The shift in the prevailing view of alcoholism from a moral paradigm towards a biomedical paradigm is often characterized as a form of biomedicalization. We will examine and critique three reasons offered for the claim that viewing alcoholism as a disease is morally problematic. The first is that the new conceptualization of alcoholism as a chronic brain disease will lead to individualization, e.g., a too narrow focus on the individual person, excluding cultural and social dimensions of alcoholism. The second claim (...) is that biomedicalization will lead to stigmatization and discrimination for both alcoholics and people who are at risk of becoming alcoholics. The third claim is that as a result of the biomedical point of view, the autonomy and responsibility of alcoholics and possibly even persons at risk may be unjustly restricted. Our conclusion is that the claims against the biomedical conceptualization of alcoholism as a chronic brain disease are neither specific nor convincing. Not only do some of these concerns also apply to the traditional moral model; above that they are not strong enough to justify the rejection of the new biomedical model altogether. The focus in the scientific and public debate should not be on some massive “biomedicalization objection” but on the various concerns underlying what is framed in terms of the biomedicalization of alcoholism. (shrink)

The shift in the prevailing view of alcoholism from a moral paradigm towards a biomedical paradigm is often characterized as a form of biomedicalization. We will examine and critique three reasons offered for the claim that viewing alcoholism as a disease is morally problematic. The first is that the new conceptualization of alcoholism as a chronic brain disease will lead to individualization, e.g., a too narrow focus on the individual person, excluding cultural and social dimensions of alcoholism. The second claim (...) is that biomedicalization will lead to stigmatization and discrimination for both alcoholics and people who are at risk of becoming alcoholics. The third claim is that as a result of the biomedical point of view, the autonomy and responsibility of alcoholics and possibly even persons at risk may be unjustly restricted. Our conclusion is that the claims against the biomedical conceptualization of alcoholism as a chronic brain disease are neither specific nor convincing. Not only do some of these concerns also apply to the traditional moral model; above that they are not strong enough to justify the rejection of the new biomedical model altogether. The focus in the scientific and public debate should not be on some massive “biomedicalization objection” but on the various concerns underlying what is framed in terms of the biomedicalization of alcoholism. (shrink)

The introduction of new energy technologies may lead to public resistance and contestation. It is often argued that this phenomenon is caused by an inadequate inclusion of relevant public values in the design of technology. In this paper we examine the applicability of the value sensitive design approach. While VSD was primarily introduced for incorporating values in technological design, our focus in this paper is expanded towards the design of the institutions surrounding these technologies, as well as the design of (...) stakeholder participation. One important methodological challenge of VSD is to identify the relevant values related to new technological developments. In this paper, we argue that the public debate can form a rich source from which to retrieve the values at stake. To demonstrate this, we have examined the arguments used in the public debate regarding the exploration and exploitation of shale gas in the Netherlands. We identified two important sets of the underlying values, namely substantive and procedural values. This paper concludes with two key findings. Firstly, contrary to what is often suggested in the literature, both proponents and opponents seem to endorse the same values. Secondly, contestation seems to arise in the precise operationalization of these values among the different stakeholders. In other words, contestation in the Dutch shale gas debate does not arise from inter-value conflict but rather from intra-value conflicts. This multi-interpretability should be incorporated in VSD processes. (shrink)

Among the most outstanding discoveries of the last century is one that is not quite as momentous as the theory of relativity or cybernetics. It may even still be enigmatic. It has no one single author, it is not expressed in a single formula, conception, or invention. Nonetheless it is worth all the others combined.