Quality of will accounts of moral responsibility hold that ill will is necessary for blameworthiness. But all such accounts are false to ordinary moral practice, which licenses blame for agents who act wrongly from epistemically unreasonable ignorance even if the act is not ill willed. This should be especially concerning to Strawsonians about moral responsibility, who think the genuine conditions of blameworthiness are derived from the standards internal to our practice. In response, I provide a theory of moral (...) blameworthiness on which ill will is not necessary for blameworthiness. On the view I defend, “Rational Capacitarianism,” agents are blameworthy whenever they act wrongly from an unreasonable attitude which is attributable to them, where an attitude is attributable to an agent just in case she has the capacity to assess reasons for and against the attitude and modulate the attitude in light of these assessments. Acting from unreasonable ignorance is just a special case of acting from an unreasonable attitude. My theory contrasts both with both quality of will accounts of blameworthiness and the Capacitarian view, which specifies that agents who act wrongly from ignorance are culpable if they could and should have known better. On Capacitarianism, a variety of awareness-relevant capacities are pertinent, including memory; on my view it is only failures of rational capacities that render the agent culpable, because only failures of rational capacities are attributable to the agent. (shrink)

As a contribution to a wider discussion on moral discernment in theological anthropology, this paper seeks to answer the question “What is the impact of mental illness on an individual’s ability to make moral decisions?” Written from a clinical psychiatric perspective, it considers recent contributions from psychology, neuropsychology and imaging technology. It notes that the popular conception that mental illness necessarily robs an individual of moral responsibility is largely unfounded. Most people who suffer from mental health problems do not lose (...) the capacity to make moral decisions, and mental illness on its own rarely explains anti-social or criminal behaviour. Moreover, the assumptions of some scientists, that recent developments in neuropsychology and brain imaging suggest biological determinism, must be treated with caution. (shrink)

One bi-lingual - hungarian-ENGLISH - meditation and research about the Illness and the Living Being. Concentrated, of course, to the specific HUMAN reporting to them. The book investigates philosophically the issue of human illness and its organic pertinence to the meaning of human life starting from the recognition that the dangerous encounter with the experience of illness is an unavoidable – and as such crucial – experience of the life of any living being. As for us humans, there is probably (...) no mortal man who has never suffered of some – any! – kind of disease from his birth to the end of his life… Illness is therefore an experience or outright a danger of existence and its possibility, as well as a way of being that nobody has ever been and will ever be ontological or existentially exempted from. So, it may well be “arbitrary” or “accidental” which disease affects which being or person, when and to what degree, in what way, etc., but it is factually unavoidable that in the course of one’s entire life – from its very beginning to its very end – one would never fall ill in some respect. The paper discusses this issue by the ontological investigation of possibility. Together with the analyses about of the origins and history of the MEDICINE. -/- The english CONTENTS -/- Illness – A Possibility of the Living Being Prolegomena to the Philosophy of Human Illness ............................................. 127 -/- Excursus Sketchy considerations regarding the problems of Christian medicine and Christian healing ...................................................... 135 -/- A dialogue-attempt with Aristotle: Dynamis, energeia, entelecheia, and steresis ...................................................... 147 . (shrink)

In her book, Illness as Metaphor, Susan Sontag focuses on metaphors and myths on diseases such as cancer and tuberculosis, which occur in different historical periods. Sontag argues that the metaphors produced related to illness overhaul illness and the things that define illness now have become metaphors produced related to them rather than their concrete and physical aspects. Illness becomes not just an illness, but a phenomenon defined by evil, mystery, fear, evil, madness, passions, wealth and poverty, temporal loginess or (...) speed, and a set of metaphors or myths that are spatially identified with the space. Metaphors and myths turn into means of socially stigmatizing the illness itself rather than giving a meaning to illness. The disease literally turns into a situation that needs to be hidden in order to avoid social stigma. The explanation of mass diseases through metaphors and myths has been seen since ancient times and this understanding of mass diseases continues to exist today. As a matter of fact, the Covid-19 pandemic has also ceased to be the subject of only medical science since it first emerged, and it has turned into an issue that concerns many areas from politics to economics, from sociology to psychology. The metaphors generated on the Covid-19 disease, which we have witnessed its reflections in many areas from the discourses of daily life to the discourse of politicians, from art to literature, have a similar function with the metaphors attributed to diseases like cancer and tuberculosis that Sontag discussed. Covid-19 is not only seen as a disease, but as a disease defined by a series of metaphors such as mysterious, evil, invisible enemy, insidious danger, and democratic virus. The metaphors generated on the disease cause the struggle against the disease itself to be explained with various metaphors. The metaphors derived from Covid-19 such as "invisible enemy" and "biological war" cause the struggle against it to be turned into a military terminology, and the metaphor of "Chinese virus" is a means of social stigmatization / marginalization by racializing the virus directly. This study tackles the issue of how Covid-19, which is the subject of medical science, has become the subject of unscientific myths and metaphors attributed to the disease, and that the disease is perceived through metaphors rather than itself in the context of Susan Sontag's thought. In the study, answers for the questions of what kind of effects appeared due to the stigmatizing power of metaphors derived from the Covid-19 and whether the metaphors are the outcomes of the strategy for coping with the pandemic will be sought. (shrink)

Exemption from blameworthiness is often bound to implicit or explicit claims of diminished agency, or even non-agency. This poses a dilemma in navigating moral relationships affected by mental illness. While it is crucial for assessments of responsibility to be responsive to the significance of mental illness, must this responsiveness come at a cost to symmetrical moral relations? In this paper we argue, contra recent critiques, that Strawsonian accounts of responsibility are able to navigate this dilemma, and can accommodate significant exculpation (...) on the basis of mental illness while maintaining symmetrical relations. We understand this to be part of the larger recognition that while we have certain fundamental entitlements within our moral relationships, it is also possible to be over-entitled, and to expect too much of others. Our account draws, in particular, on the moral significance of difficulty. Difficulty is inherently scalar, and in drawing on this explanatory framework we explicate a theory of both excuse and exemption by degree. We argue for a significant realm of excuse on the basis of mental illness that is fully compatible with symmetrical relations. However, we also acknowledge the limits of this accommodation on Strawsonian grounds, and argue that these limits are justified and appropriate. (shrink)

Personal recovery entails the idea of learning to live a good life in the face of mental illness. It takes place in a continuous dynamic between change and acceptance and involves the existential dimension in the broadest sense. With cognitive self-regulation and empowerment as central elements, however, current models of recovery mostly have an individual focus instead of a relational one. Furthermore, there seems to be an emphasis on the component of change. Little attention is payed to the role and (...) integration of dealing with loss in personal recovery. In this paper, the role of loss in mental illness will be elaborated from an existential perspective. This will be done by relating existential changes to possibly disruptive experiences of loss in wider experience. With the help of several perspectives on dealing with loss it will be argued this can be integrated in processes of recovery. Then, it will be elaborated how reexperiencing a state of being surrounded, or being included, being held is a necessary part of recovery. The result consists of a refinement of the view on personal recovery. The aim of this paper is therefore twofold: (1) to arrive at a better understanding of what existential loss and loss in wider experience in the context of psychopathology entails, and (2) to further develop perspectives on recovery in mental health care. (shrink)

