Skog Ole-Jørgen
Department of Sociology, University of Oslo, Norway.
Adv Health Econ Health Serv Res. 2005;16:145-71.
It is argued that addicts, as people in general, are forward-looking and that they try to make the best of what they have got. However, this does not imply that they are fully rational. Cognitive defects, instabilities in preferences, and irrationalities in the form of wishful thinking and dynamical inconsistency play an important role in addictive behaviours. These "imperfections" in people's rationality may not have very large consequences in the case of ordinary goods, but their effect can be dramatic in relation to addictive goods. In the first part of the paper, the rational addiction theory and the empirical evidence that have been presented in support of the theory is reviewed. Regarding the conventional tests of the theory by econometric methods, it is argued that the tests are misguided, both theoretically and methodologically. Furthermore, it is claimed that the definition of addiction implicit in the rational addiction theory is unrealistic, and that the theory makes unrealistic assumptions about human nature. Some empirical evidence for these claims is reviewed. It is concluded that although the theory has its virtues, it faces serious problems and must be rejected in its original form. Secondly, the socio-cultural embeddedness of addictive behaviours, and the social roots of individual preferences, are discussed. These issues are more or less ignored in rational addiction theory. It is argued that we cannot expect to obtain a proper understanding of many addictive phenomena, unless they are seen in their proper socio-cultural context.
有人认为,成瘾者和普通人一样,具有前瞻性,并且会尽力充分利用他们所拥有的东西。然而,这并不意味着他们完全理性。认知缺陷、偏好的不稳定性以及一厢情愿和动态不一致等形式的非理性在成瘾行为中起着重要作用。人们理性方面的这些“缺陷”在普通商品的情况下可能不会产生很大影响,但在成瘾性商品方面,其影响可能会非常显著。在本文的第一部分,回顾了理性成瘾理论以及为支持该理论而提出的实证证据。关于通过计量经济学方法对该理论进行的传统检验,本文认为这些检验在理论和方法上都是错误的。此外,有人声称,理性成瘾理论中隐含的成瘾定义是不现实的,并且该理论对人性做出了不现实的假设。本文回顾了支持这些说法的一些实证证据。结论是,尽管该理论有其优点,但它面临着严重的问题,必须摒弃其原始形式。其次,讨论了成瘾行为的社会文化嵌入性以及个人偏好的社会根源。这些问题在理性成瘾理论中或多或少被忽视了。本文认为,除非将许多成瘾现象置于适当的社会文化背景中去看待,否则我们无法期望对它们有恰当的理解。