•  73
    The Varieties of Compulsion in Addiction
    American Journal of Bioethics 2 (2): 50-51. 2012.
    The target of Hanna Pickard's very erudite and thought-provoking article is compulsion. She argues that “addiction is not a form of compulsion” and that “addictive desires are not irresistible” (Pickard 2012, 40). However, I fear that compulsion as she presents it is ultimately a metaphysical straw figure, trapped in a false metaphysical dichotomy. What is lacking is a proper attention to specific individual clinical cases, examined over time. At the same time, Pickard's discussion is extremely …Read more
  •  60
    This chapter argues that the conditions under the umbrella “personality disorders” actually constitute two very different kinds of theoretical entities. In particular, several core personality disorders are actually moral, and not medical, conditions. Thus, the categories that are held to represent them are really moral, and not medical, theoretical kinds. The chapter works back from the possibility of treatment to the nature of the kinds that are allegedly treated, revisiting 18th-century ideas…Read more
  •  632
    Descartes on émotion
    Emotion: History, Culture, Society. forthcoming.
    The primary aim of this discussion is to present a detailed case study of Descartes’ use of émotion in Les passions de l’ame and in his early writings leading up to that work. A secondary aim is to argue that while Descartes was innovative in suggesting that émotion might be a better keyword for the affective sciences than passion, he did not consistently follow his own advice. His innovation therefore failed in that regard, even though it did inspire later thinkers to explore the distinction be…Read more
  •  307
    Any ethical inquiry into addiction research is faced with the preliminary challenge that the term “addiction” is itself a matter of scientific and ethical controversy. Accordingly, the chapter begins with a brief history of the term “addiction.” The chapter then turns to ethical issues surrounding consent and decision-making capacity viewed from the perspective of the current opioid epidemic. One concern is the neglect of the cyclical nature of addiction and the implications of this for the vali…Read more
  •  93
    Decision-Making Capacity
    Stanford Encyclopedia of Philosophy. 2020.
    Decision-Making Capacity First published Tue Jan 15, 2008; substantive revision Fri Aug 14, 2020 In many Western jurisdictions the law presumes that adult persons, and sometimes children that meet certain criteria, are capable of making their own medical decisions; for example, consenting to a particular medical treatment, or consenting to participate in a research trial. But what exactly does it mean to say that a subject has or lacks the requisite capacity to decide? This question has to do wi…Read more
  •  235
    Psychiatric Ethics: A History
    In Psychiatric Ethics 5th Edition. forthcoming.
    The chapter traces the history of psychiatric ethics with a focus on the emergence of autonomy and how assumptions and thresholds surrounding informed consent and decision-making capacity have changed over the centuries. Innovators like Philippe PInel and William Tuke are featured in this account of how the 'mad' and the abuses of the 'domestication paradigm' of madness eventually gave way to more humanitarian approaches of treating the 'mad', like moral treatment. The chapter closes with a bri…Read more
  •  8
  •  6
    Tuke’s Healing Discipline
    Philosophy, Psychiatry, Psychology 9 (2): 183-186. 2003.
    THE TARGET OF ERICA LILLELEHT'S interesting comparison between 19th-century moral treatment and 20th-century psychiatric rehabilitation is contemporary psychiatric rehabilitation. Using Foucault's (1979) Discipline and Punish as her critical foil, she argues that psychiatric rehabilitation is "an approach to madness fraught with paradox." The paradox lies in the fact that the techniques of psychiatric rehabilitation can be practiced in a manner that contradicts its professed humanitarian intenti…Read more
  •  5
    Sir—In their editorial, Hall, Carter & Morley [1] present an incorrect interpretation of my central argument. The point of my paper [2] is that there are solid reasons to suspect that the capacity of heroin addicts to consent to heroin therapy is compromised because of their addiction. As one medical commentator on my paper states, if active heroin addicts can give voluntary and competent consent to heroin therapy without any problems, then we need a new conceptualization of addiction: they are …Read more
  •  22
    Ethics in speech-language pathology: Beyond the codes and canons
    with T. L. Eadie
    Journal of Speech-Language Pathology and Audiology 29 (1): 29-36. 2005.
  •  15
    Passion and Decision-Making Capacity in Anorexia Nervosa
    American Journal of Bioethics Neuroscience 6 (4): 66-68. 2015.
    The question of decision-making capacity for informed consent to experimental brain surgery for severely ill anorectic patients is about as dramatic an ethical issue one can imagine. Sabine Muller and her co-authors (2015) should be commended for this extremely timely and original clinical and ethical discussion of decision-making capacity in relation to the issues raised by informed consent to such therapies. In this commentary, I elaborate on the new account of the nature of anorexia nervosa t…Read more
  • Emotion
    with R. M. Gordon
    In Donald Borchert (ed.), Encyclopaedia of Philosophy (Vol. 2) (2nd Edition). pp. 197-203. 2005.
  •  7
    Emotion: Philosophical Issues
    In Tim Bayne, Axel Cleeremans & Patrick Wilken (eds.), The Oxford Companion to Consciousness. pp. 259-262. 2009.
