Lisa Bortolotti

This paper argues for psychological realism in the conception of psychiatric disorders. We review the following contemporary ways of understanding the future of psychiatry: (1) psychiatric classification cannot be successfully reduced to neurobiology, and thus psychiatric disorders should not be conceived of as biological kinds; (2) psychiatric classification can be successfully reduced to neurobiology, and thus psychiatric disorders should be conceived of as biological kinds. Position (1) can lead either to instrumentalism or to eliminativism about psychiatry, depending on whether psychiatric classification is regarded as useful. Position (2), which is inspired by the growing interest in neuroscience within scientific psychiatry, leads to biological realism or essentialism. In this paper we endorse a different realist position, which we label psychological realism. Psychiatric disorders are identified and addressed on the basis of their psychological manifestations which are often described as violations of epistemic, moral or social norms. A couple of examples are proposed by reference to the pathological aspects of delusions, and the factors contributing to their formation.

Contemporary philosophers and bioethicists argue that life extension is bad for the individual. According to the agency objection to life extension, being constrained as an agent adds to the meaningfulness of human life. Life extension removes constraints, and thus it deprives life of meaning. In the paper, I concede that constrained agency contributes to the meaningfulness of human life, but reject the agency objection to life extension in its current form. Even in an extended life, decision-making remains constrained, and many obstacles to the fulfilment of an agent’s goals are preserved. Agents with longer lives are also presented with new challenges: for instance, it might be harder for them to avoid chronic boredom, and sustain their motivation to act in the pursuit of their goals. Although objections from agency and boredom are often used in combination to support the view that a much longer life is likely to bring misery or become meaningless, I argue that the acceptance of the boredom objection undermines the persuasiveness of the agency objection.