Patients with serious illnesses or injuries may decide to quit their medical treatment if they think paying the fees will put their families into destitution. Without treatment, it is likely that fatal outcomes will soon follow. We call this phenomenon “near-suicide”. This study attempted to explore this phenomenon by examining how the seriousness of the patient’s illness or injury and the subjective evaluation of the patient’s and family’s financial situation after paying treatment fees affect the final decision on (...) the treatment process. Bayesian Mindsponge Framework (BMF) analytics were employed to analyze a dataset of 1042 Vietnamese patients. We found that the more serious the illnesses or injuries of patients were, the more likely they were to choose to quit treatment if they perceived that paying the treatment fees heavily affected their families’ financial status. Particularly, only one in four patients with the most serious health issues who thought that continuing the treatment would push themselves and their families into destitution would decide to continue the treatment. Considering the information-filtering mechanism using subjective cost–benefit judgments, these patients likely chose the financial well-being and future of their family members over their individual suffering and inevitable death. Our study also demonstrates that mindsponge-based reasoning and BMF analytics can be effective in designing and processing health data for studying extreme psychosocial phenomena. Moreover, we suggest that policymakers implement and adjust their policies (e.g., health insurance) following scientific evidence to mitigate patients’ likelihood of making “near-suicide” decisions and improve social equality in the healthcare system. (shrink)

Does having a mental disorder, in general, affect whether someone is morally responsible for an action? Many people seem to think so, holding that mental disorders nearly always mitigate responsibility. Against this Naïve view, we argue for a Nuanced account. The problem is not just that different theories of responsibility yield different verdicts about particular cases. Even when all reasonable theories agree about what's relevant to responsibility, the ways mental illness can affect behavior are so varied that a more nuanced (...) approach is needed. (shrink)

Patients with serious illnesses or injuries may decide to quit their medical treatment if they think paying the fees will put their families into destitution. Without treatment, it is likely that fatal outcomes will soon follow. We call this phenomenon “near-suicide”. This study attempted to explore this phenomenon by examining how the seriousness of the patient’s illness or injury and the subjective evaluation of the patient’s and family’s financial situation after paying treatment fees affect the final decision on (...) the treatment process. Bayesian Mindsponge Framework (BMF) analytics were employed to analyze a dataset of 1042 Vietnamese patients. We found that the more serious the illnesses or injuries of patients were, the more likely they were to choose to quit treatment if they perceived that paying the treatment fees heavily affected their families’ financial status. Particularly, only one in four patients with the most serious health issues who thought that continuing the treatment would push themselves and their families into destitution would decide to continue the treatment. Considering the information-filtering mechanism using subjective cost–benefit judgments, these patients likely chose the financial well-being and future of their family members over their individual suffering and inevitable death. Our study also demonstrates that mindsponge-based reasoning and BMF analytics can be effective in designing and processing health data for studying extreme psychosocial phenomena. Moreover, we suggest that policymakers implement and adjust their policies (e.g., health insurance) following scientific evidence to mitigate patients’ likelihood of making “near-suicide” decisions and improve social equality in the healthcare system. (shrink)

The caution of diagnosing someone with Suicide Behavior Disorder derives from the fact that in some scenarios, suicide can still be deemed a “rational” choice and expression of free will rather than a disease. For example, euthanasia, suicide attacks, people with mental illness but being able to take into account the weight of the illness, etc. There exists a blurry line between the considerations of suicide as a choice or an illness. Perhaps, whether it is an illness or a (...) choice is largely dependent on the context and targeted subject. It is not hard to see whether (or when) this very delimitation works is very much cultural by its nature. (shrink)

This article considers attempts to include the issues of ageing and ill health in a Rawlsian framework. It first considers Norman Daniels’ Prudential Lifespan Account, which reduces intergenerational questions to issues of intrapersonal prudence from behind a Rawslian veil of ignorance. This approach faces several problems of idealisation, including those raised by Hugh Lazenby, because it must assume that everyone will live to the same age, undermining its status as a prudential calculation. I then assess Lazenby's account, which applies (...) Rawls’ general theory of justice more directly to healthcare. Lazenby suggests that we should apply Rawls’ difference principle – which claims that any inequalities in social goods must benefit the worst off – to conclude that we should significantly prioritise treatment of young patients. I argue first that the existence of young terminally ill patients undermines a number of Rawlsian arguments for the difference principle. I then argue that the structure of ageing undermines the Rawlsian decision mechanism of the ‘veil of ignorance’ on which Lazenby relies. I conclude that age and terminal illness present significant problems for any comprehensive Rawlsian account of justice. (shrink)

The prominent philosopher Bernard Williams (1985) opened his Ethics and the Limits of Philosophy with: “It is not a trivial question, Socrates said: what we are talking about is how one should live” (p. 1) and asked whether Socrates’ question is the proper starting point for moral philosophy. In this paper, I will explore an effect of a very specific life event: a “cliff-edge” retirement. I will look at the concept of ground projects and show how cliff-edge retirements (...) create ill-shaped projects reflecting the loss of important workplace benefits such as purposeful work and social collaborations. This type of retirement prematurely closes the ground project before its natural conclusion. I will argue that attempts to recover it will likely prove difficult, inauthentic and will not remedy the project’s wrongful shape. (shrink)

Philosophical tradition has long held that free will is necessary for moral responsibility. We report experimental results that show that the folk do not think free will is necessary for moral responsibility. Our results also suggest that experimental investigation of the relationship is ill served by a focus on incompatibilism versus compatibilism. We propose an alternative framework for empirical moral psychology in which judgments of free will and moral responsibility can vary independently in response to many factors. (...) We also suggest that, in response to some factors, the necessity relation may run from responsibility to free will. (shrink)

I argue that a powers-based metaphysics radically reconfigures the existing free will problematic. This is different from claiming that such an approach solves the ill-conceived problems that emerge from Humean-Kantian default commitments.

