Informed choice and gambling: Are ‘addicted gamblers able to make rational choices?
AbstractThe decision to gamble is, or ought to be, based on an individual making an informed choice. Industry operators and governments share responsibility in guaranteeing sufficient information to individuals on which choices can be based. However, to make optimal informed choices, individuals must assume some responsibility for being aware of the motivation underlying their behaviour, being aware of the presence and impact of irrational and erroneous cognitions have an accurate perception of the probabilities of winning, and accepting the risk and implications that losing may have on their financial and personal circumstances. However, it is recognized that informed choice, by itself, does not guarantee that decisions made will be optimal. There are multiple external factors involving psychological, personality and neurobiological processes that may interact resulting in an individual selecting poor decisions. In particular, the addiction model suggests that neurochemical dysregulation involving the dopaminergic system with projections into the prefrontal lobe are associated with anticipatory rewards and inhibition of executive functions effectively ‘high-jacking’ the brain. This raises important questions as to the extent to which gambling represents a ‘rational’ choice or is the product of neurobiological forces that impair decision-making and control. Determining the extent to which an individual is responsible for poor decision-making in gambling has important therapeutic and legal implications. This presentation outlines the relevant issues but raises more questions than answers in so doing.