This paper explores how the diagnosis of mental disorder may affect the diagnosed subject’s self-concept by supplying an account that emphasizes the influence of autobiographical and social narratives on self-understanding. It focuses primarily on the diagnoses made according to the criteria provided by the Diagnostic Statistical Manual of Mental Disorders (DSM), and suggests that the DSM diagnosis may function as a source of narrative that affects the subject’s self-concept. Engaging in this analysis by appealing to autobiographies and memoirs written by (...) people diagnosed with mental disorder, the paper concludes that a DSM diagnosis is a double-edged sword for self- concept. On the one hand, it sets the subject’s experience in an established classificatory system which can facilitate self-understanding by providing insight into subject’s condition and guiding her personal growth, as well as treatment and recovery. In this sense, the DSM diagnosis may have positive repercussions on self-development. On the other hand, however, given the DSM’s symptom-based approach and its adoption of the Biomedical Disease model, a diagnosis may force the subject to make sense of her condition divorced from other elements in her life that may be affecting her mental- health. It may lead her frame her experience only as an irreversible imbalance. This form of self-understanding may set limits on the subject’s hopes of recovery and may create impediments to her flourishing. (shrink)

This paper argues that, by construing emotion as epistemologically subversive, the Western tradition has tended to obscure the vital role of emotion in the construction of knowledge. The paper begins with an account of emotion that stresses its active, voluntary, and socially constructed aspects, and indicates how emotion is involved in evaluation and observation. It then moves on to show how the myth of dispassionate investigation has functioned historically to undermine the epistemic authority of women as well as other social (...) groups associated culturally with emotion. Finally, the paper sketches some ways in which the emotions of underclass groups, especially women, may contribute to the development of a critical social theory. (shrink)

Accidie, depression, and dejection seem to be psychological phenomena that are best characterized as cases in which an agent has no motivation to pursue what he or she judges to be good or valuable. The phenomena thus seem to present a challenge to any view that draws a close connection between motivation and evaluation. ‘Accidie, Evaluation, and Motivation’ aims to show that the phenomena are actually best explained by a theory that postulates a conceptual connection between motivation and evaluation.

Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

Epistemic injustice is a harm done to a person in their capacity as an epistemic subject by undermining her capacity to engage in epistemic practices such as giving knowledge to others or making sense of one’s experiences. It has been argued that those who suffer from medical conditions are more vulnerable to epistemic injustice than the healthy. This paper claims that people with mental disorders are even more vulnerable to epistemic injustice than those with somatic illnesses. Two kinds of contributory (...) factors for epistemic injustice in psychiatric patients are outlined: global and specific. Some suggestions are made to counteract the effects of these contributory factors, for instance we suggest that physicians should participate in groups where the subjective experience of patients is explored, and learn to become more aware of their own unconscious prejudices towards psychiatric patients. (shrink)

Epistemic Perceptualists claim that emotions are sources of immediate defeasible justification for evaluative propositions that can sometimes ground undefeated immediately justified evaluative beliefs. For example, fear can constitute the justificatory ground for a belief that some object or event is dangerous. Despite its attractiveness, the view is apparently vulnerable to several objections. In this paper, I provide a limited defence of Epistemic Perceptualism by responding to a family of objections which all take as a premise a popular and attractive view (...) in value theory – Neo-Sentimentalism – according to which values are analysed in terms of fitting emotions. (shrink)

Too often, we as individuals do things that harm us, that seriously interfere with our being able to live in the way that we want. We eat food that makes us obese, that promotes diabetes, heart failure and other serious illness, while at the same time, we want to live long and healthy lives. Too many of us smoke cigarettes, even while acknowledging we wish we had never begun. We behave in ways that undercut our ability to reach some of (...) our most valued goals, despite education and despite incentives to choose the right thing. What should be done?If I were to try to harm someone else in a way that alters his future seriously and perhaps irrevocably for the worse, I would be stopped. When it comes to hurting myself, though, we have a common belief that it is wrong to interfere, even if I foresee that I will very much regret what I have done, often when it is too late to fix what I have let happen. I think this makes no sense. If it is permissible, even obligatory, to stop me when I do something that seriously interferes with someone else's chances of achieving the life he wants, I think …. (shrink)

Sometimes we get evidence of our own epistemic malfunction. This can come from finding out we’re fatigued, or have been drugged, or that other competent and well-informed thinkers disagree with our beliefs. This sort of evidence seems to seems to behave differently from ordinary evidence about the world. In particular, getting such evidence can put agents in a position where the most rational response involves violating some epistemic ideal.