Abstract: The study investigates philosophically the issue of human illness and its organic pertinence to the meaning of human life starting from the recognition that the dangerous encounter with the experience of illness is an unavoidable – and as such crucial – experience of the life of any living being. As for us humans, there is probably no mortal man who has never suffered of some – any! – kind of disease from his birth to the end of his life… (...) Illness is therefore an experience or outright a danger of existence and its possibility, as well as a way of being that nobody has ever been and will ever be ontologically or existentially exempted from. So, it may well be “arbitrary” or “accidental” which disease affects which being or person, when and to what degree, in what way, etc., but it is factually unavoidable that in the course of one’s entire life – from its very beginning to its very end – one would never fall ill in some respect. The paper discusses this issue by the ontological investigation of possibility. (shrink)

The assumption that procuring more organs will save more lives has inspired increasingly forceful calls to increase organ procurement. This project, in contrast, directly questions the premise that more organ transplantation means more lives saved. Its argument begins with the fact that resources are limited and medical procedures have opportunity costs. Because many other lifesaving interventions are more cost‐effective than transplantation and compete with transplantation for a limited budget, spending on organ transplantation consumes resources that could have been used (...) to save a greater number of other lives. This argument has not yet been advanced in debates over expanded procurement and could buttress existing concerns about expanded procurement. To support this argument, I review existing empirical data on the cost‐effectiveness of transplantation and compare them to data on interventions for other illnesses. These data should motivate utilitarians and others whose primary goal is maximizing population‐wide health benefits to doubt the merits of expanding organ procurement. I then consider two major objections: one makes the case that transplant candidates have a special claim to medical resources, and the other challenges the use of cost‐effectiveness to set priorities. I argue that there is no reason to conclude that transplant candidates’ medical interests should receive special priority, and that giving some consideration to cost‐effectiveness in priority setting requires neither sweeping changes to overall health priorities nor the adoption of any specific, controversial metric for assessing cost‐effectiveness. Before searching for more organs, we should first ensure the provision of cost‐effective care. (shrink)

My dissertation brings into conversation two thinkers who are seldom considered together and highlights previously unnoticed similarities in their critical responses to scientism, which was just as prevalent in the late nineteenth century as it is today. I analyze this attitude as consisting of two linked propositions. The first, which Nietzsche calls “the unconditional will to truth,” is that the aims of science, discovering truth and avoiding error, are the most important human aims; and the second is that no (...) practice other than science can achieve them. Both Nietzsche and James criticize the unconditional will to truth for privileging a transcendent ideal over the demands of human life. This unconditional will regards truth as valuable in itself and demands that we pursue it under all circumstances—even if that demand comes into conflict with other values. I lay out the ways in which Nietzsche and James view the value of truth and the imperative to pursue it as conditional on its promotion of human flourishing. In response to the second proposition of scientism, both philosophers argue that science can neither tell us what we should value, nor fully account for the value we in fact find in certain objects, activities, and experiences. And crucially, science cannot tell us whether or why its own goal of attaining truth is valuable. Nietzsche and James reach different conclusions about what is ultimately valuable, and whether traditional religious belief is defensible in light of the discoveries of science. Nonetheless, the hitherto unappreciated similarities I have uncovered in their arguments show that principled opposition to scientism need not be associated with any particular moral or religious viewpoint. This analysis is not only of historical interest: those who consider scientism to be ill-founded and intellectually confining can take some cues from our nineteenth-century predecessors’ strategies for combating it. (shrink)

How should addictive behavior be explained? In terms of neurobiological illness and compulsion, or as a choice made freely, even rationally, in the face of harmful social or psychological circumstances? Some of the disagreement between proponents of the prevailing medical models and choice models in the science of addiction centres on the notion of “loss of control” as a normative characterization of addiction. In this article I examine two of the standard interpretations of loss of control in addiction, one according (...) to which addicts have lost free will, the other according to which their will is weak. I argue that both interpretations are mistaken and propose therefore an alternative based on a dual-process approach. This alternative neither rules out a capacity in addicts to rationally choose to engage in drug-oriented behavior, nor the possibility that addictive behavior can be compulsive and depend upon harmful changes in their brains caused by the regular use of drugs. (shrink)

This paper raises a slightly uncomfortable question: are some delusional subjects responsible for their delusions? This question is uncomfortable because we typically think that the answer is pretty clearly just ‘no’. However, we also accept that self-deception is paradigmatically intentional behavior for which the self-deceiver is prima facie blameworthy. Thus, if there is overlap between self-deception and delusion, this will put pressure on our initial answer. This paper argues that there is indeed such overlap by offering a novel philosophical (...) account of self-deception. The account offered is independently plausible and avoids the main problems that plague other views. It also yields the result that some delusional subjects are self-deceived. The conclusion is not, however, that those subjects are blameworthy. Rather, a distinction is made between blameworthiness and ‘attributability’. States or actions can be significantly attributable to a subject—in the sense that they are expressions of their wills—without it being the case that the subject is blameworthy, if the subject has an appropriate excuse. Understanding delusions within this framework of responsibility and excuses not only illuminates the ways in which the processes of delusional belief formation and maintenance are continuous with ‘ordinary’ processes of belief formation and maintenance, it also provides a way of understanding the innocence of the delusional subject that does not involve the denial of agency. (shrink)

Open Access: Social media participation undermines individual autonomy in ways that ought to concern ethicists. Discussions in the philosophical literature are concerned primarily with egregious conduct online such as harassment and shaming, keeping the focus on obvious ills to which no one could consent; this prevents a wider understanding of the risks and harms of quotidian social media participation. Two particular concerns occupy me: social media participation carries the risks of (1) negatively formative experiences and (2) continuous partial attention due (...) to our habituation to the variable rewards that social media platforms provide. Although social media offer benefits as well as risks, self-knowledge of whether one benefits more than one suffers from one’s social media participation is vexed by the very processes involved in participating. We are not as free to leave social media as we are to enter. I conclude with a consideration and rejection of the objections that the ubiquity of the practice indicates implied consent to risks, and that users of social media can simply choose not to use such communication technologies at all. I argue that we cannot be said to consent to enter into social media usage meaningfully, even implicitly, and we do not all have equally easy options to avoid the contexts that provide the stimuli of persistent desires. (shrink)

We care not only about how people treat us, but also what they believe of us. If I believe that you’re a bad tipper given your race, I’ve wronged you. But, what if you are a bad tipper? It is commonly argued that the way racist beliefs wrong is that the racist believer either misrepresents reality, organizes facts in a misleading way that distorts the truth, or engages in fallacious reasoning. In this paper, I present a case that challenges this (...) orthodoxy: the case of the supposedly rational racist. We live in a world that has been, and continues to be, structured by racist attitudes and institutions. As a result, the evidence might be stacked in favour of racist beliefs. But, if there are racist beliefs that reflect reality and are rationally justified, what could be wrong with them? Moreover, how do I wrong you by believing what I epistemically ought believe given the evidence? To address this challenge, we must recognize that there are not only epistemic norms governing belief, but moral ones as well. This view, however, is at odds with the assumption that moral obligation requires a kind of voluntary control that we lack with regard to our beliefs. This background assumption motivates many philosophers to try to explain away the appearance that beliefs can wrong by locating the wrong elsewhere, e.g., in an agent’s actions. Further, even accounts that accept the thesis that racist beliefs can wrong restrict the class of beliefs that wrong to beliefs that are either false or the result of hot irrationality, e.g., the racist belief is a result of ill-will. In this paper I argue that although the these accounts will capture many of the wrongs associated with racist beliefs, they will be only partial explanations because they cannot explain the wrong committed by the supposedly rational racist. The challenge posed by the supposedly rational racist concerns our epistemic practices in a non-ideal world. The world is an unjust place, and there may be many morally objectionable beliefs it justifies. To address this challenge, we must seriously consider the thesis people wrong others in virtue of what they believe about them, and not just in virtue of what they do. (shrink)

