Jeanette Kennett

In this paper we look at two kinds of relations that give rise to reasons for action of a distinctive sort: friendship and erotic love. We argue that what is common to these different relations of affection is that the people in them exhibit dispositions toward mutual direction by one another and interpretation of one another (in a sense that we describe in detail below). This mutual responsiveness is, in part, a matter of responding to reasons that arise from the relation of love or friendship. These reasons are frequently distinct from – and may be opposed to – normative reasons arising from prudence or even morality. Yet reasons of love are normative: they too may obligate us. They may make demands on us that conflict with our present desires and require considerable sacrifice.

In the study reported in their rich article, Brandenburg and Strijbos investigate the attitudes of clinicians, in a facility for adults with autism, to norm transgressions by service users. In doing so they interrogate Hanna Pickard’s responsibility without blame approach to therapy and ask whether it applies across different clinical settings.Pickard draws a distinction between responsibility for an action in the sense of being the agent of the action and so, by definition, having some control over it, and moral responsibility for an action which includes being blameworthy for it. For Pickard, you can be responsible for a harmful action without being morally responsible and therefore blameworthy. You might...

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

:The spread of demands by physicians and allied health professionals for accommodation of their private ethical, usually religiously based, objections to providing care of a particular type, or to a particular class of persons, suggests the need for a re-evaluation of conscientious objection in healthcare and how it should be regulated. I argue on Kantian grounds that respect for conscience and protection of freedom of conscience is consistent with fairly stringent limitations and regulations governing refusal of service in healthcare settings. Respect for conscience does not entail that refusal of service should be cost free to the objector. I suggest that conscientious objection in medicine should be conceptualized and treated analogously to civil disobedience.

What is required of the interpreter of disordered minds and what can we learn from the process? Jonathan Glover's book focuses on human interpretation and its role in psychiatry. His hope is that a more careful and sensitive exploration of minds that are very different from our own, will assist us to answer a range of important questions about human agency, identity and responsibility. In this commentary I will focus on the process and purpose of interpretation and expand on some of the moral issues that arise out of the interpretive challenges posed by mental disorders.

In this chapter we focus on the structure of close personal relations and diagnose how these relationships are disrupted by addiction. We draw upon Peter Strawson’s landmark paper ‘Freedom and Resentment’ (2008, first published 1962) to argue that loved ones of those with addiction veer between, (1) reactive attitudes of blame and resentment generated by disappointed expectations of goodwill and reciprocity, and (2) the detached objective stance from which the addicted person is seen as less blameworthy but also as less fit for ordinary interpersonal relationships. We examine how these responses, in turn, shape the addicted person’s view of themselves, their character and their capacities, and provide a negative narrative trajectory that impedes recovery. We close with a consideration of how these effects might be mitigated by adopting less demanding variations of the participant stance.

In this chapter we draw comparisons between Kass’ views on the normative authority of repugnance and social intuitionist accounts of moral judgement which are similarly sceptical about the role of reasoned reflection in moral judgement. We survey the empirical claims made in support of giving moral primacy to intuitions generated by emotions such as repugnance, as well as some common objections. We then examine accounts which integrate intuition and reflection, and argue that plausible accounts of wisdom are in tension with Kass’ claim that our inarticulable emotional responses can be the expression of deep wisdom. We conclude that while repugnance and other emotions have a role to play in informing deliberation and judgement, we have reason to be cautious in giving them normative authority. Affective responses alone cannot discharge the burden of justification for moral judgement and are just one tool relied upon by those we consider wise.

In this chapter I argue that there is a normative aspect to self-control that is not captured by the purely procedural account to be drawn from dual process theories of cognition – which we only uncover when we consider what self-control is for and why it is valuable. For at least a significant sub-group of addicts their loss of control over their drug use may not be due to a lack or depletion of cognitive resources. Rather it may be that they have little confidence in their ability to exert control over their circumstances and shape the life they would value having and the person they would value being.

Mary Walker (2012) argues that the narrative form that self-understanding must take is capable of providing a largely truthful picture of who we are, despite neuropsychological evidence suggesting the contrary. Walker describes three approaches to counter the conclusion of falsity in self narratives: that some truths are fully intelligible only within a narrative structure; that narratives contain non-factual content with a significance and meaning otherwise unavailable; thirdly, and importantly for our purposes, she offers a constraint ‘on what can count as a correct or good self-narrative...to point to ways in which the process of self-narration should be connected to the facts’. In this commentary we elaborate and offer further support to Walker’s claim that ‘continual intersubjective checking’ provides a dynamic and corrective social mechanism for ensuring truth in self narratives.

Mental time travel is the ability to simulate alternative pasts and futures. It is often described as the ability to project a sense of self in the service of diachronic agency. It requires not only semantic representation but affective sampling of alternative futures. If people lose this ability for affective sampling their sense of self is diminished. They have less of a self to project hence are compromised as agents. If they cannot “feel the future” they cannot imaginatively inhabit it and hence their agency is compromised. The extent of such losses and consequent impairments to moral agency can be matters of degree.

