Jun 09

Alcoholism – Is it Self-Inflicted?

alcoholismA local councillor from Surrey, who also happens to sit on the Health Scrutiny Committee, caused a bit of a stir recently when a leaked email to colleagues on the committee suggested that people should be “encouraged to move out of Surrey” because of “self-inflicted morbidity (mainly – smoking, alcohol, narcotics, obesity)”.

His argument for this was as follows:

“Over time, that would result in the healthcare for the ‘other’ patients in Surrey being significantly better than the average national level for all patients, as the resources deployed to the self-inflicted would be very much reduced. This factor would attract more ‘other’ patients to come to live in Surrey – and that would push up house prices here”.

In his email, Councillor John Butcher said one way of saving the National Health Service in the UK was to encourage patients to take more care of themselves, with penalties for people who did not.

As you can imagine, his comments caused “outrage” amongst many of the more liberal members of the political fraternity in the UK, with many of the populist newspapers quick to pick up on his comments and fan the flames.

He later qualified his comments and said that in respect of addicts: “I need to make it clear that, under my proposals, a condition would not be regarded as ‘self-inflicted’ if the patient is unable to prevent the condition, as is the case with an addict, even if he or she was able to have done that before addiction set in.”

However, putting aside any political or philosophical arguments in response to these comments, it does raise the fundamental question as to whether alcoholism (or any other addiction for that matter) is self-inflicted.

In other words, if the drinker has full cognitive awareness of the likely consequences of continued heavy or harmful drinking, but continues to do it anyway – doesn’t that make him culpable if he eventually becomes an alcoholic?

Is Alcoholism a choice?

“Ah, but I just can’t help it”, I hear you cry. “I’m powerless to stop myself.”

So why is it then, when two people are faced with the same choice one can choose to moderate or eliminate their drinking and the other can’t. Are we saying that some are unable to exercise free will and effectively have no choice?

This is somewhat like the nature vs nurture debate – are we just born that way, and regardless of how hard we might try we are doomed to this particular fate. Or do our circumstances and environment lead us to make such choices because we believe this is in our best interests at the time, even if this belief is harmful to us.

To return to Councillor Butcher’s argument, “… a condition would not be regarded as ‘self-inflicted’ if the patient is unable to prevent the condition, as is the case with an addict, even if he or she was able to have done that before addiction set in.”

So in other words, it is self-inflicted whilst the drinker is wilfully harming themselves through their own choice by drinking too much, up until the point that they become addicted, when they no longer have a choice. At that point the condition is no longer “self-inflicted”.

Alcoholism – To Be or Not To Be?

This argument treats alcoholism as if it’s a binary condition – black and white; either/or – you either are or you aren’t.

Of course in reality alcoholism is as much about the journey as it is about the destination. It is a progressive condition that can take years or even a lifetime to develop, and for those who subscribe to the “nature” point of view, it may even have begun before the drinker has taken their first drink.

However,  regardless of what you may feel about Mr Butcher’s rather extreme views on the subject it could be said that by agreeing that the condition is ultimately self-inflicted this puts you in the position of being able to exercise your power of choice, and to use self-determination to achieve a different outcome for yourself in the future.

To argue otherwise suggests you are powerless over your condition… Hang on, haven’t we heard that somewhere before…?


Permanent link to this article: http://kick-the-drink.co.uk/archives/1801

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