•  657
    A Madness for Identity: Psychiatric Labels, Consumer Autonomy, and the Perils of the Internet
    Philosophy, Psychiatry, and Psychology 11 (4): 335-349. 2004.
    Psychiatric labeling has been the subject of considerable ethical debate. Much of it has centered on issues associated with the application of psychiatric labels. In comparison, far less attention has been paid to issues associated with the removal of psychiatric labels. Ethical problems of this last sort tend to revolve around identity. Many sufferers are reticent to relinquish their iatrogenic identity in the face of official label change; some actively resist it. New forms of this resistance …Read more
  •  215
    The distinction between cognitive and perceptual theories of emotion is entrenched in the literature on emotion and is openly used by individual emotion theorists when classifying their own theories and those of others. In this paper, I argue that the distinction between cognitive and perceptual theories of emotion is more pernicious than it is helpful, while at the same time insisting that there are nonetheless important perceptual and cognitive factors in emotion that need to be distinguished.…Read more
  •  179
    The Natural Kind Status of Emotion
    British Journal for the Philosophy of Science 53 (4): 511-37. 2002.
    It has been argued recently that some basic emotions should be considered natural kinds. This is different from the question whether as a class emotions form a natural kind; that is, whether emotion is a natural kind. The consensus on that issue appears to be negative. I argue that this pessimism is unwarranted and that there are in fact good reasons for entertaining the hypothesis that emotion is a natural kind. I interpret this to mean that there exists a distinct natural class of organisms wh…Read more
  •  152
    The heat of emotion: Valence and the demarcation problem
    Journal of Consciousness Studies 12 (8-10): 82-102. 2005.
    Philosophical discussions regarding the status of emotion as a scientific domain usually get framed in terms of the question whether emotion is a natural kind. That approach to the issues is wrongheaded for two reasons. First, it has led to an intractable philosophical impasse that ultimately misconstrues the character of the relevant debate in emotion science. Second, and most important, it entirely ignores valence, a central feature of emotion experience, and probably the most promising criter…Read more
  •  139
    In this paper I review some leading developments in the empirical theory of affect. I argue that (1) affect is a distinct perceptual representation governed system, and (2) that there are significant modular factors in affect. The paper concludes with the observation thatfeeler (affective perceptual system) may be a natural kind within cognitive science. The main purpose of the paper is to explore some hitherto unappreciated connections between the theory of affect and the computational theory o…Read more
  •  121
    Cynthia's dilemma: Consenting to heroin prescription
    American Journal of Bioethics 2 (2): 37-47. 2002.
    Heroin prescription involves the medical provision of heroin in the treatment of heroin addiction. Rudimentary clinical trials on that treatment modality have been carried out and others are currently underway or in development. However, it is questionable whether subjects considered for such trials are mentally competent to consent to them. The problem has not been sufficiently appreciated in ethical and clinical discussions of the topic. The challenges involved throw new light on the role of v…Read more
  •  96
    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
  •  95
    Why Psychiatry Should Fear Medicalisation
    In K. W. M. Fulford, Davies M., Gipps R., Graham G., Sadler J., Stanghellini G. & Thornton T. (eds.), The Oxford Handbook of Philosophy and Psychiatry, Oxford University Press. pp. 159-175. 2013.
    Medicalization in contemporary psychopharmacology is increasingly dominated by commercial interests that threaten the scientific and ethical integrity of psychiatry. At the same time, the proliferation of new social media has altered the manner in which the social groups and institutions that have stakes in medicalization interact. Consumers are at once more powerful than ever before, but also more vulnerable. The upshot of all these developments is that medicalization is no longer simply the pr…Read more
  •  93
    Review of "Strong Feelings: Emotion, Addiction and Human Behavior" by Jon Elster (review)
    Philosophical Review 110 (1): 108. 2001.
    The Diagnostic Statistical Manual of the American Psychiatric Association defines substance dependence, more commonly known as “drug addiction,” as “a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems. There is a pattern of repeated self-administration that usually results in tolerance, withdrawal, and compulsive drug-taking behavior.” If drug addiction is a matter of compulsio…Read more
  •  75
    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
  •  70
    Affective neuroscience and addiction
    American Journal of Bioethics 7 (1): 20-21. 2007.
    The author comments on the article “The neurobiology of addiction: Implications for voluntary control of behavior,‘ by S. E. Hyman. Hyman suggests that addicted individuals have substantial impairments in cognitive control of behavior. The author states that brain and neurochemical systems are involved in addiction. He also suggests that neuroscience can link the diseased brain processes in addiction to the moral struggles of the addicts.
  •  70
    Anorexia Nervosa as a Passion
    with Tony Hope, Anne Stewart, and Jacinta Tan
    Philosophy, Psychiatry, and Psychology 20 (4): 353-365. 2013.
    Contemporary diagnostic criteria for anorexia nervosa explicitly refer to affective states of fear and anxiety regarding weight gain, as well as a fixed and very strong attachment to the pursuit of thinness as an overarching personal goal. Yet current treatments for that condition often have a decidedly cognitive orientation and the exact nature of the contribution of affective states and processes to anorexia nervosa remains largely uncharted theoretically. Taking our inspiration from the histo…Read more
  •  68
    In this paper I link two hitherto disconnected sets of results in the philosophy of emotions and explore their implications for the computational theory of mind. The argument of the paper is that, for just the same reasons that some computationalists have thought that cognition may be a natural kind, so the same can plausibly be argued of emotion. The core of the argument is that emotions are a representation-governed phenomenon and that the explanation of how they figure in behaviour must as su…Read more
  •  66
    As Autonomy Heads Into Harm's Way
    Philosophy, Psychiatry, and Psychology 11 (4): 361-363. 2004.
