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2025, Number 1

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Revista Colombiana de Bioética 2025; 20 (1)

“Governing Addiction, Controlling the Mind”: A Biopolitical Critique from the Perspective of Complex Bioethics

Franca GL, Goldim JR

Language: Portugu?s
References: 70
Page: 1-19
PDF size: 196.54 Kb.


ABSTRACT

Purpose/Background. This study explored the intersection between bioethics, biopolitics, mental health, and chemical dependency, highlighting the influence of biopower on health policies and practices. Based on the theories of Foucault, Agamben, and Szasz, we analyzed how the management of mental health and addiction reflects dynamics of power and control, impacting affected individuals. The purpose is to understand the bioethical and biopolitical implications of approaches to mental health and addiction, proposing a critical perspective on current practices and their theoretical foundations.
Methodology/Approach. A qualitative approach was adopted, analyzing key texts and public policy documents.
Results/Findings. It was observed that mental health and addiction policies are deeply influenced by concepts of biopower, resulting in practices that prioritize social control over the autonomy and well- being of individuals. The analysis also indicates a need for reformulating these policies towards more inclusive and humanized approaches.
Discussion/Conclusions/Contributions. The study contributes to the field of bioethics and biopolitics, offering a critical perspective on mental health and addiction. We highlight the importance of interdisciplinary approaches to address the complexity of these issues, promoting public policies that respect the dignity and foster the social inclusion of individuals with these problems.


REFERENCES

  1. Abelard, Peter. 1995. Ethical writings: ethics and dialogue between a philosopher, a jew,and a christian. Hackett Publishing.

  2. Agamben, Giorgio. 2004. Estado de exceção. Boitempo.

  3. Agamben, Giorgio. 2006. A linguagem e a morte: um seminario sobre o lugar da negatividade.Editora da UFMG.

  4. Agamben, Giorgio. 2007. Homo Sacer: O Poder Soberano e a Vida Nua I. Editora daUFMG.

  5. Aristoteles. 1998. A Política. Martins Fontes.

  6. Aristoteles. 2009. Ética à Nicômaco. Atlas.

  7. Bandman, Elsie L. e Bertram Bandman. 1978. Bioethics and Human Rights: A Readerfor Health Professionals. Little, Brown, and Co.

  8. Bastos, Francisco Inácio Pinkusfeld Monteiro, Mauricio Teixeira Leite de Vasconcellos,Raquel Brandini De Boni, Neilane Bertoni dos Reis e Carolina Fausto deSouza Coutinho, eds. 2017. III Levantamento Nacional Sobre o Uso de Drogas pelaPopulação Brasileira. Fiocruz. https://www.arca.fiocruz.br/handle/icict/34614

  9. Beauchamp, Tom L. e James F. Childress. 2013. Principles of Biomedical Ethics. 7thed. Oxford University Press.

  10. Bentham, Jeremy. 1948. An Introduction to the Principles of Morals and Legislation.Hafner.

  11. Berridge, Virginia. 2021. “History and the Future of Addiction.” International Journalof Drug Policy 94: 103054. https://doi.org/10.1016/j.drugpo.2020.103054

  12. Bishop, Jeffrey e Fabrice Jotterand. 2006. “Bioethics as Biopolitics.”The Journal of Medicine and Philosophy 31 (3): 205–12. https://doi.org/10.1080/03605310600712760

  13. Bobbio, Norberto. 2004. Era Dos Direitos. Elsevier/Campus.

  14. Boucher, Lisa M., Esther S. Shoemaker, Clare E. Liddy, Lynne Leonard, Paul A.MacPherson, Justin Presseau, et al. 2022. “‘The drug use unfortunately isn’t allbad’: chronic disease self-management complexity and strategy among marginalizedpeople who use drugs.” Qualitative Health Research 32 (6): 871–86.https://doi.org/10.1177/10497323221083353

  15. Chan, Carolyn A., Bethany Canver, Ryan McNeil e Kimberly L. Sue. 2022. “Harmreduction in health care settings.” Medical Clinics of North America 106 (1): 201–17. https://doi.org/10.1016/j.mcna.2021.09.002

  16. Cohen, Aliza, Sheila P. Vakharia, Julie Netherland e Kassandra Frederique. 2022.“How the war on drugs impacts social determinants of health beyond the criminallegal system.” Annals of Medicine 54 (1): 2024–38. https://doi.org/10.1080/07853890.2022.2100926

  17. Comparato, Fábio Konder. 2008. A Afirmação Histórica Dos Direitos Humanos. 7thed. Editora Saraiva.

  18. Comte-Sponville, André. 2009. Pequeno Tratado Das Grandes Virtudes. Martins Fontes.

  19. Esposito, Roberto. 2008. Bíos. Biopolitics and Philosophy. PostHumanities Series. Universityof Minnesota Press.

  20. Esposito, Roberto. 2009. “Biopolítica y Filosofía: (Entrevistado Por VanessaLemm y Miguel Vatter).” Revista de Ciencia Política 29 (1): 133–41. https://doi.org/10.4067/s0718-090x2009000100007

