Can we save 'problem gamblers' from the consequences of their actions?

Over recent years in Victoria there has been a massive increase in money spent on gambling. This results largely from the legalisation of gaming machines. Has the creation of more opportunities for legal gambling been for the good? Is it justified?

Much of the public debate about the ethics of gambling is focussed on the consequences of gambling, and attends to the individual and social benefits and damages, mainly economic and psychological, which are claimed to come with increased opportunities for legal gambling. Consequences are undeniably important. Gambling can harm people: individual gamblers, their families, their employers and employees, and a widening circle, to the point where, it is sometimes claimed, the community is damaged. There is also a range of benefits claimed to come from gambling, both for individuals and the community.

Clearly those who make public policy ought to be concerned about the consequences of gambling. But they should also respect personal autonomy. Autonomy has been understood in various ways, and there are four features I take to be central. The first is being able to choose between courses of action. The second is having the capacity to act on the basis of one’s own deliberation. The third is being recognised by others as being capable of autonomous choice and action. The fourth is being permitted or enabled to act autonomously.

Concern for consequences and respect for autonomy are not antithetical. John Stuart Mill derived what has come to be known as the harm principle, which restricts actions in virtue of their consequences, from a concern for autonomy:

(T)he sole end for which mankind are warranted, individually or collectively, in interfering with the liberty of action of any of their number, is self-protection. That the only purpose for which power can be rightfully exercised over any member of a civilised community, against his will is to prevent harm to others.

This principle is controversial in various ways I won’t go into but it is worth pointing out that Mill conceived of it as governing the proper limits of social coercion, either through the imposition of legal penalties or the pressure of public opinion. I can properly be prevented from acting only if my action causes harm to others. The principle can also be understood as a moral guide for individuals. I should not act in a way which harms others.

What policies on gambling would come from applying the harm principle? First, people ought not to be prevented from gambling unless their actions harm others. Second, people ought not to gamble if their actions are causing harm to others. But what about compulsive gamblers? If the compulsion meant a person was not capable of free choice, then preventing them from gambling would not violate the harm principle, as they would not be acting autonomously.

However, it would be rash to assume that all “problem gamblers” are in the grip of an uncontrollable compulsion. Someone who gambles more than she can afford, and ends up in a hopeless attempt to retrieve her losses, has a serious problem, but is not necessarily addicted to gambling. “Problem gambling” is thus very difficult to define, and its value as a basis for effective strategies questionable. Another group of gamblers are identified as “at-risk”, and about 1.5 per cent of Victorians are claimed to be in this category. Mark Dickerson, a clinical psychologist, argues that the term “at-risk” is preferable to “problem gambler” because all regular gamblers are faced by the difficulty of avoiding becoming pathological gamblers: “it is quite difficult to gamble regularly on continuous forms of gambling without losing control.” Dickerson advocates the development of a code of conduct governing the marketing techniques used by gambling operators. These techniques include free drinks and meals for regular gamblers, and conceivably involve using computer software which tracks the playing patterns of individual gamblers. The purpose of the code would be to help prevent at-risk gamblers from falling over the edge, and developing gambling-related problems.

Dickerson’s approach is aimed at creating policies which restrict possible future harm to at-risk gamblers. He sees it as preferable to prevailing strategies based on identifying “problem gamblers”, such as banning people from gambling environments, mainly because of the above-mentioned difficulty of working out who belongs in this category. The term “problem gambler” can suggest some sort of prior personality disorder, rather than a condition which might well result from regular gambling. If it’s really just a matter of personality disorder, the gaming industry appears much less responsible for gambling-related problems. It is important in this context to note that so-called “problem gamblers” provide a disproportionate amount of the income of the gambling industry, with an estimated 25 per cent of gambling revenue coming from the one per cent of gamblers identified as having a problem. By emphasising the dynamic connection between psychological and financial aspects of gambling, Dickerson undermines the idea that gambling-related problems only arise for people who suffer personality disorders.

The gambling industry and its defenders sometimes argue that legal gambling is a matter of freedom of choice. However, if it is the case that a major part of the industry’s revenue comes from people who have serious gambling-related problems as a result of the operation of the industry, then that argument starts to look dangerously self-serving.

Does the harm principle have a place here? Mill continued his statement of the harm principle by saying that:

His own good, either physical or moral, is not sufficient warrant. He cannot rightfully be compelled to do or forbear because it will be better for him to do so, because it will make him happier, because, in the opinion of others, to do so would be wise, or even right.

On Mill’s view, it would only be justified to prevent someone from gambling, for example by banning her, if her actions were causing harm to others, not for her “own good”, as perceived by others. In any case, she should not gamble if she believes her actions are causing harm to others. But if others are not being harmed, it is permissible for someone to gamble.

Dickerson’s emphasis on “at-risk” gamblers fits the harm principle better than the “problem gambler” approach. First, it’s doubtful that merely preventing someone from being subject to specific marketing practices constitutes a restriction on her liberty. Second, where techniques are used on at-risk gamblers in order to keep their patronage, and the development of gambling-related problems is likely to result, the harm principle might well be violated. Grounds appear to exist for restricting the use of certain marketing techniques, in particular those based on computer software which tracks the playing patterns of individual gamblers.

We enter the muddy waters of paternalism once we consider justifying violations of the harm principle. Paternalism involves restricting a person’s liberty for her own good — that is, to prevent her from being harmed or enabling her to receive a benefit. There is an obvious conflict between paternalistic justification and the harm principle. If a person’s gambling is perceived to be damaging her life, then there seems to be a clear-cut reason to encourage her not to gamble, or at least to seek help. If she persists, does concern for her well-being justify preventing her from gambling? Again, there seems to be reason to prevent her from damaging herself. But what if she wants to continue gambling, and her actions are not harming or in future likely to harm others? Dickerson partially avoids the conflict by arguing that strategies should be applied which prevent a gambler arriving at the point where her autonomy is actually diminished. The aim is in part to enable gamblers to retain their autonomy, not just to avoid other problems associated with gambling.

Application of the harm principle would force a gap between different policies. A pathological gambler would be dealt with differently from someone autonomously choosing to gamble, even though both were suffering harm as a result of gambling. Someone whose gambling was causing harm to others would be dealt with differently from someone who was only harming herself. These complications are exacerbated by the difficulty of defining “problem gambling”, and the related difficulty of establishing what counts as harms and benefits and their extent.

Furthermore, does gambling damage or benefit our society and culture? There is a range of social costs associated with increased legal gambling, along with claimed financial benefits to the community. It has an impact on spending in other sectors of the economy, on crime, and on welfare provision. In Victoria it has been associated with a change in the aims and role of government, and the funding of public amenities, including hospitals and schools. It is also associated with a reorientation of public culture. The Crown Casino occupies a major site in Melbourne, and gaming machine locations loudly announce their presence in the suburbs. Ultimately, these factors do not tell us the appropriate moral response to gambling. The question remains open even if increased legal gambling on the scale that has occurred in Victoria has great economic benefits. Is the maximisation of economic benefits the primary responsibility of a government? Is it alright to allow increased gambling and then attempt to deal with the predictable associated harm? Attending to the consequences of gambling is obviously important. The formulation of the principle of autonomy which is most concerned with consequences of actions, the harm principle, has a role to play in determining policy. However, I think that more needs to be said, and a wider approach taken.

Public policy concerns particular practices and institutions, and those are not just sets of outcomes, but have characteristics which can be understood, and which suggest the relevant moral principles which should be applied in formulating policy. To argue that public policy should be based solely on outcomes is either to have a crude and inadequate grasp of those principles, or to deny that they express values which are relevant to the aims of public policy.