Our self-conception derives mostly from our own experience. We believe ourselves to be conscious, rational, social, ethical, language-using, political agents who possess free will. Yet we know we exist in a universe that consists of mindless, meaningless, unfree, nonrational, brute physical particles. How can we resolve the conflict between these two visions? In _Freedom and Neurobiology_, the philosopher John Searle discusses the possibility of free will within the context of contemporary neurobiology. He begins by explaining the relationship between human reality (...) and the more fundamental reality as described by physics and chemistry. Then he proposes a neurobiological resolution to the problem by demonstrating how various conceptions of free will have different consequences for the neurobiology of consciousness. In the second half of the book, Searle applies his theory of social reality to the problem of political power, explaining the role of language in the formation of our political reality. The institutional structures that organize, empower, and regulate our lives-money, property, marriage, government-consist in the assignment and collective acceptance of certain statuses to objects and people. Whether it is the president of the United States, a twenty-dollar bill, or private property, these entities perform functions as determined by their status in our institutional reality. Searle focuses on the political powers that exist within these systems of status functions and the way in which language constitutes them. Searle argues that consciousness and rationality are crucial to our existence and that they are the result of the biological evolution of our species. He addresses the problem of free will within the context of a neurobiological conception of consciousness and rationality, and he addresses the problem of political power within the context of this analysis. A clear and concise contribution to the free-will debate and the study of cognition, _Freedom and Neurobiology_ is essential reading for students and scholars of the philosophy of mind. (shrink)

Psychiatry presents a unique array of difficult ethical questions. However, a major challenge is to approach psychiatry in a way that does justice to the real ethical issues. Recently there has been a growing body of research in empirical psychiatric ethics, and an increased interest in how empirical and philosophical methods can be combined. Empirical Ethics in Psychiatry demonstrates how ethics can engage more closely with the reality of psychiatric practice and shows how empirical methodologies from the social sciences can (...) help foster this link. -/- The book is divided into two sections. In the first section there are discussions of the possibility of empirical ethics from a theoretical standpoint and an overview of the history of empirical medical ethics in general. The second, larger section is made up of chapters, discussing specific research projects in empirical psychiatric ethics. The contributors reflect on their choice of method: how and why they combine empirical and philosophical work, and how the two approaches relate to each other. The chapters in the second part thus have two purposes. The first is to present examples of empirical ethics in psychiatry; the second is to reflect on the way in which empirical research can support ethical analysis. -/- Empirical Ethics in Psychiatry is a unique contribution to bioethics and will be fascinating reading for all those working within the field, as well as mental health care professionals. (shrink)

Persons of diminished capacity, especially those who are still legally competent but are de facto incompetent should still be able to participate in moderately risky research projects that benefit the class of persons with similar diseases. It is argued that this view can be supported with a modified communitarianism, a philosophy ofmedicine that holds that health care is a joint responsibility that meets foundational human needs. The mechanism for obtaining a substituted consent I call ``community consent,'' and distinguish this from (...) the usual family or surrogate consent for treatment. Care givers are included in the community that might consent for an individual who has no identifiable family members. (shrink)

In this article, we present a dialogical approach to empirical ethics, based upon hermeneutic ethics and responsive evaluation. Hermeneutic ethics regards experience as the concrete source of moral wisdom. In order to gain a good understanding of moral issues, concrete detailed experiences and perspectives need to be exchanged. Within hermeneutic ethics dialogue is seen as a vehicle for moral learning and developing normative conclusions. Dialogue stands for a specific view on moral epistemology and methodological criteria for moral inquiry. Responsive evaluation (...) involves a structured way of setting up dialogical learning processes, by eliciting stories of participants, exchanging experiences in (homogeneous and heterogeneous) groups and drawing normative conclusions for practice. By combining these traditions we develop both a theoretical and a practical approach to empirical ethics, in which ethical issues are addressed and shaped together with stakeholders in practice. Stakeholders' experiences are not only used as a source for reflection by the ethicist; stakeholders are involved in the process of reflection and analysis, which takes place in a dialogue between participants in practice, facilitated by the ethicist. This dialogical approach to empirical ethics may give rise to questions such as: What contribution does the ethicist make? What role does ethical theory play? What is the relationship between empirical research and ethical theory in the dialogical process? In this article, these questions will be addressed by reflecting upon a project in empirical ethics that was set up in a dialogical way. The aim of this project was to develop and implement normative guidelines with and within practice, in order to improve the practice concerning coercion and compulsion in psychiatry. (shrink)

