Abstract:We propose that accountability plays an implicit, important, and relatively unexamined role in psychiatry. People generally think of accountability as a relation in which one party is held accountable by another. In this paper, we examine accountability as a virtue, drawing on philosophy, psychiatry, and psychology to examine what it means to welcome being accountable in an excellent way that promotes flourishing. When people manifest accountability as a virtue, they are both responsive to others they owe a response, and they are responsible for their attitudes and actions in light of these relationships. Psychiatric treatment often aims to correct disordered forms of accountability, including difficulties with empathy and self-regulation. Both the process of treatment and the practice of professionalism depend on relationally responsible accountability. We examine accountability as an overlooked complement to healthy autonomy. Whereas acting autonomously in congruence with one’s values is characteristic of mental health, accountability that is interpersonally responsive and responsible is vital to successful treatment as well as professionalism in psychiatry. We review components of accountability and developmental aspects of the virtue; highlight the role of accountability in healthy functioning; and describe implications for psychiatric assessment, treatment, and professionalism. We aim to catalyze awareness of accountability as intrinsic to mental health care and human flourishing.
{"title":"Accountability as a Key Virtue in Mental Health and Human Flourishing","authors":"J. Peteet, C. Witvliet, C. Evans","doi":"10.1353/ppp.2022.0008","DOIUrl":"https://doi.org/10.1353/ppp.2022.0008","url":null,"abstract":"Abstract:We propose that accountability plays an implicit, important, and relatively unexamined role in psychiatry. People generally think of accountability as a relation in which one party is held accountable by another. In this paper, we examine accountability as a virtue, drawing on philosophy, psychiatry, and psychology to examine what it means to welcome being accountable in an excellent way that promotes flourishing. When people manifest accountability as a virtue, they are both responsive to others they owe a response, and they are responsible for their attitudes and actions in light of these relationships. Psychiatric treatment often aims to correct disordered forms of accountability, including difficulties with empathy and self-regulation. Both the process of treatment and the practice of professionalism depend on relationally responsible accountability. We examine accountability as an overlooked complement to healthy autonomy. Whereas acting autonomously in congruence with one’s values is characteristic of mental health, accountability that is interpersonally responsive and responsible is vital to successful treatment as well as professionalism in psychiatry. We review components of accountability and developmental aspects of the virtue; highlight the role of accountability in healthy functioning; and describe implications for psychiatric assessment, treatment, and professionalism. We aim to catalyze awareness of accountability as intrinsic to mental health care and human flourishing.","PeriodicalId":45397,"journal":{"name":"Philosophy Psychiatry & Psychology","volume":"15 1","pages":"49 - 60"},"PeriodicalIF":2.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83362545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Accountability and Autonomy","authors":"J. Peteet, C. Witvliet, C. Evans","doi":"10.1353/ppp.2022.0011","DOIUrl":"https://doi.org/10.1353/ppp.2022.0011","url":null,"abstract":"","PeriodicalId":45397,"journal":{"name":"Philosophy Psychiatry & Psychology","volume":"62 1","pages":"69 - 71"},"PeriodicalIF":2.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90912934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract:This paper asks what sorts of ethical caution ought to attach to increasingly data-driven approaches to understanding the brain. This is taken to be an important question especially owing to a likely near future of neuromonitoring and neuromodulation devices with applications in psychiatry. The paper explores this by i) sketching the concept of ‘digital twin,’ ii) drawing a schematic picture of ‘brain datafication’ in general, and iii) developing a means of understanding some challenges present in datafication through the lens of digital twins. One central concern arises from the role algorithmic processing of neural recordings plays in terms of neuroscientific objectivity, with knock on effects for psychiatric ethics. Essentially, this is owing to a way in which algorithmic processing in brain data construction appears to be deductive in character, but is in fact based on a particular scheme of inductive inference. The challenges explored urge ethical caution as they concern epistemological gaps in data-centered neuroscientific progress, as well as knock-on effects for psychiatry.
