Elimination controversies are ubiquitous in philosophy and the human sciences. For example, it has been suggested that human races, hysteria, intelligence, mental disorder, propositional attitudes such as beliefs and desires, the self, and the super-ego should be eliminated from the list of respectable entities in the human sciences. I argue that eliminativist proposals are often presented in the framework of an oversimplified “phlogiston model” and suggest an alternative account that describes ontological elimination on a gradual scale between criticism of empirical (...) assumptions and conceptual choices. (shrink)

Elimination controversies are ubiquitous in philosophy and the human sciences. For example, it has been suggested that human races, hysteria, intelligence, mental disorder, propositional attitudes such as beliefs and desires, the self, and the super-ego should be eliminated from the list of respectable entities in the human sciences. I argue that eliminativist proposals are often presented in the framework of an oversimplified “phlogiston model” and suggest an alternative account that describes ontological elimination on a gradual scale between criticism of empirical (...) assumptions and conceptual choices. (shrink)

With advances in medical science, the concept of agency has received increasing attention in biomedical ethics. However, most of the ethical discussion around definitions of agency has focused either on patients suffering from mental disorders or on patients receiving cutting-edge medical treatments in developed countries. Very little of the discussion around concepts of agency has focused on the situation of patients suffering from common diseases that affect populations worldwide. Therefore, the most widely-used definitions of agency may be not appropriate to (...) analyse common diseases among large populations. The branch of social sciences known as development studies draw on their own definitions of the term agency that may provide a more applicable and accurate way of referring to common and general cases than the definitions currently used in bioethics. Moreover, the psychological Self-Determination Theory may improve the usefulness of these definitions in common situations. This article explains the characteristics and the shortcomings of current bioethical definitions of agency when they are applied to common medical conditions worldwide. A new, value-based concept of agency, informed by development studies, is proposed as more accurate and useful for biomedical ethics. (shrink)

In a recent paper, it was argued forcefully by Thomas Szasz that it is crucial to the scientific credibility of psychiatry that it abandon talk of the behaviour of the mentally “ill” in terms of causes: such behaviour is not caused by their condition—it simply has reasons, which are discounted by the medical model. It is argued in this paper that Szasz's theory is incomplete for two reasons: first, in assuming that reasons are radically different from causes, it cannot account (...) for the possibility that “sane” behaviour might be just as much caused as “insane”; and second, it tacitly assumes that the origin of behaviour always lies with the agent—a view that arguably is an accident of grammar. Hence while there is no mental illness, this is because there is nothing that could be ill—and this means that there is no such thing as mental “health” either. (shrink)

El concepto de trastorno mental permite justificar intervenciones médicas, psicológicas y judiciales. Además, facilita a la/el consultante acceder a tratamientos mediante reembolsos o programas de salud pública, y por otro lado, podría conllevar estereotipos sociales. No obstante, el significado de dicho concepto no ha dejado de suscitar debate. En el presente artículo argumentaré que los trastornos de personalidad, tal como son definidos en el DSM-5, no cumplen con los criterios de patología de las propuestas principales (i.e. teoría bio-estadística de la (...) salud, disfunción dañina, o entidad patológica) debido a tres razones independientes: (i) no se han propuesto dis/funciones a la base de cada trastorno y, dado el estado del arte de la psicología evolucionista, es poco probable que se pueda llevar a cabo ese programa en el futuro; (ii) el concepto de daño (distrés, perjuicio) aplicable a los trastornos de personalidad es constitutivamente social (aunque no exclusivamente social), por lo que resulta más adecuado hablar de grados de discapacidad que de trastornos del individuo; y (iii) que la ausencia de condiciones patognomónicas para cada trastorno, junto a la elevada comorbilidad y multimorbilidad entre trastornos de personalidad, horada la validez de la nosología actual y de los diagnósticos diferenciales. Propondré como solución la eliminación de los trastornos de personalidad de la nosología psiquiátrica. Eliminar los trastornos de personalidad no equivale a desconocer el sufrimiento de las personas diagnosticadas, ni a ignorar que dicho sufrimiento precede a, –y no acaba con la disolución de– la etiqueta diagnóstica. Por ello, se propondrá una reconceptualización de dicho sufrimiento en términos de discapacidad, entendida desde el modelo social, y que no presupone patología. (shrink)