Dominic Murphy

This chapter begins by sketching an account of morally responsible agency and the general conditions under which it may fail. We discuss how far individuals with psychiatric diagnoses may be exempt from morally responsible agency in the way that infants are, with examples drawn from a sample of diagnoses intended to make dierent issues salient. We further discuss a recent proposal that clinicians may hold patients responsible without blaming them for their acts. We also consider cognitively impaired subjects in the light of related issues in moral and political theory, asking whether they have been unjustly excluded from liberal conceptions of political community due to their presumed lack of agency

Kendler and Schaffner have written an exemplary case study of the rise of the dopamine hypothesis and, if not its fall, at least its stagnation and transmutation. They bring out well both the state of the science and the opportunities offered by the theory to consider some famous philosophical theories of scientific progress. So well, in fact, have they done this, that I do not have a lot to say about it. I will just mention one or two points that I found interesting, and then say a little about what looks to me like an omission from the story that the two Kens recount.One point they raise is the importance of competitor theories: now, there is supposed to be an old story about a quack who was apprehended during ..

In lieu of an abstract, here is a brief excerpt of the content:What Is Psychiatry About?Dominic Murphy, PhD (bio)There are no such things as minds, but there are animate objects who behave differently from other types of natural entity. They move around under their own power, and some of their activity seems to be very different from that of other natural objects. Furthermore, some of our predictions about these objects are disproved in interesting ways; if we make a false prediction we do not revise our best theory about how such things generally behave, but we instead conclude that there is something wrong with the object of the prediction. These intelligent unpredictable things need a special vocabulary, and mental talk has arisen to serve as that vocabulary. But since a mind is not a thing in nature we face the problem of saying what the sciences of the mind are actually about.There are, then, intelligent systems that can be judged pathological, and some of them are our conspecifics. It is fair to say that there is no agreement about how such judgments are made or should be made. The question of what a mental illness is part of this larger picture, and it raises several different issues.First, how should we think about our practices of judging deviance? It would be contrary to accepted practice to wear a swimsuit to a state funeral, but what sort of norms would it violate and what state of mind would we ascribe to somebody who did it? Second, what is the difference between a judgment of deviance and a judgment of pathology? We have many ways of distinguishing between types of deviance, and the lines between criminality, immorality and pathology, to take three examples, are not always easy to discern. Third, what makes an illness a mental illness? This is Gough's topic, and I will get to it in a moment, but it worth situating it within this broader framework which asks what we are doing when we make these judgments of norm-violation.Gough begins by quite correctly pointing out that if we look at the domain of psychiatry as currently understood, we would have a hard time seeing what it is supposed to be the science of. It is customary to see psychiatry as dealing with the mental but, as Gough notes, there are some mental processes that psychiatry does not deal with, and some processes that psychiatry deals with that are not mental. Gough's response to this problem is a very interesting one, which starts from the idea that the point of psychiatry is to help those who need it; how different do things look if we start from this position? Conley and Glackin (2021) argues that the practical and therapeutic aspirations of psychiatry should constrain our understanding of mental illness. Glackin argues that we should [End Page 41] see this 'norms-first' view, as I will call it, as part of a broader liberal-democratic conversation about the ways in which we should live togetherA view that starts with norms is typically opposed to the 'naturalist' position. A naturalist begins with positive facts as the basis for diagnostic concepts, on the grounds that our concepts of disease and health are supposed to answer to facts about the physical and mental constitution of human beings. Gough's view is neither a norms-first view or a naturalist's view. We could call it an institutionalist view, or, if we were being a bit less kind, an ostensive one—"these things here, that's mental illness."David Hull (1988) taught us that every science (indeed, every intellectual formation or tradition) needs to be understood in two ways. First, we have the theoretical commitments that are taken to define it. Second, there are the practices and institutions that separate its practitioners off from others. Contemporary evolutionary biology, for instance, is built on the twin foundations of the modern synthesis—Darwinian natural selection and Mendelian genetics. These two theoretical commitments have been transformed and adapted and supplemented in diverse ways so that their modern forms no longer resemble their originals very closely. Still, they continue as the central undertakings about the nature of the living world that modern...

In this paper, I will argue that the NIMH’s new Research Domain of Criteria is a useful test of the philosophical hypothesis of eliminative materialism and demonstrates the superiority of a moderate eliminativism over integrationism, which is a rival philosophical framework for the cognitive sciences. I begin by going over the motivation for RDOC, which rests on the problems with the existing Diagnostic and Statistical Manual of Mental Disorders framework in psychiatry. Then, I introduce the main tenets of RDoC before discussing eliminativism and trying to show what a moderate eliminativism looks like through the example of addiction. I then contrast that approach with intregrationism to the latter’s detriment. I end by wondering whether the broadly political consequences of eliminativism give us non-scientific reasons for resisting it, as it threatens to rob ordinary people of important means of self-description.

