ABSTRACTThe paper distinguishes between two different ways of cashing out the general insight that often goes by the name of ‘liberal naturalism’. The objective is to show how these two different argumentative strategies undergird two fundamentally different approaches to the project of elucidating the specificity of mental phenomena. On one approach, the central concern of such a project is the ontological status of subjective conscious phenomena; on the other, the central concern is the irreducibility of parochial capacities in the (...) adoption of intentional stances. I begin by tracing out some of the origins of this important divergence and then focus on the motivations of the latter approach. I show that there is a tension between its motivations and the way that it has been used to rehabilitate idealist themes from the post-Kantian tradition. (shrink)

A child is a developing person with evolving capacities that include autonomy, mental capacity and capacity to assume responsibility. Hence, children are entitled to participatory rights in South Africa as observed in the Children’s Act 38 of 2005. According to section 129 of the Act a child may consent to his or her own medical treatment provided that he or she is over the age of 12 years and is of sufficient maturity and decisional capacity to understand the (...) various implications of the treatment including the risks and benefits thereof. However, the Act does not provide a definition for what qualifies as ‘sufficient maturity’ nor does it stipulate how health professionals ought to assess the decisional capacity of a child. In addition, South Africa is a culturally diverse country. The Western liberal notion of autonomy may not necessarily find equal prominence in the mores of people with a different worldview. Hence we demonstrate a few salient comparisons between legal liberal moral theory and African communitarianism as pertinent to the autonomy of the child. Children are rights-holders by virtue of their humanity. Their dignity as individual human persons affords them the entitlement to human rights as contemplated under the Constitution of the Republic of South Africa. However, contrary to the traditional Western notion of individual autonomous persons African societies hold a communalistic notion of person hence there is less regard for individual autonomy and rights with more emphasis on the communal good and maintaining the continuity of relationships and interdependencies shared within a community. A child considered in this view is not regarded as a full person. This implies that decisions concerning the child, including consent to medical treatment are discussed and determined by the community to which the child belongs. Lastly, in this article, we draw on the notion of capacity for responsibility to produce a pragmatic definition of sufficient maturity. It seems reasonable to suggest a move away from a general legal age of consent for medical treatment toward more individualised, context-specific approaches in determining the maturity of a child patient to consent to medical treatment. Perhaps, decision-making with respect to consent to the medical treatment of a child belonging to a traditional African community where the notion of a person is embedded in communitarianism ought to involve the child’s parents/guardians/caregivers where possible provided that the best interests of the child are awarded priority. (shrink)

There have long been controversies about how it is that minds can fit into a physical universe. Emergence in Mind presents new essays by a distinguished group of philosophers investigating whether mental properties can be said to 'emerge' from the physical processes in the universe. Such emergence requires mental properties to be different from physical properties, and much of the discussion relates to what the consequences of such a difference might be in areas such as freedom of the (...) will, and the possibility of scientific explanations of non-physical (for example, social) phenomena. The volume also extends the debate about emergence by considering the independence of chemical properties from physical properties, and investigating what would need to be the case for there to be groups that could be said to exercise rationality. (shrink)

This book brings together insights from the enactivist approach in philosophy of mind and existing work on autonomous agency from both philosophy of action and feminist philosophy. It then utilizes this proposed account of autonomous agency to make sense of the impairments in agency that commonly occur in cases of dissociative identity disorder, mood disorders, and psychopathy. While much of the existing philosophical work on autonomy focuses on threats that come from outside the agent, this book addresses how inner (...) conflict, instability of character, or motivational issues can disrupt agency. In the first half of the book, the author conceptualizes what it means to be self-governing and to exercise autonomous agency. In the second half, she investigates the extent to which agents with various forms of mental disorder are capable of exercising autonomy. In her view, many forms of mental disorder involve disruptions to self-governance, so that agents lack sufficient control over their intentional behavior or are unable to formulate and execute coherent action plans. However, this does not mean that they are utterly incapable of autonomous agency; rather, their ability to exercise this capacity is compromised in important respects. Understanding these agential impairments can help to deepen our understanding of what it means to exercise autonomy, and also devise more effective treatments that restore subjects' agency. Autonomy, Enactivism, and Mental Disorder will be of interest to researchers and advanced students working in philosophy of mind, philosophy of action, philosophy of psychiatry, and feminist philosophy. (shrink)

