Allen, Anita L.. Mental Disorders and the “System of Judgmental Responsibility”
2010, Boston University Law Review 90: 621-640.
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Added by: Simon Fokt
Diversifying Syllabi: Thesis: Those affected by mental disorders whose actions are episodically influenced by their disorder are often overlooked by philosophers of moral and ethical responsibility. Allen gives us reasons for thinking it is inappropriate to either: a) “summarily exclude people with mental problems out of the universe of moral agents, reducing them to the status of rocks, trees, animals, and infants” b) “include the group on the false assumption that their moral lives are precisely like the paradigmatic moral lives of the epistemically-sound and well-regulated people never personally touched by a mental condition” We must explore a revised approach to moral and ethical responsibility and obligation for this group.Comment : This text is useful in teaching in two main contexts: (1) in discussing ethical issues related to mental disorders; and (2) to provide a challenging case in classes on blame and responsibility. The text can be also used in the context of the free will and determinism debate, and as a further reading in classes on moral agency.Bok, Sissela. The Limits of Confidentiality1983, Hastings Center Report 13 (1):24-31.-
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Added by: Clotilde Torregrossa, Contributed by: Simon Fokt
Introduction: Doctors, lawyers, and priests have traditionally recog nized the duty of professional secrecy regarding what individuals confide to them: personal matters such as alcoholism or depression, marital difficulties, corporate or political problems, and indeed most concerns that patients or clients want to share with someone, yet keep from all others.' Accountants, bankers, social workers, and growing numbers of professionals now invoke a similar duty to guard confidences. As codes of ethics take form in old and new professions, the duty of confidentiality serves in part to reinforce their claim to professional status, and in part to strengthen their capacity to offer help to clients.Bordo, Susan. Anorexia Nervosa: Psychopathology as the Crystallization of Culture1993, In her Unbearable Weight: Feminism, Western Culture, and the Body. Berkeley: University of California Press.-
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Added by: Simon Fokt
Diversifying Syllabi: Bordo claims that the recent increase in women with Anorexia is a symptom of the “central ills” of our culture. Bordo discusses three sources of this “cultural illness” which leads to anorexia: the dualist axis, the control axis, and the gender/power axis. She spends the bulk of the paper discussing each “axis” or problematic component of society which is reflected back to us in the increasing diagnosis of anorexia. These “psychopathogolgies” are expressions of the culture, she claims.Comment : This text is most readily applicable in teaching feminist theory and social philosophy. However, it is also very useful in at least three other contexts: (1) as a critical approach to mind-body dualism, especially when teaching on Descartes or Plato's Phaedo; (2) in teaching on the ethics of mental illness and the anti-psychiatry movement, as an example of socially constructed disorders; and (3) more broadly in teaching on personal and collective moral responsibility.Bortolotti, Lisa, John Harris. Disability, Enhancement and the Harm-Benefit Continuum2006, In John R. Spencer & Antje Du Bois-Pedain (eds.), Freedom and Responsibility in Reproductive Choice. Hart Publishers-
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Added by: Simon Fokt, Contributed by: Nils-Hennes StearAbstract:
Suppose that you are soon to be a parent and you learn that there are some simple measures that you can take to make sure that your child will be healthy. In particular, suppose that by following the doctor’s advice, you can prevent your child from having a disability, you can make your child immune from a number of dangerous diseases and you can even enhance its future intelligence. All that is required for this to happen is that you (or your partner) comply with lifestyle and dietary requirements. Do you and your partner have any moral reasons (or moral obligations) to follow the doctor’s advice? Would it make a difference if, instead of following some simple dietary requirements, you consented to genetic engineering to make sure that your child was free from disabilities, healthy and with above average intelligence? In this paper we develop a framework for dealing with these questions and we suggest some directions the answers might take.
Comment : This is a paper that gives an account of enhancement and disability in terms of one's relative position on a harmed and benefitted continuum, and defends enhancement on completely general moral grounds according to which the pro tanto duty to enhance is the same as the pro tanto duty not to disable. It pairs well with criticisms of the 'new eugenics', such as Robert Sparrow's 'A Not-So-New Eugenics' (2011) and more generally with consequentialist or specifically harm-based accounts of moral obligation.Brazier, Margaret Rosetta. Exploitation and enrichment: The paradox of medical experimentation2008, Journal of Medical Ethics 34 (3):180--183.-
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Added by: Clotilde Torregrossa, Contributed by: Simon Fokt
Abstract: Modern medicine is built on a long history of medical experimentation. Experiments in the past often exploited more vulnerable patients. Questionable ethics litter the history of medicine. Without such experiments, however, millions of lives would be forfeited. This paper asks whether all the ``unethical'' experiments of the past were unjustifiable, and do we still exploit the poorer members of the community today? It concludes by wondering if Harris is right in his advocacy of a moral duty to participate in medical research.Haksar, Vinit. The responsibility of psychopaths1965, The philosophical quarterly 15(59): 135-145.-
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Added by: Simon Fokt
Content: The paper examines various arguments looking at the responsibility psychopaths bear for their immoral actions, using neurological knowledge about psychopathy.Comment : Useful in teaching about the 'mad or bad' dilemma, and about responsibility and issues in psychiatric ethics in general.Heal, Jane. Mental disorder and the value(s) of ‘autonomy’2012, In Autonomy and Mental Disorder, Lubomira Radoilska (ed.). New York: Oxford University Press, 3-25.-
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Added by: Jamie RobertsonAbstract:
