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Can we hold addicts responsible without blame?

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Pickard argues that clinic-style responsibility without blame treats people as capable of change without the stigma of condemnation.

Source

Responsibility without Blame for Addiction

Pickard H · Neuroethics · 2017

doi.org/10.1007/s12152-016-9295-2Read the full paper ↗57 citationscc by

What they did

Drawing on work in a therapeutic community, Pickard distinguishes the moral model (addicts as bad characters) from a clinical stance that still treats people as having choice and control. She uses a reasons-responsive idea of responsibility and separates it from blame.

What they found

Stigma marks social disgrace and blocks treatment. In the clinic, holding people to account can motivate change because capacity for choice remains. Responsibility without blame is the stance she found in that setting. She also notes that alcohol is a drug, and that safer supply plus education could reduce overdose risk among inexperienced users.

The limits

What it doesn't show

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.

Key terms

Responsibility without blame
Holding someone to account for choice and change without condemnation or stigma.
Moral model
The view that addicts are people of bad character who simply choose badly and deserve criticism.
Stigma
A mark of social disgrace that ostracises and often blocks housing, work and care.
Reasons-responsiveness
A theory of responsibility: one is responsible if one can respond to reasons.

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Pickard’s slogan?

Common questions

Does Pickard deny responsibility?

No. She keeps responsibility (choice, control, accountability) and drops blame as condemnation.

Why does stigma matter?

It shames people, deters treatment, and can legally bar healthcare, housing and work.

Where did the stance come from?

From clinical work, especially a therapeutic community.

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