Theo C. Meyering, in “Mind Matters: Physicalism and the Autonomy of the Person,” takes yet a third approach to the issue of reduction. He states that “if (true, downward) mental causation implies nonreducibility [as Stoeger and Murphy argue] and physicalism implies the converse, it is hard to see how these two views could be compatible.” Meyering distinguishes three versions of reductionism: radical (industrial strength) physicalism; ideal (regular strength) physicalism, and mild or token physicalism. Radical physicalism asserts that all (...) special sciences are reducible to physics in the sense that their laws can be deduced via bridge laws from those of physics. Ideal physicalism asserts that while it is practically impossible to reduce the special sciences, such reduction would be possible were there an ideally complete physics" (Note: This distinction parallels Stoeger’s recognition that epistemological reducibility is relative to the meaning of “laws of nature). Token physicalism is ontologically reductionist: there are no events that are not “token-identical” with some physical event or other (Note: See above, sec. 3.3). However, there are no identities between higher-level and lower- level types of events; consequently some events described by the special sciences have no physical explanation at all. -/- All of these reductionist positions are to be contrasted with compositional (milder than mild) physicalism, which asserts that some higher-level events are not even token-identical with physical events because the higher-level event (say, a crash in the stock market) is constituted by innumerable physical particulars in all sorts of states and interactions. -/- Meyering then surveys some of the existing arguments for the nonreducibility of the special sciences. One of the most important is the argument from multiple realizability. The claim is that economics, for example, is not reducible to physics because economic concepts (for example, monetary exchange) are “wildly multiply realizable” (for example, using coins, strings of wampum, signing a check). Thus, there can be no bridge laws and no reduction. Such an argument, however, only cuts against radical physicalism, not the weaker (and a priori more plausible) ideal physicalism. -/- A stronger argument for the indispensability of special-science explanations is based on the role of functional explanations. For example, the functional description of aspirin as an analgesic is in some instances a more useful explanation of its causal role (relieving a headache) than is its description as the chemical level. -/- Meyering’s own contribution focuses neither on multiple realizability of supervenient properties nor on multiple “fillers” of functional roles, but on “multiple supervenience.” In particular, a single subvenient state of affairs (for example, a cloud of free electrons permeating the metal of which a ladder is constructed) may realize a variety of supervenient dispositional properties (in this case, electrical conductivity, thermal conductivity, opacity). An explanation (say, of the cause of a deadly accident) requires reference to the dispositional property (electrical conductivity), not merely to the subvenient property. Meyering argues that it is this possibility of multiple supervenience, not multiple realizability, that gives arguments against reduction based on functional properties their real force. Downward causation, then, can be understood in terms of selective activation of one of several dispositional properties of a lower-level state, and thus can be assigned a stable place in our picture of how the world is organized without upsetting our conception of physics as constituting a closed and complete system of physical events. (shrink)

The English version of the first chapter of Erwin Rogler and Gerhard Preyer: Materialismus, anomaler Monismus und mentale Kausalität. Zur gegenwärtigen Philosophie des Mentalen bei Donald Davidson und David Lewis »Anomaler Monismus und Mentale Kausalität. Ein Beitrag zur Debatte über Donald Davidsons Philosophie des Mentalen« is a contribution to the current debates on the philosophy of the mental and mental causality initiated from Donald Davidson's philosophy with his article »Mental Events«. It is the intent of the English (...) version to give a response to the controversy among American, British and Australian philosophers in the context of a global exchange of ideas on problems understanding the mental. Contents 1. Preliminary Remarks 2. The Critique of Property-Epiphenomenalism and Counterarguments The Enlargement of Nomological Reasoning The Counterfactual Analysis Supervenient Causality 3. Are Mental Properties real or unreal?Things and events are fundamental entities in Davidson's ontology. Less distinct is the ontological status of properties, especially of mental types. Despite of some eliminative allusions there are weighty reasons to understand Davidson's philosophy of mind as including intentional realism. With it, the question of mental causality arises. There are two striking solutions to this problem: the epiphenomenalism of mental properties and the downward causation of mental events. Davidson cannot accept either. He claims to justify the mental as supervenient causality in order to thus integrate it into physicalism. But his argument at best proves the explanatory, not the causal relevance of mental properties. For this and for other reasons, Davidson fails the aspired synthesis of a sufficiently strong physicalism and the autonomy of the mental; a project whose realization is anyhow hard to achieve. (shrink)