Summary (from Introduction of Autonomy and Mental Disorder, Radoilska ed.): In 'Mental disorder and the value(s) of autonomy', Jane Heal identifies and critically examines a form of thought which is implicit in discussions about what we, as a society, owe to people with mental disorder. This form of thought builds upon intuitions which link respect for a person with respect for a person's autonomy. In light of these intuitions, the issue of how to treat a person with mental disorder may seem to revolve around the question whether or not this person has the capacity for autonomy. However, Heal argues, inquiries that share this logical form are methodologically inappropriate and potentially unhelpful in answering either of the questions they put together: what we owe to people with mental disorder and what is involved in autonomy as a capacity. The reason for this is twofold. Firstly, the apparent consensus about autonomy as a capacity for self-determination that ought to be protected from interference by a corresponding right to self-determination is too shallow to ground a coherent course of action in terms of respect for autonomy. Even if we work with the assumption that autonomy is part of the Enlightenment project, we face an important dilemma since we have to choose between a Kantian or rationality oriented and a Millian or well-being oriented take on the nature and significance of autonomy. Secondly, even if we were to reach a substantive consensus on the concept of autonomy, it would arguably require an intricate array of mental capacities, outside the reach of at least some people with mental disorder. Getting clearer on what autonomy is will not help us find out what it means to treat these people respectfully.Comment : This text would be a good candidate for inclusion in a course about autonomy, philosophy of disability, or the ethics or political philosophy of mental health or aging (due to discussion of dementia). If assigned as part of a course on autonomy, students will benefit from considering Heal's approach to breaking down the logical components of the concept and her nuanced discussion of the limitations of autonomy as a moral principle for understanding our obligations toward people with mental disorders. This second element is the central question of the paper and would be of interest when examining disability or mental health from a philosophical perspective.Hoffmann, Nimi. Involuntary experiments in former colonies: The case for a moratorium2020, World Development 127, 104805-104808-
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Added by: Simon Fokt, Contributed by: Anonymous
Abstract: There is a rich literature on the use of medical trials as a model for designing and evaluating the outcomes of social policy interventions in former colonies. Yet social experimentalists have not engaged in a correspondingly vibrant discussion of medical ethics. A systematic review of social experiments shows that few studies explicitly discuss informed consent, or the serious constraints on securing informed consent from impoverished or child participants, particularly in the context of cluster randomization. The silence on informed consent, and in some cases active denial thereof, suggests that it is often considered less important than other elements of experimental design. This matters since involuntary experimentation on vulnerable people violates their personhood, increases the risk of unintended harm, and establishes continuities with colonial experimentation. There is a need to develop more effective mechanisms for regulating social experiments in former colonies. In the interim, scholars in the South have a responsibility to call for a moratorium on experiments.
Comment : Are useful counterweight to the literature on the randomise control trial is in development economics, shows that they are much more ethically controversial than they're willing to admit, also good for bringing out of the colonial aspect of even contemporary economics.Jackson, Jennifer. Ethics in medicine: Virtue, Vice and Medicine2006, Cambridge: Polity.-
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Publisher’s Note:
Publisher: How, in a secular world, should we resolve ethically controversial and troubling issues relating to health care? Should we, as some argue, make a clean sweep, getting rid of the Hippocratic ethic, such vestiges of it as remain? Jennifer Jackson seeks to answer these significant questions, establishing new foundations for a traditional and secular ethic which would not require a radical and problematic overhaul of the old. These new foundations rest on familiar observations of human nature and human needs. Jackson presents morality as a loose anatomy of constituent virtues that are related in different ways to how we fare in life, and suggests that in order to address problems in medical ethics, a virtues–based approach is needed. Throughout, attention is paid to the role of philosophy in medical ethics, and how it can be used to clarify key notions and distinctions that underlie current debates and controversial issues. By reinstating such concepts as justice, cardinal virtue, and moral duty, Jackson lays the groundwork for an ethics of health care that makes headway toward resolving seeming dilemmas in medical ethics today. This penetrating and accessible book will be invaluable to students of sociology and health care, as well as those who are interested in the ethical uncertainties faced by the medical world.Comment : Particularly useful in teaching is Chapter 10 which discusses abortion, reviewing arguments made by J.J. Thompson and M. Tooley, and enquiring into what makes killing wrong. Chapter 9 looks at distributive justice in medicine, reviewing some problematic cases and distinguishing between bad luck and injustice. Chapter 5 treats on conscientious objection and issues related to toleration and imposition of values.Jaworska, Agnieszka. Respecting the Margins of Agency: Alzheimer’s Patients and the Capacity to Value1999, Philosophy and Public Affairs 28(2): 105–138.-
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Added by: Simon Fokt
Introduction: Dworkin puts forth two main arguments to justify adhering to the wishes the patient expressed before becoming demented. As he sees it, this course of action both promotes the patient’s well-being and is required in order to respect the patient’s autonomy. In each argument, while I consider most of the ideas well-founded, I challenge the crucial premise. In the argument focused on the patient’s well-being, I dispute the claim that demented patients are no longer capable of generating what Dworkin calls “critical interests.” In the argument concerning autonomy, I question the premise that demented patients no longer possess the “capacity for autonomy.”7 In each case, I will trace how the problematic premise arises within Dworkin’s argument and then develop an alternative account of the relevant capacity.Comment : Jaworska asks: 'Should we, in our efforts to best respect a patient with dementia, give priority to the preferences and attitudes this person held before becoming demented, or should we follow the person’s present preferences?' (p. 108). The article offers a useful critical overview of the views expressed by Rebecca Dresser and Ronald Dworkin. It is best used as a primary reading in ethics classes focusing directly on medical ethics or autonomy, or as further reading in general ethics teaching on autonomy.Can’t find it?Contribute the texts you think should be here and we’ll add them soon!
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