How much should your confidence in your beliefs be shaken when you learn that others – perhaps 'epistemic peers' who seem as well-qualified as you are – hold beliefs contrary to yours? This article describes motivations that push different philosophers towards opposite answers to this question. It identifies a key theoretical principle that divides current writers on the epistemology of disagreement. It then examines arguments bearing on that principle, and on the wider issue. It ends by describing some outstanding questions (...) that thinking about this issue raises. (shrink)

Journal of Social Philosophy, EarlyView.

A novel solution is offered for how emotional experiences can function as sources of immediate prima facie justification for evaluative beliefs, and in such a way that suffices to halt a justificatory regress. Key to this solution is the recognition of two distinct kinds of emotional skill (what I call generative emotional skill and doxastic emotional skill) and how these must be working in tandem when emotional experience plays such a justificatory role. The paper has two main parts, the first (...) negative and the second positive. The negative part criticises the epistemic credentials of Epistemic Perceptualism (e.g., Tappolet 2012, 2016; Doring 2003, 2007; Elgin 2008; Roberts 2003), the view that emotional experience alone suffices to prima facie justify evaluative beliefs in a way that is analogous to how perceptual experience justifies our beliefs about the external world. The second part of the paper develops an account of emotional skill and uses this account to frame a revisionary form of Epistemic Perceptualism that succeeds where the traditional views could not. I conclude by considering some objections and replies. (shrink)

Mental health-care clinicians report that they hold patients responsible for morally objectionable behaviour but at the same time consider blaming attitudes to be inappropriate. These practices present a conundrum for all Strawsonian theories of responsibility. In response to this conundrum, Pickard has proposed severing the Strawsonian connection between being responsible and being an appropriate target of blaming attitudes. In this article I will argue that her solution fails to explain the practices at stake and provide an alternative solution that uncovers (...) an under-theorized stance we take towards those whose abilities are underdeveloped or compromised. (shrink)

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 (...) sense. Her account is based on what are considered best practices in the treatment of people with borderline personality disorder and addiction. We ask if this account generalizes across different diagnostic criteria and different clinical contexts. To begin to answer this question, we compare the clinical stance to an account of what are considered best practices in the treatment of service users at a specialized clinic for people with autism spectrum disorder in the Netherlands. We refer to this alternative account as the nurturing stance and highlight relevant similarities and differences between the clinical stance and the nurturing stance. We conclude with suggestions for further research and theorizing. (shrink)

What happens to our conception of mind and rational agency when we take seriously future-directed intentions and plans and their roles as inputs into further practical reasoning? The author's initial efforts in responding to this question resulted in a series of papers that he wrote during the early 1980s. In this book, Bratman develops further some of the main themes of these essays and also explores a variety of related ideas and issues. He develops a planning theory of intention. Intentions (...) are treated as elements of partial plans of action. These plans play basic roles in practical reasoning, roles that support the organization of our activities over time and socially. Bratman explores the impact of this approach on a wide range of issues, including the relation between intention and intentional action, and the distinction between intended and expected effects of what one intends. (shrink)

In autonomous action the agent herself directs and governs the action. But what is it for the agent herself to direct and to govern? One theme in a series of articles by Harry G. Frankfurt is that we can make progress in answering this question by appeal to higher-order conative attitudes. Frankfurt's original version of this idea is that in acting of one's own free will, one is not acting simply because one desires so to act. Rather, it is also (...) true that this desire motivates one's action because one desires that this desire motivate one's action. This latter desire about the motivational role of one's desire is a second-order desire. It is, in particular, what Frankfurt calls a second-order “volition.” And, according to Frankfurt's original proposal, acting of one's own free will involves in this way such second-order, and sometimes yet higher order, volitions. (shrink)

