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Responsibility without Blame: Philosophical Reflections on Clinical Practice

In K. W. M. Fulford, Martin Davies, Richard Gipps, George Graham, John Sadler, Giovanni Stanghellini & Tim Thornton (eds.), The Oxford handbook of philosophy and psychiatry. Oxford: Oxford University Press (2013)

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  1. Irrational blame.Hanna Pickard - 2013 - Analysis 73 (4):613-626.
    I clarify some ambiguities in blame-talk and argue that blame's potential for irrationality and propensity to sting vitiates accounts of blame that identify it with consciously accessible, personal-level judgements or beliefs. Drawing on the cognitive psychology of emotion and appraisal theory, I develop an account of blame that accommodates these features. I suggest that blame consists in a range of hostile, negative first-order emotions, towards which the blamer has a specific, accompanying second-order attitude, namely, a feeling of entitlement—a feeling that (...)
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  • Nonhuman Moral Agency: A Practice-Focused Exploration of Moral Agency in Nonhuman Animals and Artificial Intelligence.Dorna Behdadi - 2023 - Dissertation, University of Gothenburg
    Can nonhuman animals and artificial intelligence (AI) entities be attributed moral agency? The general assumption in the philosophical literature is that moral agency applies exclusively to humans since they alone possess free will or capacities required for deliberate reflection. Consequently, only humans have been taken to be eligible for ascriptions of moral responsibility in terms of, for instance, blame or praise, moral criticism, or attributions of vice and virtue. Animals and machines may cause harm, but they cannot be appropriately ascribed (...)
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  • Agency in Mental Illness and Cognitive Disability.Dominic Murphy & Natalia Washington - 2022 - In Manuel Vargas & John Doris (eds.), The Oxford Handbook of Moral Psychology. Oxford, U.K.: Oxford University Press. pp. 893-910.
    This chapter begins by sketching an account of morally responsible agency and the general conditions under which it may fail. We discuss how far individuals with psychiatric diagnoses may be exempt from morally responsible agency in the way that infants are, with examples drawn from a sample of diagnoses intended to make dierent issues salient. We further discuss a recent proposal that clinicians may hold patients responsible without blaming them for their acts. We also consider cognitively impaired subjects in the (...)
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  • Moral Patiency Partially Grounds Moral Agency.Dorna Behdadi - manuscript
    This paper argues that, although moral agency and moral patiency are distinct concepts, we have pro tanto normative reasons to ascribe some moral agency to all moral patients. Assuming a practice-focused approach, moral agents are beings that participate in moral responsibility practices. When someone is a participant, we are warranted to take a participant stance toward them. Beings who lack moral agency are instead accounted for by an objective stance. As such, they are assumed to be exempted from moral responsibility (...)
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  • Why Standing to Blame May Be Lost but Authority to Hold Accountable Retained: Criminal Law as a Regulative Public Institution.Nicola Lacey & Hanna Pickard - 2021 - The Monist 104 (2):265-280.
    Moral and legal philosophy are too entangled: moral philosophy is prone to model interpersonal moral relationships on a juridical image, and legal philosophy often proceeds as if the criminal law is an institutional reflection of juridically imagined interpersonal moral relationships. This article challenges this alignment and in so doing argues that the function of the criminal law lies not fundamentally in moral blame, but in regulation of harmful conduct. The upshot is that, in contrast to interpersonal relationships, the criminal law (...)
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  • Delusional Evidence-Responsiveness.Carolina Flores - 2021 - Synthese 199 (3-4):6299-6330.
    Delusions are deeply evidence-resistant. Patients with delusions are unmoved by evidence that is in direct conflict with the delusion, often responding to such evidence by offering obvious, and strange, confabulations. As a consequence, the standard view is that delusions are not evidence-responsive. This claim has been used as a key argumentative wedge in debates on the nature of delusions. Some have taken delusions to be beliefs and argued that this implies that belief is not constitutively evidence-responsive. Others hold fixed the (...)
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  • Holding Responsible Reconsidered.Larisa Svirsky - 2020 - Public Affairs Quarterly 34 (4):321-339.