In Anglo-American society, virtually every moral theory of any note, including any plausible form of utilitarianism, places great stress upon autonomy, treats it as intimately bound up with morality, and regards it as of considerable moral significance to normal adult humans and to the value of their lives. In these respects, Kantianisms, contracturalisms, rightstheories, and utilitarianisms are very alike. They are also alike in that their emphasis upon autonomy inevitably sets up fully autonomous beings as something of a (...) special or privileged class, against which the lives of nonautonomous beings, such as infants, the very severely mentally-enfeebled, the seriously brain-damaged, the irreversibly comatose, and animals are viewed and their value assessed. The attempts theorists of all stripes make to squeeze as many beings as possible into the autonomous class illustrate the special or privileged caracter of that class in our moral thinking. (shrink)

According to the High Court in England and Wales, the primary purpose of legal interventions into the lives of vulnerable adults with mental capacity should be to allow the individuals concerned to regain their autonomy of decision making. However, recent cases of clinical decision making involving capacitous vulnerable adults have shown that, when it comes to medical law, medical ethics and clinical practice, vulnerability is typically conceived as opposed to autonomy. The first aim of this paper is (...) to detail the problems that arise when the courts and health care practitioners respond to the vulnerability of capacitous adults on the basis of such an opposition. It will be shown that not only does the common law approach to vulnerability fail to adequately capture the autonomy of capacitous vulnerable adults, the conception of vulnerability and autonomy in oppositional terms leads to objectionably paternalistic health care responses that undermine the autonomy of vulnerable patients as well as clinical and legal interventions that violate their autonomy. In response, the second aim of this paper is to show that the concepts of autonomy and vulnerability are necessarily entwined and, on that basis, the focus should be on promoting the autonomy of capacitous vulnerable adults where possible. In order to make this case, the paper explains the limitations of standard approaches to the autonomy of vulnerable adults and, in their place, offers a conception of legitimate, self-authorised autonomy that is fundamentally dependent on intersubjective practices of recognition. (shrink)

This metatheoretical paper investigates mind wandering from the perspective of philosophy of mind. It has two central claims. The first is that, on a conceptual level, mind wandering can be fruitfully described as a specific form of mental autonomy loss. The second is that, given empirical constraints, most of what we call “conscious thought” is better analyzed as a subpersonal process that more often than not lacks crucial properties traditionally taken to be the hallmark of personal-level cognition - (...) such as mental agency, explicit, consciously experienced goal-directedness, or availability for veto control. I claim that for roughly two thirds of our conscious life-time we do not possess mental autonomy (M-autonomy) in this sense. Empirical data from research on mind wandering and nocturnal dreaming clearly show that phenomenally represented cognitive processing is mostly an automatic, non-agentive process and that personal-level cognition is an exception rather than the rule. This raises an interesting new version of the mind-body problem: How is subpersonal cognition causally related to personal-level thought? More fine-grained phenomenological descriptions for what we called “conscious thought” in the past are needed, as well as a functional decomposition of umbrella terms like “mind wandering” into different target phenomena and a better understanding of the frequent dynamic transitions between spontaneous, task-unrelated thought and meta-awareness. In an attempt to lay some very first conceptual foundations for the now burgeoning field of research on mind wandering, the third section proposes two new criteria for individuating single episodes of mind-wandering, namely, the “self-representational blink” (SRB) and a sudden shift in the phenomenological “unit of identification” (UI). I close by specifying a list of potentially innovative research goals that could serve to establish a stronger connection between mind wandering research and philosophy of mind. (shrink)

Neurotechnologies broadly understood are tools that have the capability to read, record and modify our mental activity by acting on its brain correlates. The emergence of increasingly powerful and sophisticated techniques has given rise to the proposal to introduce new rights specifically directed to protect mental privacy, freedom of thought, and mental integrity. These rights, also proposed as basic human rights, are conceived in direct relation to tools that threaten mental privacy, freedom of thought, mental (...) integrity, and personal identity. In this paper, our goal is to give a philosophical foundation to a specific right that we will call right to mental integrity. It encapsulates both the classical concepts of privacy and non-interference in our mind/brain. Such a philosophical foundation refers to certain features of the mind that hitherto could not be reached directly from the outside: intentionality, first-person perspective, personal autonomy in moral choices and in the construction of one's narrative, and relational identity. A variety of neurotechnologies or other tools, including artificial intelligence, alone or in combination can, by their very availability, threaten our mental integrity. Therefore, it is necessary to posit a specific right and provide it with a theoretical foundation and justification. It will be up to a subsequent treatment to define the moral and legal boundaries of such a right and its application. (shrink)