This paper argues for a new understanding of Strawson’s distinction between personal, impersonal, and self-reactive attitudes. Many Strawsonians take these basic reactive attitude types to be distinguished by two factors. Is it the self or another who is treated with good- or ill-will? And is it the self or another who displays good- or ill-will? On this picture, when someone else wrongs me, my reactive attitude is personal; when someone else wrongs someone else, my reactive attitude is impersonal; (...) and when I wrong someone else, my attitude is self-reactive. Against this account, I argue that the basic reactive attitude types are better distinguished according to whether they express partial or impartial concern. This fits Strawson’s discussion in “Freedom and Resentment”, and it allows us to see an important point that the alternative approach obscures. Namely, while attitudes like resentment, gratitude, shame, and pride can arise as responses to our own treatment and behavior, they can also arise as third-party responses to the treatment and behavior of our family members, romantic partners, and close friends. Similarly, attitudes like moral indignation and disapprobation also have a wider scope than is often acknowledged; they can arise as responses to others’ treatment, but they can also arise as responses to our own treatment when we react impartially to circumstances involving ourselves. (shrink)

Our culture is conflicted about morally judging and condemning. We can't avoid it altogether, yet many layfolk today are loathe to do it for reasons neither they nor philosophers well understand. Their resistance is often confused (by themselves and by theorists) with some species of antiobjectivism. But unlike a nonobjectivist, most people think that (a) for us to judge and condemn is generally (objectively) morally wrong , yet (b) for God to do so is (objectively) proper, and (c) so too (...) for certain persons in certain relations (e.g., self-condemnation, parental child rearing.) Certainly, religious (e.g., Christian) critics of judging and condemning without doubting the objective truth of their tradition's core moral teachings. Most puzzling is that (a) merely judging and condemning in one's heart may be improper, and (b) someone else with no more evidence or expertise might properly judge and condemn the same action. The answer is in condemning's complex structure of presuppostions. Condemning and judging are acts, and attitudes initiated by the act. Condemnation is motivated by two judgments presumed to justify it, a criticism of a target, and a judgment that the criticism justifies some negative response toward the target. Unlike nonpunitive penalties, punishments are motivated and explained by condemnation. Condemnation is an act of a hostile will, wishing some evil for its target, not (just) as a means to some good. Its root is in damning, an act akin to cursing. It declares a degraded status. The hostility makes it harder to justify condemnation than criticism, and punishment than nonpunitive penalties. Condemning claims objectivity and authority. It involves reflexive evaluation, regarding itself justified, approving its hostile feelings toward the target. Condemners presume themselves entitled to sit in judgment, pass judgment, and cast the condemned down. Those presumptions inhere in sitting in judgment, assuming jurisdiction. Unlike mathematical or scientific judgments, passing moral judgment seems to be a political act subject to extraepistemic constraints. "Who are you to judge?" may properly challenge your right to pass judgment. (shrink)

It is axiomatic for most African scholars that the colonizers are responsible for the present problems facing the African continent. This is given much credence by Maduabuchi Dukor citing a barrage of issues which in summary pointed to the fact that the legacy of the colonizers to the African continent was ill willed to create chaos and therefore to make the African perpetually dependent on the colonizers. This paper accepts this fact but insists that the African as a human being (...) with free will and responsibility cannot continue to blame the colonizers when he has choice either to reject the colonial predetermined events or to accept them taking responsibility for his actions. (shrink)

The most common approach to the problem of requests for futile treatment – the hospital futility policy – rests on the assumption that demands for futile treatment are both intractable and irrational. But there is another approach to the futility problem, an approach that would be dialogic, piecemeal, and case-by-case. This is the only approach that attempts to deal with both the hospital’s problem and the patient’s or family’s problem that motivates the request/demand for futile treatments. As such, it holds (...) the promise of resolving the problem of demands for futile treatment in a way that does not generate anger and ill will at the hospital staff for what will inevitably strike patients and their families as a blatant assertion of the hospital’s power. (shrink)

G.E.M. Anscombe famously remarked that an adequate philosophy of psychology was needed before we could do ethics. Fifty years have passed, and we should now ask what significance our best theories of the psychology of agency have for moral philosophy. My focus is on non-moral conceptions of autonomy and self-governance that emphasize the limits of deliberation -- the way in which one's cares render certain options unthinkable, one's intentions and policies filter out what is inconsistent with them, and one's resolutions (...) function to block further reflection. I argue that we can expect this deliberative "silencing" to lead to moral failures that occur because the morally correct option was filtered out of the agent's deliberation. I think it follows from these conceptions of self-governance that we should be considered culpable for unwitting acts and omissions, even if they express no ill will, moral indifference, or blameworthy evaluative judgments. The question is whether this consequence is acceptable. Either way, the potential tradeoff between self-governance and moral attentiveness is a source of doubt about recent attempts to ground the normativity of rationality in our concern for self-governance. (shrink)

We praise people for morally good things: giving to charity, being generous, having compassion for the needy. We blame for morally bad things: cheating on one’s spouse, being selfish, harboring ill will towards others. What are praise and blame, though? When are they appropriate? This essay reviews influential answers to these questions.

