Addiction · Moral responsibility
Addiction can leave the capacity for choice intact and still not deserve blame
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Short answer
Responsibility and blame can be separated, allowing people with addiction to be held accountable without stigma and without denying their agency.
What happened
Pickard sets out a 'responsibility without blame' stance drawn from clinical work in therapeutic communities. Stigma marks social disgrace and blocks people from treatment. In the clinic, holding people to account can motivate change precisely because the capacity for choice remains. She also notes that alcohol is a drug, and that safer supply together with education could reduce harm.
Why it matters
Public argument about addiction runs between two positions that share an assumption: that responsibility and blame travel together, so the only way to remove blame is to remove agency. Separating them is what makes the clinical stance coherent — and it is a philosophical move, not an empirical finding, which is why it cannot be settled by a trial.
Evidence
- Study type
- Philosophical argument informed by clinical practice in therapeutic communities
- Sample
- Conceptual argument with clinical observation; no participant sample
- Journal
- Neuroethics · peer reviewed
- Replication
- Not assessed in this corpus; the position is contested within the addiction ethics literature
- Limitations
- Not a trial of the clinical approach described. Cross-cultural stigma claims are cited rather than tested, and the stance is developed for clinical settings, not criminal justice.
What this connects to
Sources
The one study this explanation is built from, by the role each plays. Every source links to PaperFren’s explanation of it and to the original paper.
Primary study
- Can we hold addicts responsible without blame?
Pickard argues that clinic-style responsibility without blame treats people as capable of change without the stigma of condemnation.
What it does not showLimitations
This is not a new RCT of therapeutic communities. Cross-cultural stigma citations are from others. The clinical stance may not transfer easily to criminal courts.
PaperFren explanationStudy with cards and a quizOriginal paper (DOI)cc by
Before
Addiction debate has been framed as a choice between a moral model that blames and a brain-disease model that removes blame by removing responsibility.
Now
A third position holds people responsible without blaming them, and the paper reports it as the stance found in clinical practice. This is not a trial of therapeutic communities, cross-cultural stigma evidence is cited from others, and the stance may not transfer to criminal courts.