Moral and legal responsibility is diminished in neuropsychiatric patients who lack the capacity to use reasoning to determine morally appropriate behavior. Patients with behavioral-variant frontotemporal dementia (bvFTD), however, develop immoral behaviors as a result of their disease despite the ability to explicitly state that their behavior is wrong. In order to determine whether bvFTD patients should be held responsible for their immoral behavior, we begin by discussing the philosophical concepts of free will, determinism, and responsibility. Those who believe in both (...) determinism and free will are called compatibilists. We argue that reason-responsiveness, a specific type of compatibilism, cannot fully determine responsibility in bvFTD patients if reason-responsiveness is considered to be a single, unified concept. Instead, we argue that several different neuropsychological capacities, including many that are impaired in bvFTD patients, contribute to a patient's ability to respond to certain reasons in specific situations. Finally, we propose a new framework for understanding reason-responsiveness, using case examples to illustrate how this model can be used to determine responsibility in neuropsychiatric patients. (shrink)

Although philosophers have explored several connections between neuroscience and moral responsibility, the issue of how real-world neurological modifications, such as Deep Brain Stimulation, impact moral responsibility has received little attention. In this article, we draw on debates about the relevance of history and manipulation to moral responsibility to argue that certain kinds of neurological modification can diminish the responsibility of the agents so modified. We argue for a historicist position - a version of the history-sensitive reflection view - and defend (...) that account against a rival, relational view of responsibility. We conclude that DBS can, under certain conditions, diminish responsibility, and explore the circumstances under which this might be so. We conclude by suggesting that philosophical debates about moral responsibility, manipulation, and history have greater practical relevance than is sometimes thought, and that attention to practical cases can help inform and deepen this body of scholarship. (shrink)