  21. Fisher, Celia B. 2011. “Addiction research ethics and the belmont principles: dodrug users have a different moral voice?” Substance Use & Misuse 46 (6): 728–41. https://doi.org/10.3109/10826084.2010.528125

  22. Fluyau, Dimy, Muhammad F. Hashmi e Thomas E. Charlton. 2024. Drug Addiction.StatPearls. https://pubmed.ncbi.nlm.nih.gov/31747190/

  23. Foucault, Michel. 1999. Em Defesa Da Sociedade. Coleção Tópicos. Martins Fontes.

  24. Foucault, Michel. 2001a. Os Anormais: Curso No Collège de France (1974-1975). MartinsFontes.

  25. Foucault, Michel. 2001b. Madness and Civilization: A History of Insanity in the Age ofReason. Routledge.

  26. Foucault, Michel. 2006. História da sexualidade, 1: a vontade de saber. Graal.

  27. Foucault, Michel. 2008a. O nascimento da biopolítica. Martins Fontes.

  28. Foucault, Michel. 2008b. Segurança, território, população. Martins Fontes.28. Goffman, Erving. 1982. Estigma: notas sobre a manipulação da identidade deteriorada.Zahar.

  29. Goffman, Erving. 1999. Manicômios, prisões e conventos. Perspectiva.

  30. Goldim, José Roberto. 2009. “[Complex bioethics: a comprehensive approach todecision making process].” Revista AMRIGS 53 (1): 58–63.

  31. Hardt, Michael e Antonio Negri. 2000. Empire. Harvard University Press.

  32. Hart, Carl L. 2017. “Viewing addiction as a brain disease promotes social injustice.”Nature Human Behaviour 1: 0055. https://doi.org/10.1038/s41562-017-0055

  33. Hobsbawm, Eric. 1996. Ecos Da Marselhesa. Cia das Letras.

  34. Honneth, Axel. 2002. “Grounding recognition: a rejoinder to critical questions.”Inquiry-an Interdisciplinary Journal of Philosophy 45 (4): 499–519. https://doi.org/10.1080/002017402320947577

  35. Honneth, Axel. 2003. Luta por reconhecimento: a gramática moral dos conflitos sociais.Editora 34.

  36. Jonas, Hans. 1985. The imperative of responsibility: in search of an ethics for the technologicalage. University of Chicago Press. https://doi.org/10.7208/chicago/9780226850337.001.0001

  37. Kaebnick, Gregory E. 2020. “Bioethics and Addiction.” Hastings Center Report 50(4): 2–2. https://doi.org/10.1002/hast.1165

  38. Lévinas, Emmanuel. 1997. Entre nós: ensaios sobre a alteridade. Vozes.38. Lewis, Marc. 2015. The biology of desire: why addiction is not a disease. DoubledayCanada.

  39. Lo, T. Wing, Jerf W. K. Yeung e Cherry H. L. Tam. 2020. “Substance abuse andpublic health: a multilevel perspective and multiple responses.” InternationalJournal of Environmental Research and Public Health 17 (7): 2610. https://doi.org/10.3390/ijerph17072610

  40. Louie, Eva, Emma L. Barrett, Andrew Baillie, Paul Haber e Kirsten C. Morley. 2021.“A systematic review of evidence-based practice implementation in drug andalcohol settings: applying the consolidated framework for implementation researchframework.” Implementation Science 16 (1): 22. https://doi.org/10.1186/s13012-021-01090-7

  41. Mill, John Stuart. 1909. On Liberty. Collier.

  42. Nalli, Marcos. 2013. “Communitas/immunitas: a releitura de Roberto Esposito dabiopolítica.” Revista de Filosofia Aurora 25 (37): 79–105. https://doi.org/10.7213/aurora.25.037.DS04

  43. Nelson, Ediomo-Ubong. 2023. “Harm reduction interventions for people who injectdrugs.” The Lancet Global Health 11 (5): e632–33. https://doi.org/10.1016/S2214-109X(23)00111-0

  44. Olsen, Yngvild. 2022. “What is addiction? history, terminology, and core concepts.”Medical Clinics of North America 106 (1): 1–12. https://doi.org/10.1016/j.mcna.2021.08.001

  45. Parsons, Michelle Anne. 2022. “Thinking about social determinants of healththrough the relationality of work and drug use.” Medical Anthropology Quarterly36 (2): 272–89. https://doi.org/10.1111/maq.12690

  46. Pellegrino, Edmund D. e David C. Thomasma. 1993. The virtues in medical practice. OxfordUniversity Press. https://doi.org/10.1093/oso/9780195082890.001.0001

  47. Rabinow, Paul e Nikolas Rose. 2006. “Biopower Today.” BioSocieties 1 (2): 195–217. https://doi.org/10.1017/S1745855206040014

  48. Richa, S., E. Dirani, C. Lucet e X. Laqueille. 2022. “Les traitements de substitutionaux opiaces : un parcours de respect de la dignité de la personne humaine.”L’Encéphale 48 (3): 351–53. https://doi.org/10.1016/j.encep.2021.03.006

