Although many psychiatrists regard psychopathy as a coherent scientific construction, some clinicians and philosophers regard it as irrelevant. According to the latter, psychopathy is nothing more than a means of social control. The present study focuses on the issues of the neurological bases and moral responsibility related to psychopathy. While neuroscience aims to identify dysfunctions in psychopaths, action theory and ethics tend to vindicate the hypothesis of the moral irresponsibility of the psychopath. However, rather than reinforcing the concept of psychopathy, (...) recent results in neuroscience tend to stress its incoherence. Philosophical speculations on psychopaths’ responsibility are not sufficiently empirically informed and seem to announce endless ethical debates. (shrink)

How psychopaths and their capacity for moral action are viewed is not only philosophically interesting but is also important and relevant for policy. The philosophical discussion of psychopathy has focussed upon the psychological faculties that are prerequisites for moral responsibility and empirical findings regarding psychopathy that are relevant to philosophical accounts of moral understanding and motivation. However, there are legitimate worries about whether psychopathy is a robust scientific construct, and there are risks attached to reifying psychopathy or other psychiatric constructs. (...) We defend the concept of psychopathy by pointing out the relevance of empirical studies about it for our ordinary practices of ascribing moral responsibility and folk psychological accounts of moral understanding and motivation. (shrink)

Volume 23, Issue 3, September 2020, Page 214-233.

The question of whether psychopaths are criminally and morally responsible has generated significant controversy in the literature. In this paper, we discuss what relevance a psychopathy diagnosis has for criminal responsibility. It has been argued that figuring out whether psychopathy is a mental illness is of fundamental importance, because it is a precondition for psychopaths’ eligibility to be excused via the legal insanity defense. But even if psychopathy counts as a mental illness, this alone is not sufficient to show the (...) insanity defense is applicable; it must also be shown that, as a result of the illness, specific deficits in moral understanding or control are present. In this paper, we show that a diagnosis of psychopathy will generally not indicate that a defendant is eligible for an insanity defense. This is because the group of individuals subsumed under the diagnosis is so heterogeneous that while some psychopaths do show significant impairments in affect and control which may impact on their responsibility, many psychopaths are not incapacitated in a way relevant to responsibility. (shrink)

Psychopathy attracts considerable interdisciplinary interest. The idea of a group of people with abnormal morality and interpersonal relations raises important philosophical, legal, and clinical issues. However, before engaging these issues, we ought to examine whether this category is scientifically grounded. We frame the issue in terms of the question whether ‘psychopathy’ designates a natural kind according to the cluster approaches. We argue that currently there is no sufficient evidence for an affirmative answer to this question. Furthermore, we examine three ways (...) of dealing with the category of psychopathy. We could eliminate the category, revise it, or subscribe to a more encompassing account of kinds, which could capture psychopathy as it is currently conceptualized. We argue that while a revision of the category of psychopathy is to be expected with empirical and theoretical advancements, we also emphasize its role in clinical and forensic research that makes it an important pragmatic kind. (shrink)

The aim of this paper is to analyze, from a philosophical perspective, the scientific robustness of the construct of psychopathy as measured by the Psychopathy Checklist Revised that was developed by Robert Hare (1991; 2003). The scientific robustness and validity of classifications are topics of many debates in philosophy of science and philosophy of psychiatry more specifically. The main problem consists in establishing whether scientific classifications reflect natural kinds where the concept of a natural kind refers to the existence of (...) some objective divisions in nature that do not depend exclusively on subjective judgments of the classifier. The construct of psychopathy is especially interesting since the diagnosis of psychopathy has substantial social consequences. In the light of the recent debates regarding the problem of natural kinds in philosophy of psychiatry, we advocate the following distinction between two types of scientific classifications: natural and practical kinds. Natural kinds refer to those categories that are united by common causal mechanisms or properties. Practical kinds refer to categories that fulfill some practical classificatory goals such as prediction. We argue that the construct of psychopathy can fulfill the role of a practical kind. In addition, we contend that our current scientific knowledge about psychopathy does not allow us to conclude that this category is a natural kind. (shrink)

One of the philosophical discussions stimulated by the recent scientific study of psychopathy concerns the mental illness status of this construct. This paper contributes to this debate by recommending a way of approaching the problem at issue. By relying on and integrating the seminal work of the philosopher of psychiatry Bill Fulford, I argue that a mental illness is a harmful unified construct that involves failures of ordinary doing. Central to the present proposal is the idea that the notion of (...) failure of ordinary doing, besides the first personal experience of the patient, has to be spelled out also by referring to a normative account of idealised conditions of agency. This account would have to state in particular the conditions which are required for moral responsibility. I maintain that psychopathy is a unified enough construct that involves some harms. The question whether the condition involves also a failure of ordinary doing, as this notion is understood in this paper, is not investigated here. (shrink)

Currently, psychopathy and related terms such as antisocial personality disorder are popular yet problematic constructs within forensic psychology and other disciplines. Psychopathy is traced typically to the works of Pinel and Prichard in the early 19th century, and it has even been linked to biblical passages, although there appears to be little or no support for the latter claim. The first use of the term psychopathy in German psychiatry of the mid-19th century referred only to psychological disturbance in general, or (...) ‘personality diseases’, although German psychiatrists such as Kraepelin did propose more specific definitions of the term related to social deviance. Our modern understanding of psychopathy as a psychiatric disorder of an undetermined genetic origin involving antisocial elements and a lack of feeling or concern for others owes much to the clinical work and writings of Cleckley. Antisocial personality disorder appears similarly to derive from the work of psychiatric nosologists like Kraepelin and Schneider, while sociopathy is due more to the work of Partridge in the 1920s and 1930s. (shrink)

The recurring claim that the construct of psychopathy is value laden often is not qualified in enough detail. The chapters in this part of the volume, instead, investigate in depth the role and significance of values in different aspects of the construct of psychopathy. Following these chapters, but also by offering a background to them, we show how certain values are involved in the characterisation of psychopathy, inform societal needs satisfied by this construct, and have a central role in determining (...) whether psychopathy is a mental disorder. Moreover, we relate this description to our criticism of the view that the entrenchment of the notion of psychopathy with values in principle renders it irreconcilable with sound psychiatric theory and practice. However, we also recognize that the value-ladenness of psychopathy leaves open other important challenges. Meeting them needs addressing interdisciplinary interrelated issues that have empirical, normative, and theoretical dimensions. (shrink)

This article offers a critique and reconstruction of the concept of medicalization. Most researchers describe medicalization as the redefinition of social problems as medical concerns, and track its spread by the proliferation of disease language and diagnostic categories. Forensic psychiatry and disorders like psychopathy are often cited in these debates. I argue that focusing on discourse overlooks how medical language can justify or mask non-medical practices and outcomes, and lead researchers to identify medicalization where it has not occurred. Building on (...) other critiques of medicalization and recent studies of medical and legal expertise, I propose an alternative conception based on conditions for the performance of medical practice and other forms of expert labor. I distinguish the participation or intervention of medical practitioners from the medicalization of expert practice and identify several institutional factors that facilitate the latter. I illustrate this approach using a critical historical case: the first adult penal psychiatric clinic in the United States, founded by the eminent psychopathologist Bernard Glueck at New York’s Sing Sing Prison in 1916. Glueck’s extensive writings reveal little evidence of medicalization: psychopaths were largely defined and diagnosed according to penal rather than medical criteria, and they received additional punishment rather than treatment. A review of recent research confirms that psychopathy remains primarily a penal rather than medical condition. I conclude that focusing studies of medicalization on practice rather than discourse clarifies the concept and avoids reifying the notion of a medicalized society. (shrink)