Mohamed Ali Shazeea
Monash University, Clayton, VIC, 3168, Australia.
Department of Geriatric Medicine, Austin Health, Heidelberg, VIC, 3084, Australia.
Monash Bioeth Rev. 2024 Oct 3. doi: 10.1007/s40592-024-00207-0.
New Zealand and Malaysia have abandoned plans to introduce a generational smoking ban because of concerns that such a policy is incompatible with liberal democracy as it undermines autonomy. This paper challenges this claim by showing that smoking is not an autonomous act. Autonomy requires a deliberation of preferences, wills and inclinations. This does not occur in smokers because of three related factors: nicotine addiction, cognitive biases and psychosocial development in addiction. Nicotine addiction results in strong physical and psychological desires to seek pleasure and to avoid withdrawal. This is further potentiated by conditioned behaviour. Cognitive biases explain why smokers act in ways that are detrimental to their health. Psychosocial development explains how the brains of smokers are unable to make rational decisions. This combination renders smokers unable to reflect on their actions and thus act autonomously. This stance is compatible with Mill's view that actions that devalue autonomy cannot be considered autonomous. Defenders of liberalism should not be quick to dismiss a smoking ban and can instead foster autonomy by supporting it.
新西兰和马来西亚已放弃引入代际吸烟禁令的计划，原因是担心这样一项政策与自由民主不相容，因为它会破坏自主性。本文通过表明吸烟并非自主行为来质疑这一说法。自主性需要对偏好、意愿和倾向进行思考。由于三个相关因素，吸烟者不会进行这种思考：尼古丁成瘾；认知偏差；成瘾中的心理社会发展。尼古丁成瘾导致强烈的生理和心理欲望，以寻求愉悦并避免戒断反应。条件行为进一步加剧了这种情况。认知偏差解释了吸烟者为何会以损害自身健康的方式行事。心理社会发展解释了吸烟者的大脑为何无法做出理性决策。这种综合情况使吸烟者无法反思自己的行为，从而无法自主行动。这一立场与密尔的观点相符，即贬低自主性的行为不能被视为自主行为。自由主义的捍卫者不应急于驳回吸烟禁令，相反，可以通过支持它来促进自主性。
