Philosophical inquiry in nursing: an argument for radical empiricism as a philosophical framework for the phenomenology of addiction

Addiction and Moralization: the Role of the Underlying Model of Addiction

Addiction appears to be a deeply moralized concept. To understand the entwinement of addiction and morality, we briefly discuss the disease model and its alternatives in order to address the following questions: Is the disease model the only path towards a 'de-moralized' discourse of addiction? While it is tempting to think that medical language surrounding addiction provides liberation from the moralized language, evidence suggests that this is not necessarily the case. On the other hand non-disease models of addiction may seem to resuscitate problematic forms of the moralization of addiction, including, invoking blame, shame, and the wholesale rejection of addicts as people who have deep character flaws, while ignoring the complex biological and social context of addiction. This is also not necessarily the case. We argue that a deficit in reasons responsiveness as basis for attribution of moral responsibility can be realized by multiple different causes, disease being one, but it also seems likely that alternative accounts of addiction as developed by Flanagan, Lewis, and Levy, may also involve mechanisms, psychological, social, and neurobiological that can diminish reasons responsiveness. It thus seems to us that nondisease models of addiction do not necessarily involve moralization. Hence, a non-stigmatizing approach to recovery can be realized in ways that are consistent with both the disease model and alternative models of addiction.

Thai men's experiences of alcohol addiction and treatment

Background

Men are overrepresented with regard to alcohol addiction and in terms of alcohol treatment worldwide. In Thailand, alcohol consumption continues to rise, but few of those afflicted with alcohol addiction attend alcohol treatment programs, even though there is universal care for all. No comprehensive studies have been done on men’s experiences with addiction and alcohol treatment programs in Thailand.

Objective

The aim of this study was to explore men’s experiences in terms of the ‘pros and cons of alcohol consumption’ in order to identify the barriers that exist for Thai men with regard to alcohol addiction and the decision to stop drinking.

Design

Purposive sampling was applied in the process of recruiting participants at an alcohol clinic in a hospital in Thailand. Thirteen men with alcohol addiction (aged 32–49 years) were willing to participate and were interviewed in thematic interviews. The analysis of the data was done with descriptive phenomenology.

Results

Through men’s descriptions, three clusters of experiences were found that were ‘mending the body’, ‘drinking as payoff and doping related to work’, and ‘alcohol becoming a best friend’ as ways of describing the development of addiction.

Conclusions

The results highlight the importance of addressing concepts of masculinity and related hegemonic ideas in order to decrease the influence of the barriers that exist for Thai men with alcohol addiction with regard to entering treatment and to stop drinking.

The experience of addiction as told by the addicted: incorporating biological understandings into self-story

How do the addicted view addiction against the framework of formal theories that attempt to explain the condition? In this empirical paper, we report on the lived experience of addiction based on 63 semi-structured, open-ended interviews with individuals in treatment for alcohol and nicotine abuse at five sites in Minnesota. Using qualitative analysis, we identified four themes that provide insights into understanding how people who are addicted view their addiction, with particular emphasis on the biological model. More than half of our sample articulated a biological understanding of addiction as a disease. Themes did not cluster by addictive substance used; however, biological understandings of addiction did cluster by treatment center. Biological understandings have the potential to become dominant narratives of addiction in the current era. Though the desire for a "unified theory" of addiction seems curiously seductive to scholars, it lacks utility. Conceptual "disarray" may actually reflect a more accurate representation of the illness as told by those who live with it. For practitioners in the field of addiction, we suggest the practice of narrative medicine with its ethic of negative capability as a useful approach for interpreting and relating to diverse experiences of disease and illness.

Nursing Leaders' Experiences With the Ethical Dimensions of Nursing Education

This pilot study explores four nursing leaders' experiences with the ethical dimensions of leadership in education. Gathering and interpreting such data of experience fosters greater understanding of the nature of moral leadership as it is lived in nursing education. A phenomenological approach was used to collect and analyze the data. The results revealed four major themes: integrity, justice, wrestling with decisions in the light of consequences, and the power of information. These themes clarify the values that direct these leaders' actions as they mediate community needs common to educational and health care institutions.

The shifting sands of self: a framework for the experience of self in addiction

The self is a common yet unclear theme in addiction studies. William James's model of self provides a framework to explore the experience of self. His model details the subjective and objective constituents, the sense of self-continuity through time, and the ephemeral and plural nature of the changing self. This exploration yields insights into the self that can be usefully applied to subjective experiences with psychoactive drugs of addiction. Results of this application add depth to the common understanding of self in addiction, acknowledge the importance of feelings and choice in the sense of self created in addiction experiences, and affirm the values salient to these interior experiences in addiction. These results suggest meaning derived from those values, and provide important background knowledge for the nurse interacting with these clients.