Delusions are defined as irrational beliefs that compromise good functioning. However, in the empirical literature, delusions have been found to have some psychological benefits. One proposal is that some delusions defuse negative emotions and protect one from low self-esteem by allowing motivational influences on belief formation. In this paper I focus on delusions that have been construed as playing a defensive function (motivated delusions) and argue that some of their psychological benefits can convert into epistemic ones. Notwithstanding their epistemic costs, (...) motivated delusions also have potential epistemic benefits for agents who have faced adversities, undergone physical or psychological trauma, or are subject to negative emotions and low self-esteem. To account for the epistemic status of motivated delusions, costly and beneficial at the same time, I introduce the notion of epistemic innocence. A delusion is epistemically innocent when adopting it delivers a significant epistemic benefit, and the benefit could not be attained if the delusion were not adopted. The analysis leads to a novel account of the status of delusions by inviting a reflection on the relationship between psychological and epistemic benefits. (shrink)

The main objective in this chapter is to examine the role of judgments of rationality in the current understanding of psychiatric disorders. To what extent are the criteria for classification and diagnosis independent of judgments of rationality? The typical symptoms of many psychiatric disorders are described as instances of epistemic, procedural, or emotional irrationality, and references to such forms of irrationality are frequently made in the current classificatory and diagnostic criteria for schizophrenia, dementia, depression, and personality disorders. That said, the (...) chapter defend the view that irrationality is neither necessary nor sufficient for a behavior to be characterized as symptomatic of a psychiatric disorder. (shrink)

Journal of Social Philosophy, EarlyView.

How can black feminist and women of color feminist theoretical interventions help create frameworks for discerning agentic action in the context of power, oppression, and violence? In this paper, I explore the social dimension of agency and argue that intention is not just authored by the agent as a function of practical reasoning, but is also socially authored through others' discernment and translation of her action. Further, when facilitated by reasoning designed to reinforce and rationalize systems of domination, social authoring (...) systematically distorts the intentions of some agents. Although some theorists have argued that those agents whose intentions are not recognized by others are forced to exercise a diminished agency, I contend that this account obscures agency that is practiced despite or through conditions of oppression. As an alternative, I propose that feminist of color theory that examines the structural and existential erasures of women of color maps a conceptual space to help us better discern agentic action that is practiced by those subjects whose acts are defined away from them. (shrink)

Abstract: If anger is the emotion of injustice, and if most injustices have prominent epistemic dimensions, then where is the anger in epistemic injustice? Despite the question my task is not to account for the lack of attention to anger in epistemic injustice discussions. Instead, I argue that a particular texture of transformative anger – a knowing resistant anger – offers marginalized knowers a powerful resource for countering epistemic injustice. I begin by making visible the anger that saturates the silences (...) that epistemic injustices repeatedly manufacture and explain the obvious: silencing practices produce angry experiences. I focus on tone policing and tone vigilance to illustrate the relationship between silencing and angry knowledge management. Next, I use María Lugones’s pluralist account of anger to bring out the epistemic dimensions of knowing resistant anger in a way that also calls attention to their histories and felt textures. The final section draws on feminist scholarship about the transformative power of angry knowledge to suggest how it might serve as a resource for resisting epistemic injustice. (shrink)