In this paper, I develop a phenomenological description of lived autonomy and describe possible alterations of lived autonomy associated with chronic depression as they relate to specific psychopathological symptoms. I will distinguish between two types of lived autonomy, a pre-reflective type and a reflective type, which differ with respect to the explicitness of the action that is willed into existence; and I will relate these types to the classical distinction between freedom of intentional action and freedom of (...) the will. I will then describe how a chronically depressed person habitually discloses her experiential workspace with an impaired scope of perceivable action-properties, and pre-reflectively values many of these perceived action-properties as demanding or devalues these properties as well as her own abilities and drive to perform the respective actions. These alterations, typically experienced in a passive manner, imply an impairment of both types of lived autonomy. Drawing on first-hand accounts, I will then argue that small islands of lived autonomy, even of the reflective type, are possible if the afflicted identifies with at least some of her ‘depressive disabilities’. Lastly, I will compare this manner of life-conduct with the constellation of includence, as described by Tellenbach, and discuss the limitations of this study. (shrink)

In 2014 the Essex Autonomy Project undertook a six month project, funded by the AHRC, to provide technical advice to the UK Ministry of Justice on the question of whether the Mental Capacity Act is compliant with the United Nations Convention on the Rights of Persons with Disabilities. Over the course of the project, the EAP research team organised a series of public policy roundtables, hosted by the Ministry of Justice, and which brought together leading experts to discuss (...) and debate the issues. A one-day public conference was held at the Institute for Government in July. In September 2014, the EAP research team submitted its findings to the Ministry of Justice. (shrink)

In 2014 the Essex Autonomy Project undertook a six month project, funded by the AHRC, to provide technical advice to the UK Ministry of Justice on the question of whether the Mental Capacity Act is compliant with the United Nations Convention on the Rights of Persons with Disabilities. Over the course of the project, the EAP research team organised a series of public policy roundtables, hosted by the Ministry of Justice, and which brought together leading experts to discuss (...) and debate the issues. A one-day public conference was held at the Institute for Government in July. In September 2014, the EAP research team submitted its findings to the Ministry of Justice. (shrink)

In 2014 the Essex Autonomy Project undertook a six month project, funded by the AHRC, to provide technical advice to the UK Ministry of Justice on the question of whether the Mental Capacity Act is compliant with the United Nations Convention on the Rights of Persons with Disabilities. Over the course of the project, the EAP research team organised a series of public policy roundtables, hosted by the Ministry of Justice, and which brought together leading experts to discuss (...) and debate the issues. A one-day public conference was held at the Institute for Government in July. In September 2014, the EAP research team submitted its findings to the Ministry of Justice. (shrink)

abstract Ryan Tonkens proposes that my Kantian approach to suicide intervention with respect to the mentally ill (2002) wrongly assumes that the suicidally mentally ill are rational and are therefore rational agents to whom Kantian moral constraints ought to apply. Here I indicate how the empirical evidence concerning the suicidally mentally ill does not support Tonkens' criticism that the suicidally mentally ill are irrational. In particular, that evidence does not support the conclusion that such individuals are systemically practically irrational so (...) as to undermine the attribution of at least minimal rational autonomy to them. A Kantian moral framework, albeit one developed in a non-ideal direction, remains applicable to such individuals. (shrink)

In 2014 the Essex Autonomy Project undertook a six month project, funded by the AHRC, to provide technical advice to the UK Ministry of Justice on the question of whether the Mental Capacity Act is compliant with the United Nations Convention on the Rights of Persons with Disabilities. Over the course of the project, the EAP research team organised a series of public policy roundtables, hosted by the Ministry of Justice, and which brought together leading experts to discuss (...) and debate the issues. A one-day public conference was held at the Institute for Government in July. In September 2014, the EAP research team submitted its findings to the Ministry of Justice. (shrink)

