Several recent studies have explored how people may favor different explanations for others’ beha... more Several recent studies have explored how people may favor different explanations for others’ behavior depending on the moral or evaluative valence of the behavior in question. This research tested whether people would be less willing to believe that a person's environment played a role in causing them to exhibit antisocial (as compared to prosocial) behavior. In three experiments, participants read a description of a person engaging in either antisocial or prosocial behavior. Participants were less willing to endorse environmental causes of antisocial (vs. prosocial) behavior when the environmental influence in question was witnessing others behaving similarly, either during childhood (Experiment 1) or recently (Experiment 2), or being directly encouraged by others to engage in the behavior described (Experiment 3). These results could be relevant to understanding why people resist attributing wrongdoing to causes outside of individual control in some cases.
John Locke offers an unusual account of madness which, unlike the dominant medical theories of hi... more John Locke offers an unusual account of madness which, unlike the dominant medical theories of his time, explains it as a pathology of ideas rather than of mental faculties or of physiology. In madness, according to Locke, ideas become associated through a variety of mechanisms that occur outside the ambit of the understanding. Locke contrasts associated ideas with healthy ones, which are connected through the activity of mental operations like discernment, composition, and abstraction. After presenting Locke's account of madness as the association of ideas, this paper shows how its justification drew on his commitments to the tenets of ancient medical skepticism, which discouraged speculation and theorization in favor of observation and experience. It then discusses how Locke mobilized this account to further his philosophical projects-namely his case against nativism-using traditional Pyrrhonian strategies. Locke argued that associated ideas, when used to construct maxims, can lead to false beliefs that seem to have all the certainty and indubitability of inspiration. He used madness to explain the irreconcilable religious and political rifts that engulfed him, and to argue that skepticism about our beliefs, and about the origins of our ideas, is the best prophylactic against dogmatism and zealotry.
DOAJ (DOAJ: Directory of Open Access Journals), 2021
The biopsychosocial model, which was deeply influential on psychiatry following its introduction ... more The biopsychosocial model, which was deeply influential on psychiatry following its introduction by George L. Engel in 1977, has recently made a comeback. Derek Bolton and Grant Gillett have argued that Engel's original formulation offered a promising general framework for thinking about health and disease, but that this promise requires new empirical and philosophical tools in order to be realized. In particular, Bolton and Gillett offer an original analysis of the ontological relations between Engel's biological, social, and psychological levels of analysis. I argue that Bolton and Gillett's updated model, while providing an intriguing new metaphysical framework for medicine, cannot resolve some of the most vexing problems facing psychiatry, which have to do with how to prioritize different sorts of research. These problems are fundamentally ethical, rather than ontological. Without the right prudential motivation, in other words, the unification of psychiatry under a single conceptual framework seems doubtful, no matter how compelling the model. An updated biopsychosocial model should include explicit normative commitments about the aims of medicine that can give guidance about the sorts of causal connections to be prioritized as research and clinical targets.
People tend to rate prosocial or positive behavior as more strongly influenced by the actor's... more People tend to rate prosocial or positive behavior as more strongly influenced by the actor's genes than antisocial or negative behavior. The current study tested whether people would show a similar asymmetry when rating the role of genes in their own behavior, and if so, what variables might mediate this difference. Participants were prompted to think about an example of their own behavior from the past year that was either prosocial or antisocial. Those in the prosocial condition rated the role of genetics in causing the behavior as significantly greater than did those in the antisocial condition. A mediation analysis suggested that this asymmetry could be accounted for by a tendency to view prosocial behavior as more natural and more aligned with one's true self than antisocial behavior. These findings add to a growing body of evidence suggesting that people's reasoning about genetics may be influenced by evaluative judgments.
This event will take place as a public Zoom panel starting at 3:00 pm EDT. Please REGISTER HERE i... more This event will take place as a public Zoom panel starting at 3:00 pm EDT. Please REGISTER HERE in advance. After registering, you will receive a confirmation email containing information about joining the meeting. Please email disability@columbia.edu to request disability accommodations. Advance notice is necessary to arrange for some accessibility needs. Event Video: Kathryn Tabb, Can Precision Medicine Care for the Polis? A recent vogue in medicine has been for “precision”. This new paradigm for medicine, also referred to as “personalized” medicine, promises to particularize patient care to the sensitivities of each of our bodies, which we ourselves may or may not be aware of, by identifying rare genetic variants and other biomarkers of disease. While advocates of precision medicine often characterize it in opposition to traditional practices and methods that are vague, careless or nonspecific, I argue that the true opponent of precision medicine — that is, the sort of medicine ...
