The Long Shadow of Aristotelian Naturalism in the Development of Ethics

A critical notice of Terence Irwin, The Development of Ethics, A Historical and Critical Study, Vol. I: From Socrates to the Reformatio

Nurture before responsibility: self-in-relation competence and self-harm

Borderline personality disorder (BPD) is a disorder that affects mainly women and often manifests itself through self-injurious behaviour and suicide attempts. The perception that these patients are themselves to blame for their self-destructive behaviour is a common reaction when clinical practitioners are faced with this behaviour. Recent philosophical work has tried to reconceptualise the responsibility of personality disorder patients (i.e. Pickard’s responsibility without blame). In this paper I problematise the focus on responsibility as a conceptual and therapeutic approach to deliberate self-injury in BPD. I suggest that this thin, content-neutral account of responsibility fails to properly consider the complex phenomenology of BPD selfhood and self-harm. Instead, I forward an alternative model based on a thick account of responsibility to examine in more detail the social formation of substantive content of the will. The paper explains how borderline is a disorder of the self-in-relation, which tracks the socialising, relational factors that contribute to the development of a dysfunctional BPD selfhood premised on self-punishment, self-abnegation, and self-loathing. Moreover, the framework lends itself to an alternative normative standpoint to self-harming behaviour in individuals with BPD which focuses on the therapeutic nurturance and validation of emotion and needs, prior to the treatment of individuals as responsible agents. I explore how such a standpoint is applied in Schema-Focused and Dialectical Behavioral Therapy treatments of BPD

Hume and practical reason: a non-sceptical interpretation

It has become increasingly common to interpret Hume as a ‘sceptic’ of practical reason. This means that Hume supposedly contests, not only the ability of reason to provide demonstrable truths, in the conventional rationalist sense, but also reason’s ability to guide our practical action. Proponents of this reading include Jean Hampton, Elijah Millgram and Christine Korsgaard. If this ‘sceptical reading’ of Hume is correct, he would lack the philosophical resources to justify his account of political justice. However, if examined further, this sceptical reading begins with deep-seated Kantian presuppositions about the role and function of practical reason. The paper critiques these presuppositions, arguing that they must be set aside in order to appreciate more fully how Hume does indeed have a proper theory of practical reason. Specifically, Hume believes practical reason encompasses the discursive articulation and evaluation of human character traits and moral values within the social context. These articulatory and intersubjective dimensions of practical reasoning emphasized in the Humean account could provide further theoretical inspiration for communitarian critiques of contemporary liberalism

Ethical dangers of facial phenotyping through photography in Psychiatric Genomics studies

Psychiatric genomics research protocols are increasingly incorporating tools of deep phenotyping to observe and examine phenotypic abnormalities among individuals with neurodevelopmental disorders. In particular, photography and the use of two-dimensional and three-dimensional facial analysis is thought to shed further light on the phenotypic expression of the genes underlying neurodevelopmental disorders, as well as provide potential diagnostic tools for clinicians. In this paper, I argue that the research use of photography to aid facial phenotyping raises deeply fraught issues from an ethical point of view. First, the process of objectification through photographic imagery and facial analysis could potentially worsen the stigmatisation of persons with neurodevelopmental disorders. Second, the use of photography for facial phenotyping has worrying parallels with the historical misuse of photography to advance positive and negative eugenics around race, ethnicity and intellectual disability. The paper recommends ethical caution in the use of photography and facial phenotyping in psychiatric genomics studies exploring neurodevelopmental disorders, outlining certain necessary safeguards, such as a critical awareness of the history of anthropometric photography use among scientists, as well as the exploration of photographic methodologies that could potentially empower individuals with disabilities

Constructing female sexual and reproductive agency in mental capacity law

Respect for the sexual, reproductive, and relational choices of women with learning disabilities remains unrealised to date, despite the autonomy-based focus of mental capacity law in England and Wales as well as the UN Convention for the Rights of Persons with Disabilities. Instead, such women appear trapped within a triple-bind – where they not only act in ways that might reinforce oppressive norms around gender and disability, but they are mentally incapable of even making such self-subjugating choices. The triple-bind emerges for two reasons: first, learning disability is understood as an essentialist property that determines action; second, the normative logic of feminism and the social model of disability is bound to the binary between emancipation – subjugation, which excludes the nuanced and ambiguous agency of women with learning disabilities as a result. What is needed instead is an alternative framework of female agency that can accommodate a mode of ambivalence, indifference, inhabitation, and at times, complicity – in other words, instances where women make choices that appear contrary to their emancipation from disabling, patriarchal norms or relationships. Women with learning disabilities navigate a complex nexus of norms, power relations, and relational connections, some of which are coercive and oppressive, yet simultaneously subjectively affirming and enabling. I argue for an alternative analytical framework of female agency in order to accommodate how women with learning disabilities undertake the complex negotiation of power and social norms, as well as render visible their agency in their sexual, relational, and reproductive choices