: This article explores certain issues that arise at the borderline between conceptual analysis and metaphysics, where answers to questions of a conceptual nature compete with answers to questions of an ontological or metaphysical nature. I focus on the way in which three philosophers, Kant, Collingwood and Davidson, articulate the relationship between the conceptual question "What are actions?" and the metaphysical question "How is agency possible?" I argue that the way in which one handles the relationship between the conceptual and (...) the ontological question has important implications for one’s conception of the nature of philosophy, and that thinking hard about what it takes to defend the autonomy of the mental and of the agent-centred perspective should force us to think about our underlying conception of philosophy and to choose between one that understands it as first science and one that understands it as the under-labourer of science. (shrink)

It is commonly thought that mental disorders can undermine autonomy. In her new book, Michelle Maiese addresses the question to what extent this is the case. Her insightful book makes contributions...

In this chapter, I consider the idea that physician-assisted death might come into question in the cases of psychiatric patients who are incapable of making autonomous choices about ending their lives. I maintain that the main arguments for physician-assisted death found in recent medical ethical literature support physician-assisted death in some of those cases. After assessing several possible criticisms of what I have argued, I conclude that the idea that physicianassisted death can be acceptable in some cases of psychiatric patients (...) who lack autonomy ought to be taken into account in assessing the moral and legal acceptability of physician-assisted death. (shrink)

The subject matter of the essay is the autonomy of art, which will be analysed from a Jungian perspective. What Jung had in mind with his notion of the independence of the artistic process is its freedom from the conscious mind of an artist, rather than its independence from the current social, political or cultural conditions. Art, according to Jung, is autonomous if it comes from deeper levels of the human psyche, and that is unconsciousness. To test the validity (...) of Jung’s "autonomous complex", I will be checking the empirical reality of artistic creation, by providing professional artists’ accounts of the creative process. Also, I will challenge the categorically laid and the deeply rooted idea of a close link between artistic talent and mental illness, trying to see if the artistic process can be independent of an artist’s psychological state. In Jung’s view, art happens instead of and not because of potential illness of an artist. Additionally, I am going to contrast his view with Freud’s, for whom an artwork is a sublimation of sexual drive or a product of neurosis. This idea was not acceptable to Jung, as he believed in the existence of not only sexual but also art complex. Finally, I will try to argue that Jung’s view is more accurate in the depiction of artistic process than Freud’s and that his emphasis on the autonomy in art, although radical, deserves more attention from scholars in philosophy and psychology of art. (shrink)

The Convention on the Rights of Persons with Disabilities is increasingly seen as driving a paradigm shift in mental health law, particularly in relation to the understanding that it requires a shift from substituted to supported decisions. This article identifies two competing moral commitments implied by this shift, both of which appeal to the notion of autonomy. It is argued that because of these commitments the Convention is in tension with more general calls in the medical ethics literature (...) for preserving patient autonomy through support. The competing commitments within the Convention also present a particular challenge in putting the support it requires into practice. A discursive control account of freedom is used to develop some practical guidelines for navigating this new moral territory. (shrink)

Psychiatric labeling has been the subject of considerable ethical debate. Much of it has centered on issues associated with the application of psychiatric labels. In comparison, far less attention has been paid to issues associated with the removal of psychiatric labels. Ethical problems of this last sort tend to revolve around identity. Many sufferers are reticent to relinquish their iatrogenic identity in the face of official label change; some actively resist it. New forms of this resistance are taking place in (...) the private chat rooms and virtual communities of the Internet, a domain where consumer autonomy reigns supreme. Medical sociology, psychiatry, and bioethics have paid little attention to these developments. Yet these new consumer-driven initiatives actually pose considerable risks to consumers. They also present complex ethical challenges for researchers. Clinically, there is even sufficient evidence to wonder whether the Internet may be the nesting ground for a new kind of identity disturbance. The purpose of the present discussion is to survey these developments and identify potential issues and problems for future research. Taken as a whole, the entire episode suggests that we may have reached a turning point in the history of psychiatry where consumer autonomy and the Internet are now powerful new forces in the manufacture of madness. (shrink)

Organized by the Mind and Life Institute, this discussion addresses some of the most troublesome questions that have driven a wedge between Western science and religion. Where Buddhism Meets Neuroscience resulted from meetings of the Dalai Lama and a group of eminent neuroscientists and psychiatrists. Is the mind an ephemeral side effect of the brain's physical processes? Are there forms of consciousness so subtle that science has not yet identified them? How does consciousness happen? The Dalai Lama's incisive, open-minded approach (...) both challenges and offers inspiration to Western scientists. The book consists primarily of dialogue and intense, frank conversations between the Dalai Lama and participants. Questions of perception, dualism, categories of consciousness, memory, dreams, the nature of mental illness, and the mind during and after death are all explored. (shrink)