In a world where meat is often a token of comfort, health, hospitality, and abundance, one can be forgiven for raising an eyebrow at the conjunction “meat and evil.” Why pull meat into the orbit of harm, pestilence, ill-will, and privation? From another perspective, the answer is obvious: meat—the flesh of slaughtered animals taken for food—is the remnant of a feeling creature who was recently alive and whose death was premature, violent, and often gratuitous. The truth is that meat (...) has a checkered history in the West. From its origin-story in Abrahamic religion to its industrial production in today’s world, meat is well-marbled with evil and its minions: sin, violence, injustice, destruction, suffering, and death. Beyond keeping company with these obtrusive forms of evil, meat’s success at remaining, nevertheless, in our collective good graces illuminates some of evil’s subtler shades too. We might learn something of insidiousness, self-deception, rationalization, and bad faith by exploring why the ever-strengthening consensus that habitual meat-eating is unhealthful, morally dubious, and environmentally damaging is often still no match for a philosopher’s savor of cheeseburgers. My aim is to consider meat’s fitness for a place in the Western history of evil by reflecting briefly on its outsized roles at the bookends of this narrative: meat’s primeval history in Genesis, and its contribution today to ethical and environmental problems of arguably apocalyptic proportions. (shrink)

From antiquity to date, communal clashes, inter tribal even to global crisis of war is antecedented by penetration of ill-will, unfair sharing formula of human and natural resources by a privileged few resulting in high social, economic and political acrimony hence, the growing calls to reframe the politics of poverty reduction and social protection in particular, in terms of extending the ‘social contract’ to the poorest groups as people are getting increasingly aware of injustice. This premise is on the (...) widening gap between the rich and poor on daily bases. With the increase of awareness, knowledge, technology and the advent of post-modernist era, the quest for social justice has heightened. Even communism and democracy attempt to offer social justice to its natives. Communism states that humans are free to engage in any kind of occupation and express ourselves freely without government interference, unlike the alienated labour society of the capitalist industry: this for communism is social Justice, while democracy thinks equality before law and power to its natives is social justice. All through the era of Philosophy, Philosophers differ on the definition, and what constitute social justice. Until now, there is no unifying explanation on what social justice is and consists of. This paper tends to look into the history of social Justice and different philosophers from different epochs. It also tried to expose the problems inherent in the definition and what constitute social justice, and cautioned that complimentary imperative should be employ to curtail human egoistic tendency that aids social injustice. (shrink)

While there is a vast philosophical literature exploring the conditions under which it is appropriate to hold individuals morally responsible for their actions, relatively little attention has been paid to the related question of which kinds of individuals merit these responsibility ascriptions. Under normal circumstances, typical adult human beings are held morally responsible for their behaviour but infants and nonhuman animals are not. In this thesis, I aim to account for this difference. That is, I aim to give an analysis (...) of the concept of moral agency. In Chapter One, I begin with a schema of moral agency, under which moral agents are characterised by the possession of certain abilities, enabling certain actions, for which certain responses are warranted. The literature on moral responsibility offers many ways of filling in these details, primarily by specifying the relevant agential abilities in terms of various responsibility conditions. My aim in this chapter is to offer a basic account, under which moral agents are characterised by the simplest possible abilities while still being appropriate targets of the relevant responses, such as praise and blame. I draw on the work of Nomy Arpaly, whose account of moral responsibility identifies the relevant ability as the ability to act out of good or ill will. I offer an analysis of this ability, under which basic moral agency is characterised by the ability to have desires about others’ mental states. In Chapter Two, I consider a range of alternative responsibility conditions offered by other philosophers, each of which appears to be necessary for moral agency. I argue that these conditions are not necessary for a basic account of moral agency. In Chapter Three, I move beyond basic moral agency to offer a more restrictive account that aims to capture other important aspects of our moral lives: the practice of justification and our ability to improve our moral character. I claim these aspects are underpinned by the use of moral reasons to guide our behaviour, and in contrast to moral motivation, this guidance is characterised by the ability to have beliefs about the desirability of actions. In Chapter Four, I aim to answer two questions: at what age do humans become moral agents, and are there any nonhuman animals who are moral agents. I draw on the work of Josef Perner, who offers a three-stage framework of the development of mental representation during childhood. I consider the conceptual coherence of this framework, its applicability to both accounts of moral agency developed in the thesis, and the empirical evidence that bears on the framework. As a result, I tentatively conclude that basic moral agency develops at around 18 months of age and may be present in a few species of nonhuman animal, whereas the more restrictive type of moral agency developed in Chapter Three develops no earlier than around 3.5 years of age and is restricted to human beings. (shrink)

The main message of Neuroethics is that neuroscience forces us to reconceptualize human agency as marvelously diverse and flexible. Free will can arise from unconscious brain processes. Individuals with mental disorders, including addiction and psychopathy, exhibit more agency than is often recognized. Brain interventions should be embraced with cautious optimism. Our moral intuitions, which arise from entangled reason and emotion, can generally be trusted. Nevertheless, we can and should safely enhance our brain chemistry, partly because motivated reasoning crops up (...) in everyday life and in the practice of neuroscience itself. Despite serious limitations, brain science can be useful in the courtroom and marketplace. Recognizing all this nuance leaves little room for anxious alarmism or overhype and urges an emphasis on neurodiversity. The result is a highly opinionated tour of neuroethics as an exciting field full of implications for philosophy, science, medicine, law, and public policy. (shrink)

The Philosophy of Psychiatry is a unique area of research because the nature of the subject matter leads to quite distinct methodological issues. Naturalism, Interpretation, and Mental Disorder is an original new work focusing on the challenges we face when trying to interpret and understand mental illness. The book integrates a hermeneutical perspective, and shows how such an approach can reveal important facts about historical sources in psychiatry and the nature of dialogue in the therapeutic encounter. In addition, the book (...) demonstrates how such an approach can be valuable for understanding the concept of mental disorder itself. Naturalism, Interpretation, and Mental Disorder brings fresh thinking to the philosophy of psychiatry, and will be of interest to students and scholars in the fields of Mental Health and Philosophy. (shrink)

The Protagoras is the touchstone of Socrates’ moral intellectualist stance. The position in a nutshell stipulates that the proper reevaluation of a desire is enough to neutralize it.[1] The implication of this position is that akrasia or weakness of will is not the result of desire (or fear for that matter) overpowering reason but is due to ignorance. -/- Socrates’ eliminativist position on weakness of will, however, flies in the face of the common-sense experience regarding akratic action and (...) thus Aristotle was at pains to render Socrates’ account of moral incontinence intelligible. The key improvement Aristotle makes to Socrates’s model is to underscore that the conditioning of the akratic’s body plays a critical role in determining the power of one’s appetites and, accordingly, the capacity of one to resist the temptations these appetites present for rational evaluation. As Aristotle puts it, “For the incontinent man is like the people who get drunk quickly and on little wine, i.e., on less than most people.” (1151a 3-4). Aristotle presents what I shall call a somatic paradigm (i.e. the drunkard analogy) in order to tackle the problem of akrasia and it is this somatic solution that marks a significant improvement over Socrates’s intellectualist or informational model or so the tradition tells us. -/- In this paper, I wish to push back on the above Aristotelian explanation. I argue that when one fully examines Socrates’ account of weakness of will that Aristotle’s solution is less effective than is traditionally thought. In fact, Socrates can bring Aristotle’s model into his own; just as Aristotle absorbs what is right about Socrates’s model, namely, that akratic action utilizes reason but to a limited degree, Socrates in Meno (77C-78A) develops his own somatic model of weakness of will that connects to the intellectualist paradigm of the Protagoras. To achieve this rapprochement between the two models, I zero in on the description provided by Socrates of those individuals who desire bad things knowing they are bad as “ill-starred” or “bad spirited” (κακοδαίμων ). The “bad-spirited” is the coward and, in contrast to Aristotle’s drunkard, becomes fearful quickly from little danger. This additional somatic component, when connected to Socrates’s position on akrasia in Protagoras adds a new twist to Socrates’s model in the following way: while no one wishes to be ill-starred such that more harm than good will befall one, one may become so as a result of the bad choices one knowingly makes. -/- -/- [1] “After him came Socrates, who spoke better and further about this subject, but even he was not successful. For he used to make the virtues into sciences, and this is impossible. For the sciences all involve reason, and reason is to be found in the intellectual part of the soul. So that all the virtues, according to him arise in the rational part of the soul. The result is that in making the virtues into sciences he is doing away with the nonrational part of the soul and is thereby doing away with passion and character…” (Aristotle, Magna Moralia 1.1. 1182 a15-26). (shrink)