Care for the Polis is a conversation that exists in a multi-temporal and virtual space, a space d... more Care for the Polis is a conversation that exists in a multi-temporal and virtual space, a space designed to reimagine how medical humanities and public humanities shape, and are shaped by, the city and its diverse publics. In a series of weekly Z-Panels, our invited speakers will discuss the effects of health on the conception of cities and publics—including, in the context of pandemic, the foreclosure of public space and what it means to become an online yet domestic-bound public. Together, we will address emerging concerns such as economic impact and recovery, domesticity and democracy, public care and public reconstruction.
, the initiative aims to recruit a nationally representative research cohort of one million peopl... more , the initiative aims to recruit a nationally representative research cohort of one million people in order to "accelerate our understanding of individual variability and its effect on disease onset, progression, prevention, and treatment." 1 Along with a burst of public funding for cancer genomics, the Initiative was part of a national embrace of precision medicine, which the National Research Council defines as "the tailoring of medical treatment to the individual characteristics of each patient" (2011); the National Cancer Institute describes it as "an approach to patient care that allows doctors to select treatments that are most likely to help patients based on a genetic understanding of their disease." 2 One immediate effect of the growing interest in precision medicine has been a reallocation of resources toward genetics and other basic sciences that promise to generate the sort of discoveries that will transform clinical diagnostics in these ways. The author thanks Maël Lemoine, Scott Lilienfeld, Jan-Willem Romeijn, Jim Tabery, and Hanna M. Van Loo for discussions about these themes and feedback on this chapter.
Chapter 24 is a commentary on Chapter 23, which covers operationalism, Bridgman, DSM-III, the str... more Chapter 24 is a commentary on Chapter 23, which covers operationalism, Bridgman, DSM-III, the structured interview, phenomenology, and the origins of this term, its historical permutations, and its current status in the diagnostic manuals.
Chapter 11 discusses how the debates over the relationship between social factors and progress in... more Chapter 11 discusses how the debates over the relationship between social factors and progress in psychiatry have been muddied by confusion over how the term “social construction” has been, and should be, used. It covers how one option is to move away from the language of social construction, like many in the literature have done since the 1990s. But this move risks obscuring the continued importance of attending to the role of the social in psychiatric progress. This chapter aims to clarify the different positions taken by social constructionists about psychiatric disorders and to advocate for what it calls “inclusionary social constructionism.” Through a comparison between the history of HIV/AIDS and the present state of schizophrenia in research and medical settings, the chapter illustrates and evaluates the space of possible characterizations of social construction by psychiatrists and philosophers of psychiatry.
Western psychiatry emerged as a medical specialty caring for the mentally ill over the course of ... more Western psychiatry emerged as a medical specialty caring for the mentally ill over the course of the late 18th and early 19th centuries. This emergence was a contingent process, dependent on the co-occurrence of three historical developments that together shaped the young discipline. The first was the rise of the mind as an entity with numerous active faculties in the conceptual space between the body and the Christian soul. Only by the latter half of the 18th century was it common to conceptualize conditions like mania or melancholy as mental illnesses. The second advance critical to psychiatry's proto-specialty status, with its increasing focus on a mechanistic understanding of disease, was the rejection of humoral theories of insanity in favor of the brain and nerves as the seat of madness. The third development was the rise of the asylum. Only in dedicated institutions could mad-doctors be exposed to large numbers of the insane, permitting the development of a specialized clinical vocabulary grounded in faculties of mind, which led to new nosologic systems. The decline of humoral medicine, with its purges, bleeding, and emetics, and the urgent clinical need for care produced, in early asylums, the first novel treatment from the young specialty: moral therapy. We tell this story focusing mainly on the work of five philosophers and physicians: Descartes, Willis, Locke, Boerhaave, de Sauvages, and Cullen. Throughout its history, psychiatry has struggled with its sometimes disconjugate goals of understanding both mind and brain, with alternating efforts to expel one of these tasks from the profession. A historical perspective demonstrates that psychiatry is a profession inextricably linked to these two contrasting projects-and, indeed, jointly constituted by them.
