who [hurt] our loved ones, the choices we made put us at risk of ending up in a sorry state where we were capable of doing things we would have never dreamed of. Unless you were raised on Mars, we all deep down knew the risk of our choices, especially if you’re talking about coke, crack, meth or heroin, but we chose to roll the dice anyways. At a certain point, when I was starting to do coke almost every weekend, I knew that it would be wise to stop, but I chose not to because I was having fun and I told myself it will never happen to me. By the end, I was going on solo three-day benders with alcohol and cocaine, and I landed in treatment. … My point is that I made the choice to try the substance, the choice to begin to use the substance more regularly and the choice not to quit when I could have.”
While there may have been significant moral culpability at the beginning of an individual’s descent into addiction, it is still critical for us to never stigmatize, patronize or abandon those who are in the throes of addiction. They may feel they are defined entirely by their addiction, unlovable and wretched, rather than seeing that they are, in fact, human beings who are precious to God and those around them, and even now endowed with some tiny space of remaining freedom. That tiny space will become key to determining whether they ultimately choose the behavioral changes needed to improve their situation and recover the human freedom that is rightfully theirs. We should support, encourage and love them in ways that will help lead them toward those good choices and successful outcomes.
Father Tadeusz Pacholczyk, Ph.D., earned his doctorate in neuroscience from Yale and did post-doctoral work at Harvard. He is a priest of the diocese of Fall River, Mass., and serves as the director of education at the National Catholic Bioethics Center in Philadelphia. See www.ncbcenter.org.