The principle of autonomy presupposes Patient Decision Making Competence (PDMC). For a few decades a considerable amount of empirical research has been done into PDMC. In this contribution that research is explored. After a short exposition on four qualities involved in PDMC, different approaches to assess PDMC are distinguished, namely a negative and a positive one. In the negative approach the focus is on identifying psychopathologic conditions that impair sound decision making; the positive one attempts to assess whether a patient (...) actually has the required abilities and qualities. Characteristic of the latter approach is the use of (or development of) test-like instruments for PDMC assessment. Some of these tests are discussed and commented on. Although they may be useful in investigating aspects of PDMC, none of the described approaches and tests offers a reliable and valid method for PDMC assessment. In response to a potential misuse of tests, the concept of a supportive situation is briefly introduced in order to draw attention to the risk of prematurely deeming patients incompetent on the basis of low test scores, whereas their insufficient performance may be (partly) attributable to alack of situational support. Also, the need for and possibility of an emotionalist concept of PDMC are suggested, as an alternative to the more common rationalist one. In this regard,the legitimacy of competence being conceived as a presumption or fiction of law, deserves further investigation. (shrink)

The forensic psychiatrist’s task is often considered to be tightly connected to the concept of free will. Yet, there is also a lack of clarity about the role of the concept of free will in forensic psychiatry. Recently, Morse has argued that forensic psychiatrists should not mention free will in their reports or testimonies, and, moreover, that they should not even think about free will. Starting from a discussion on Morse’s claims, I will develop my own view on how forensic (...) psychiatrists are confronted with the issue of free will and how they should deal with this concept and the confusion surrounding it. I conclude that psychiatrists should at least feel free to think about free will and that the conceptual challenges connected to the issues of free will and accountability could rather encourage than deter forensic psychiatrists to think about them. (shrink)

The medical assessments of criminal responsibility and competence to consent to treatment are performed, developed and debated in distinct domains. In this paper I try to connect these domains by exploring the similarities and differences between both assessments. In my view, in both assessments a decision-making process is evaluated in relation to the possible influence of a mental disorder on this process. I will argue that, in spite of the relevance of the differences, both practices could benefit from the recognition (...) of this similarity. For cooperative research could be developed directed at elucidating exactly how various mental disturbances can affect decision-making processes. (shrink)

An important discussion in contemporary ethics concerns the relevance of empirical research for ethics. Specifically, two crucial questions pertain, respectively, to the possibility of inferring normative statements from descriptive statements, and to the danger of a loss of normativity if normative statements should be based on empirical research. Here we take part in the debate and defend integrated empirical ethical research: research in which normative guidelines are established on the basis of empirical research and in which the guidelines are empirically (...) evaluated by focusing on observable consequences. We argue that in our concrete example normative statements are not derived from descriptive statements, but are developed within a process of reflection and dialogue that goes on within a specific praxis. Moreover, we show that the distinction in experience between the desirable and the undesirable precludes relativism. The normative guidelines so developed are both critical and normative: they help in choosing the right action and in evaluating that action. Finally, following Aristotle, we plead for a return to the view that morality and ethics are inherently related to one another, and for an acknowledgment of the fact that moral judgments have their origin in experience which is always related to historical and cultural circumstances. (shrink)

This comprehensive reference provides an exhaustive guide to current scholarship on the perennial problem of Free Will--perhaps the most hotly and voluminously debated of all philosophical problems. While reference is made throughout to the contributions of major thinkers of the past, the emphasis is on recent research. The essays, most of which are previously unpublished, combine the work of established scholars with younger thinkers who are beginning to make significant contributions. Taken as a whole, the Handbook provides an engaging and (...) accessible roadmap to the state of the art thinking on this enduring topic. (shrink)

In order to protect patients against medical paternalism, patients have been granted the right to respect of their autonomy. This right is operationalized first and foremost through the phenomenon of informed consent. If the patient withholds consent, medical treatment, including life-saving treatment, may not be provided. However, there is one proviso: The patient must be competent to realize his autonomy and reach a decision about his own care that reflects that autonomy. Since one of the most important patient rights hinges (...) on the patient's competence, it is crucially important that patient decision making incompetence is clearly defined and can be diagnosed with the greatest possible degree of sensitivity and, even more important, specificity. Unfortunately, the reality is quite different. There is little consensus in the scientific literature and even less among clinicians and in the law as to what competence exactly means, let alone how it can be diagnosed reliably. And yet, patients are deemed incompetent on a daily basis, losing the right to respect of their autonomy. In this article, we set out to fill that hiatus by beginning at the very beginning, the literal meaning of the term competence. We suggest a generic definition of competence and derive four necessary conditions of competence. We then transpose this definition to the health care context and discuss patient decision making competence. (shrink)

If among the spate of books on free will in recent years there are any that a philosopher concerned with that topic should have handy, this is one of them. Its coverage of the free-will issues debated in the philosophical literature of the last twenty years or so is penetrating, instructive, and by far the most thorough I’ve seen. Kane defends his own positions, but he is unusually fair, even generous, in expounding opposing views. And, while the book is not (...) a popular treatment, it is written in an accessible and engaging style. It could have been shorter, by being less repetitious and in places more succinctly written, without loss of content or accessibility—indeed with some gain in accessibility for those who are not engaged in reading it through but just wish to consult it for what it has to say on particular issues. There is a fairly extensive and helpful index. It is altogether a very appealing and useful book. (shrink)

In The Rules of Insanity, Carl Elliott draws on philosophy and psychiatry to develop a conceptual framework for judging the moral responsibility of mentally ill offenders. Arguing that there is little useful that can be said about the responsibility of mentally ill offenders in general, Elliott looks at specific mental illnesses in detail; among them schizophrenia, manic-depressive disorders, psychosexual disorders such as exhibitionism and voyeurism, personality disorders, and impulse control disorders such as kleptomania and pyromania. He takes a particularly hard (...) look at the psychopath or sociopath, who many have argued is incapable of understanding morality. Making extensive use of psychiatric case histories, Elliott explores the various ways in which mental illness can affect a person's intentions and thus excuse him or her from moral responsibility. (shrink)

This book explores an important issue within the free will debate: the relation between free will and moral responsibility.

