Louis C. Charland

(1958 - 2021)

The evolution of the internet and associated social media pose novel challenges for psychiatric ethics. Issues surrounding emotional contagion, personal identity, and misinformation figure importantly among these new challenges, with important consequences for consumers of mental health services, as well as psychiatrists and other mental health professionals. The evolution of the internet and associated social media pose novel challenges for psychiatric ethics. Issues surrounding emotional contagion, personal identity, and misinformation figure importantly among these new challenges, with important consequences for consumers of mental health services, as well as psychiatrists and other mental health professionals.

This essay results from a common interest in the history of emotions shared by an academic with appointments in philosophy and psychiatry (Charland) and a literary historian (White). Where our interests converge is in the early modern concept of 'the passions,' as explanatory of what we now call mental illness. The task we have set ourselves is to see how this might: (a) be exemplified in a 'case study' of the dramatic revelation of Leontes's jealousy in the first half of William Shakespeare's The Winter's Tale, and his 'cure' which takes sixteen years. Both events have troubled literary critics as implausible, lacking in realistic motivation, and clumsy as narrative devices, but can be explained in terms of theories of the passions ; and (b) open up a greater, modern understanding of irrational, pathological states, their onset and termination, by using as an explanatory model the early modern understanding of passions as revived and refined in the nineteenth century by Théodule Ribot. Janus-like, this chapter faces into the past and the future (our present) via a play written in 1610 that is still performed to receptive audiences today. We hope to show that the theory can illuminate a playtext, and that the play can revivify the theory, and to contend that historical analysis can shed light on modern clinical problems. The particular historical distinction which lies at the heart of our approach derives from early modern terminology offered by Thomas Wright in his book, The Passions of the Minde in Generall (first published in 1601; corrected, enlarged and augmented in 1604), and presented in more modern fashion in the nineteenth century by Théodule Ribot, in his La Psycholgie des sentiments * We dedicate this essay to Philippa Maddern, whose inspiration has generated so much inter-disciplinary research in the history of emotions and has brought so many like-minded scholars into fertile contact—in our cases, linking Western Ontario and Western Australia.

Mental competence, or decision‐making capacity, is an important concept in law, psychiatry, and bioethics. A major problem faced in the development and implementation of standards for assessing mental competence is the issue of objectivity. The problem is that objective standards are hard to formulate and apply. The aim here is to review the limited philosophical literature on the place of value in competence in an attempt to introduce the issues to a wider audience. The thesis that the assessment of competence must incorporate elements of value and rationality is defended, and some tentative suggestions offered about how this might be achieved in a clinical setting.

The York Retreat is famous in the histor y of nineteenth-centur y psychiatr y because of its association with moral treatment. Although there exists a substantial historical literature on the evolution of moral treatment at the Retreat, several interpretive problems continue to obscure its unique therapeutic legacy. The nature of moral treatment as practised at the Retreat will be clarified and discussed in a historical perspective. It will be argued that moral treatment at the Retreat was pr imar ily a matter of affective conditioning guided by `benevolent theory'.

Alexander Crichton (1763—1856) made significant contributions to the medical theory of the passions, yet there exists no systematic exegesis of this particular aspect of his work. The present article explores four themes in Crichton's work on the passions: (1) the role of irritability in the physiology of the passions; (2) the manner in which irritability and sensibility contribute to the valence, or polarity, of the passions; (3) the elaboration of a psychopathology of the passions that emphasizes their physiological form rather than meaningful content or connections; and (4) the insistence that medical science ought to ignore ethical and other `moral' psychological and social aspects of the passions.

Building on what he believed was a new ‘medico-philosophical’ method, Philippe Pinel made a bold theoretical attempt to find a place for the passions and other affective posits in psychopathology. However, his courageous attempt to steer affectivity onto the high seas of medical science ran aground on two great reefs that still threaten the scientific status of affectivity today. Epistemologically, there is the elusive nature of the signs and symptoms of affectivity. Ethically, there is the stubborn manner in which fact and value are intermingled in affectivity. Both obstacles posed insuperable difficulties for Pinel, who never really managed to extricate his affective psychopathology from the confines of the Lockean intellectual paradigm.

Purpose of review This review considers the literature on ethical and conceptual issues in eating disorders from the last 18 months. Some reference to earlier work is necessary in order to provide context for the recent findings from research that is ongoing. Recent findings Empirical ethics research on anorexia nervosa includes novel ethical and conceptual findings on the role of authenticity and personal identity in individuals’ reports of their experience, as well as new evidence on the role of affective states and values in decision making at later stages of the illness. Evidence points to the hypothesis that anorexia nervosa may be a distinct affective syndrome that organizes feelings and emotions in accordance with a fixed idea. Summary There has been impressive progress in empirical ethics research on anorexia nervosa, with important implications for ethical and conceptual issues that surround decision-making capacity and our understanding of the illness.