  • Qualia
    In David Sanders & Klaus Scherer (eds.), The Oxford Companion to Emotion and Affective Sciences. pp. 327. 2009.
  • Affect (Philosophical Perspective)
    In David Sanders & Klaus Scherer (eds.), The Oxford Companion to Emotion and Affective Sciences, . pp. 9-10. 2009.
  •  4
    Moral Treatment
    In Robin L. Cautin & Scott O. Lilienfeld (eds.), The Encyclopedia of Clinical Psychology, Wiley-blackwell. 2015.
    Moral treatment refers to a psychological approach to treating mental disorder that arose across Europe and North America around the turn of the eighteenth century. It is mostly associated with the French physician Philippe Pinel (1745–1826) and the English Quaker philanthropist William Tuke (1732–1819). Pinel and Tuke each independently developed their own distinct models of the once popular therapy known as moral treatment. Although moral treatment is often considered to have been a successful…Read more
  •  8
    Jean-Etienne Esquirol (1772-1840)
    In Robin L. Cautin & Scott O. Lilienfeld (eds.), The Encyclopedia of Clinical Psychology, Wiley-blackwell. 2015.
    Along with Philippe Pinel (1745–1826), Jean‐Étienne Esquirol (1772–1840) is often considered one of the fathers of clinical psychiatry. While his indebtedness to the views of his teacher, Pinel, is indisputable, his own later contributions to the diagnosis and treatment of mental disorder are often considered to be clinically superior and more sophisticated than those of his mentor. Esquirol's contributions to the psychopathology of affectivity are especially important and differ in many importa…Read more
  •  12
    Philippe Pinel (1745-1826)
    In Robin L. Cautin & Scott O. Lilienfeld (eds.), The Encyclopedia of Clinical Psychology, Wiley-blackwell. 2015.
    Philippe Pinel (1745–1826) is often said to be the father of modern clinical psychiatry. He is most famous for being a committed pioneer and advocate of humanitarian methods in the treatment of the mentally ill, and for the development of a mode of psychological therapy known as moral treatment. Pinel also made important contributions to nosology and the diagnosis and treatment of mental disorder, especially the psychopathology of affectivity, stressing the role of the passions in mental disorde…Read more
  •  1
    Mental Competence and Value: The Problem of Normativity in the Assessment of Decision-Making Capacity
    In Françoise Baylis, Jocelyn Downie, Barry Hoffmaster & Susan Sherwin (eds.), Health Care Ethics in Canada. pp. 267-278. 2004.
  •  45
    This chapter argues that the conditions under the umbrella “personality disorders” actually constitute two very different kinds of theoretical entities. In particular, several core personality disorders are actually moral, and not medical, conditions. Thus, the categories that are held to represent them are really moral, and not medical, theoretical kinds. The chapter works back from the possibility of treatment to the nature of the kinds that are allegedly treated, revisiting 18th-century ideas…Read more
  •  17
    Psychopathology is the science of what mental illnesses are. Affective psychopathology – or, alternately, the ‘psychopathology of affectivity’ – is the branch of psychopathology devoted to the study of mental disorders that implicate mental states associated with moods and emotions and what used to be called ‘passions’. Some segments of the history of affective psychopathology have been skillfully traced. However, there is one episode in that history that has not received the attention it deserv…Read more
  •  19
    Decisional Capacity and Responsibility in Addiction
    In Jeffrey Poland & George Graham (eds.), Addiction and Responsibility. pp. 139-159. 2011.
    Addiction of the variety discussed in this chapter, is a condition that by its very nature compromises decision-making capacity across the decisional spectrum. The impairment is present not only at moments of withdrawal and intoxication, but at all stages of the active addictive cycle, as long as the pathological dispositions to overvalue addictive drugs remain entrenched and operative. In light of this entrenched and pervasive reorientation in pathological values, it seems reasonable to questio…Read more
  •  14
    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 conta…Read more
  •  5
    Shakespeare’s Winter’s Tale: Anatomy of a Passion
    with R. S. White
    In Susan Broomhall (ed.), Ordering Emotions in Europe, 1100-1800, . pp. 197-225. 2015.
    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 T…Read more
  •  6
    Bill C-203: a postmortem analysis of the "right-to-die" legislation that died
    Canadian Medical Association Journal 148 (10): 1705-1708. 1993.
  •  1
    Should Compassion be Included in Codes of Ethics for Physicians?
    with Paul T. Dick
    Annals of the Royal College of Physicians and Surgeons of Canada 28 (7): 415-418. 1995.
    Compassion is mentioned in the Principles of the American Medical Association but not in the Code of Ethics of the Canadian Medical Association. In this article, we assess the case for including compassion in a code of ethics for physicians. We argue that, properly understood, there is a strong case for including compassion in codes of ethics for physicians on the basis that it is both clinically and ethically central to the practice of medicine.
  •  34
    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 assessme…Read more
  •  3
    Benevolent Theory: Moral Treatment at the York Retreat
    History of Psychiatry 18 (1): 61-80. 2007.
    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 im…Read more