    Interdisciplinary work of the sort attempted in my paper is fraught with risks and obstacles. One especially pernicious obstacle is the short-sighted prejudice that insists we should always divide a problem into its various components, allocate different parts to their respective disciplines, publish each separately, and, above all, keep the ethics separate from the rest. Although this may sometimes constitute good tactical advice in the mature stages of inquiry on a complex topic, it begs the q…Read more
  •  61
    Appreciation and emotion: Theoretical reflections on the Macarthur treatment competence study
    Kennedy Institute of Ethics Journal 8 (4): 359-376. 1998.
    When emotions are mentioned in the literature on mental competence, it is generally because they are thought to influence competence negatively; that is, they are thought to impede or compromise the cognitive capacities that are taken to underlie competence. The purpose of the present discussion is to explore the possibility that emotions might play a more positive role in the determination of competence. Using the MacArthur Treatment Competence Study as an example, it is argued that appreciatio…Read more
  •  59
    Moral nature of the dsm-IV cluster B personality disorders
    Journal of Personality Disorders 20 (2): 116-125. 2006.
    Moral considerations do not appear to play a large role in discussions of the DSM-IV personality disorders and debates about their empirical validity. Yet philosophical analysis reveals that the Cluster B personality disorders, in particular, may in fact be moral rather than clinical conditions. This finding has serious consequences for how they should be treated and by whom.
  •  58
    Medical or Moral Kinds? Moving Beyond a False Dichotomy
    Philosophy, Psychiatry, and Psychology 17 (2): 119-125. 2010.
    I am delighted that Zachar and Potter have chosen to refer to my work on the DSM-IV cluster B personality disorders in their very interesting and ambitious target article. Their suggestion that we turn to virtue ethics rather than traditional moral theory to understand the relation between moral and nonmoral factors in personality disorders is certainly original and worth pursuing. Yet, in the final instance, I am not entirely sure about the exact scope of their proposed analysis. I also worry w…Read more
  •  55
  •  48
    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
  •  46
    In Defence of “Emotion” (review)
    Canadian Journal of Philosophy 31 (1): 133-154. 2001.
  •  45
    Is Mr. Spock mentally competent? Competence to consent and emotion
    Philosophy, Psychiatry, and Psychology 5 (1): 67-81. 1998.
    Most contemporary models and tests for mental competence do not make adequate provision for the positive influence of emotion in the determination of competence. This most likely is due to a reliance on an outdated view of emotion according to which these models are essentially noncognitive. Leading developments in modern emotion theory indicate that this noncognitive theory of emotion is no longer tenable. Emotions, in fact, are essentially representational in a manner that makes them “cognitiv…Read more
  •  43
    The passions have vanished. After centuries of dominance in the ethical and scientific discourse of the West, they have been eclipsed by the emotions. To speak of the passions now is to refer to a relic of the past, the crumbling foundation of a once mighty conceptual empire that permeated all aspects of Western cultural life. Philosophical and scientific wars continue to be fought in these ruins; new encampments are built, rebels plot in the catacombs, and bold victors plant their flags on the …Read more
  •  42
    Anorexia and the MacCAT-T Test for Mental Competence: Validity, Value, and Emotion
    Philosophy, Psychiatry, & Psychology 13 (4): 283-287. 2007.
    How does one scientifically verify a psychometric instrument designed to assess the mental competence of medical patients who are asked to consent to medical treatment? Aside from satisfying technical requirements like statistical reliability, results yielded by such a test must conform to at least some accepted pretheoretical desiderata; for example, determinations of competence, as measured by the test, must capture a minimal core of accepted basic intuitions about what competence means and wh…Read more
  •  42
    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
  •  41
    Cognitive modularity of emotion
    In Luc Faucher & Christine Tappolet (eds.), The Modularity of Emotions, University of Calgary Press. pp. 213-228. 2008.
  •  39
    Emotion Experience and the Indeterminacy of Valence
    In Lisa Feldman Barrett, Paula M. Niedenthal & Piotr Winkielman (eds.), Emotion and Consciousness, Guilford Press. pp. 231-254. 2005.
  •  38
    Decision-making capacity
    Stanford Encyclopedia of Philosophy. 2011.
    In many Western jurisdictions, the law presumes that adult persons, and sometimes children that meet certain criteria, are capable of making their own health care 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 last question has to do with what is commonly called “decisional capacity,” a central concept in health care law …Read more
  •  37
    I very much enjoyed reading the interesting and original article by Steel and colleagues (2017). But I found myself strongly disagreeing with its conclusion once the real point of the argument became clear to me. At the same time, I believe that the authors are correct to draw attention to the importance of context and inequities in framing discussions of the ethics of voluntary consent in heroin prescription research. I begin with a brief summary of the authors’ conclusion, quoting directly and…Read more
  •  36
    Describing our “humanness”: Can genetic science Alter what it means to be “human”?
    with Angela Campbell and Kathleen Cranley Glass
    Science and Engineering Ethics 4 (4): 413-426. 1998.
    Over the past several decades, geneticists have succeeded in identifying the genetic mutations associated with disease. New strategies for treatment, including gene transfer and gene therapy, are under development. Although genetic science has been welcomed for its potential to predict and treat disease, interventions may become ethically objectionable if they threaten to alter characteristics that are distinctively human. Before we can determine whether or not a genetic technique carries this r…Read more