Addiction and autonomy: Can addicted people consent to the prescription of their drug of addiction?
Addiction and autonomy: Can addicted people consent to the prescription of their drug of addiction?
复制标题
DOI：
10.1111/j.1467-8519.2006.00470.x
复制
发表时间：
2006-02-01
期刊：
影响因子：
2.2
通讯作者：
Savulescu, J
中科院分区：
文献类型：
--
作者：
Foddy, B;Savulescu, J
人们经常声称，当海洛因成瘾者在吸毒和戒毒之间做出选择时，他们的自主权就会受到损害。这是声称他们无能力同意服用海洛因的依据。我们基于许多经验和理论依据拒绝这些主张。首先，我们认为，在接近研究人员参与研究时，成瘾者可能是清醒的，因此能够进行理性思考。我们拒绝接受旨在证明成瘾者缺乏自主权的行为证据。我们提出一个论点，即外部力量必须是不可抗拒的，才能做出非自主的选择。我们认为海洛因并不具有如此不可抗拒的力量。我们认为，以毒品为导向的欲望是强烈的常规欲望，不会损害同意。最后我们认为，成瘾者明显想要从事有害行为不能被解释为非理性或强迫性思维的证据。根据这些论点，清醒的海洛因成瘾者必须被视为有能力、自主且能够给予同意。更一般地说，任何反对毒品合法化或支持侵犯那些想要吸毒成瘾者的自由的论点都必须基于对伤害和家长作风的考虑，而不是基于吸毒者缺乏意志自由的错误主张。
It is often claimed that the autonomy of heroin addicts is compromised when they are choosing between taking their drug of addiction and abstaining. This is the basis of claims that they are incompetent to give consent to be prescribed heroin. We reject these claims on a number of empirical and theoretical grounds. First we argue that addicts are likely to be sober, and thus capable of rational thought, when approaching researchers to participate in research. We reject behavioural evidence purported to establish that addicts lack autonomy. We present an argument that extrinsic forces must be irresistible in order to make a choice non-autonomous. We argue that heroin does not present such an irresistible force. We make a case that drug-oriented desires are strong regular appetitive desires, which do not compromise consent. Finally we argue that an addict's apparent desire to engage in a harmful act cannot be construed as evidence of irrational or compulsive thought. On these arguments, a sober heroin addict must be considered competent, autonomous and capable of giving consent. More generally, any argument against legalisation of drugs or supporting infringement of the liberty of those desiring to take drugs of addiction must be based on considerations of harm and paternalism, and not on false claims that addicts lack freedom of the will.