Does a diagnosis of brain dysfunction matter for ascriptions of moral responsibility? This chapter argues that, while knowledge of brain pathology can inform judgments of moral responsibility, its evidential value is currently limited for a number of practical and theoretical reasons. These include the problem of establishing causation from correlational data, drawing inferences about individuals from group data, and the reliance of the interpretation of brain findings on well-established psychological findings. Brain disorders sometimes matter for moral responsibility, however, because they (...) change an individual’s moral psychology in a way that is beyond their control. While control over psychological changes is not an excusing factor, brain disorders can mitigate moral responsibility because they confront individuals with new psychological deficits or urges for which their previous moral education and existing external and internal moral resources have not prepared them. (shrink)

In this paper, I address the question whether mental disorders should be understood to be brain disorders and what conditions need to be met for a disorder to be rightly described as a brain disorder. I defend the view that mental disorders are autonomous and that a condition can be a mental disorder without at the same time being a brain disorder. I then show the consequences of this view. The most important of these is that brain differences underlying mental (...) disorders derive their status as disordered from the fact that they realize mental dysfunction and are therefore non-autonomous or dependent on the level of the mental. I defend this view of brain disorders against the objection that only conditions whose pathological character can be identified independently of the mental level of description count as brain disorders. The understanding of brain disorders I propose requires a certain amount of conceptual revision and is at odds with approaches which take the notion of brain disorder to be fundamental or look to neuroscience to provide us with a purely physiological understanding of mental illness. It also entails a pluralistic understanding of psychiatric illness, according to which a condition can be both a mental disorder and a brain disorder. (shrink)

I shall begin with the "anti-psychiatry" view that the lack of a physical basis excludes many familiar mental disorders from the category of "illness". My response to this argument will be that anti-psychiatrists are probably right to hold that most mental disorders do not involve any physical disorder, but that they are wrong to conclude from this that these mental disorders are not illnesses.

If mental illnesses are externally constituted, then so are somatic illnesses. Will Davies makes a persuasive case for externalism in psychiatry; as I show here, parallel examples exist in somatic medicine.

The law has taken a long-standing interest in the mind. Cognitive neuroscience, the study of the mind through the brain, has gained prominence in part as a result of the advent of functional neuroimaging as a widely used tool for psychological research. Existing legal principles make virtually no assumptions about the neural bases of criminal behavior, and as a result they can comfortably assimilate new neuroscience without much in the way of conceptual upheaval: new details, new sources of evidence, but (...) nothing for which the law is fundamentally unprepared. Neuroscience challenges ultimately reshape our intuitive sense of justice. It draws a familiar distinction between the consequentialist justification for state punishment, according to which punishment is merely an instrument for promoting future social welfare, and the retributivist justification for punishment, according to which the principal aim of punishment is to give people what they deserve based on their past actions. (shrink)

Psychiatry widely assumes an internalist biomedical model of mental illness. I argue that many of psychiatry’s diagnostic categories involve an implicit commitment to constitutive externalism about mental illness. Some of these categories are socially externalist in nature.

This paper will be about the relationship between mental disorder and physical disorder. I shall also be concerned with the connection between these notions and the notion of ‘illness’.