People tend to rate prosocial or positive behavior as more strongly influenced by the actor&#... more People tend to rate prosocial or positive behavior as more strongly influenced by the actor's genes than antisocial or negative behavior. The current study tested whether people would show a similar asymmetry when rating the role of genes in their own behavior, and if so, what variables might mediate this difference. Participants were prompted to think about an example of their own behavior from the past year that was either prosocial or antisocial. Those in the prosocial condition rated the role of genetics in causing the behavior as significantly greater than did those in the antisocial condition. A mediation analysis suggested that this asymmetry could be accounted for by a tendency to view prosocial behavior as more natural and more aligned with one's true self than antisocial behavior. These findings add to a growing body of evidence suggesting that people's reasoning about genetics may be influenced by evaluative judgments.
Since the turn of the twenty-first century, biomedical psychiatry around the globe has embraced t... more Since the turn of the twenty-first century, biomedical psychiatry around the globe has embraced the so-called precision medicine paradigm, a model for medical research that uses innovative techniques for data collection and analysis to reevaluate traditional theories of disease. The goal of precision medicine is to improve diagnostics by restratifying the patient population on the basis of a deeper understanding of disease processes. This paper argues that precision is ill-fitting for psychiatry for two reasons. First, in psychiatry, unlike in fields like oncology, precision medicine has been understood as an attempt to improve medicine by casting out, rather than merely revising, traditional taxonomic tools. Second, in psychiatry the term "biomarker" is often used in reference to signs or symptoms that allow patients to be classified and then matched with treatments; however, in oncology "biomarker" usually refers to a disease mechanism that is useful not only for diagnostics, but also for discovering causal pathways that drug therapies can target. Given these differences between how the precision medicine paradigm operates in psychiatry and in other medical fields like oncology, while precision psychiatry may offer successful rhetoric, it is not a promising paradigm.
Addicts are often portrayed as compelled by their addiction and thus as a paradigm of unfree acti... more Addicts are often portrayed as compelled by their addiction and thus as a paradigm of unfree action and mitigated blame. This chapter argues that our best scientific theories of addiction reveal that, psychologically, addicts are not categorically different from non-addicts. There is no pairing of contemporary accounts of addiction and of prominent theories of moral responsibility that can justify our intuitions about the mitigation of addicts but not non-addicts. Two conclusions are advanced. First, we should either treat addicts as we normally treat non-addicts (as fully culpable) or embrace the skeptical conclusion that everyone is less responsible than we thought—perhaps not responsible at all. Second, we should be doubtful that theorizing about responsibility will be advanced by focusing on particular kinds of psychopathologies.
Several recent studies have explored how people may favor different explanations for others’ beha... more Several recent studies have explored how people may favor different explanations for others’ behavior depending on the moral or evaluative valence of the behavior in question. This research tested whether people would be less willing to believe that a person's environment played a role in causing them to exhibit antisocial (as compared to prosocial) behavior. In three experiments, participants read a description of a person engaging in either antisocial or prosocial behavior. Participants were less willing to endorse environmental causes of antisocial (vs. prosocial) behavior when the environmental influence in question was witnessing others behaving similarly, either during childhood (Experiment 1) or recently (Experiment 2), or being directly encouraged by others to engage in the behavior described (Experiment 3). These results could be relevant to understanding why people resist attributing wrongdoing to causes outside of individual control in some cases.
John Locke offers an unusual account of madness which, unlike the dominant medical theories of hi... more John Locke offers an unusual account of madness which, unlike the dominant medical theories of his time, explains it as a pathology of ideas rather than of mental faculties or of physiology. In madness, according to Locke, ideas become associated through a variety of mechanisms that occur outside the ambit of the understanding. Locke contrasts associated ideas with healthy ones, which are connected through the activity of mental operations like discernment, composition, and abstraction. After presenting Locke's account of madness as the association of ideas, this paper shows how its justification drew on his commitments to the tenets of ancient medical skepticism, which discouraged speculation and theorization in favor of observation and experience. It then discusses how Locke mobilized this account to further his philosophical projects-namely his case against nativism-using traditional Pyrrhonian strategies. Locke argued that associated ideas, when used to construct maxims, can lead to false beliefs that seem to have all the certainty and indubitability of inspiration. He used madness to explain the irreconcilable religious and political rifts that engulfed him, and to argue that skepticism about our beliefs, and about the origins of our ideas, is the best prophylactic against dogmatism and zealotry.