Kant claimed both that "moral feeling is the capacity to be affected by a moral judgment" and that moral motivation is motivation by principle. What are the psychological mechanism that could enable principles to motivate? This chapter develops in more detail a suggestion made elsewhere by the author that posits a connection between susceptibility to the discomfort of cognitive dissonance and moral motivation of a broadly Kantian kind. The chapter argues that the possession of principles is constitutively connected to one’s status as a diachronic self and to one’s rational agentive capacities. If psychopaths are insensitive to cognitive dissonance, they cannot have or be motivated by principles. This provides an explanation of the failure of moral motivation in psychopaths that differs from the usual focus on lack of empathy.

Psychopaths have long been of interest to moral philosophers, since a careful examination of their peculiar deficiencies may reveal what features are normally critical to the development of moral agency. What underlies the psychopath's amoralism? A common and plausible answer to this question is that the psychopath lacks empathy. Lack of empathy is also claimed to be a critical impairment in autism, yet it is not at all clear that autistic individuals share the psychopath's amoralism. How is empathy characterized in the literature, and how crucial is empathy, so described, to moral understanding and agency? I argue that an examination of moral thinking in high-functioning autistic people supports a Kantian rather than a Humean account of moral agency.

We argue that companion friendship is not importantly marked by self-disclosure as understood in either of these two ways. One's close friends need not be markedly similar to oneself, as is claimed by the mirror account, nor is the role of private information in establishing and maintaining intimacy important in the way claimed by the secrets view. Our claim will be that the mirror and secrets views not only fail to identify features that are in part constitutive of close or companion friendship, but that they miss the mark quite broadly and fail to capture anything significant and distinctive about the ways in which friendship has an impact on the self. The article will proceed as follows. In the first section we outline our account of the self in friendship. In the next two sections we examine the mirror and secrets views and develop our own view in counterpoint to these. In the final section we defend our own account by showing how it provides the governing conditions which do distinguish friendship from other kinds of relations between persons.

We have argued elsewhere that moral responsibility over time depends in part upon the having of psychological connections which facilitate forms of self-control. In this chapter we explore the importance of mental time travel - our ordinary ability to mentally travel to temporal locations outside the present, involving both memory of our personal past and the ability to imagine ourselves in the future - to our agential capacities for planning and control. We suggest that in many individuals with dissociative disorders, forms of amnesia, or other frontal lobe damage, our capacity for mental time travel is impaired, resulting in commensurate losses to agency autonomy, and a forensic condition essential for holding persons responsible: in legal terms, the capacity for mens rea.

Substance use and misuse occurs at a very high rate among people with mental health problems and the relationship between the two conditions is complex. In this paper we argue that treatment of substance use in dual diagnosis clients must begin from an understanding of the losses suffered by those with mental illness. We outline the fundamental condition of effective agency, unified agency, which is disrupted in mental illness and show how this is needed to secure access to central social and moral goods such as continuing employment and satisfying relationships. We argue that drug use will be disvaluable primarily in so far as it too prevents access to this set of agential goods and focuses the agent on synchronic well-being to the exclusion of diachronic well-being. The goals and methods of treatment for dual diagnosis patients should thus reflect the primary impairment to unified agency.

What is the role and value of pleasure in addiction? Foddy and Savulescu have claimed that substance use is just pleasure-oriented behavior. They describe addiction as "strong appetites toward pleasure" and argue that addicts suffer in significant part because of strong social and moral disapproval of lives dominated by pleasure seeking. But such lives, they claim, can be autonomous and rational. The view they offer is largely in line with the choice model and opposed to a disease model of addiction. Foddy and Savulescu are sceptical of self-reports that emphasize the ill effects of addiction such as loss of family and possessions, or that claim an absence of pleasure after tolerance sets in. Such reports they think are shaped by social stigma which makes available a limited set of socially approved addiction narratives. We will not question the claim that a life devoted to pleasure can be autonomously chosen. Nor do we question the claim that the social stigma attached to the use of certain drugs increases the harm suffered by the user. However our interviews with addicts reveal a genuinely ambivalent and complex relationship between addiction, value, and pleasure. Our subjects did not shy away from discussing pleasure and its role in use. But though they usually valued the pleasurable properties of substances, and this played that did not mean that they valued an addictive life. Our interviews distinguished changing attitudes towards drug related pleasures across the course of substance use, including diminishing pleasure from use over time and increasing resentment at the effects of substance use on other valued activities. In this paper we consider the implications of what drug users say about pleasure and value over the course of addiction for models of addiction. Well don't get me wrong, I love using mate. If I could use successfully I would. I'd still be using. I love using. I just don't like the shit that comes with it.

Dissociative Identity Disorder (DID) (formerly known as Multiple Personality Disorder) is a condition in which a person appears to possess more than one personality, and sometimes very many. Some recent criminal cases involving defendants with DID have resulted in "not guilty" verdicts, though the defense is not always successful in this regard. Walter Sinnott-Armstrong and Stephen Behnke have argued that we should excuse DID sufferers from responsibility, only if at the time of the act the person was insane (typically delusional); otherwise the presumption should be that persons with DID are indeed responsible for their actions. We find their interpretation of DID and of the way in which the requirements for criminal insanity relate to this condition worrying and likely to result in injustice to DID sufferers. Our thesis is that persons with DID cannot be responsible for their actions if the usual features of the condition are present. A person with DID is a single person in the grip of a very serious mental disorder. By focusing on the features of DID which have, as we argue, the effect of deluding the patient, we try to show that such a person is unable to fulfill the ordinary conditions of responsible agency (namely, autonomy and self-control).