Ira W. DeCamp Bioethics

Abstract: Millions of people around the world are addicted to drugs.  While many of these people sincerely want to give up their addiction or not relapse, they often struggle to do so.  Why is this?  In this paper, I call this the Hard Problem of addiction because the explanation for this problem seems difficult to find.  I first argue that the disease model and certain versions of the choice model of addiction are inadequate for explaining the Hard Problem. I then propose that paying closer attention to the confidence levels of those with addiction gives us a fuller explanation of the Hard Problem. I discuss how the role of confidence is supported by empirical research on self-efficacy and metacognition, and how it is broadly compatible with research in neurobiology.  I then respond to some potential objections and show that they do not undermine the role of confidence in explaining the Hard Problem.  Lastly, I consider some implications of attending to the role of confidence in the treatment of addiction. 

S. Matthew Liao is Arthur Zitrin Chair of Bioethics, Director of the Center for Bioethics, Professor of Global Public Health, and Affiliated Professor in the Department of Philosophy at New York University.  He is the author or editor of The Right to Be Loved (Oxford University Press); Ethics of Artificial Intelligence (Oxford University Press); Moral Brains: The Neuroscience of Morality (Oxford University Press); The Philosophical Foundations of Human Rights (Oxford University Press); Current Controversies in Bioethics (Routledge), and over 60 articles in philosophy and bioethics.  He has given TED and TEDx talks in New York and CERN, Switzerland, and he has been featured in the New York Times, The Atlantic, The Guardian, the BBC, Harper’s Magazine, Sydney Morning Herald, Scientific American and other media outlets. Liao obtained his doctorate in philosophy from Oxford University and his AB from Princeton University.  He is the Editor-in-Chief for the Journal of Moral Philosophy, a peer-reviewed international journal of moral, political and legal philosophy.