Are there limits to what it is morally okay to imagine? More particularly, is imaginatively inhabiting morally suspect perspectives something that is off-limits for truly virtuous people? In this paper, I investigate the surprisingly fraught relation between virtue and a familiar form of imaginative perspective taking I call empathy. I draw out a puzzle about the relation between empathy and virtuousness. First, I present an argument to the effect that empathy with vicious attitudes is not, in fact, something that the (...) fully virtuous person can indulge in. At least one prominent way of thinking about the psychology of the virtuous person excludes the possibility that the virtuous could emotionally apprehend the world in a less than virtuous way, and empathizing with vicious outlooks does seem to run afoul of that restriction. Then, I develop an argument that runs in the contrary direction: virtue in fact requires empathy with vicious outlooks, at least in some situations. There is reason to think that a crucial part of being virtuous is ministering effectively to others’ needs, and there is also reason to think that other people may need to be empathized with, even if their emotional outlooks are at least minorly vicious. Finally, I outline two different solutions to this puzzle. Both solutions hold some promise, but they also bring new challenges in their train. (shrink)

Empathy is a form of emotionally charged imaginative perspective‐taking. It is also the unique source of a particular form of understanding, which I will call humane understanding. Humane understanding consists in the direct apprehension of the intelligibility of others’ emotions. This apprehension is an epistemic good whose ethical significance is multifarious. In this paper, I focus on elaborating the sense in which humane understanding of others is non‐instrumentally valuable to its recipients. People have a complex but profound need to be (...) humanely understood. Because we respond to others’ very real need when we pursue this sort of understanding of their emotions, empathy is best understood as itself a way of caring, rather than just a means to promote other caring behavior. (shrink)

A central question of environmental ethics remains one of how best to account for the intuitions generated by the Last Man scenarios; that is, it is a question of how to explain our experience of value in nature and, more importantly, whether that experience is justified. Seeking an alternative to extrinsic views, according to which nonhuman entities possess normative features that obligate us, I turn to constitutive views, which make value or whatever other limits nonhuman nature places on action dependent (...) on features intrinsic to human beings and constitutive of them or their obligations. After examining two kinds of constitutive views—environmental virtue ethics and Korsgaard’s Kantianism—I suggest an alternative that takes up the strengths of both while avoiding their shortcomings. On this view, we have an indirect obligation to experience nature as obligating us, although we have direct obligations only to human beings. (shrink)

This is a welcome reprint of a book that continues to grow in importance.

Self-control is integral to successful human agency. Without it we cannot extend our agency across time and secure central social, moral, and personal goods. But self-control is not a unitary capacity. In the first part of this paper we provide a taxonomy of self-control and trace its connections to agency and the self. In part two, we turn our attention to the external conditions that support successful agency and the exercise of self-control. We argue that what we call moral security (...) is a critical foundation for agency. Parts three and four explore what happens to agency when moral security is lacking, as in the case of those subject to racism, and those living in poverty. The disadvantages suffered by those who are poor, in a racial minority or other oppressed group, or suffering mental illness or addiction, are often attributed to a lack of individual self-control or personal responsibility. In particular, members of these groups are often seen as irresponsibly focused on short-term pleasures over long-term good, a view underwritten by particular psychological theories of self-control. We explore how narratives about racism and poverty undermine moral security, and limit and distort the possibility of synchronic and diachronic self-control. Where moral security is undermined, the connection between self-control and diachronic goods often fails to obtain and agency contracts accordingly. We close with some preliminary reflections on the implications for responsibility. (shrink)

Games occupy a unique and valuable place in our lives. Game designers do not simply create worlds; they design temporary selves. Game designers set what our motivations are in the game and what our abilities will be. Thus: games are the art form of agency. By working in the artistic medium of agency, games can offer a distinctive aesthetic value. They support aesthetic experiences of deciding and doing. -/- And the fact that we play games shows something remarkable about us. (...) Our agency is more fluid than we might have thought. In playing a game, we take on temporary ends; we submerge ourselves temporarily in an alternate agency. Games turn out to be a vessel for communicating different modes of agency, for writing them down and storing them. Games create an archive of agencies. And playing games is how we familiarize ourselves with different modes of agency, which helps us develop our capacity to fluidly change our own style of agency. (shrink)

The illusory appeal of double effect -- The significance of intent -- Means and ends -- Blame.

