Obese Man to Sue NHS for letting him get fat.

[mistermack]

Svartalf, I think I'm in the same position as you. I'm slightly addicted to eating too much. If I wasn't, I would never be other than my ideal weight, because I would deliberately maintain that weight. But I'm not able to do that.
Also, I know that if I didn't exercise ANY restraint, and just ate what I felt like, I would be just enormous, and probably ill.
The way I look at it, I never evolved to have drinks and snacks at my fingertips 24 hours a day. Nor did you evolve to have alcohol available whenever you wanted it.
The problem is just a mismatch between our evolution, and the lifestyle we find ourselves leading.
It doesn't make the problem go away, but as I see it, it's a problem that found me, not one that I went out and got. So I experience no shade of guilt, in admitting a slight addiction. In fact, it just gives me a buzz, when I achieve little victories, like losing a few pounds.

[Cunt]

There are many reasons to reject the label 'addict', among them the widely varying and sloppy (at best) definitions people have for them.
I can reject the label 'addict' like I reject the label 'sinner' because they both have so little rational meaning to them...let's look at one common description...

Addiction is a psychological and physiological process (the amount of either component verying with the particular case) where a given behavior, most usually the intake of a given psychoactive substance, becomes necessary for the subject to feel well, or at least not too bad.

If I use your definition, I can fit sleep, shitting, pissing, expectorating and masturbation in there. I can also squeeze just about every other regular human behaviour.

Of course, you could always add to your definition, until it suits your purpose.

But can you see how useless even the better descriptions are?

[JimC]

There are many reasons to reject the label 'addict', among them the widely varying and sloppy (at best) definitions people have for them.
I can reject the label 'addict' like I reject the label 'sinner' because they both have so little rational meaning to them...let's look at one common description...

Addiction is a psychological and physiological process (the amount of either component verying with the particular case) where a given behavior, most usually the intake of a given psychoactive substance, becomes necessary for the subject to feel well, or at least not too bad.

If I use your definition, I can fit sleep, shitting, pissing, expectorating and masturbation in there. I can also squeeze just about every other regular human behaviour.

Of course, you could always add to your definition, until it suits your purpose.

But can you see how useless even the better descriptions are?

So, would you dny that the painful process of withdrawal from, say, nicotine or heroin has any reality at all?

I can testify personally to the very unpleasant physical and mental experience of nicotine withdrawal, at least...

[Cunt]

There are many reasons to reject the label 'addict', among them the widely varying and sloppy (at best) definitions people have for them.
I can reject the label 'addict' like I reject the label 'sinner' because they both have so little rational meaning to them...let's look at one common description...

Addiction is a psychological and physiological process (the amount of either component verying with the particular case) where a given behavior, most usually the intake of a given psychoactive substance, becomes necessary for the subject to feel well, or at least not too bad.

If I use your definition, I can fit sleep, shitting, pissing, expectorating and masturbation in there. I can also squeeze just about every other regular human behaviour.

Of course, you could always add to your definition, until it suits your purpose.

But can you see how useless even the better descriptions are?

So, would you dny that the painful process of withdrawal from, say, nicotine or heroin has any reality at all?

I can testify personally to the very unpleasant physical and mental experience of nicotine withdrawal, at least...

Why does denial of that sort seem to you to follow from my rejection of a sloppy, meaningless word?

It's like I attacked a sacred cow or something.

[Hermit]

one cannot be slightly addicted any more than they can be slightly sinful.

Wrong on both counts. Severity of addiction can be ascertained on a very pragmatic level. How difficult is it for any particular individual to get away from it? As for sinfulness, historically speaking for several centuries a distinction has been made between mortal and venial sins.

I wish to add, after a slightly pregnant pause, that your tendency to see things only in terms of black and white is not very unique.

[Cunt]

one cannot be slightly addicted any more than they can be slightly sinful.

Wrong on both counts. Severity of addiction can be ascertained on a very pragmatic level. How difficult is it for any particular individual to get away from it? As for sinfulness, historically speaking for several centuries a distinction has been made between mortal and venial sins.

