Alcoholism as Sickness and Wrongdoing

It is now commonplace to call persons sick when their wrongdoing becomes entrenched, extensive, and extreme. This mixing of moral and therapeutic categories seems incoherent if we uncritically embrace a morality-therapy dichotomy: Behavioral problems like alcoholism are either moral or therapeutic matters, but not both. This paper dissolves the dichotomy by arguing that chronically abusive drinking is simultaneously a sickness and wrongdoing. Alcoholism is at least partly a self-inflicted impairment of responsible agency that has unhealthy consequences and usually requires therapeutic interventions. Morality and therapy are not inherently opposed. Morality enjoins compassionate helping and nonjudgemental therapy, and therapy is rooted in moral values of caring and respect. The polarized positions of Herbert Fingarette in Heavy Drinking and George E. Vaillant in The Natural History of Alcoholism are reconciled by paying close attention to their accounts of the condition, causes, consequences, and cure of alcoholism.