    Following Strawson, many philosophers have claimed that holding someone responsible necessitates its being appropriate to feel or express the negative reactive attitudes (e.g., resentment) toward her. This view, while compelling, is unable to capture the full range of cases in which we hold others responsible in ordinary life. Consider the parent who holds her five-year-old responsible for not teasing his sister, or the therapist who holds her patient responsible for avoiding self-injurious behavior. Holding responsible in such cases requires enforcing normative (...)
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  • Responsibility and the Problem of So-Called Marginal Agents.Larisa Svirsky - 2020 - Journal of the American Philosophical Association 6 (2):246-263.
    Philosophical views of responsibility often identify responsible agency with capacities like rationality and self-control. Yet in ordinary life, we frequently hold individuals responsible who are deficient in these capacities, such as children or people with mental illness. The existing literature that addresses these cases has suggested that we merely pretend to hold these agents responsible, or that they are responsible to a diminished degree. In this paper, I demonstrate that neither of these approaches is satisfactory, and offer an alternative focused (...)
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  • Autonomy, Consent, and the “Nonideal” Case.Hallvard Lillehammer - 2020 - Journal of Medicine and Philosophy 45 (3):297-311.
    According to one influential view, requirements to elicit consent for medical interventions and other interactions gain their rationale from the respect we owe to each other as autonomous, or self-governing, rational agents. Yet the popular presumption that consent has a central role to play in legitimate intervention extends beyond the domain of cases where autonomous agency is present to cases where far from fully autonomous agents make choices that, as likely as not, are going to be against their own best (...)
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  • If You Can't Change What You Believe, You Don't Believe It.Grace Helton - 2018 - Noûs 54 (3):501-526.
    I develop and defend the view that subjects are necessarily psychologically able to revise their beliefs in response to relevant counter-evidence. Specifically, subjects can revise their beliefs in response to relevant counter-evidence, given their current psychological mechanisms and skills. If a subject lacks this ability, then the mental state in question is not a belief, though it may be some other kind of cognitive attitude, such as a supposition, an entertained thought, or a pretense. The result is a moderately revisionary (...)
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  • Questions for a Science of Moral Responsibility.Marcelo Fischborn - 2018 - Review of Philosophy and Psychology 9 (2):381-394.
    In the last few decades, the literature on moral responsibility has been increasingly populated by scientific studies. Studies in neuroscience and psychology, in particular, have been claimed to be relevant for discussions about moral responsibility in a number of ways. And at the same time, there is not yet a systematic understanding of the sort of questions a science of moral responsibility is supposed to answer. This paper is an attempt to move toward such an understanding. I discuss three models (...)
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  • Responsibility without Blame for Addiction.Hanna Pickard - 2017 - Neuroethics 10 (1):169-180.
    Drug use and drug addiction are severely stigmatised around the world. Marc Lewis does not frame his learning model of addiction as a choice model out of concern that to do so further encourages stigma and blame. Yet the evidence in support of a choice model is increasingly strong as well as consonant with core elements of his learning model. I offer a responsibility without blame framework that derives from reflection on forms of clinical practice that support change and recovery (...)
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  • Psychiatric fictionalism and narratives of responsibility.Sam Wilkinson - 2022 - Philosophical Explorations 26 (1):91-109.
    I explore the relationship between psychiatric fictionalism and the attribution of moral responsibility. My central claim is as follows. If one is a psychiatric fictionalist, one should also strongly consider being a fictionalist about responsibility. This results in the ‘intrinsic view’, namely, the view that mental illness does not just happen to interfere with moral responsibility: that interference is an intrinsic part of the narrative. I end by discussing three illustrative examples.
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  • Addiction and the Concept of Disorder, Part 1: Why Addiction is a Medical Disorder.C. Wakefield Jerome - 2016 - Neuroethics 10 (1):39-53.
    In this two-part analysis, I analyze Marc Lewis’s arguments against the brain-disease view of substance addiction and for a developmental-learning approach that demedicalizes addiction. I focus especially on the question of whether addiction is a medical disorder. Addiction is currently classified as a medical disorder in DSM-5 and ICD-10. It is further labeled a brain disease by NIDA, based on observed brain changes in addicts that are interpreted as brain damage. Lewis argues that the changes result instead from normal neuroplasticity (...)
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  • Responsibility in healthcare: what’s the point?Hanna Pickard - 2019 - Journal of Medical Ethics 45 (10):650-651.