Locke is famous for defining madness as an intellectual disorder in the realm of ideas. Numerous commentators take this to be his main and only contribution to the history of psychiatry. However, a detailed exegetical review of all the relevant textual evidence suggests that this intellectualist interpretation of Locke’s account of madness is both misleading and incomplete. Affective states of various sorts play an important role in that account and are in fact primordial in the determination of human conduct generally. Locke’s legacy in this domain must therefore be revised and the intellectualist bias that dominates discussions of his views must be redressed.

Following a Canadian Supreme Court ruling invalidating an absolute prohibition on physician assisted dying, two reports and several commentators have recommended that the Canadian criminal law allow medical assistance in dying (MAID) for persons with a diagnosis of mental disorder. A key element in this process is that the person requesting MAID be deemed to have the ‘mental capacity’ or ‘mental competence’ to consent to that option. In this context, mental capacity and mental competence refer to ‘decision-making capacity’, which is a distinct area of clinical study and research in the theory of informed consent. The purpose of this discussion is to bring several controversial but insufficiently acknowledged problems associated with decision-making capacity to the forefront of the proposed extension of MAID to persons diagnosed with mental disorders. Open-ended access to MAID by persons who suffer from mental health conditions already exists in Belgium and the Netherlands, where the issues raised here are equally relevant. In this paper, we highlight the serious limitations of relying on capacity assessments to allow access to MAID/Euthanasia.

Philippe Pinel is widely regarded as one of the founders of modern evidence-based psychiatry. Yet, until recently, his most important contributions to psychiatric theory and practice were effectively lost in myth, or lost in translation. It is instructive to review the history of these developments in order to correct any errors or omissions that may stand in the way of an accurate recognition of Pinel’s contributions to psychiatry, while at the same time highlighting some of his achievements that have been hidden by his celebrated mythical status as a pioneering humanitarian reformer. The aim of this article is to motivate further historical study of Pinel’s work, especially his 1809 Medico-Philosophical Treatise on Mental Alienation, which has only recently become available in English translation.

The engine of reason, the seat of the soul: a philosophical journey into the brain, Paul M. Churchland. Cambridge: Bradford Books, MIT Press, 1995 ISBN: 0–262–03244–4Cognition in the wild, Edwin Hutchins. Cambridge, MA: MIT Press, 1995. ISBN: 0–262–08231–4Dimensions of creativity, Margaret A. Boden, (Ed.) Cambridge, MA: MIT Press, 1994 ISBN 0–262–02368–7Contemplating minds: a forum for Artificial Intelligence, William J. Clancey, Stephen W. Smoliar & Mark J. Stefik (Eds) Cambridge: Bradford Books, MIT Press, 1994 ISBN 0–262–53119–4Passion and reason: making sense of our emotions, Richard S. Lazarus & Bernice N. Lazarus. Oxford: Oxford University Press, 1994. ISBN 0–19–508757–7Mental reality, Galen Strawson. Cambridge, MA: MIT Press, 1994 ISBN 0–262–19352–3The body and the self, Jose Luis Bermudez, Anthony Marcel & Naomi Eilan (Eds) Cambridge, MA: MIT Press, 1995. ISBN 0–262–02386–5.

First ever English Translation of Philippe PInel's 2nd Medico-Philosophical Treatise on Mental Alienation. The founder of French psychiatry wrote Medico-Philosophical Treatise on Mental Alienation in 1800 and reworked it nine years later. This book is the "Entirely Reworked and Extensively Expanded" version from 1809. Today, it can give historians of medicine and psychiatrists an overview of mental illnesses as they were viewed in that era. The author, Philippe Pinel, became known as the doctor who worked to free the insane from chains.

There is a large amount of scientific work on emotion in psychology, neuroscience, biology, physiology, and psychiatry, which assumes that it is possible to study emotions and other affective states, objectively. Emotion science of this sort is concerned primarily with 'facts' and not 'values', with 'description' not 'prescription'. The assumption behind this vision of emotion science is that it is possible to distinguish factual from evaluative aspects of affectivity and emotion, and study one without the other. But what really is the basis for distinguishing fact and value in emotion and affectivity? And can the distinction withstand careful scientific and philosophical scrutiny? The essays in this collection all suggest that the problems behind this vision of emotion science may be more complex than is commonly supposed.

This case study in the history of “passion” and “emotion” is based on the writings of William James. James is famous for his (1884) theory of emotion. However, like his illustrious colleague, Théodule Ribot, he also recognized the importance of “passion” in psychology. That aspect of James’s work is underappreciated. Ribot explicitly defends the necessity of including “passion” in psychology. James does not go that far. But he does utilize a very similar concept in connection with the term “passion” and there can be little doubt he considered it scientifically legitimate. Consequently, like Ribot, James must be considered an exception to historical accounts of this period which describe a transition from “passion” to “emotion” in which “passion” plays no part.