  49. Rieder, Travis N. 2020. “Solving the opioid crisis isn’t just a public health challenge—it’s a bioethics challenge.” Hastings Center Report 50 (4): 24–32. https://doi.org/10.1002/hast.1169

  50. Roque Junges, José. 2011. “O nascimento da bioética e a constituição dobiopoder.” Acta Bioethica 17 (2): 171–78. https://doi.org/10.4067/s1726-569x2011000200003

  51. Rush, Alan. 2006. “A Teoria Pós-Moderna Do Império (Hardt & Negri) e Seus Críticos.”In Filosofia Política Contemporãnea: Controvérsias Sobre Civilização, Impérioe Cidadania, editado por Atilio A. Boron. Consejo Latinoamericano de CienciasSociales - Clacso. https://biblioteca.clacso.edu.ar/clacso/se/20100601023401/filopolit.pdf

  52. Savulescu, Julian e David Birks. 2012. “Bioethics: Utilitarianism.” InELS, editado por Angus Clarke. John Wiley & Sons, Ltd. https://doi.org/10.1002/9780470015902.a0005891.pub2

  53. Savulescu, Julian e Ingmar Persson. 2012. “Moral Enhancement, Freedom, andthe God Machine.” The Monist 95 (3): 399–421. https://doi.org/10.5840/monist201295321

  54. Singer, Peter. 1990. Animal Liberation. 2nd ed. New York Review.

  55. Singer, Peter. 1993. Ética Prática. Martins Fontes.

  56. Snoek, Anke e Craig Fry. 2015. “Lessons in Biopolitics and Agency: Agamben onAddiction.” The New Bioethics 21 (2): 128–41. https://doi.org/10.1179/2050287715Z.00000000066

  57. Stone, Bryant M. 2022. “The War on Drugs Has Unduly Biased Substance UseResearch.” Psychological Reports, 127 (4): 003329412211467. https://doi.org/10.1177/00332941221146701

  58. Stowe, M-J, Rita Gatonye, Ishwor Maharjan, Seyi Kehinde, Sidarth Arya, Jorge HerreraValderrábano, et al. 2024. “The war on drugs is a war on us: young peoplewho use drugs and the fight for harm reduction in the global south.” HarmReduction Journal 21 (1): 43. https://doi.org/10.1186/s12954-023-00914-7

  59. Szasz, Thomas S. 1971. “American Association for the Abolition of InvoluntaryMental Hospitalization.” American Journal of Psychiatry 127 (12): 1698. https://doi.org/10.1176/ajp.127.12.1698

  60. Szasz, Thomas S. 1972a. “Bad habits are not diseases. A refutation of the claim thatalcoholism is a disease.” Lancet 300 (7767): 83–84. https://doi.org/10.1016/S0140-6736(72)91564-4

  61. Szasz, Thomas S. 1972b. “The ethics of addiction.” American Journal of Psychiatry10 (1): 541–46. https://doi.org/10.1176/ajp.128.5.541

  62. Szasz, Thomas S. 1972c. “Voluntary mental hospitalization. an unacknowledgedpractice of medical fraud.” The New England Journal of Medicine 287 (6): 277–78.https://doi.org/10.1056/NEJM197208102870604

  63. Szasz, Thomas S. 1974. The myth of mental illness: foundations of a theory of personalconduct. Harper & Row. https://doi.org/10.1016/B978-0-08-017738-0.50007-7

  64. UNESCO. 1998. “UNESCO: Universal Declaration on the Human Genome andHuman Rights.” The Journal of Medicine and Philosophy 23 (3): 334-341. UNESCO.https://doi.org/10.1076/jmep.23.3.334.2578

  65. United Nations. 1993. Vienna Declaration and Programme of Action. United Nations.https://doi.org/10.1017/S002086040008061X

  66. United Nations Development Programme. 2000. Human Development Report 2000:Human Rights and Human Development. Oxford University Press.

  67. UNODC. 2022. World Drug Report 2022. United Nations. https://www.unodc.org/unodc/en/data-and-analysis/world-drug-report-2022.html

  68. Vearrier, Laura. 2019. “The Value of Harm Reduction for Injection Drug Use: AClinical and Public Health Ethics Analysis.” Disease-a-Month 65 (5): 119–41.https://doi.org/10.1016/j.disamonth.2018.12.002

  69. Wogen, Jenifer e Maria Teresa Restrepo. 2020. “Human Rights, Stigma, and SubstanceUse.” Health and Human Rights 22 (1): 51–60. http://www.ncbi.nlm.nih.gov/pubmed/32669788

  70. Zou, Zhiling, Huijun Wang, Federico d’Oleire Uquillas, Xiaomei Wang, JianruiDing e Hong Chen. 2017. “Definition of Substance and Non-Substance Addiction.”En Substance and Non-substance Addiction. Advances in Experimental Medicineand Biology, editado por Zhang, X., J. Shi e R. Tao. Springer. https://doi.org/10.1007/978-981-10-5562-1_2




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