DOAJ (DOAJ: Directory of Open Access Journals), 2021
The biopsychosocial model, which was deeply influential on psychiatry following its introduction ... more The biopsychosocial model, which was deeply influential on psychiatry following its introduction by George L. Engel in 1977, has recently made a comeback. Derek Bolton and Grant Gillett have argued that Engel's original formulation offered a promising general framework for thinking about health and disease, but that this promise requires new empirical and philosophical tools in order to be realized. In particular, Bolton and Gillett offer an original analysis of the ontological relations between Engel's biological, social, and psychological levels of analysis. I argue that Bolton and Gillett's updated model, while providing an intriguing new metaphysical framework for medicine, cannot resolve some of the most vexing problems facing psychiatry, which have to do with how to prioritize different sorts of research. These problems are fundamentally ethical, rather than ontological. Without the right prudential motivation, in other words, the unification of psychiatry under a single conceptual framework seems doubtful, no matter how compelling the model. An updated biopsychosocial model should include explicit normative commitments about the aims of medicine that can give guidance about the sorts of causal connections to be prioritized as research and clinical targets.
People tend to rate prosocial or positive behavior as more strongly influenced by the actor's... more People tend to rate prosocial or positive behavior as more strongly influenced by the actor's genes than antisocial or negative behavior. The current study tested whether people would show a similar asymmetry when rating the role of genes in their own behavior, and if so, what variables might mediate this difference. Participants were prompted to think about an example of their own behavior from the past year that was either prosocial or antisocial. Those in the prosocial condition rated the role of genetics in causing the behavior as significantly greater than did those in the antisocial condition. A mediation analysis suggested that this asymmetry could be accounted for by a tendency to view prosocial behavior as more natural and more aligned with one's true self than antisocial behavior. These findings add to a growing body of evidence suggesting that people's reasoning about genetics may be influenced by evaluative judgments.
This event will take place as a public Zoom panel starting at 3:00 pm EDT. Please REGISTER HERE i... more This event will take place as a public Zoom panel starting at 3:00 pm EDT. Please REGISTER HERE in advance. After registering, you will receive a confirmation email containing information about joining the meeting. Please email disability@columbia.edu to request disability accommodations. Advance notice is necessary to arrange for some accessibility needs. Event Video: Kathryn Tabb, Can Precision Medicine Care for the Polis? A recent vogue in medicine has been for “precision”. This new paradigm for medicine, also referred to as “personalized” medicine, promises to particularize patient care to the sensitivities of each of our bodies, which we ourselves may or may not be aware of, by identifying rare genetic variants and other biomarkers of disease. While advocates of precision medicine often characterize it in opposition to traditional practices and methods that are vague, careless or nonspecific, I argue that the true opponent of precision medicine — that is, the sort of medicine ...
Care for the Polis is a conversation that exists in a multi-temporal and virtual space, a space d... more Care for the Polis is a conversation that exists in a multi-temporal and virtual space, a space designed to reimagine how medical humanities and public humanities shape, and are shaped by, the city and its diverse publics. In a series of weekly Z-Panels, our invited speakers will discuss the effects of health on the conception of cities and publics—including, in the context of pandemic, the foreclosure of public space and what it means to become an online yet domestic-bound public. Together, we will address emerging concerns such as economic impact and recovery, domesticity and democracy, public care and public reconstruction.
, the initiative aims to recruit a nationally representative research cohort of one million peopl... more , the initiative aims to recruit a nationally representative research cohort of one million people in order to "accelerate our understanding of individual variability and its effect on disease onset, progression, prevention, and treatment." 1 Along with a burst of public funding for cancer genomics, the Initiative was part of a national embrace of precision medicine, which the National Research Council defines as "the tailoring of medical treatment to the individual characteristics of each patient" (2011); the National Cancer Institute describes it as "an approach to patient care that allows doctors to select treatments that are most likely to help patients based on a genetic understanding of their disease." 2 One immediate effect of the growing interest in precision medicine has been a reallocation of resources toward genetics and other basic sciences that promise to generate the sort of discoveries that will transform clinical diagnostics in these ways. The author thanks Maël Lemoine, Scott Lilienfeld, Jan-Willem Romeijn, Jim Tabery, and Hanna M. Van Loo for discussions about these themes and feedback on this chapter.