{"title":"Datafied Brains and Digital Twins: Lessons From Industry, Caution For Psychiatry","authors":"Stephen Rainey","doi":"10.1353/ppp.2022.0005","DOIUrl":"https://doi.org/10.1353/ppp.2022.0005","url":null,"abstract":"Abstract:This paper asks what sorts of ethical caution ought to attach to increasingly data-driven approaches to understanding the brain. This is taken to be an important question especially owing to a likely near future of neuromonitoring and neuromodulation devices with applications in psychiatry. The paper explores this by i) sketching the concept of ‘digital twin,’ ii) drawing a schematic picture of ‘brain datafication’ in general, and iii) developing a means of understanding some challenges present in datafication through the lens of digital twins. One central concern arises from the role algorithmic processing of neural recordings plays in terms of neuroscientific objectivity, with knock on effects for psychiatric ethics. Essentially, this is owing to a way in which algorithmic processing in brain data construction appears to be deductive in character, but is in fact based on a particular scheme of inductive inference. The challenges explored urge ethical caution as they concern epistemological gaps in data-centered neuroscientific progress, as well as knock-on effects for psychiatry.","PeriodicalId":45397,"journal":{"name":"Philosophy Psychiatry & Psychology","volume":"18 1","pages":"29 - 42"},"PeriodicalIF":2.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81827352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract:Most people would never question what makes a thought theirs. Nothing seems to signal ‘madness’ such as schizophrenia more than the claims that one’s thoughts and actions are not one’s own. In a sense, individuals with schizophrenia suffer from a kind of disbelief, namely the disbelief toward the Cartesian certainty. Anything that challenges this certainty is penalized by the wider society and labeled as ‘delusional,’ ‘unreal,’ and ‘false.’ After all, to go against the Cartesian certainty is to go against the authority of the first person. The core of the experience of a schizophrenic disorder lies within a labyrinth of uncertain, paradoxical, unstable and unsustainable ‘in-between’ states of thought, perception and volition that in their totality contribute to what may be termed ‘ontologically impossible’ experiences. In this paper, I aim to explain what it means to go through such experiences, their significance to the understanding of thought and perception, how they might help with the clinician’s differential diagnosis, before discussing the implications of ‘what if’ these experiences are not so impossible after all.
{"title":"Isolated by Oneself: Ontologically Impossible Experiences in Schizophrenia","authors":"Clara S. Humpston","doi":"10.1353/ppp.2022.0001","DOIUrl":"https://doi.org/10.1353/ppp.2022.0001","url":null,"abstract":"Abstract:Most people would never question what makes a thought theirs. Nothing seems to signal ‘madness’ such as schizophrenia more than the claims that one’s thoughts and actions are not one’s own. In a sense, individuals with schizophrenia suffer from a kind of disbelief, namely the disbelief toward the Cartesian certainty. Anything that challenges this certainty is penalized by the wider society and labeled as ‘delusional,’ ‘unreal,’ and ‘false.’ After all, to go against the Cartesian certainty is to go against the authority of the first person. The core of the experience of a schizophrenic disorder lies within a labyrinth of uncertain, paradoxical, unstable and unsustainable ‘in-between’ states of thought, perception and volition that in their totality contribute to what may be termed ‘ontologically impossible’ experiences. In this paper, I aim to explain what it means to go through such experiences, their significance to the understanding of thought and perception, how they might help with the clinician’s differential diagnosis, before discussing the implications of ‘what if’ these experiences are not so impossible after all.","PeriodicalId":45397,"journal":{"name":"Philosophy Psychiatry & Psychology","volume":"1 1","pages":"15 - 5"},"PeriodicalIF":2.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83944105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract:There is still a good deal of disagreement about which conditions should be viewed as psychiatric disorders. In the third and fourth editions of the Diagnostic and Statistical Manual of Mental Disorders, the "bereavement exclusion" distinguished symptoms of non-disordered grief from major depressive disorder, because treating "normal" grief medically was considered inappropriate. In DSM-5, this "bereavement exclusion" was removed, on the grounds that symptoms of grief reaching the intensity and duration of symptoms of major depressive disorder should be treated as "complicated" grief in order to alleviate suffering. This removal was controversial. What was at stake in this change was whether it is better to err in the direction of undertreating or overtreating those with distressing grief. A widespread underlying assumption—on all sides of the controversy—is that normal reactions to major losses should not be classified as psychiatric disorders. I challenge this assumption. This article proposes including a new concept of psychological injury in the broader concept of psychiatric disorder. Psychological injury, like physical injury, can evoke a normal response that calls for clinical attention. When major losses (such as bereavement) are conceptualized as psychological injuries, treatment eligibility can be assured without classifying the patient's reactions to loss as pathological or abnormal. The word "pathological," with its evocations of nineteenth century microscopy, is unhelpful in this psychiatric context. The word "abnormal" is also best avoided here because of its associations with normative judgments. The word "disorder" serves a useful and less stigmatizing role that should not be identified with the terms "pathology" or "abnormality."