    In a welcome broadening of the discussion surrounding responsibility in healthcare, Rebecca Brown and Julian Savulescu propose that standard philosophical accounts of responsibility are too narrow to be useful. Although these accounts of course differ with respect to the exact conditions they posit as necessary and sufficient for responsibility, they are nonetheless relatively united in their focus on a single individual at a single moment in time. Suppose a subject S performs an action a at a time t that has (...)
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  • Drug Courts and the ‘Responsibility without Blame’ Approach.Nicolas Nayfeld - 2023 - Journal of Applied Philosophy 40 (3):488-504.
    This article starts from a paradox and aims to solve it. On the one hand, although Drug Courts (DCs) are one of the most interesting penal innovations in recent years, running counter to the dominant retributive approach and the rival approach based on deterrence, they have surprisingly not attracted the attention of philosophers and therefore lack a solid philosophical foundation. On the other hand, although Pickard's ‘responsibility without blame’ approach looks very convincing on paper, its practical applications remain unclear outside (...)
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  • Offender Agency in a State-Centred Sentencing Process: In Search of an Agentic Sentencing Model.Elise Maes - 2022 - Criminal Law and Philosophy 16 (3):575-609.
    Punishment is a grave intrusion into individual liberty, yet in most liberal criminal justice systems, including England and Wales, those punished are rarely directly engaged in determining their sentence. Consequently, the offender’s agency in respect of sentence—i.e. the offender’s capacity to play an active part in the sentencing process—is limited. Drawing on existing theories of punishment, the article argues that there may be justifications and scope for allowing offenders to exercise agency in a state-centred sentencing process, even though this scope (...)
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  • Responsibility as an Obstacle to Good Policy: The Case of Lifestyle Related Disease.Neil Levy - 2018 - Journal of Bioethical Inquiry 15 (3):459-468.
    There is a lively debate over who is to blame for the harms arising from unhealthy behaviours, like overeating and excessive drinking. In this paper, I argue that given how demanding the conditions required for moral responsibility actually are, we cannot be highly confident that anyone is ever morally responsible. I also adduce evidence that holding people responsible for their unhealthy behaviours has costs: it undermines public support for the measures that are likely to have the most impact on these (...)
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  • The Limits of Blame, by Erin I. Kelly.Nicola Lacey - 2019 - Mind 129 (516):1337-13348.
    The Limits of Blame, by KellyErin I. Cambridge, MA: Harvard University Press, 2018. Pp. 221.
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  • From the Consulting Room to the Court Room? Taking the Clinical Model of Responsibility Without Blame into the Legal Realm.Nicola Lacey & Hanna Pickard - 2013 - Oxford Journal of Legal Studies 33 (1):1-29.
    Within contemporary penal philosophy, the view that punishment can only be justified if the offender is a moral agent who is responsible and hence blameworthy for their offence is one of the few areas on which a consensus prevails. In recent literature, this precept is associated with the retributive tradition, in the modern form of ‘just deserts’. Turning its back on the rehabilitative ideal, this tradition forges a strong association between the justification of punishment, the attribution of responsible agency in (...)
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  • Q: Is Addiction a Brain Disease or a Moral Failing? A: Neither.Nick Heather - 2017 - Neuroethics 10 (1):115-124.
    This article uses Marc Lewis’ work as a springboard to discuss the socio-political context of the brain disease model of addiction (BDMA). The claim that promotion of the BDMA is the only way the general public can be persuaded to withhold blame and punishment from addicts is critically examined. After a discussion of public understandings of the disease concept of addiction, it is pointed out that it is possible to develop a scientific account of addiction which is neither a disease (...)
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  • Blame for me and Not for Thee: Status Sensitivity and Moral Responsibility.Henry Argetsinger - 2022 - Ethical Theory and Moral Practice 25 (2):265-282.
    In our day-to-day lives, we form responsibility judgements about one another – but we are imperfect beings, and our judgments can be mistaken. This paper suggests that we get things wrong not merely by chance, but predictably and systematically. In particular, these miscues are common when we are dealing with large gaps in social status and power. That is, when we form judgements about those who are much more or less socially powerful than ourselves, it is increasingly likely that “epistemic (...)