I wish to add, after a slightly pregnant pause, that your tendency to see things only in terms of black and white is not very unique.

I take issue with the word used and I get accused of everything from denying the effects of chemical dependency to having a tendency to see things only in terms of black and white.

[JimC]

Cunt wrote:

Why does denial of that sort seem to you to follow from my rejection of a sloppy, meaningless word?

It's like I attacked a sacred cow or something.

I'm sure that people use the word addiction in sloppy ways that stretch its meaning. However, in this thread, the way you have expressed this seems to most paticipants to be a rejection of any reality at all to addiction, rather than a critique of poor application of the term by some (or even many)

[Hermit]

I take issue with the word used and I get accused of everything from denying the effects of chemical dependency to having a tendency to see things only in terms of black and white.

You seem to be doing a bit more than that. To me, a range of behavioural tendencies - be they determined by chemical, hormonal or psychological factors - can be said to be caused by "addiction" just like the tendency of things to fall can be said to be caused by "gravity". They are just labels we apply to bunches of observed phenomena that have something in common. The way I read your posts is that you deny the very concept of addiction. Like this:

The only contribution 'addicted' seems to make to the conversation is to give some vague psychological excuse for making bad choices.

It's hard to think of a more libertarian attitude. I was hoping we were gradually becoming too mature to subscribe to such an immature Weltanschauung. Social sciences, statistics and neurology have each in their own way provided mountains of evidence since they became sciences that you, I and everyone else is not an autonomously choice-making individual.

[Svartalf]

There are many reasons to reject the label 'addict', among them the widely varying and sloppy (at best) definitions people have for them.
I can reject the label 'addict' like I reject the label 'sinner' because they both have so little rational meaning to them...let's look at one common description...

Addiction is a psychological and physiological process (the amount of either component verying with the particular case) where a given behavior, most usually the intake of a given psychoactive substance, becomes necessary for the subject to feel well, or at least not too bad.

If I use your definition, I can fit sleep, shitting, pissing, expectorating and masturbation in there. I can also squeeze just about every other regular human behaviour.

Of course, you could always add to your definition, until it suits your purpose.

But can you see how useless even the better descriptions are?

Did you not know? most living creatures are indeed addicted to the proper performance of their physiological processes, and suffer great discomfort when those processes don't perform correctly, or if they try to neglect them. Unlike most cases, neglecting those particular instances is apt to turn deadly (ever tried spending a whole week without drinking, pissing or shitting?).

Also, you should agree that excessive devotions to those things (like masturbating 50 times a day, or scatophilia... or excessive eating) are definitely pathological.

[JimC]

I take issue with the word used and I get accused of everything from denying the effects of chemical dependency to having a tendency to see things only in terms of black and white.

You seem to be doing a bit more than that. To me, a range of behavioural tendencies - be they determined by chemical, hormonal or psychological factors - can be said to be caused by "addiction" just like the tendency of things to fall can be said to be caused by "gravity". They are just labels we apply to bunches of observed phenomena that have something in common. The way I read your posts is that you deny the very concept of addiction. Like this:

The only contribution 'addicted' seems to make to the conversation is to give some vague psychological excuse for making bad choices.

It's hard to think of a more libertarian attitude. I was hoping we were gradually becoming too mature to subscribe to such an immature Weltanschauung. Social sciences, statistics and neurology have each in their own way provided mountains of evidence since they became sciences that you, I and everyone else is not an autonomously choice-making individual.

I suspect Cunt is wrestling with an issue which is important in ethics and criminology; the issue of personal responsibility for their own criminal, or generally destructive actions. There is a tendency for criminal lawyers, for example, to attempt to show diminshed responsibility and guilt because of biological factors affecting their clients, addiction being one. There is also a tendency for people to blame their own actions on their addiction.

