Further information: Jerry Kroll & Perry Mason, Conceptual and Ethical Issues Involved in Psychiatry

There are four main questions that will underlie the eight sessions of this course.

A. Mental Illnesses: Are they diseases vs social constructions?

  • What are the requirements for illnesses to be diseases?
  • What are the requirements for illnesses/troubles to be unusual human behaviors or ways of being that become defined as disorders
  • Examination of all points between diseases and socially-constructed disorders – where are the joints or critical cutting scores?

B. Confounding Conditions: Are they important considerations?

  • Scientific: issues of methodology, bias, scientific limitations
  • Political: power; prejudices; social conformity; religious beliefs and values
  • Economic: special interests driving the definitions, research, and reimbursements
  • Professional Organizations: protecting one’s turf

C. Who speaks for the patient, family, community?

  • Who selects the values that guide decisions?
  • Who has the right to object to being diagnosed, being treated, being confined?
  • What are the credentials for being the ‘Decider’?
  • What credibility and epistemic privilege are given to Lived Experience?

D. What are philosophy’s contributions to these deliberations and actions?

  • Analyze and weigh the basic concepts involved
  • Assess the coherence of arguments
  • Parse out the role of moral/ethics in the theory and practice of psychiatry
  • Look at the role of existential, transcendental, and social theories of the meaning of life/worldviews in deciding health and illness.

Readings will be mainly from Jennifer Radden (ed.), The Philosophy of Psychiatry: A Companion, used paperback copies of which are listed online (bookfinder.com, alibris.com, amazon.com, etc.) for under $20. 
Additional readings will be provided by email.

Class schedule:

  1.   What is mental disorder? I: Basic general concepts of health and illness
    Radden, “Introduction,” pp. 3-18
    Gert & Culver, “Defining Mental Disorder,” pp. 415-25
    Church, “Social Constructionist Models”, pp. 393-406
    emailed pdf hand-outs
  2.   What is mental disorder? II:  Illness as dysfunction; Example of Depression
    Gillet, “Cognition: Brain Pain: Psychotic Cognition, Hallucination, and Delusions,” pp. 21-35
    Hansen, “Affectivity: Depression and Mania,” pp. 36-53
    Ericksson, Are SSRIs effective only for severe depression? – email PDF
    McHugh (book review), “The loss of sadness; How psychiatry transformed normal sorrow into depressive disorder” – email PDF
  3.   What is mental disorder III: Neurological reductionism
    Phillips, “Understanding/Explanation,” pp. 180-90
    Thornton, “Reductionism/Antireductionism,” pp. 191-204
    Gamar & Hardcastle, “Phenomenological and Hermeneutic Models: Understanding and Interpretation in Psychiatry,” pp. 364-80
    Szasz, “The Myth of Mental Illness” email PDF
  4.   Diagnosis of mental disorder I: disorders as natural kinds? Compare DSM-1, 2, and 3
    Sadler, “Diagnosis/Antidiagnosis,” pp. 164-79
    Fulford, “Facts/Values: Ten Principles of Values-Based Medicine,” pp. 205-34
    Harré, “Setting Benchmarks for Psychiatric Concepts,” pp. 409-14
    Sections on Depression and Schizophrenia: DSM-I (1952); II (1968); III (1980) -email PDF
  5.  Diagnosis of mental disorder II: Antipsychiatry, arbitrariness of criteria, religiosity
    Berlim et al: Notes on Antipsychiatry. Email PDF
    Cross-cultural constructs of norms of family interdependence
    Cross-cultural constructs re religious beliefs (mainstream; cults; demons)
    Jackson & Fulford, “Spiritual experience and psychopathology,” Email PDF
  6.  Mental Illness and Diagnostic Category “Creep”
    Are socially “undesirable” behaviors diagnostic of mental illness?
    Examples from DSM: Tobacco Use Disorder; Gambling Disorder
    History of changing diagnosis of Homosexuality across successive DSMs
    Criminal Behavior as evidence of mental illness: Mad vs Bad
    Wilson & Adshead, “Criminal Responsibility,” pp. 296 – 311
    Readings: selected email PDFs
  7.  A case in point: personality disorders–are they illnesses?
    Categories vs. Dimensional Models for conceptualizing Personality Disorders
    Borderline Personality Disorder; selected email PDFs (Kroll)
    Narcissistic Personality Disorder and Politics: Should psychiatry jump in?
    Kroll & Pouncy: “The ethics of APAs Goldwater Rule”, Email PDF
  8.  Moral virtue and mental disorder—client and psychiatrist
    Does the psychiatrist treat the person’s illness or the ‘whole’ person?
    What does the psychiatrist owe the patient, and vice-versa?
    Selected Email PDFs