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  • The Clinical Stance and the Nurturing Stance: Therapeutic Responses to Harmful Conduct by Service Users in Mental Healthcare.Daphne Brandenburg & Derek Strijbos - 2020 - Philosophy, Psychiatry, and Psychology 27 (4):379-394.
    Abstract: In this article, we explore what are ethical forms of holding service users responsible in mental health care contexts. Hanna Pickard has provided an account of how service users should be held responsible for morally wrong or seriously harmful conduct within contexts of mental health care, called the clinical stance. From a clinical stance one holds a person responsible for harm, but refrains from emotionally blaming the person and only considers the person responsible for this conduct in a detached (...)
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  • Interconnected Blameworthiness.Stephanie Collins & Niels de Haan - 2021 - The Monist 104 (2):195-209.
    This paper investigates agents’ blameworthiness when they are part of a group that does harm. We analyse three factors that affect the scope of an agent’s blameworthiness in these cases: shared intentionality, interpersonal influence, and common knowledge. Each factor involves circumstantial luck. The more each factor is present, the greater is the scope of each agent’s vicarious blameworthiness for the other agents’ contributions to the harm. We then consider an agent’s degree of blameworthiness, as distinct from her scope of blameworthiness. (...)
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  • Infallibilism, evidence and pragmatics.Jessica Brown - 2013 - Analysis 73 (4):626-635.
    According to one contemporary formulation of infallibilism, probability 1 infallibilism, if a subject knows that p, then the probability of p on her evidence is 1. To avoid an implausible scepticism about knowledge, probability 1 infallibilism needs to allow that, in a wide range of cases, a proposition can be evidence for itself. However, such infallibilism needs to explain why it is typically infelicitous to cite p as evidence for p itself. I argue that probability 1 infallibilism has no explanation (...)
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  • Inadequate Agency and Appropriate Anger.Daphne Brandenburg - 2019 - Ethical Theory and Moral Practice 22 (1):169-185.
    Communication and cultivation accounts of responsibility argue that blaming has an important communicative and agency-cultivating function when addressed at someone we consider to be deserving of blame. On these accounts, responsible agents are agents who can understand negative reactive attitudes and are sensitive to their moral-agency cultivating function. In this paper I examine our reproachful engagements with agents whose moral agency is underdeveloped or compromised. I discuss how these engagements compare to blaming on CC accounts and argue reproachful engagements can (...)
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  • Agency’s Constitutive Normativity: An Elucidation.Federica Berdini - 2019 - Journal of Value Inquiry 53 (4):487-512.
    My aim in this paper is to provide a conceptual elucidation of the notion of constitutive normativity, which is central to Constitutivism as a first-order theory of agency, as well as to its metanormative ambitions. After introducing and clarifying the origins and scope of Constitutivism (Section 2), I focus on Christine M. Korsgaard’s version thereof (Section 3), which provides an explicit articulation of the notion of constitutive norms. Despite Korsgaard’s explicit acknowledgement that the concepts of action and agency come in (...)
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  • Knowing More by Knowing Less? A Reading of Give Me Everything You Have. On Being Stalked by James Lasdun, London: Jonathan Cape, 2013.Neil Armstrong - 2017 - Journal of Medical Humanities 38 (3):287-302.
    James Lasdun’s memoir of being stalked, Give Me Everything You Have, has provoked considerable controversy. Whilst the quality of the writing is widely praised, some critics object to the way Lasdun documents in unsparing detail his experiences without taking any account of the stalker’s apparent mental health problems. There are ethical and conceptual problems with Lasdun’s approach, but side-stepping medical knowledge and relying on what we might call common sense help Lasdun to find ways to interpret his stalker’s actions as (...)
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  • Psychopathy: Morally Incapacitated Persons.Heidi Maibom - 2017 - In Thomas Schramme & Steven Edwards (eds.), Handbook of the Philosophy of Medicine. Springer. pp. 1109-1129.
    After describing the disorder of psychopathy, I examine the theories and the evidence concerning the psychopaths’ deficient moral capacities. I first examine whether or not psychopaths can pass tests of moral knowledge. Most of the evidence suggests that they can. If there is a lack of moral understanding, then it has to be due to an incapacity that affects not their declarative knowledge of moral norms, but their deeper understanding of them. I then examine two suggestions: it is their deficient (...)
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