There are reasons to believe that decision‐making capacity (mental competence) of women in labor may be compromised in relation to giving informed consent to epidural analgesia. Not only severe labor pain, but also stress, anxiety, and premedication of analgesics such as opioids, may influence women’s decisional capacity. Decision‐making capacity is a complex construct involving cognitive and emotional components which cannot be reduced to ‘understanding’ alone. A systematic literature search identified a total of 20 empirical studies focused on women’s decision‐making about epidural analgesia for labor pain. Our review of these studies suggests that empirical evidence to date is insufficient to determine whether women undergoing labor are capable of consenting to epidural analgesia. Given such uncertainties, sufficient information about pain management should be provided as part of prenatal education and the consent process must be carefully conducted to enhance women’s autonomy. To fill in the significant gap in clinical knowledge about laboring women’s decision‐making capacity, well‐designed prospective and retrospective studies may be required.

I very much enjoyed reading the interesting and original article by Steel and colleagues (2017). But I found myself strongly disagreeing with its conclusion once the real point of the argument became clear to me. At the same time, I believe that the authors are correct to draw attention to the importance of context and inequities in framing discussions of the ethics of voluntary consent in heroin prescription research. I begin with a brief summary of the authors’ conclusion, quoting directly and adding my own emphases, since there are major philosophical points I wish to make that hinge on nuances in wording...

What follows is a case study in the foundations of cognitive science. In it I explore the relation between the computational theory of mind and the theory of emotion. The argument of the thesis is that these two domains have much more to do with one another than has traditionally been supposed. The strategy adopted is to formulate a computational theory of emotion and then go on to extol its virtues. On the whole the aim of the project is to explore the possibility of interpreting information processing models of emotion computationally. The conclusion reached is that computational foundations for emotion theory are not only possible, but that in fact they provide a provocative perspective within which to reinterpret and focus a large amount of hitherto ossified and otherwise nomologically scattered results in emotion theory.

When emotions are mentioned in the literature on mental competence, it is generally because they are thought to influence competence negatively; that is, they are thought to impede or compromise the cognitive capacities that are taken to underlie competence. The purpose of the present discussion is to explore the possibility that emotions might play a more positive role in the determination of competence. Using the MacArthur Treatment Competence Study as an example, it is argued that appreciation, a central theoretical concept in many contemporary approaches to competence, has important emotive components that are seldom sufficiently recognized or acknowledged. If true, this means that some leading contemporary accounts of competence need to be revised in order to make more adequate provision for the positive contribution of emotion.

It has been argued recently that some basic emotions should be considered natural kinds. This is different from the question whether as a class emotions form a natural kind; that is, whether emotion is a natural kind. The consensus on that issue appears to be negative. I argue that this pessimism is unwarranted and that there are in fact good reasons for entertaining the hypothesis that emotion is a natural kind. I interpret this to mean that there exists a distinct natural class of organisms whose behavior and development are governed by emotion. These are emoters. Two arguments for the natural kind status of emotion are considered. Both converge on the existence of emotion as a distinct natural domain governed by its own laws and regularities. There are then some reasons for being optimistic about the prospects for consilience in emotion theory. 1 The mantra 2 Griffiths on emotions as natural kinds 3 Panksepp on emotions as natural kinds 4 Emotion as a neurobiological kind 5 Emotion as a psychological kind 6 Response to the mantra 7 Unification or fragmentation? 8 Concluding remarks.

In this paper I link two hitherto disconnected sets of results in the philosophy of emotions and explore their implications for the computational theory of mind. The argument of the paper is that, for just the same reasons that some computationalists have thought that cognition may be a natural kind, so the same can plausibly be argued of emotion. The core of the argument is that emotions are a representation-governed phenomenon and that the explanation of how they figure in behaviour must as such be undertaken in those terms. I conclude with some interdisciplinary reflections in defence of the hypothesis that emotions might be more fundamental in the organization of behaviour than cognition; that, in effect, we may be emoters before we are cognizers. The aim of the paper is: (1) to introduce a number of promising results in philosophical and empirical emotion theory to a wider audience; and (2) to begin the task of organizing those results into a computational theoretical framework.

Psychiatric labeling has been the subject of considerable ethical debate. Much of it has centered on issues associated with the application of psychiatric labels. In comparison, far less attention has been paid to issues associated with the removal of psychiatric labels. Ethical problems of this last sort tend to revolve around identity. Many sufferers are reticent to relinquish their iatrogenic identity in the face of official label change; some actively resist it. New forms of this resistance are taking place in the private chat rooms and virtual communities of the Internet, a domain where consumer autonomy reigns supreme. Medical sociology, psychiatry, and bioethics have paid little attention to these developments. Yet these new consumer-driven initiatives actually pose considerable risks to consumers. They also present complex ethical challenges for researchers. Clinically, there is even sufficient evidence to wonder whether the Internet may be the nesting ground for a new kind of identity disturbance. The purpose of the present discussion is to survey these developments and identify potential issues and problems for future research. Taken as a whole, the entire episode suggests that we may have reached a turning point in the history of psychiatry where consumer autonomy and the Internet are now powerful new forces in the manufacture of madness.