When terminally ill patients have had enough suffering they often turn to euthanasia. The Assisted suicide is still unethical and illegal in most countries. As of now it is practiced in the Netherlands but still considered illegal. The few that still use euthanasia have to go through a certain legal route. Often patients have had enough and find it easier to take matter into their own hands or in this case let the doctors help in assisting with ending their life. (...) There are many different reasons why it is bad to euthanize patients and by writing this article I will explain a few of those reasons. My report will help understand why euthanasia is still illegal in most countries. Using euthanasia is unethical for physicians and goes against the oath they took to protect and do no harm to patients and no matter under what circumstances it is still illegal. Euthanasia is an unnatural way to end life. Using Euthanasia to end one patients life is still considered murder and unethical. (shrink)

Martin Luther King Jr. claimed that “the salvation of the world lies in the hands of the maladjusted”. I elaborate on King’s claim by focusing on the way in which we treat and understand ‘maladjustment’ that is responsive to severe trauma (e.g. PTSD that is a result of military combat or rape). Mental healthcare and our social attitudes about mental illness and disorder will prevent us from recognizing real injustice that symptoms of mental illness can be appropriately responding to, (...) unless we recognize that many emotional states (and not just beliefs!) that constitute those symptoms are warranted by the circumstances they are responsive to. I argue that there is a failure to distinguish between PTSD symptoms that are warranted emotional responses to trauma and those that are not. This results in us focusing our attention on “fixing” the agent internally, but not on fixing the world. It is only by centering questions of warrant that we will be able to understand and expose the relationship between agents’ internal mental states and their oppression. But we also need to ask when someone’s emotional response is unwarranted by their experience (as in the case of someone who develops PTSD after a non-traumatic event). If we fail to do this—as, I claim, both our mental healthcare and the broader social world fail to do—we treat warranted and unwarranted emotions as on a par. This undermines the epistemic judgment of the agent who has warranted PTSD symptoms, resulting in her failing to trust her evaluation of whether her emotional response to her own trauma is warranted by that trauma, and thus failing to recognize her own oppression. (shrink)

Testimony about the future dangerousness of a person has become a central staple of many judicial processes. In settings such as bail, sentencing, and parole decisions, in rulings about the civil confinement of the mentally ill, and in custody decisions in a context of domestic violence, the assessment of a person’s propensity towards physical or sexual violence is regarded as a deciding factor. These assessments can be based on two forms of expert testimony: actuarial or clinical. The purpose of this (...) paper is to examine the scientific and epistemological basis of both methods of prediction or risk assessment. My analysis will reveal that this kind of expert testimony is scientifically baseless. The problems I will discuss will generate a dilemma for factfinders: on the one hand, given the weak predictive abilities of the branches of science involved, they should not admit expert clinical or actuarial testimony as evidence; on the other hand, there is a very strong tradition and a vast jurisprudence that supports the continued use of this kind of expert testimony. It is a clear case of the not so uncommon conflict between science and legal tradition. (shrink)

I argue for two propositions. First, contrary to the common wisdom, we may justly punish individuals who are not morally responsible for their crimes. Psychopaths – individuals who lack the capacity to feel sympathy – help to prove this point. Scholars are increasingly arguing that psychopaths are not morally responsible for their behavior because they suffer from a neurological disorder that makes it impossible for them to understand, and therefore be motivated by, moral reasons. These same scholars then infer from (...) this conclusion that they must also lack criminal responsibility and therefore that our continuing to punish psychopaths for their crimes is unjust. My response is that this inference is entirely fallacious. -/- Criminal responsibility turns out to be quite distinct from moral responsibility. The two kinds of responsibility require very different conditions to be satisfied. In particular, criminal responsibility, unlike moral responsibility, does not require an agent be able to grasp and follow moral reasons; it requires only that the individual be able to grasp and follow criminal laws. Once this point is recognized, it becomes much easier to accept my thesis: while the subset of psychopaths who commit crimes are not morally responsible for their criminal behavior because they cannot understand moral reasons, they are still criminally responsible because they can understand what the consequences will be if they get caught. For this reason, even though I concede that psychopaths are not morally responsible for the crimes that they commit, our practice of punishing them for these crimes is still just. -/- Second, I argue that psychopathy is a mental illness and should be recognized as such. One reason that it should be recognized as a mental illness is simply because it is; it satisfies the main criteria for inclusion in the DSM-IV, the “bible” of mental disorders. The other reason is more practical than conceptual. It starts with two facts: the U.S. Supreme Court has decided that the preventive detention of any individual who is not a criminal suspect is not constitutional unless the individual is not only dangerous but also mentally ill; and psychopathy is not currently considered to be a mental illness. So, as things now stand, we cannot preventively commit dangerous psychopaths – that is, psychopaths who have clearly indicated that they will be committing serious crimes. Instead, we must wait for them to commit the crimes before we can lock them up. Unfortunately, this incarceration always comes too late for the victims. It would therefore be better if we could lock them up before they actually inflict any harm. Once again, then, I propose that the legal and psychological communities classify psychopathy as a mental illness. (shrink)

Saigle, Dubljevic, and Racine (2018) claim that Libet-style experiments are insufficient to challenge that agents have free will. They support this with evidence from experimen- tal psychology that the folk concept of freedom is consis- tent with monism, that our minds are identical to our brains. However, recent literature suggests that evidence from experimental psychology is less than determinate in this regard, and that folk intuitions are too unrefined as to provide guidance on metaphysical issues like monism. In light (...) of this, it is worthwhile to examine the authors’ insuf- ficiency claim under the assumption that monism is false and dualism true (our minds are not identical to our brains). We conclude that, were dualism true, then Libet- style experiments would tell us no more about freedom and moral responsibility than what the authors initially claimed, thus further bolstering their point that Libet-style experiments are ill-suited to speak to the free will of agents. In what follows we first discuss some of the reasons to be skeptical of using folk intuitions to make claims about the nature of freedom and moral responsibility. We then draw from the work of E. J. Lowe to demonstrate that Libet-style experiments would likely give the same results regardless of the truth of monism or dualism. (shrink)