Challenging many of the currently accepted conceptions of autonomy and of how it is valued, Oshana develops a social-relational account of autonomy that is constituted by a person's relations with others and by the absence of certain social relations. She denies that command over one's motives and the freedom to realize one's will are sufficient to secure the kind of command over one's life that autonomy requires, and argues against psychological, procedural, and content neutral accounts of autonomy.

Lisa Bortolotti argues that some irrational beliefs are epistemically innocent and deliver significant epistemic benefits that could not be easily attained otherwise. While the benefits of the irrational belief may not outweigh the costs, epistemic innocence helps to clarify the epistemic and psychological effects of irrational beliefs on agency.

Personal autonomy is often lauded as a key value in contemporary Western bioethics. Though the claim that there is an important relationship between autonomy and rationality is often treated as uncontroversial in this sphere, there is also considerable disagreement about how we should cash out the relationship. In particular, it is unclear whether a rationalist view of autonomy can be compatible with legal judgments that enshrine a patient's right to refuse medical treatment, regardless of whether the reasons underpinning the choice (...) are known and rational, or indeed whether they even exist. Jonathan Pugh brings recent philosophical work on the nature of rationality to bear on the question of how we should understand personal autonomy in contemporary bioethics. In doing so, he develops a new framework for thinking about the concept of autonomy, one that is grounded in an understanding of the different roles that rational beliefs and rational desires have to play in it. Pugh's account allows for a deeper understanding of d the relationship between our freedom to act and our capacity to decide autonomously. His rationalist perspective is contrasted with other prominent accounts of autonomy in bioethics, and the revisionary implications it has for practical questions in biomedicine are also outlined. (shrink)

Research suggests that the explicit reasoning we offer to ourselves and to others is often rationalization, that we act instead on instincts, inclinations, stereotypes, emotions, neurobiology, habits, reactions, evolutionary pressures, unexamined principles, or justifications other than the ones we think we’re acting on, then we tell a post hoc story to justify our actions. I consider two benefits of rationalization, once we realize that rationalization is sincere. It allows us to work out, under practical pressure of rational consistency, which are (...) good reasons to act on. Rationalization also prompts us to establish meaningful patterns out of merely permissible options. (shrink)

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 (...) in patients who cause harm to themselves and others. This framework can be used to interrogate our own attitudes and responses, so that we can better see how to acknowledge the truth about choice and agency in addiction, while avoiding stigma and blame, and instead maintaining care and compassion alongside a commitment to working for social justice and good. (shrink)

Self‐management is often presented as a panacea for chronic disease care. It plays an important role at the policy level and increasingly guides the delivery of health care services. Self‐management approaches to care are founded on traditional individualistic views of autonomy in which the patient is understood as being independent, rational, self‐interested, and self‐governing. This conceptualization of autonomy has been challenged, particularly by feminist scholars. In this paper I review predominant critiques of self‐management and the traditional individualistic view of autonomy. (...) I propose that a relational approach to autonomy, which is premised on social embeddedness and attends to social, political, and material conditions, is a more sound conception of autonomy capable of taking into consideration the complexities of illness experiences. I suggest that integrating a relational perspective of autonomy into self‐management will be valuable in guiding its progression and elaborate ways in which self‐management research and practice could benefit from incorporating a relational approach to autonomy. (shrink)

Self-trust is a necessary condition of personal autonomy and self-respect. Self-trust involves a positive sense of the motivations and competence of the trusted person; a willingness to depend on him or her; and an acceptance of vulnerability. It does not preclude trust in others. A person may be rightly said to have too much self-trust; however core self-trust is essential for functioning as an autonomous human being.