Beyond the sub-Humean model: Instrumental reason in Aristotle, Hume and Kant.

The thesis illustrates the importance of philosophical frameworks to our conception of instrumental reason through the comparative exegetical analysis of Aristotle, Hume, and Kant. Interpretations of each thinker reveal the significance of their respective philosophical frameworks in helping them avoid the subjectivist and freestanding connotations of the standard model. Specifically, since Aristotle, Hume, and Kant incorporate a notion of ethical normative objectivity within their frameworks, I show that these three thinkers represent a rich if divergent historical tradition according to which an adequate understanding of the normative significance of instrumental practical reasoning depends on situating it within a broader moral, social, or metaphysical framework. I establish how Aristotle's, Hume's, and Kant's thinking about practical reason is integrated within a more general frame of moral and political theorising that in each case reflects a degree of philosophical unease with the allure of a freestanding conception of instrumental rationality. Thus, a sympathetic examination of these historical thinkers' metaphysical commitments are important to illustrate the need for contemporary philosophers to directly confront, examine and articulate the comparative moral framework situating our current conception of instrumental reason. (Abstract shortened by UMI.)

From best interest to better interests? Values, unwisdom, and objectivity in mental capacity law

The Mental Capacity Act 2005 governs personal decision-makingfor adults. It incorporates five overarching principles, including that incapacity may not be inferredmerelyfrom a person’s unwise decisions, andthat where a person lackscapacity decisions must be made in her best interests. Through analysis of judicial treatment of unwisdom, best interests, subjectivity, and objectivity, considered against Parliamentary debates on the Mental Capacity Bill and philosophical critique of ideas of (un)wisdom, we argue that these principles are problematically irreconcilable. The Act’s radical under-specificity means, paradoxically, that these come to be resolved through abstracted values, rather than the centricity of the person herself

Education vs screening: the use of capacity to consent tools in Psychiatric Genomics

Informed consent procedures for participation in psychiatric genomics research amongst individuals with mental disorder and intellectual disability can often be unclear, particularly because the underlying ethos guiding consent tools reflects a core ethical tension between safeguarding and inclusion. This tension reflects important debates around the function of consent tools, as well as the contested legitimacy of decision-making capacity thresholds to screen potentially vulnerable participants. Drawing on human rights, person-centred psychiatry, and supported decision-making, this paper problematises the use of consent procedures as screening tools in psychiatric genomics studies, particularly as increasing normative emphasis has shifted towards empowerment and participation of those with mental disorder and intellectual disabilities. We expound on core aspects of supported decision-making, such as relational autonomy and hermeneutic competence, to orient consent procedures towards a more educative, participatory framework that is better aligned with developments in disability studies. The paper concludes with an acknowledgement of the pragmatic and substantive challenges in adopting this framework in psychiatric genomics studies if this participatory ethos towards persons with mental disorder and intellectual disability is to be fully realised

Prioritising African perspectives in Psychiatric Genomics Research: issues of translation and informed consent

Psychiatric genomics research with African populations comes with a range of practical challenges around translation of psychiatric genomics research concepts, procedures, and nosology. These challenges raise deep ethical issues particularly around legitimacy of informed consent, a core foundation of research ethics. Through a consideration of the constitutive function of language, the paper problematises like-for-like, designative translations which often involve the ‘indigenization’ of English terms or use of metaphors which misrepresent the risks and benefits of research. This paper argues that effective translation of psychiatric genomics research terminology in African contexts demands substantive engagement with African conceptual schemas and values. In developing attenuated forms of translational thinking, researchers may recognise the deeper motivational reasons behind participation in research, highlighting the possibility that such reasons may depart from the original meaning implied within informed consent forms. These translational issues might be ameliorated with a critical re-examination of how researchers develop and present protocols to institutional ethics review boards