Introduction: The incidence of chronic low back pain (LBP) is very high in Bangladesh. There is a high prevalence of psychiatric diseases among chronic low back pain patients. But primary care physicians and specialists do not screen this association. The aims of this study were to evaluate the incidence and pattern of psychiatric diseases in chronic low back pain patients. Materials and methods: A prospective cross-sectional hospital-based study of 135 chronic low back pain patients using simple, direct, standardized questionnaire including (...) history and detailed psychiatric evaluation by a consultant psychiatrist from January to December 2014. Results: A total 69 chronic low back pain patients (51.1%) were diagnosed with psychiatric problems. Predominant group were female (65.9%), above 40 years of age (60.7%). Depression (44.9 %) and anxiety (31.9%) were the major psychiatric illness diagnosed (76.8%). Only 17.4 % patients expects complete cure. Fear of disease outcome was the commonest precipitating factor found (66.6%). With the adjuvant psychiatric management, 81.1% showed improvement clinically. Conclusion: Detecting the level of psychiatric illness among chronic low back pain patients at early stage will improve the treatment outcome. A referral system to psychiatrists by physicians needs to develop to screen the mental disorder symptoms to treat the problem. (shrink)

Digital phenotyping will potentially enable earlier detection and prediction of mental illness by monitoring human interaction with and through digital devices. Notwithstanding its promises, it is certain that a person’s digital phenotype will at times be at odds with their first-person testimony of their psychological states. In this paper, we argue that there are features of digital phenotyping in the context of psychiatry which have the potential to exacerbate the tendency to dismiss patients’ testimony and treatment preferences, which (...) can be instances of epistemic injustice. We first explain what epistemic injustice is, and why it is argued to be an extensive problem in health and disability settings. We then explain why epistemic injustice is more likely to apply with even greater force in psychiatric contexts, and especially where digital phenotyping may be involved. Finally, we offer some tentative suggestions of how epistemic injustice can be minimised in digital psychiatry. (shrink)

The antipsychiatrists in the 1960's, specifically Thomas Szasz, have claimed that mental illness does not exist. This argument was based on a specific definition of physical disease that, Szasz argued, could not be applied to mental illness. Thus, by problematizing mental illness, the spotlight had turned to physical disease. Since then, philosophers of medicine have proposed definitions applying both to pathophysiological and psychopathological conditions. This paper analyzes prominent naturalist definitions which aim to provide value-free accounts of pathological conditions, as well (...) as normative accounts that propose value-laden accounts. The approaches surveyed differ not only in terms of value, but also in terms of their perspective. This perspective concerns whether the concept of health, illness or disease/disorder is emphasized. The emphasis on health or illness is holistic as it looks at the human being as a whole, while focus on disease or disorder is analytic as it considers part functions. I will here argue in favor of holism and will propose a definition of mental health based on Sartre's existential psychoanalysis of Gustave Flaubert. (shrink)

The history of psychiatry does not inspire confidence, even among psychiatrists, and there has always been a cottage industry in medicine and psychology that wrestles with various conceptual problems around mental illness. It’s arguable that philosophers of science have not paid enough attention to this literature. Even if you aren’t interested in psychiatry, you might profit from the debates in psychometrics on the measurement of mental constructs, or look at the arguments over causation, reduction, and explanation that psychiatrists fight out (...) among themselves, increasingly with some philosophical input. Kenneth Kendler is a major contributor to this literature as theorist, experimentalist, and (via his role in the DSM) institution-builder and gatekeeper. He stands out too for his willingness to engage and learn from philosophy; and also to teach, for many of us can vouch to learning a lot about psychiatry from Kendler’s willingness to collaborate with philosophers and integrate the two communities. So it is a great pleasure to have a selection of Kendler’s papers assembled in one place. The essays in this volume cover a variety of conceptual issues in psychiatry, together with some historical material looking at the recent development of biomedical psychiatry. The most notable historical piece is the chapter on the origins of the Fechner criteria for validation of diagnoses, which had an enormous impact on the development of biological psychiatry in the 1970s. This collection covers many issues, and we won’t try to discuss everything, instead opting for one or two main issues that we think philosophers of science will be especially interested in. But there is something here for almost everyone in philosophy of science, and we urge them to look at this volume even if psychiatry is not on their normal reading list. (shrink)

Emerging reprogenetic technologies may radically change how humans reproduce in the not-so-distant future. One foreseeable consequence of disruptive innovations in the procreative domain is an increase in the reproductive autonomy of intended parents. Regarding the prospective parental liberty of enhancing non-health–related traits of the offspring, one controversy has particularly dominated the literature. Does parents' choice of genetically enhancing the traits of their descendants compromise children's future personal autonomy? In this article, I will analyse the main arguments which posit that (...) reprogenetic enhancement could be at odds with the child's future autonomy. I will argue that these objections are ill-founded. Moreover, I will present other arguments that show that reprogenetic technologies can enhance the autonomy of future children. Autonomy enhancement is a plausible and pro tanto desirable application of emerging reprogenetic technologies. (shrink)

Contra the dominant readings, Hieronymi—refusing to sideline concerns of metaphysics for the impasse of normativity—argues that the core of Strawson's argument in "Freedom and Resentment" rests on an implicit and overlooked metaphysics of morals grounded in social naturalism, focusing her discussion on Strawson's conception of objective attitudes. The objective attitude deals with exemption, rather than excuse. This distinction is critical to Strawson's picture of responsibility: In addition to our personal reactive attitudes are their impersonal or vicarious analogues. There are two (...) such cases: first, cases where we suspend or modify reactive attitudes due to error about the quality of the will. In these cases of excuse, we might include an actor who we learn was innocently ignorant, or whose behavior was an accident, and so we see that he or she really meant no harm. Consequently, we exculpate the injury in question. In cases of excuse, we are mistaken about the quality of the actor's will and, thus, our reactive attitude changes, but the moral demands stay. However, one might view other people as equipped with mental attributes and as people about whom one is disposed not to indulge in with those reactive attitudes of resentment, approbation, and so on; this involves viewing others objectively. We encounter these scenarios in the case of small children, people suffering from dementia, or those with forms of other serious mental illness. This second category involves exemption: Rather than reacting with the corresponding reactive attitudes, we view those actors—who lack the capacities required to fit into the usual system tolerably well—objectively, thereby exempting them from the usual demands of ordinary interpersonal relating. (shrink)