Motivation has been the subject of much research in the sport psychology literature, whereas athlete mental health has received limited attention. Motivational complexities in elite sport are somewhat reflected in the mental health literature, where there is evidence for both protective and risk factors for athletes. Notably, few studies have linked motivation to mental health. Therefore, the key objective of this study was to test four mental health outcomes in the motivational sequence posited by the Hierarchical (...) Model of Intrinsic and Extrinsic Motivation: motivational climate  basic psychological needs  motivation  mental health outcomes. Elite team-sport athletes (140 females, 75 males) completed seven psychometric inventories of motivation-related and mental health variables. Overall, the athletes reported positive motivational patterns, with autonomous motivation and task climate being more prevalent than their less adaptive counterparts. Elevated depressive symptoms and poor sleep quality affected nearly half of the cohort. Structural equation modelling supported pathways between motivational climate, basic needs, motivation, and mood, depressive symptoms, sleep quality, and trait anxiety. Specifically, a task climate was positively associated with the three basic psychological needs, and an ego climate was positively associated with competence. Autonomy and relatedness had positive and negative associations with autonomous and controlled forms of motivation, respectively. Controlled motivation regulations were positively associated with the four mental health outcomes. Integrated regulation had a negative association with anxiety, and intrinsic regulation had a positive association with depressive symptoms. These findings highlight the complexities of and interrelations between motivation and mental health among athletes, and support the importance of considering mental health as an outcome of motivation. (shrink)

This paper introduces a concept called task muddiness as a metric for higher intelligence. Task muddiness is meant to be inclusive and expendable in nature. The intelligence required to execute a task is measured by the composite muddiness of the task described by multiple muddiness factors. The composite muddiness explains why many challenging tasks are muddy and why autonomous mental development is necessary for muddy tasks. It facilitates better understanding of intelligence, what the human adult mind can do, and (...) how to build a machine to acquire higher intelligence. The task-muddiness indicates a major reason why a higher biological mind is autonomously developed from autonomous, simple-to-complex experience. The paper also discusses some key concepts that are necessary for understanding the mind and intelligence, such as intelligence metrics, the mode a task is conveyed to the task executor, a human and a machine being a joint task performer in the traditional artificial intelligence (AI), a developmental agent (human or machine) being a sole task performer, and the need for autonomy in task-nonexplicit learning. (shrink)

Dog ownership is believed to benefit owner wellbeing but, contrary to popular belief, there is limited evidence to suggest that simply owning a dog is associated with improved mental health. This mixed-methods study investigates whether dog owners with stronger relationships with their dogs experience better mental health. Participants completed an online survey. Owners’ health was measured using the validated PROMIS questions regarding depression, anxiety, emotional support, and companionship. The dog–owner relationship was measured using the validated MDORS scale, which (...) has three subscales: interaction, emotional closeness, and perceived costs. Univariable and multivariable linear regression analyses were conducted, adjusting for confounding factors. Additionally, positive and negative impacts of dog ownership on mental wellbeing were coded from open questions using thematic analysis. A stronger dog–owner relationship was associated with greater feelings of emotional support and companionship but poorer mental health in terms of anxiety or depression. However, the perceived costs subscale was consistently associated with better mental health outcomes. Direction of causality cannot be inferred as people with poor mental health may acquire dogs to help relieve symptoms, which qualitative analysis supported. Key themes included positive impacts on owner wellbeing and happiness through providing purpose, companionship and self-acceptance, pleasure and distraction, as well as lessening emotional pain and suffering and reducing risk behaviors. However, negative impacts of a strong relationship include anticipatory grief over loss of the dog, and concerns regarding the burden of responsibility and ability to meet dog’s needs. Perceived ability to adequately meet dog’s needs promoted personal growth and positive relationships with others, whereas perceived inability led to feelings of guilt, or anger/frustration, and reduced autonomy and sense of environmental mastery. Dog ownership contributes to both hedonic and eudaimonic wellbeing in multiple ways, including supporting owners through periods of poor mental health and providing purpose. However, the burden of responsibility and owner and dog characteristics can create challenges, and owners may benefit from support in caring for their dogs and reducing problematic behaviors. (shrink)

