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No Need for the Disease Label: Choice is Complicated. Reply to Heather

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The Original Article was published on 01 April 2017

Abstract

Despite its historical contribution, Heather sees the Brain Disease Model of Addiction (BDMA) as failing to relieve stigma, increasing fatalism, and fundamentally wrong. He also sees “choice” as partly volitional and partly unconscious, implying no moral violation. I agree on all counts. Heather then presents a disorder-of-choice (DOC) model of addiction, highlighting the failure of self-regulation with respect to immediate goals. Not only do I endorse such modeling, but the neural mechanisms I describe may help to explicate it more thoroughly.

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References

  1. Heather, Nick. 2017. Q: Is addiction a brain disease or a moral failing? A: Neither. Neuroethics 10. doi:10.1007/s12152-016-9289-0.

  2. Lewis, Marc D. 2015. The biology of desire. Why addiction is not a disease. New York: Public Affairs.

  3. Lewis, Marc D. 2017. Addiction and the brain: Development, not disease. Neuroethics 10. doi:10.1007/s12152-016-9293-4.

  4. Segal, Gabriel, and Nick Heather. 2016. Addiction and choice. Rethinking the relationship. Oxford: Oxford University Press.

  5. Lewis, Marc D. 2017. Once more, with feeling! Reply to Ainslie. Neuroethics 10, forthcoming.

  6. Ainslie, George. 2017. Intertemporal bargaining in habit. Neuroethics 10. doi:10.3389/fpsyt.2013.00063.

  7. Hall, Wayne D., Adrian Carter, and Anthony Barnett. 2017. Disease or developmental disorder: Competing perspectives on the neuroscience of addiction. Neuroethics 10. doi:10.1007/s12152-017-9303-1.

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Correspondence to Marc Lewis.

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Lewis, M. No Need for the Disease Label: Choice is Complicated. Reply to Heather. Neuroethics 10, 125–127 (2017). https://doi.org/10.1007/s12152-017-9320-0

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  • DOI: https://doi.org/10.1007/s12152-017-9320-0

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