Background: Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home. Depression affects an estimated one in 15 adults (6.7%) in any given (...) year. And one in six people (16.6%) will experience depression at some time in their life. Depression can strike at any time, but on average, first appears during the late teens to mid-20s. Women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime. Objectives: The main goal of this expert system is to get the appropriate diagnosis of disease and the correct treatment and give the appropriate method of treatment through several tips that concern the disease and how to treat it and we will see it through the application on the expert system. Methods: in this paper the design of the proposed Expert System which was produced to help Psychologist in diagnosing depression disease through its symptoms such as: a loss of energy, a change in appetite, sleeping more or less, anxiety, reduced concentration, indecisiveness, restlessness, feelings of worthlessness, guilt or hopelessness and thoughts of self-harm or suicide. The proposed expert system presents an overview about depression disease is given, the cause of diseases is outlined and the treatment of disease whenever possible is given out. SL5 Object Expert System language was used for designing and implementing the proposed expert system. Results: The proposed depression disease diagnosis expert system was evaluated by psychologist students and they were satisfied with its performance. Conclusions: The Proposed expert system is very useful for psychologist, patients with depression and newly graduated psychologist. (shrink)

Aggregative moral theories face a series of devastating problems when we apply them in a physically realistic setting. According to current physics, our universe is likely _infinitely large_, and will contain infinitely many morally valuable events. But standard aggregative theories are ill-equipped to compare outcomes containing infinite total value so, applied in a realistic setting, they cannot compare any outcomes a real-world agent must ever choose between. This problem has been discussed extensively, and non-standard aggregative theories proposed to overcome (...) it. This paper addresses a further problem of similar severity. Physics tells us that, in our universe, how remotely in time an event occurs is _relative_. But our most promising aggregative theories, designed to compare outcomes containing infinitely many valuable events, are sensitive to how remote in time those events are. As I show, the evaluations of those theories are then relative too. But this is absurd; evaluations of outcomes must be absolute. So we must reject such theories. Is this objection fatal for all aggregative theories, at least in a relativistic universe like ours? I demonstrate here that, by further modifying these theories to fit with the physics, we can overcome it. (shrink)

Children are routinely treated paternalistically. There are good reasons for this. Children are quite vulnerable. They are ill-equipped to meet their most basic needs, due, in part, to deficiencies in practical and theoretical reasoning and in executing their wishes. Children’s motivations and perceptions are often not congruent with their best interests. Consequently, raising children involves facilitating their best interests synchronically and diachronically. In practice, this requires caregivers to (in some sense) manage a child’s daily life. If apposite, this management (...) class='Hi'>will focus partly on a child’s well-being. To be ably executed, an account of children’s well-being will need to be articulated. This chapter focuses on the nature of children’s well-being. It has five sections. The first section clarifies the focus. The second section examines some hurdles to articulating a view of children’s well-being. The third section evaluates some accounts of children’s well-being. The fourth section addresses the view that children possess features essential to them that make their lives on balance prudentially bad for them. The fifth section sums things up. (shrink)

Just as sadness is not always a symptom of mood disorder, irrational beliefs are not always symptoms of illness. Pathological irrational beliefs are distinguished from non-pathological ones by considering whether their existence is best explained by assuming some underlying dysfunctions. The features from which to infer the pathological nature of irrational beliefs are: un-understandability of their progression; uniqueness; coexistence with other psycho-physiological disturbances and/or concurrent decreased levels of functioning; bizarreness of content; preceding organic diseases known to be associated with irrational (...) beliefs; treatment response to medical intervention, etc. Severe irrationality is sometimes caused by normal human motivation rather than by mental or physical dysfunction. Pure forms of self-deception may satisfy the diagnostic criteria of delusional disorder, but there may be no evidence that suggests that they are caused by illness. Although those with pathological delusions do not recognize their delusions as symptomatic of illness, differentiating pathological beliefs from normal irrational beliefs is vitally important: If a belief is pathological, psychiatrists must seriously consider treating the patient against her will. If it is not pathological, conversely, involuntary treatments are prohibited because they offend her basic autonomy. (shrink)

1. Animal Cruelty Industrial farming is appallingly abusive to animals. Pigs. In America, nine-tenths of pregnant sows live in “gestation crates. ” These pens are so small that the animals can barely move. When the sows are first crated, they may flail around, in an attempt to get out. But soon they give up. Crated pigs often show signs of depression: they engage meaningless, repetitive behavior, like chewing the air or biting the bars of the stall. The sows live like (...) this for four months. Gestation crates will be phased out in Europe by the end of 2012, but they will still be used in America.1 In nature, pigs nurse their young for about thirteen weeks. But in industrial farms, piglets are taken from their mothers after about ten days. Because the piglets are weaned prematurely, they develop a lifelong craving to suck and chew. But the farmers don’t want them sucking and chewing on other pigs’ tails. So the growers routinely snip off the tails of all their pigs. They do this with a pair of pliers and no anesthetic. However, the whole tail is not removed; a tender stump remains. The point is to render the area sensitive, so the pigs being chewed on will fight back. Which they do.2 Over 113 million pigs are slaughtered each year in America.3 Typically, these pigs are castrated, their needle teeth are clipped, and one of their ears is notched for identification —all without pain relief.4 In nature, pigs spend up to three quarters of their waking hours foraging and exploring their environment.5 But in the factory farms, “tens of thousands of hogs spend their entire lives ignorant of earth or straw or sunshine, crowded together beneath a metal roof standing on metal slats suspended over a septic tank. ”6 Bored, and in constant pain, the pigs must perpetually inhale the fumes of their own waste. These pigs often get sick, and their ill health is exacerbated by the overcrowding. In 2000, the U.S. Department of Agriculture compared hog farms containing over 10,000 pigs—which is the norm—with farms containing under 2,000 pigs. (shrink)

Much disease and disability is the result of lifestyle behaviours. For example, the contribution of imprudence in the form of smoking, poor diet, sedentary lifestyle, and drug and alcohol abuse to ill-health is now well established. More importantly, some of the greatest challenges facing humanity as a whole – climate change, terrorism, global poverty, depletion of resources, abuse of children, overpopulation – are the result of human behaviour. In this chapter, we will explore the possibility of using advances in (...) the cognitive sciences to develop strategies to intentionally manipulate human motivation and behaviour. While our arguments apply also to improving prudential motivation and behaviour in relation to health, we will focus on the more controversial instance: the deliberate targeted use of biomedicine to improve moral motivation and behaviour. We do this because the challenge of improving human morality is arguably the most important issue facing humankind (Persson and Savulescu, forthcoming). We will ask whether using the knowledge from the biological and cognitive sciences to influence motivation and behaviour erodes autonomy and, if so, whether this makes it wrong. (shrink)