Philosopher to discuss nature of addiction at UB conference

The nation’s leading philosopher of psychiatry will deliver a keynote address on the nature of addiction at this year’s Romanell Conference, a three-day event exploring bioethics and the philosophy of medicine presented by UB’s Department of Philosophy.

Jerome Wakefield, a professor in New York University’s Silver School of Social Work and a professor of the conceptual foundations of psychiatry in NYU’s School of Medicine, will discuss such issues as whether all addictions are diseases and whether all mental diseases are brain diseases in his address at 10:45 a.m. July 28.

“Given the opioid crisis, getting clear on the nature of addition, whether it is a psychiatric or neurological disease or neither, and whether addicts can be responsible, is obviously pertinent,” says David Hershenov, professor of philosophy and co-director of UB’s Romanell Center for Clinical Ethics and the Philosophy of Medicine.

Sessions for the center’s sixth annual conference will be held in 141 Park Hall, North Campus, on July 26, while the July 27 and July 28 talks will be in 280 Park.

All conference events are free and open to the public.  A complete schedule of events is available online.

Wakefield is the foremost proponent of the Harmful Dysfunction Account of Disorder. He argues that all disorders, his synonym for disease and pathology, must be both dysfunctions and harmful.

Two speakers will take up that theme of harm and dysfunction at 1 p.m. immediately following Wakefield’s keynote.

Neil Feit, Distinguished Teaching Professor at SUNY Fredonia, and UB graduate student David Limbaugh, both members of UB’s Romanell Center who have published articles about Wakefield’s account in the prestigious journal Theoretical Medicine and Bioethics, will debate whether disorders must, in fact, be both dysfunctional and harmful.

“There are three viewpoints about harm and dysfunction — that of the naturalist, hybrid and normativist,” says Hershenov.

“There is Wakefield’s hybrid view that both must be present, but naturalists see disease as purely dysfunction, where the parts of the body are making suboptimal contributions toward survival and reproduction. Wakefield objects to naturalism because you might have dead cells as a result of dysfunction, but that wouldn’t be disease if it didn’t cause harm. Organs might be switched around, but not causing harm to a person. Typhoid Mary may have been dysfunctional but not diseased, since she was a carrier who never was harmed by her condition,” says Hershenov.

“And finally, according to the normativist, disease depends not on the presence of dysfunction but just on the values of society. If disease depends upon values, then we can see a condition as harmful and classify it as a disease, but later change our minds about that harm. Homosexuality is among the more infamous examples.”

Also on July 28, Barry Smith, SUNY Distinguished Professor of Philosophy and director of the National Center for Ontological Research at UB, will discuss capabilities.

“A capability is an attribute of a person, machine or system which brings benefits when realized,” Hershenov explains. “Clinicians must deal with human capabilities and also with human disabilities. Barry’s talk will attempt to advance the understanding of what capabilities and disabilities are and how they are related to function and dispositions.”

Talks on July 27 include an abortion debate between Don Marquis, University of Kansas professor emeritus, and Patrick Lee, professor of philosophy at Franciscan University in Steubenville.

“It might be a little misleading to call this an abortion debate because they are both pro-lifers,” says Hershenov. “But they disagree about the best way to defend the anti-abortion position.”

Hershenov points out that Marquis actually invited himself back to this year’s conference after speaking at a previous Romanell event.

“He’s so confident in his stance that he now sees the debate as being between him and other pro-lifers,” says Hershenov, smiling.

Marquis is an atheist and Lee is a Roman Catholic.

“For Marquis, the wrongness of killing a healthy fetus would deprive it of a valuable future. He sees the wrongness of killing dependent upon the value of that future. For instance, the future of a human being wouldn’t be valuable if they were comatose, in great pain or had a terminal disease,” says Hershenov. “That would be inegalitarian from Lee’s point of view because we are beings with a capacity for freedom and rationality. Appealing to degrees of value treats humans unequally. For Lee, killing any one human is just as wrong as killing any other human.”

Other speakers include Yishai Cohen of the University of Southern Maine, an expert on free will and moral responsibility; Travis Timmerman, assistant professor of philosophy at Seton Hall and an expert on moral status; Derek Doroski, an embryologist from Franciscan University, who is the sole non-philosopher participating; Phil Reed from Canisius College, an expert on physician-assisted suicide; Pat Daly,  a physician and philosopher from Boston University; and Steve Kershnar of SUNY Fredonia, who will argue against one of the sacred cows of bioethics: informed consent.

“Kershnar is our most notorious speaker,” Hershenov says jokingly. “In the NCAA tradition of vacating wins as a form of penalty enforcement, we might do something similar with Kershnar and expunge him from the record of previous conferences.

“It will be like he was never there,” Hershenov laughs.