Personally, I am rather cold and merciless here; the addiction may indeed be a reality, but it should not in anyway dimish personal responsibility, or reduce possible punishments. The ultimate source of the addiction is to be found in the actions of the person at some stage in their life; more importantly, there is a pragmatic purpose to justice, that of protecting society and deterring offenders. Unless someone tied you down, and kept injecting you with heroin until you were addicted, you cop the consequences of the bad decisions you make in your life, and don't whinge about it to society in general.

The main point about the recognition of addiction as a medical reality is it aids us to see that those who wish to be free of it will need considerable assistance from knowledgeable and experienced practitioners.

[Cunt]

Cunt wrote:

Why does denial of that sort seem to you to follow from my rejection of a sloppy, meaningless word?

It's like I attacked a sacred cow or something.

I'm sure that people use the word addiction in sloppy ways that stretch its meaning. However, in this thread, the way you have expressed this seems to most paticipants to be a rejection of any reality at all to addiction, rather than a critique of poor application of the term by some (or even many)

Since the concept itself is so vague and smoky, why NOT reject it?

--------------------

I suspect Cunt is wrestling with an issue which is important in ethics and criminology; the issue of personal responsibility for their own criminal, or generally destructive actions. There is a tendency for criminal lawyers, for example, to attempt to show diminshed responsibility and guilt because of biological factors affecting their clients, addiction being one. There is also a tendency for people to blame their own actions on their addiction.

You bet I wrestle with it, JimC. I work with people who self-identify as having a disability. Here in Canada, that means that, if you are an employer, you have a 'Duty to Accommodate' disabilities. Claiming that you are an addict (a usually self-diagnosed ball of crap) is enough. If you notice that your employee's performance is sliding, and fire him/her, they can go to the human rights commission and get reinstated based on the fact that their addiction made them a shitty worker.
If you intercede first, and tell the employee to get help (which, as an aside, is pretty much only AA - which is a religious organization with horrible results) AND they refuse to get help and you fire them - guess what? They can then make the (reasonable) case that denial is part of their disability, and thus protected.

It becomes quite a rats nest, adding nothing to the employers tools (even when they are trying to be understanding) and adding nothing to the treatment of the person suffering from a self-described disability.

Criminal lawyers do indeed achieve lighter sentences for those who claim to have been addicted to a substance at the time. More points if they get some fellow 'addicts' from a group like AA to claim that they have been attending meetings.

I freely admit that people can have tough challenges due to substance abuse.

Personally, I am rather cold and merciless here; the addiction may indeed be a reality, but it should not in anyway dimish personal responsibility, or reduce possible punishments. The ultimate source of the addiction is to be found in the actions of the person at some stage in their life; more importantly, there is a pragmatic purpose to justice, that of protecting society and deterring offenders. Unless someone tied you down, and kept injecting you with heroin until you were addicted, you cop the consequences of the bad decisions you make in your life, and don't whinge about it to society in general.

I take it a bit further, myself. If someone has been binge drinking every night of their adult life, I still consider every drink to be their choice.
Even the second. Even the third.
When someone 'blacks out', they did so by choosing many drinks to get them there.

When someone weighs a hundred pounds more than they should, many individual cheeseburger (for example) choices got them there. Depression or not, each over-indulgence was chosen.

Someone earlier said that if they were not slightly addicted to food, they would never eat more than a perfect diet (approximately). That just isn't so. To eat the perfect diet, one would need to do lots of research, and spend quite a lot of effort preparing to eat every day.

If someone wants to keep drinking under control, they have to be similairly diligent. Coasting along without paying attention to what food (or drug, or alcohol) you are taking into your system is like agreeing that you don't care what happens to your body.

The main point about the recognition of addiction as a medical reality is it aids us to see that those who wish to be free of it will need considerable assistance from knowledgeable and experienced practitioners.

So far, it seems that the efforts of 'knowledgeable and experienced practitioners' have been met with a success rate which is somewhere around zero.

Did you know that the knowledgeable and experienced practitioners over at the Canadian Psychology Association have something to say about alcohol treatment? It goes like this...

