Bioethics of Addiction and Intervention

In a recently published article entitled At the Heart of the Tragedy of Addiction, Bioethicist Tadeusz Pacholcyzk* offers two valuable observations on the nature and scope of addiction’s tragic impact on individuals and families.  Father Tad, as he is known, writes from a Roman Catholic, spiritual perspective.  His message demonstrates what I have come to see as the core of misunderstanding and stigmatization that we face as individuals, families and a community.


“,,,radical loss of freedom lies at the heart of the tragedy of addiction. Because we  are creatures of habit, the choices we make, either for good or for evil, form us in one direction or the other, so we become individuals who are either capable or incapable of choosing the good freely.” (article)


It is encouraging to hear from the pastoral realm of human service and care about the spiritually dynamic aspects of addiction and(implicitly) recovery.  Where the essence of stigmatization forms, it is in judgement and condemnation for the individual’s perceived rejection of grace and abundance in health and fulfillment.


            “…oh well, I am an addict or alcoholic.  I therefore do not have any choice but to continue            on this path…” (paraphrase)


Father Ted also quotes addicts whose recovery was initiated by intervention after their capacities to choose had diminished – in the sense that is often referred to as “progressive disease” and that a key to recovery becomes personal choice.  That personal choice cannot be made, as the quoted recovering persons who are among millions or billions know, alone or in a vacuum of self-direction and self-will.


With the bioethical considerations of addiction, a contrasting set of ethical dilemma appears.  Genetic predisposition, gradual decay of healthy neurotransmission in the human brain and a host of other physiopathologies can become the “excuse” to continue using, or enabling addictive use.  While our increasing knowledge illuminates the professional treatment community and its patients with their families, the challenge remains to be fully human and humane, respecting the choices of persons compromised by addiction.


A bioethics of intervention brings unique ethical matters into the whole care continuum process.  Medically safe detoxification, the safety & well-being of minor dependent children and even public safety are at the front of the gallery of considerations.  Every domain of professional care from intervention to transitional therapeutic living requires attention with informed expertise.  The bio-psycho-social (or holistic) perspective we practice and preach must include respect for the human dignity and well-being of any and all who are touched by addiction.  It must also respect the right of the individual to accept or decline help for the sake of spiritual integrity.