Cover -- Half Title -- Title Page -- Copyright Page -- Table of Contents -- List of Contributors -- Preface -- Foreword -- Introduction -- Chapter 1 Alternate Possibilities and Moral Responsibility -- Chapter 2 Responsibility and Alternative Possibilities -- Chapter 3 Blameworthiness and Frankfurt's Argument Against the Principle of Alternative Possibilities -- Chapter 4 In Defense of the Principle of Alternative Possibilities: Why I Don't Find Frankfurt's Argument Convincing -- Chapter 5 Responsibility, Indeterminism and Frankfurt-style Cases: A Reply to (...) Mele and Robb -- Chapter 6 Classical Compatibilism: Not Dead Yet -- Chapter 7 Bbs, Magnets and Seesaws: The Metaphysics of Frankfurt-style Cases -- Chapter 8 Moral Responsibility without Alternative Possibilities -- Chapter 9 Freedom, Foreknowledge and Frankfurt -- Chapter 10 Source Incompatibilism and Alternative Possibilities -- Chapter 11 Robustness, Control, and the Demand for Morally Significant Alternatives: Frankfurt Examples with Oodles and Oodles of Alternatives -- Chapter 12 Alternate Possibilities and Reid's Theory of Agent-causation -- Chapter 13 Responsibility and Agent-causation -- Chapter 14 Soft Libertarianism and Flickers of Freedom -- Chapter 15 'Ought' Implies 'Can', Blameworthiness, and the Principle of Alternate Possibilities -- Chapter 16 The Moral Significance of Alternate Possibilities -- Chapter 17 The Selling of Joseph - A Frankfurtian Interpretation -- Chapter 18 Some Thoughts Concerning PAP -- Bibliography -- Index. (shrink)

Most people assume that, even though some degenerative or criminal behavior may be caused by influences beyond our control, ordinary human actions are not similarly generated, but rather are freely chosen, and we can be praiseworthy or blameworthy for them. A less popular and more radical claim is that factors beyond our control produce all of the actions we perform. It is this hard determinist stance that Derk Pereboom articulates in Living Without Free Will. Pereboom argues that our best scientific (...) theories have the consequence that factors beyond our control produce all of the actions we perform, and that because of this, we are not morally responsible for any of them. He seeks to defend the view that morality, meaning and value remain intact even if we are not morally responsible, and furthermore, that adopting this perspective would provide significant benefit for our lives. (shrink)

Robert Kane provides a critical overview of debates about free will of the past half century, relating this recent inquiry to the broader history of the free will issue and to vital currents of twentieth century thought. Kane also defends a traditional libertarian or incompatibilist view of free will, employing arguments that are both new to philosophy and that respond to contemporary developments in physics and biology, neuro science, and the cognitive and behavioral sciences.

Daniel C. Dennett is a brilliant polemicist, famous for challenging unexamined orthodoxies. Over the last thirty years, he has played a major role in expanding our understanding of consciousness, developmental psychology, and evolutionary theory. And with such groundbreaking, critically acclaimed books as Consciousness Explained and Darwin's Dangerous Idea (a National Book Award and Pulitzer Prize finalist), he has reached a huge general and professional audience. In this new book, Dennett shows that evolution is the key to resolving the ancient problems (...) of moral and political freedom. Like the planet's atmosphere on which life depends, the conditions on which our freedom depends had to evolve, and like the atmosphere, they continue to evolve-and could be extinguished. According to Dennett, biology provides the perspective from which we can distinguish the varieties of freedom that matter. Throughout the history of life on this planet, an interacting web and internal and external conditions have provided the frameworks for the design of agents that are more free than their parts-from the unwitting gropings of the simplest life forms to the more informed activities of animals to the moral dilemmas that confront human beings living in societies. As in his previous books, Dennett weaves a richly detailed narrative enlivened by analogies as entertaining as they are challenging. Here is the story of how we came to be different from all other creatures, how our early ancestors mindlessly created human culture, and then, how culture gave us our minds, our visions, our moral problems-in a nutshell, our freedom. (shrink)

This article demonstrates that there is no free will problem in forensic psychiatry by showing that free will or its lack is not a criterion for any legal doctrine and it is not an underlying general foundation for legal responsibility doctrines and practices. There is a genuine metaphysical free will problem, but the article explains why it is not relevant to forensic practice. Forensic practitioners are urged to avoid all usage of free will in their forensic thinking and work product (...) because it is irrelevant and spawns confusion. (shrink)