What psychological approaches are used to treat alcohol abuse and alcohol dependence?

The best known treatment for alcohol abuse/dependence is Alcoholics Anonymous (AA). The AA approach is consistent with the medical model and includes a strong spiritual component. Abstinence (no drinking at all) is the treatment goal. Research has shown AA is effective for those who stick with it. One of its strengths is peer support and encouragement. However, AA has high dropout rates.

Notice that they don't quite claim that AA is the best treatment, but make it sound pretty good? They mention a couple more treatment types (CBT and MI) which they claim, have similar effectiveness to AA.

Appalling. And these are the knowledgeable and experienced practitioners.

EDIT - to add the line in red and quotes above it

[Hermit]

I suspect Cunt is wrestling with an issue which is important in ethics and criminology; the issue of personal responsibility for their own criminal, or generally destructive actions.

That seems to be the case, and Canadian law in regard to it seems to suck indeed, particularly as far as employers are concerned.

Personally, I am rather cold and merciless here; the addiction may indeed be a reality, but it should not in anyway dimish personal responsibility, or reduce possible punishments. The ultimate source of the addiction is to be found in the actions of the person at some stage in their life; more importantly, there is a pragmatic purpose to justice, that of protecting society and deterring offenders. Unless someone tied you down, and kept injecting you with heroin until you were addicted, you cop the consequences of the bad decisions you make in your life, and don't whinge about it to society in general.

I agree with everything you say there, except for the "responsibility" thing. To me, punishments - and the mere possibility of them - are no more than aversion therapy, but that is precisely why they are needed. The concept of free will that is behind every assertion that we can make decisions autonomously - and hence are ultimately responsible for what we do - is a fiction.

[mistermack]

I find Cunt's description of Canada's labour laws amazing, but I don't see that the problem is with our understanding of dependence, or addiction, or with the fuzzy nature of that aspect of human nature.

The problem is with Canada, it's regulations and labour courts.
Any self-inflicted disability should be treated very differently to one that happens involuntarily. And any disability that is concealed, when someone applies for a job, should be legitimate grounds for dismissal, if it prevents that person doing the job efficiently.

If a bus driver poked his own eyes out, you wouldn't expect him to be kept on. If he becomes alcoholic, the same applies. But if you take on a very fat person, you shouldn't sack him if being fat gets in the way of working efficiently.

If alcoholism is being treated as a disability, it should be something you have to declare when applying for a job. If the employer wants to take a chance on you, at least he knows what he's in for.

You really can't have it both ways.

[Cunt]

I find Cunt's description of Canada's labour laws amazing, but I don't see that the problem is with our understanding of dependence, or addiction, or with the fuzzy nature of that aspect of human nature.

I should clarify that it was a case study which I can't find now. What I remember is that someone who self-identified as an alcoholic to their employer was sent to 'treatment'. Later, he had a relapse which caused him to miss a shift, and was dismissed for it. The judge (or human rights panel?) found that, since relapse is a firm part of that disability, the employer had not done enough to accommodate, and the employee was reinstated.
There had been a 'last chance agreement' in place, but it was found to be worthless.
The employer has a 'Duty to Accommodate' up to the point of 'undue hardship'. The really funny thing is, 'Undue Hardship' would be very different if you were running a business with one employee, compared to what 'Undue Hardship' would mean to a large corporation.

Fucked up stuff.

The problem is with Canada, it's regulations and labour courts.
Any self-inflicted disability should be treated very differently to one that happens involuntarily.

Says who? (I mean besides you)
If 'addiction' is really beyond a persons power to control, and is a real disability, on what grounds would you treat them differently?

Remember, you may have to get by a judge (or Human Rights Adjudication Panel) with your grounds.

And any disability that is concealed, when someone applies for a job, should be legitimate grounds for dismissal, if it prevents that person doing the job efficiently.

