Excellent article, though there is a point I’d like to see adressed on the topic.
One salient feature of these marginal, lifestyle-relaed conditions is the large number of false positives that comes with diagnosis. How many alcoholics, chronic gamblers, and so on, are really incapable of helping themselves, as opposed to just being people who enjoy drinking or gambling and claim to be unable to help themselves to diminish social disapproval? Similarly, how many are diagnosed by their peers (He’s so mopey, he must be depressed) and possibly come to believe it themselves?
The existence of these false positives is probably a big reason for the sympathy/treatment difference these conditions have to more typical diseases. The diagnosis for cancer is fairly straightforward (you have a cancerous tumor → you have cancer), the diagnosis for gambling addiction is much less so (maybe you are neurologically normal and just really like gambling, maybe there’s something deeply wrong with your neurochemistry.).
The lower lethality also makes it so that a person can not only self-diagnose a marginal condition and also justify never seeking treatment. If you don’t seek treatment for cancer, you die. If you don’t seek treatment for TB, you also put a lot of people at risk. If you don’t seek treatment for obesity… you stay fat. Barring a certain extreme, that isn’t going to kill you nor anyone else. Neither will chronic gambling or any of the other examples, though they might correlate with things that do kill you with a high probability, say alcoholism and drunk driving.
This is pretty much the opposite concern as the one stated in the conclusion of the main post: If a biological fix exists, is there a moral obligation to use it?
“How many alcoholics, chronic gamblers, and so on, are really incapable of helping themselves, as opposed to just being people who enjoy drinking or gambling and claim to be unable to help themselves to diminish social disapproval?”
But by self-diagnosing as an alcoholic, a person would thereby be much more likely to become the focus of deliberate social interventions, like being taken to Alcoholics Anonymous (a shining example, by the way, of well-rganied and effective social treatment of a disease) or some such. This sort of focused attention, essentially being treated as if one had a disease, I would think would be the opposite of what a hedonistic boozer would want. Would they really consider possible medical intervention a fair price to pay for slightly less disapproval from friends?
“How many alcoholics, chronic gamblers, and so on, are really incapable of helping themselves, as opposed to just being people who enjoy drinking or gambling and claim to be unable to help themselves to diminish social disapproval?”
But by self-diagnosing as an alcoholic, a person would thereby be much more likely to become the focus of deliberate social interventions, like being taken to Alcoholics Anonymous (a shining example, by the way, of well-rganied and effective social treatment of a disease) or some such. This sort of focused attention, essentially being treated as if one had a disease, I would think would be the opposite of what a hedonistic boozer would want. Would they really consider possible medical intervention a fair price to pay for slightly less disapproval from friends?
Excellent article, though there is a point I’d like to see adressed on the topic.
One salient feature of these marginal, lifestyle-relaed conditions is the large number of false positives that comes with diagnosis. How many alcoholics, chronic gamblers, and so on, are really incapable of helping themselves, as opposed to just being people who enjoy drinking or gambling and claim to be unable to help themselves to diminish social disapproval? Similarly, how many are diagnosed by their peers (He’s so mopey, he must be depressed) and possibly come to believe it themselves?
The existence of these false positives is probably a big reason for the sympathy/treatment difference these conditions have to more typical diseases.
The diagnosis for cancer is fairly straightforward (you have a cancerous tumor → you have cancer), the diagnosis for gambling addiction is much less so (maybe you are neurologically normal and just really like gambling, maybe there’s something deeply wrong with your neurochemistry.).
The lower lethality also makes it so that a person can not only self-diagnose a marginal condition and also justify never seeking treatment. If you don’t seek treatment for cancer, you die. If you don’t seek treatment for TB, you also put a lot of people at risk. If you don’t seek treatment for obesity… you stay fat. Barring a certain extreme, that isn’t going to kill you nor anyone else. Neither will chronic gambling or any of the other examples, though they might correlate with things that do kill you with a high probability, say alcoholism and drunk driving.
This is pretty much the opposite concern as the one stated in the conclusion of the main post: If a biological fix exists, is there a moral obligation to use it?
“How many alcoholics, chronic gamblers, and so on, are really incapable of helping themselves, as opposed to just being people who enjoy drinking or gambling and claim to be unable to help themselves to diminish social disapproval?”
But by self-diagnosing as an alcoholic, a person would thereby be much more likely to become the focus of deliberate social interventions, like being taken to Alcoholics Anonymous (a shining example, by the way, of well-rganied and effective social treatment of a disease) or some such. This sort of focused attention, essentially being treated as if one had a disease, I would think would be the opposite of what a hedonistic boozer would want. Would they really consider possible medical intervention a fair price to pay for slightly less disapproval from friends?
“How many alcoholics, chronic gamblers, and so on, are really incapable of helping themselves, as opposed to just being people who enjoy drinking or gambling and claim to be unable to help themselves to diminish social disapproval?”
But by self-diagnosing as an alcoholic, a person would thereby be much more likely to become the focus of deliberate social interventions, like being taken to Alcoholics Anonymous (a shining example, by the way, of well-rganied and effective social treatment of a disease) or some such. This sort of focused attention, essentially being treated as if one had a disease, I would think would be the opposite of what a hedonistic boozer would want. Would they really consider possible medical intervention a fair price to pay for slightly less disapproval from friends?