Much of the literature on impairment to self-governance focuses on cases in which a person either lacks the ability to protect herself from errant urges or cases in which a person lacks the capacity to initiate self-reflective agential processes. This has led to frameworks for thinking about self-governance designed with only the possibility of these sorts of impairments in mind. I challenge this orthodoxy using the case of melancholic depression to show that there is a third way that self-governance can (...) be undermined: an agent may fail to form the desire she most wants to act on. (shrink)

This paper argues that environmental virtue ethics requires the adoption of an ethical ideal in order to guide the identification and practice of virtues. I recommend friendship as one such ideal due to emphasis such an ideal places upon the quality of the relationship with nature rather than the evaluation of individual actions. After describing the value of friendship as an ethical ideal, I respond to some of the objections that have been raised against it in the context of environmental (...) virtue. (shrink)

In the era of information and communication, issues of misinformation and miscommunication are more pressing than ever. _Epistemic injustice - _one of the most important and ground-breaking subjects to have emerged in philosophy in recent years - refers to those forms of unfair treatment that relate to issues of knowledge, understanding, and participation in communicative practices. The Routledge Handbook of Epistemic Injustice is an outstanding reference source to the key topics, problems and debates in this exciting subject. The first collection (...) of its kind, it comprises over thirty chapters by a team of international contributors, divided into five parts: Core Concepts Liberatory Epistemologies and Axes of Oppression Schools of Thought and Subfields within Epistemology Socio-political, Ethical, and Psychological Dimensions of Knowing Case Studies of Epistemic Injustice. As well as fundamental topics such as testimonial and hermeneutic injustice and epistemic trust, the Handbook includes chapters on important issues such as social and virtue epistemology, objectivity and objectification, implicit bias, and gender and race. Also included are chapters on areas in applied ethics and philosophy, such as law, education, and healthcare. The Routledge Handbook of Epistemic Injustice is essential reading for students and researchers in ethics, epistemology, political philosophy, feminist theory, and philosophy of race. It will also be very useful for those in related fields, such as cultural studies, sociology, education and law. (shrink)

How should we make choices when we know so little about our futures? L. A. Paul argues that we must view life decisions as choices to make discoveries about the nature of experience. Her account of transformative experience holds that part of the value of living authentically is to experience our lives and preferences in whatever ways they evolve.

Since Mill's seminal work On Liberty, philosophers and political theorists have accepted that we should respect the decisions of individual agents when those decisions affect no one other than themselves. Indeed, to respect autonomy is often understood to be the chief way to bear witness to the intrinsic value of persons. In this book, Sarah Conly rejects the idea of autonomy as inviolable. Drawing on sources from behavioural economics and social psychology, she argues that we are so often irrational in (...) making our decisions that our autonomous choices often undercut the achievement of our own goals. Thus in many cases it would advance our goals more effectively if government were to prevent us from acting in accordance with our decisions. Her argument challenges widely held views of moral agency, democratic values and the public/private distinction, and will interest readers in ethics, political philosophy, political theory and philosophy of law. (shrink)

This book concerns the foundations and implications of a particular form of liberal political theory. Colburn argues that one should see liberalism as a political theory committed to the value of autonomy, understood as consisting in an agent deciding for oneself what is valuable and living life in accordance with that decision. Understanding liberalism this way offers solutions to various problems that beset liberal political theory, on various levels. On the theoretical level, Colburn claims that this position is the only (...) defensible theory of liberalism in current circulation, arguing that other more dominant theories are either self-contradictory or unattractive on closer inspection. And on the practical level, Colburn draws out the substantive commitments of this position in educational, economic, and social policy. Hence, the study provides a blueprint for a radical liberal political agenda which will be of interest to philosophers and to politicians alike. (shrink)

Understanding human beings and their distinctive rational and volitional capacities requires a clear account of such things as reasons, desires, emotions, and motives, and how they combine to produce and explain human behaviour. Maria Alvarez presents a fresh and incisive study of these concepts, centred on reasons and their role in human agency.

Linking the process of rational decision making to emotions, an award-winning scientist who has done extensive research with brain-damaged patients notes the dependence of thought processes on feelings and the body's survival-oriented regulators. 50,000 first printing.

Nomy Arpaly rejects the model of rationality used by most ethicists and action theorists. Both observation and psychology indicate that people act rationally without deliberation, and act irrationally with deliberation. By questioning the notion that our own minds are comprehensible to us--and therefore questioning much of the current work of action theorists and ethicists--Arpaly attempts to develop a more realistic conception of moral agency.