Lisa Bortolotti

In this chapter, our focus is the role played by notions of rationality in the diagnosis of mental disorders, and in the practice of overriding patient autonomy in psychiatry. We describe and evaluate different hypotheses concerning the relationship between rationality and diagnosis, raising questions about what features underpin psychiatric categories. These questions reinforce widely held concerns about the use of diagnosis as a justification for overriding autonomy, which have motivated a shift to mental incapacity as an alternative justification. However, this approach too has recently been criticized from a mental disability rights perspective. Our analysis of the relationship between mental capacity and rationality is used to illuminate these concerns, and to investigate further the relationship between rationality and psychiatric diagnosis.

Does conscious reflection lead to good decision-making? Whereas engaging in reflection is traditionally thought to be the best way to make wise choices, recent psychological evidence undermines the role of reflection in lay and expert judgement. The literature suggests that thinking about reasons does not improve the choices people make, and that experts do not engage in reflection, but base their judgements on intuition, often shaped by extensive previous experience. Can we square the traditional accounts of wisdom with the results of these empirical studies? Should we even attempt to? I shall defend the view that philosophy and cognitive sciences genuinely interact in tackling questions such as whether reflection leads to making wise choices.

We talk about irrationality when behaviour defies explanation or prediction, when decisions are driven by emotions or instinct rather than by reflection, when reasoning fails to conform to basic principles of logic and probability, and when beliefs lack coherence or empirical support. Depending on the context, agents exhibiting irrational behaviour may be described as foolish, ignorant, unwise or even insane. In this clear and engaging introduction to current debates on irrationality, Lisa Bortolotti presents the many facets of the concept and offers an original account of the importance of judgements of irrationality as value judgements. The book examines the standards against which we measure human behaviour, and reviews the often serious implications of judgements of irrationality for ethics and policy. Bortolotti argues that we should adopt a more critical stance towards accepted standards of rationality in the light of the often surprising outcomes of philosophical inquiry and cognitive science research into decision making. Irrationality is an accessible guide to the concept and will be essential reading for students and scholars interested in the limitations of human cognition and human agency.

Delusions are a common symptom of schizophrenia and dementia. Though most English dictionaries define a delusion as a false opinion or belief, there is currently a lively debate about whether delusions are really beliefs and indeed, whether they are even irrational. The book is an interdisciplinary exploration of the nature of delusions. It brings together the psychological literature on the aetiology and the behavioural manifestations of delusions, and the philosophical literature on belief ascription and rationality. The thesis of the book is that delusions are continuous with ordinary beliefs, a thesis that could have important theoretical and practical implications for psychiatric classification and the clinical treatment of subjects with delusions. By bringing together recent work in philosophy of mind, cognitive psychology and psychiatry, the book offers a comprehensive review of the philosophical issues raised by the psychology of normal and abnormal cognition, defends the doxastic conception of delusions, and develops a theory about the role of judgements of rationality and of attributions of self-knowledge in belief ascription. Presenting a highly original analysis of the debate on the nature of delusions, this book will interest philosophers of mind, epistemologists, philosophers of science, cognitive scientists, psychiatrists, and mental health professionals.

In this paper we analyse the degree to which a distinction between social science and public health research and other non-research activities can account for differences between a number of large scale social surveys performed at the national and European level. The differences we will focus on are differences in how participation is elicited and how data are used for government, research and other purposes. We will argue that the research / non-research distinction does not account for the identified differences in recruitment or use and that there are no other convincing justifications. We argue that this entails that eliciting participation by coercion or manipulation becomes very difficult to justify.

There is an apparent tension in current accounts of the relationship between reason giving and self knowledge. On the one hand, philosophers like Richard Moran (2001) claim that deliberation and justification can give rise to first-person authority over the attitudes that subjects form or defend on the basis of what they take to be their best reasons. On the other hand, the psychological evidence on the introspection effects and the literature on elusive reasons suggest that engaging in explicit deliberation or justification leads subjects to report attitudes that are not consistent with their previous attitudes or with their future behavior. On the basis of these findings, Tim Wilson (2002) argues that analyzing reasons compromises self knowledge. I shall defend a realistic account of the effects of reason giving which is compatible with the empirical findings on introspection and also with the claim that deliberation and justification have epistemic benefits.

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.