Hyman Steven E
Harvard University, Cambridge, MA 02138, USA.
Am J Bioeth. 2007 Jan;7(1):8-11. doi: 10.1080/15265160601063969.
There continues to be a debate on whether addiction is best understood as a brain disease or a moral condition. This debate, which may influence both the stigma attached to addiction and access to treatment, is often motivated by the question of whether and to what extent we can justly hold addicted individuals responsible for their actions. In fact, there is substantial evidence for a disease model, but the disease model per se does not resolve the question of voluntary control. Recent research at the intersection of neuroscience and psychology suggests that addicted individuals have substantial impairments in cognitive control of behavior, but this "loss of control" is not complete or simple. Possible mechanisms and implications are briefly reviewed.
关于成瘾是最好被理解为一种脑部疾病还是一种道德状况,一直存在争论。这场争论可能会影响与成瘾相关的污名以及治疗的可及性,其往往源于我们是否以及在多大程度上能够公正地让成瘾者为自己的行为负责这一问题。事实上,有大量证据支持疾病模型,但疾病模型本身并未解决自主控制的问题。神经科学与心理学交叉领域的最新研究表明,成瘾者在行为的认知控制方面存在严重缺陷,但这种“失去控制”并非完全或简单的。本文简要回顾了可能的机制及影响。