The Ethical Conundrum of Medicalizing Self-control: An Examination of Addiction, Obesity, and ADHD

2023 Lecturer Steven E. Hyman, MD

Medical schools, the physicians they graduate, and public health officials are appropriately concerned with human behaviors that affect risk of morbidity and mortality. Unfortunately, to a great extent, medical education and medical practice remain mired in folk psychological rather than scientific understandings of decision-making and self-control. Thus, views of people suffering from such conditions as drug addiction, obesity, and conditions that impair executive function often lurch between the extremes of moral opprobrium and fatalistic biological determinism. Failure to engage wisely with our advancing, albeit still incomplete scientific understanding of behavioral control is not only damaging to public health, but represents an ethical failure on the part of medical educators and practitioners that contribute to distress and poor outcomes for patients.

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