{"title":"On the Concept of \"Psychiatric Disorder\": Incorporating Psychological Injury","authors":"M. Solomon","doi":"10.1353/ppp.2021.0051","DOIUrl":"https://doi.org/10.1353/ppp.2021.0051","url":null,"abstract":"Abstract:There is still a good deal of disagreement about which conditions should be viewed as psychiatric disorders. In the third and fourth editions of the Diagnostic and Statistical Manual of Mental Disorders, the \"bereavement exclusion\" distinguished symptoms of non-disordered grief from major depressive disorder, because treating \"normal\" grief medically was considered inappropriate. In DSM-5, this \"bereavement exclusion\" was removed, on the grounds that symptoms of grief reaching the intensity and duration of symptoms of major depressive disorder should be treated as \"complicated\" grief in order to alleviate suffering. This removal was controversial. What was at stake in this change was whether it is better to err in the direction of undertreating or overtreating those with distressing grief. A widespread underlying assumption—on all sides of the controversy—is that normal reactions to major losses should not be classified as psychiatric disorders. I challenge this assumption. This article proposes including a new concept of psychological injury in the broader concept of psychiatric disorder. Psychological injury, like physical injury, can evoke a normal response that calls for clinical attention. When major losses (such as bereavement) are conceptualized as psychological injuries, treatment eligibility can be assured without classifying the patient's reactions to loss as pathological or abnormal. The word \"pathological,\" with its evocations of nineteenth century microscopy, is unhelpful in this psychiatric context. The word \"abnormal\" is also best avoided here because of its associations with normative judgments. The word \"disorder\" serves a useful and less stigmatizing role that should not be identified with the terms \"pathology\" or \"abnormality.\"","PeriodicalId":45397,"journal":{"name":"Philosophy Psychiatry & Psychology","volume":"41 1","pages":"329 - 339"},"PeriodicalIF":2.3,"publicationDate":"2022-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77872613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Concepts, Concrete Struggles Mohammed Abouelleil Rashed What Is Meant by “the scope of
Mohammed Abouelleil Rashed“范围”的含义是什么
{"title":"Recognition and Identity: Abstract Concepts, Concrete Struggles","authors":"M. Rashed","doi":"10.1353/ppp.2021.0050","DOIUrl":"https://doi.org/10.1353/ppp.2021.0050","url":null,"abstract":"Concepts, Concrete Struggles Mohammed Abouelleil Rashed What Is Meant by “the scope of","PeriodicalId":45397,"journal":{"name":"Philosophy Psychiatry & Psychology","volume":"1 1","pages":"323 - 328"},"PeriodicalIF":2.3,"publicationDate":"2022-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86104173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Limits of Community for A Theory of Recognition","authors":"Audra L. Goodnight","doi":"10.1353/ppp.2021.0049","DOIUrl":"https://doi.org/10.1353/ppp.2021.0049","url":null,"abstract":"","PeriodicalId":45397,"journal":{"name":"Philosophy Psychiatry & Psychology","volume":"34 3","pages":"319 - 322"},"PeriodicalIF":2.3,"publicationDate":"2022-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72556846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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