Chapter 24 is a commentary on Chapter 23, which covers operationalism, Bridgman, DSM-III, the str... more Chapter 24 is a commentary on Chapter 23, which covers operationalism, Bridgman, DSM-III, the structured interview, phenomenology, and the origins of this term, its historical permutations, and its current status in the diagnostic manuals.
Chapter 11 discusses how the debates over the relationship between social factors and progress in... more Chapter 11 discusses how the debates over the relationship between social factors and progress in psychiatry have been muddied by confusion over how the term “social construction” has been, and should be, used. It covers how one option is to move away from the language of social construction, like many in the literature have done since the 1990s. But this move risks obscuring the continued importance of attending to the role of the social in psychiatric progress. This chapter aims to clarify the different positions taken by social constructionists about psychiatric disorders and to advocate for what it calls “inclusionary social constructionism.” Through a comparison between the history of HIV/AIDS and the present state of schizophrenia in research and medical settings, the chapter illustrates and evaluates the space of possible characterizations of social construction by psychiatrists and philosophers of psychiatry.
Western psychiatry emerged as a medical specialty caring for the mentally ill over the course of ... more Western psychiatry emerged as a medical specialty caring for the mentally ill over the course of the late 18th and early 19th centuries. This emergence was a contingent process, dependent on the co-occurrence of three historical developments that together shaped the young discipline. The first was the rise of the mind as an entity with numerous active faculties in the conceptual space between the body and the Christian soul. Only by the latter half of the 18th century was it common to conceptualize conditions like mania or melancholy as mental illnesses. The second advance critical to psychiatry's proto-specialty status, with its increasing focus on a mechanistic understanding of disease, was the rejection of humoral theories of insanity in favor of the brain and nerves as the seat of madness. The third development was the rise of the asylum. Only in dedicated institutions could mad-doctors be exposed to large numbers of the insane, permitting the development of a specialized clinical vocabulary grounded in faculties of mind, which led to new nosologic systems. The decline of humoral medicine, with its purges, bleeding, and emetics, and the urgent clinical need for care produced, in early asylums, the first novel treatment from the young specialty: moral therapy. We tell this story focusing mainly on the work of five philosophers and physicians: Descartes, Willis, Locke, Boerhaave, de Sauvages, and Cullen. Throughout its history, psychiatry has struggled with its sometimes disconjugate goals of understanding both mind and brain, with alternating efforts to expel one of these tasks from the profession. A historical perspective demonstrates that psychiatry is a profession inextricably linked to these two contrasting projects-and, indeed, jointly constituted by them.
People tend to rate prosocial or positive behavior as more strongly influenced by the actor&#... more People tend to rate prosocial or positive behavior as more strongly influenced by the actor's genes than antisocial or negative behavior. The current study tested whether people would show a similar asymmetry when rating the role of genes in their own behavior, and if so, what variables might mediate this difference. Participants were prompted to think about an example of their own behavior from the past year that was either prosocial or antisocial. Those in the prosocial condition rated the role of genetics in causing the behavior as significantly greater than did those in the antisocial condition. A mediation analysis suggested that this asymmetry could be accounted for by a tendency to view prosocial behavior as more natural and more aligned with one's true self than antisocial behavior. These findings add to a growing body of evidence suggesting that people's reasoning about genetics may be influenced by evaluative judgments.