Fair enough, but as I mentioned, denial is an expected part of that disability though. So is relapse. I also read about a fellow being denied a job because of the safety-sensitive nature of the position. He was reinstated because...well...relapse is part of the disability.

Aw, let me quote something a bit more authoritative (not to mention ridiculous) than my memory...

The Facts:
After winning reinstatement at arbitration in 1997 and again in 2000 after being fired twice for stealing drugs from the hospital where he worked, a British Columbia nurse with a prescription pill problem fell off the wagon and was fired a third time in May 2003, this time by a different hospital to which he had transferred.
The grievor was first dismissed from his position as head nurse at Castlegar and District Hospital in 1996 for stealing drugs and falsifying patient records to cover it up. In a May 26, 1997 award, British Columbia Arbitrator Dalton Larson ruled that both the thefts and the patient record frauds were inextricably linked to the grievor's addiction to prescription painkillers and were therefore non-culpable. He ordered the grievor reinstated subject to a last chance agreement, which provided that "he may be forthwith terminated from his employment" if he did not abstain from drugs.
After the grievor relapsed and was fired a second time in 1998, Larson ordered the hospital to reinstate the grievor a second time, subject to a new last chance agreement that explicitly provided for summary dismissal in the event of a future relapse. (For a review of this decision, see Lancaster's Health Care Employment Law News, May/June, 2000.)
The grievor returned to work and transferred to a different hospital, the Kootenay Boundary Regional Hospital (KBRH). After failing a drug test in April 2003, the grievor admitted that he had relapsed and stolen "wastage" drugs from the hospital's surgical floor. He was dismissed from KBRH on May 11, 2003, and a grievance was filed by the B.C. Nurses' Union challenging the dismissal.
In an interim award, Arbitrator Marguerite Jackson ruled that, because KBRH was not a party to the Larson awards and the last chance agreement, they no longer applied to the grievor's employment (for a review of this decision, see Lancaster's Discharge & Discipline E-Bulletin, Issue No. 47). On the merits, Arbitrator Jackson ruled that the grievor's misconduct constituted "the reassertion of his chronic disease of chemical dependency with its compulsive features". Applying the "hybrid" approach set out by the B.C. Labour Relation's Board in I.W.A., Local 1-424 v. Fraser Lake Sawmills, [2002] B.C.L.R.B.D. No. 390 (QL) (reviewed in Lancaster's Disability and Accommodation Reporter, January/February, 2003), which held that in cases of addiction-related misconduct, arbitrators "must" address "the issue of the duty to accommodate", Jackson ruled that by not considering alternatives to terminating the grievor's employment, the hospital had breached its duty to accommodate him to the point of undue hardship. (See Lancaster's Disability & Accommodation E-Bulletin, Issue No. 51, for further details and analysis of this decision.)

Emphasis mine.
(oh - look at the bit in red...looks like professionals use better language than 'addict' to describe these problems...does anyone here wonder why that is?)
I should also mention that the third decision was later overturned, but it doesn't change the fact that it was pretty fucking trying for the employer. (I wonder who paid the legal bills...?)

If a bus driver poked his own eyes out, you wouldn't expect him to be kept on. If he becomes alcoholic, the same applies. But if you take on a very fat person, you shouldn't sack him if being fat gets in the way of working efficiently.

Are you sure? What if they are only 100lbs over when you hire them, but they get fatter along the way?
I bet a good lawyer could get that person some 'duty to accommodate' type gravy.

If alcoholism is being treated as a disability, it should be something you have to declare when applying for a job. If the employer wants to take a chance on you, at least he knows what he's in for.

Do you really think that employers should be allowed to screen candidates based on their disabilities?
If you are a food addict, as you describe, do you disclose this to all new potential employers? I guess what I am asking is do you 'walk the walk' you are typing here?

You really can't have it both ways.

[Warren Dew]

I'm making the argument that the reason that our brains HAVE these reward mechanisms, is that they originally rewarded various eating activities.

While I agree that some eating disorders may be "addictions", I would also point out that not all reward mechanisms are necessarily addictions.