In this paper, I will argue that the NIMH’s new Research Domain of Criteria is a useful test of the philosophical hypothesis of eliminative materialism and demonstrates the superiority of a moderate eliminativism over integrationism, which is a rival philosophical framework for the cognitive sciences. I begin by going over the motivation for RDOC, which rests on the problems with the existing Diagnostic and Statistical Manual of Mental Disorders framework in psychiatry. Then, I introduce the main tenets of RDoC before discussing eliminativism and trying to show what a moderate eliminativism looks like through the example of addiction. I then contrast that approach with intregrationism to the latter’s detriment. I end by wondering whether the broadly political consequences of eliminativism give us non-scientific reasons for resisting it, as it threatens to rob ordinary people of important means of self-description.

The paper develops a framework for discussing concepts of health and disease along two dimensions. The first is the role of values in our disease concepts, and the second is the relationship between science and folk psychology. This framework is then applied to the concept of mental disorder. I argue that existing treatments of the concept yield too much authority to common sense, which produces a tension within the program of finding a scientific basis for our ascriptions of mental disorder. The science should be given more authority, even if this leads to counterintuitive results. I conclude by identifying several smaller scale conceptual problems within the application of science to mental illness, and argue that the debate needs to shift towards dealing with such problems in an empirically informed way, rather than remaining at the level of conceptual analysis. 2012 APA, all rights reserved)

Philosophy of psychiatry has boomed in the last few years. We are now seeing a growing literature on the nature of psychiatric explanation, including work that makes contact with longstanding disputes in the philosophy of science as well as more specific work on mental disorders. This paper looks at some recent work on both representing and explaining mental illness. An emerging picture sees explanation of mental disorder as first constructing causal‐statistical networks that represent disease pathways as they unfold in time, and then choosing strategies for causal explanation. The epistemic problems in psychiatry are huge, and they arise from the extreme variety in the causes and trajectories of mental disorders across patients. Existing concepts of levels of explanation and mechanism may seem like an obvious epistemic armoury, but they may not fit psychiatry very well, and philosophical theories of psychiatric explanation stress different ways of trying to understand robust patterns amid the individual variation.

The need for research to advance scientific understanding must be balanced with ensuring the rights and wellbeing of participants are safeguarded, with some research topics posing more ethical quandaries for researchers than others. Moral injury is one such topic. Exposure to potentially morally injurious experiences can lead to significant distress, including post-traumatic stress disorder, depression, and selfinjury. In this article, we discuss how the rapid expansion of research in the field of moral injury could threaten the wellbeing, dignity and integrity of participants. We also examine key guidance for carrying out ethically responsible research with participants’ rights to self-determination, confidentiality, non-maleficence and beneficence discussed in relation to the study of moral injury. We describe how investigations of moral injury are likely to pose several challenges for researchers including managing disclosures of potentially illegal acts, the risk of harm that repeated questioning about guilt and shame may pose to participant wellbeing in longitudinal studies, as well as the possible negative impact of exposure to vicarious trauma on researchers themselves. Finally, we offer several practical recommendations that researchers, research ethics committees and other regulatory bodies can take to protect participant rights, maximise the potential benefits of research outputs and ensure the field continues to expand in an ethically responsible way.

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

De Haan has provided a novel and distinctly enactivist solution to the problem of integrating the physiological, experiential, social and existential. We admire her articulation of her fourth "existential" dimension. Not only does it represent a real attempt to bridge, as she says, enactivism's explanatory gap, it is also a potentially useful construct for conceptualizing the way that self-reflexivity seems to go astray in much psychopathology. We think that pinpointing this phenomenon is something that phenomenological accounts excel at. We have, however, two key reservations about her account, which we outline.To begin with, we are unsure that there is any particular scientific research program that derives from...

Jennifer Radden argues that delusions play an important role in modernist epistemology, which is preoccupied with the justification and evaluation of beliefs. Another theme running through the book is the importance of culture for attribution of delusion. Beliefs that look delusional will not be treated as pathological if they are expressions of religious views or other culturally acceptable forms of life. It is hard to see why cultural acceptability should play a role in the modernist project of justification. I suggest that we think less about a philosophical project of justification and turn our attention instead to commonsense judgements of the circumstances in which we see a belief as evidence of underlying pathology. I discuss cases in which unjustified beliefs are nonetheless treated as phenomena that are consistent with our views of how healthy human beings act, and suggest that alongside folk psychology we should acknowledge a folk epistemology that embraces such instances. I suggest that delusions are beliefs that folk epistemology treats as inexplicable, and that this approach solves some of the puzzles that Radden identifies as growing out of the modernist epistemic project