Since the turn of the twenty-first century, biomedical psychiatry around the globe has embraced t... more Since the turn of the twenty-first century, biomedical psychiatry around the globe has embraced the so-called precision medicine paradigm, a model for medical research that uses innovative techniques for data collection and analysis to reevaluate traditional theories of disease. The goal of precision medicine is to improve diagnostics by restratifying the patient population on the basis of a deeper understanding of disease processes. This paper argues that precision is ill-fitting for psychiatry for two reasons. First, in psychiatry, unlike in fields like oncology, precision medicine has been understood as an attempt to improve medicine by casting out, rather than merely revising, traditional taxonomic tools. Second, in psychiatry the term "biomarker" is often used in reference to signs or symptoms that allow patients to be classified and then matched with treatments; however, in oncology "biomarker" usually refers to a disease mechanism that is useful not only for diagnostics, but also for discovering causal pathways that drug therapies can target. Given these differences between how the precision medicine paradigm operates in psychiatry and in other medical fields like oncology, while precision psychiatry may offer successful rhetoric, it is not a promising paradigm.
Addicts are often portrayed as compelled by their addiction and thus as a paradigm of unfree acti... more Addicts are often portrayed as compelled by their addiction and thus as a paradigm of unfree action and mitigated blame. This chapter argues that our best scientific theories of addiction reveal that, psychologically, addicts are not categorically different from non-addicts. There is no pairing of contemporary accounts of addiction and of prominent theories of moral responsibility that can justify our intuitions about the mitigation of addicts but not non-addicts. Two conclusions are advanced. First, we should either treat addicts as we normally treat non-addicts (as fully culpable) or embrace the skeptical conclusion that everyone is less responsible than we thought—perhaps not responsible at all. Second, we should be doubtful that theorizing about responsibility will be advanced by focusing on particular kinds of psychopathologies.
Until recently, medicine has had little to offer most of the millions of patients suffering from ... more Until recently, medicine has had little to offer most of the millions of patients suffering from rare and ultrarare genetic conditions. But the development in 2019 of Milasen, the first genetic intervention developed for and administered to a single patient suffering from an ultrarare genetic disorder, has offered hope to patients and families. In addition, Milasen raised a series of conceptual and ethical questions about how individualised genetic interventions should be developed, assessed for safety and efficacy and financially supported. The answers to these questions depend in large part on whether individualised therapies are understood as human subjects research or clinical innovation, different domains of biomedicine that are regulated by different modes of oversight, funding and professional norms. In this article, with development and administration of the drug Milasen as our case study, we argue that at least some individualised genetic therapies are not, as some have argued, either research or treatment. Instead, they are research-treatment hybrids, a category that has both epistemological and pragmatic repercussions for funding, ethics oversight and regulation.
People tend to rate prosocial or positive behavior as more strongly influenced by the actor's gen... more People tend to rate prosocial or positive behavior as more strongly influenced by the actor's genes than antisocial or negative behavior. The current study tested whether people would show a similar asymmetry when rating the role of genes in their own behavior, and if so, what variables might mediate this difference. Participants were prompted to think about an example of their own behavior from the past year that was either prosocial or antisocial. Those in the prosocial condition rated the role of genetics in causing the behavior as significantly greater than did those in the antisocial condition. A mediation analysis suggested that this asymmetry could be accounted for by a tendency to view prosocial behavior as more natural and more aligned with one's true self than antisocial behavior. These findings add to a growing body of evidence suggesting that people's reasoning about genetics may be influenced by evaluative judgments.
In our article (Lilienfeld et al., 2019), we hypothesized that psychopathy and some other persona... more In our article (Lilienfeld et al., 2019), we hypothesized that psychopathy and some other personality disorders are emergent interpersonal syndromes (EISs): interpersonally malignant configurations of distinct personality subdimensions. We respond to three commentaries by distinguished scholars who raise provocative challenges to our arguments and intriguing suggestions for future research. We clarify the role of folk concepts in our understanding of psychopathy, offer further suggestions for testing our interactional hypotheses, consider the role of boldness in motivational accounts of psychopathy, and discuss future directions for incorporating developmental considerations and the role of victims in our EIS account. We are optimistic that this account will prove to be of heuristic value, and should encourage researchers and theoreticians to explore alternative models of psychopathy and other personality disorders.
