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Kittay, Eva Feder. When Caring Is Just and Justice is Caring: Justice and Mental Retardation
2001, Public Culture 13(3): 557-580

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Added by: Jamie Robertson

Summary: In this paper, Kittay advances a conception of justice that 'begins with an acknowledgement of dependency and seeks to organise society so that our well-being is not inversely related to our need for care or to care' (576). Her motivation for advancing this view is that ideals of citizenship in liberal society, including independence and productivity, perpetuate the victimisation, social exclusion, or stigmatisation of people with mental retardation and their carers. This is because liberal definitions of personhood do not provide resources for responding in a morally adequate way to the mutual dependence of people with mental retardation and their carers/advocates. People with mental retardation are inescapably dependent because of their central need for attentive care. And, carers' work is so deeply other-directed that they also do not fit the liberal model of the rationally self-interested actor. Thus, both carers and their charges are vulnerable and need to be advocated for so that they can be seen as having important entitlements to public resources and claims to justice. To this end, Kittay proposes a conception of personhood that is based on relationships. Although those with mental retardation are inherently dependent, they still count as persons because they are able to participate in relationships. This makes them entitled to the satisfactions that make life worth living. To achieve the twin goal of achieving justice for familial or paid carers, Kittay advances a new principle of justice, doulia, which calls for larger society to support those who care for the inexorably dependent. Kittay takes her relational conception of personhood and her principle of doulia to ensure that appropriate forms of social organization exist to support all those who become dependent. She claims her view is needed because principles of charity and beneficence are not adequate since they are consistent with the continued stigmatization of mental retardation and care work, and ground only low-priority social obligations.

Comment: This paper, with it's helpful discussions of the elements of the liberal tradition with which Kittay specifically takes issue and the inadequacies of the Americans with Disabilities Act, would be an appropriate reading for courses about the philosophy of disability or about liberal political theory.

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Bordo, Susan. Anorexia Nervosa: Psychopathology as the Crystallization of Culture
1993, 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.

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Cooper, Rachel. Psychiatry and philosophy of science
2014, Routledge.

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Added by: Simon Fokt
Publisher’s Note:
Publisher: Psychiatry and Philosophy of Science explores conceptual issues in psychiatry from the perspective of analytic philosophy of science. Through an examination of those features of psychiatry that distinguish it from other sciences - for example, its contested subject matter, its particular modes of explanation, its multiple different theoretical frameworks, and its research links with big business - Rachel Cooper explores some of the many conceptual, metaphysical and epistemological issues that arise in psychiatry. She shows how these pose interesting challenges for the philosopher of science while also showing how ideas from the philosophy of science can help to solve conceptual problems within psychiatry. Cooper's discussion ranges over such topics as the nature of mental illnesses, the treatment decisions and diagnostic categories of psychiatry, the case-history as a form of explanation, how psychiatry might be value-laden, the claim that psychiatry is a multi-paradigm science, the distortion of psychiatric research by pharmaceutical industries, as well as engaging with the fundamental question whether the mind is reducible to something at the physical level. "Psychiatry and Philosophy of Science" demonstrates that cross-disciplinary contact between philosophy of science and psychiatry can be immensely productive for both subjects and it will be required reading for mental health professionals and philosophers alike.

Comment: This book is written in a very approachable way and requires little prior knowledge of psychiatry or philosophy, which makes it an excellent resource for undergraduate teaching. Chapters two and three contain one of the most informative and clear reviews of the debate about the nature of mental illness. Chapters four to seven focus on the scientific status of psychiatry and look at the possibility of neurobiological reductionism. The text can be used in a number of teaching situations, stretching from moral dilemmas related to mental illness, to the philosophy of mind questions on mind-brain reductionism.

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Cooper, Rachel. Classifying madness: a philosophical examination of the diagnostic and statistical manual of mental disorders
2005, Dordrecht: Springer.

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Added by: Simon Fokt
Publisher’s Note:
Publisher: Classifying Madness concerns philosophical problems with the Diagnostic and Statistical Manual of Mental Disorders, more commonly known as the D.S.M. The D.S.M. is published by the American Psychiatric Association and aims to list and describe all mental disorders. The first half of Classifying Madness asks whether the project of constructing a classification of mental disorders that reflects natural distinctions makes sense. Chapters examine the nature of mental illness, and also consider whether mental disorders fall into natural kinds. The second half of the book addresses epistemic worries. Even supposing a natural classification system to be possible in principle, there may be reasons to be suspicious of the categories included in the D.S.M. I examine the extent to which the D.S.M. depends on psychiatric theory, and look at how it has been shaped by social and financial factors. I aim to be critical of the D.S.M. without being antagonistic towards it. Ultimately, however, I am forced to conclude that although the D.S.M. is of immense practical importance, it is unlikely to come to reflect the natural structure of mental disorders.

Comment: The early chapters are particularly useful in teaching, as they discuss the treatment of mental disorders as natural kinds. They are particularly useful in teaching applied ethics related to mental disorders and can inform a discussion on the claims made by the members of the antipsychiatrist movement. The text can also provide good support for advanced level teaching focusing on natural kinds and social constructs.

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Haksar, Vinit. The responsibility of psychopaths
1965, 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.

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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 SyllabiThesis: 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.

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