Samuelsson Eva, Cisneros Örnberg Jenny
Department of Social Work, Stockholm University, Stockholm, Sweden.
Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
Front Psychiatry. 2022 Jul 25;13:953673. doi: 10.3389/fpsyt.2022.953673. eCollection 2022.
The gambling market is a complex field of conflicting stakeholders and interests involving dimensions, such as economy, health, social inequality and morals. The division of responsibility between gamblers, the gambling industry and the regulating state for limiting the harmful effects of this activity, however, are unclear. The aim of this study was to explore how gamblers in the Swedish market attribute responsibility to various actors within the gambling field. Qualitative interviews were conducted with 37 gamblers experiencing extensive gambling problems. Based on a discourse analytical approach, five ideological dilemmas were identified, highlighting the tension between the, often contradictory, values that the participants need to relate to. On the individual level, the gamblers emphasize their own responsibility for their problem, thereby showing accountability in relation to themselves, their significant others and their peers as agents in recovery. On the corporate- and state levels however, the participants argue for a stronger public health approach, where the gambling companies should take further responsibility by living up to the legal regulations and where the state should ensure compliance and safeguard funding for treatment and research. The essential paradox between the individual responsibility discourse of self-regulation and the prevailing medical discourse of the gambler's incapacity for self-control signifies an impossible equation that imposes feelings of guilt and shame upon an individual who is concurrently considered as both responsible and incapable. In order to reduce harm, the gambling industry must be more proactive with coercive external control measures to fulfill the duty of care they claim to adhere to, and the regulating state must ensure its compliance.
赌博市场是一个利益相关者相互冲突、利益错综复杂的领域，涉及经济、健康、社会不平等和道德等多个层面。然而，赌徒、赌博行业和监管国家在限制这种活动的有害影响方面的责任划分并不明确。本研究的目的是探讨瑞典市场上的赌徒如何将责任归咎于赌博领域内的各个行为主体。对37名有严重赌博问题的赌徒进行了定性访谈。基于话语分析方法，确定了五个意识形态困境，突出了参与者需要面对的、往往相互矛盾的价值观之间的紧张关系。在个人层面，赌徒强调自己对自身问题的责任，从而表明在康复过程中，他们对自己、重要他人和同龄人作为行为主体负有责任。然而，在企业和国家层面，参与者主张采取更强有力的公共卫生方法，即赌博公司应通过遵守法律法规承担更多责任，国家应确保合规并为治疗和研究提供资金保障。自我监管的个人责任话语与普遍存在的关于赌徒缺乏自我控制能力的医学话语之间的本质矛盾，意味着一个无法解决的等式，给一个同时被认为既有责任又无能力的个体带来内疚和羞耻感。为了减少危害，赌博行业必须更加积极主动地采取强制性外部控制措施，以履行他们声称遵守的照护责任，监管国家必须确保其合规。