The majority position among philosophers of psychiatry as well as psychiatrists themselves is tha... more The majority position among philosophers of psychiatry as well as psychiatrists themselves is that instead of revising psychiatric categories, researchers should attempt to discover causal mechanisms that can explain these common clusters of signs and symptoms. The task is how to figure out what sorts of presumably multilevel causal explanations can realistically be hoped for given the profound complexity of psychopathological phenomena. Given that the sort of bottom-up reduction that is possible in the case some of closed physical systems is not a viable or appropriate aim for psychiatry, we argue here that instead of complete causal pathways, psychiatric nosologists should aim to construct categories that represent robust patterns in the data that emerge from our best theories about psychopathology. Our term robust pattern is a portmanteau that introduces two philosophical terms to psychiatric context: Daniel Dennett's real patterns, and William Wimsatt's theory of robustness. As opposed to natural kinds, robust patterns do not refer to a discrete sort of entity that exists in the world. Rather they are better seen heuristically-as categories that grow out our best empirical theories in response to our practical needs. Taking schizophrenia as a case study, we explore how a robust pattern approach might differ from a tradition diagnostic kind as formulated by the Diagnostic and Statistical Manual of Mental Disorders. We will conclude by considering the ontological status of diagnostic categories if they are viewed as robust patterns, and comparing it with a natural kinds approach.
s insightful chapter provides a deeper look at the operationalist philosophy that so markedly inf... more s insightful chapter provides a deeper look at the operationalist philosophy that so markedly influenced post-1980 psychiatry. Other scholars have framed discussions of contemporary psychiatry with a history of the philosophical antecedents of DSM-III by citing Hempel's 1959 paper-reprinted as (Hempel 1965b)-but Parnas and Bovet further examine the influence of Percy
HOPOS: Journal for the International Society for the History of Philosophy of Science
JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, a... more JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.
While issues of distributive justice in the clinical setting have received significant attention ... more While issues of distributive justice in the clinical setting have received significant attention from bioethicists, less attention has been paid to the distribution of resources in the research setting. This paper focuses on ethical tensions brought about between shifting funding priorities in psychiatric research over time, that is, questions of “diachronic justice.” It focuses on current adjustment to the National Institute of Mental Health’s budget, which reflect a growing interest in funding basic science research over clinical research in pursuit of the epistemic value of “precision.” Chapter 1 introduces the NIMH’s new vision for psychiatric progress, best captured in its framework for classifying research proposals, the Research Domain Criteria Project. Chapter 2 shows how this shift in vision can be described as a problem of diachronic justice. While there are numerous theoretical challenges involved in assessing diachronic justice, the present discussion focuses on empirical ones that are requisite to any analysis, here called “epistemic puzzles.” Chapter 3 discusses the epistemic puzzles most central to assessments of the ethics of precision psychiatry. Finally, a concluding chapter considers other ethical concerns that arise from the embrace of a precision medicine paradigm in psychiatry, and introduces two alternative frameworks for thinking about psychiatric research that avoid some of these pitfalls.
There is a rich tradition in bioethics of gathering empirical data to inform, supplement, or test... more There is a rich tradition in bioethics of gathering empirical data to inform, supplement, or test the implications of normative ethical analysis. To this end, bioethicists have drawn on diverse methods, including qualitative interviews, focus groups, ethnographic studies, and opinion surveys to advance understanding of key issues in bioethics. In so doing, they have developed strong ties with neighboring disciplines such as anthropology, history, law, and sociology. Collectively, these lines of research have flourished in the broader field of “empirical bioethics” for more than 30 years (Sugarman & Sulmasy 2010). More recently, philosophers from outside the field of bioethics have similarly employed empirical methods—drawn primarily from psychology, the cognitive sciences, economics, and related disciplines—to advance theoretical debates. This approach, which has come to be called experimental philosophy (or x-phi), relies primarily on controlled experiments to interrogate the concepts, intuitions, reasoning, implicit mental processes, and empirical assumptions about the mind that play a role in traditional philosophical arguments (Knobe et al. 2012). Within the moral domain, for example, experimental philosophy has begun to contribute to long-standing debates about the nature of moral judgment and reasoning; the sources of our moral emotions and biases; the qualities of a good person or a good life; and the psychological basis of moral theory itself (Alfano, Loeb, & Plakias 2018). We believe that experimental philosophical bioethics—or “bioxphi”—can similarly contribute to bioethical scholarship and debate. Here, we introduce this emerging discipline, explain how it is distinct from empirical bioethics more broadly construed, and attempt to characterize how it might advance theory and practice in this area.
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Papers by Kathryn Tabb