Autonomy is a fundamental though contested concept both in philosophy and the broader intellectual culture of today’s liberal societies. For instance, most of us place great value on the opportunity to make our own decisions and to lead a life of our own choosing. Yet, there is stark disagreement on what is involved in being able to decide autonomously, as well as how important this is compared to other commitments. For example, the success of every group project requires that (...) group members make decisions about the project collectively rather than each on their own. This disagreement notwithstanding, mental disorder is routinely assumed to put a strain on autonomy; however, it is unclear whether this is effectively the case and, if so, whether this is due to the nature of mental disorder or the social stigma that often attaches to it. This book is the first exploration of the nature and value of autonomy with reference to mental disorder. By reflecting on instances of mental disorder where autonomy is apparently compromised, it offers a systematic discussion of the underlying presuppositions of the present autonomy debates in philosophy and psychiatry. In so doing, it helps address different kinds of emerging scepticism questioning either the appeal of autonomy as a concept or its relevance to specific areas of normative ethics, including psychiatric ethics. (shrink)

In this Introduction, I situate the underlying project “Autonomy and Mental Disorder” with reference to current debates on autonomy in moral and political philosophy, and the philosophy of action. I then offer an overview of the individual contributions. More specifically, I begin by identifying three points of convergence in the debates at issue, stating that autonomy is: 1) a fundamentally liberal concept; 2) an agency concept and; 3) incompatible with (severe) mental disorder. Next, I explore, (...) in the context of decisional capacity assessments, the difficulties to reconcile 1) and 2) with 3) which they at the same time seem to imply. Having clarified the centrality of a cogent notion of mental disorder for addressing these difficulties, I comment on three promising lines of inquiry about the nature and scope of autonomy that emerge from the following chapters. (shrink)

Nonreductive physicalism states that actions have sufficient physical causes and distinct mental causes. Nonreductive physicalism has recently faced the exclusion problem, according to which the single sufficient physical cause excludes the mental causes from causal efficacy. Autonomists respond by stating that while mental-to-physical causation fails, mental-to-mental causation persists. Several recent philosophers establish this autonomy result via similar models of causation :1031–1049, 2016; Zhong, J Philos 111:341–360, 2014). In this paper I argue that both of (...) these autonomist models fail on account of the problem of Edwards’s Dictum. However, I appeal to foundational principles of action theory to resuscitate mental-to-mental causation in a manner that is consistent with the models of causation endorsed by these autonomists. (shrink)

Kant takes the idea of autonomy of the will to be his distinctive contribution to moral philosophy. However, this idea is more nuanced and complicated than one might think. In this chapter, I sketch the rough outlines of Kant’s idea of autonomy of the will while also highlighting contentious exegetical issues that give rise to various possible interpretations. I tentatively defend four basic claims. First, autonomy primarily features in Kant’s account of moral agency, as the condition of (...) the possibility of moral obligation. Second, autonomy amounts to a metaphysical property as well as a normative principle and a psychological capacity. Third, although there is legitimate scholarly disagreement about whether or not autonomy involves self-legislation of the moral law, there is good reason to believe it underwrites an ‘inside-out’ (as opposed to ‘outside-in’) conception of the relationship between the will and moral requirements. Fourth, persons have dignity because their autonomy makes them members in the set of beings over whom the categorical imperative requires us to universalise our maxims, not because autonomy is an independently important property. (shrink)

The current state of mental health law in England and Wales exhibits a set of systematic antinomies. This should not be seen as a flaw of the legislation; the antinomies in law reflect an underlying antinomial structure at work where the vocations of care are practiced and regulated in a broadly liberal legal environment. The aim of this paper is to identify these antinomial structures and to deploy resources from the post-Kantian idealist tradition to diagnose them and to consider (...) how they might be managed. (shrink)

Authenticity has recently emerged as an important issue in discussions of mental disorder. We show, on the basis of personal accounts and empirical studies, that many people with psychological disorders are preoccupied with questions of authenticity. Most of the data considered in this paper are from studies of people with bipolar disorder and anorexia nervosa. We distinguish the various ways in which these people view the relationship between the disorder and their sense of their authentic self. We discuss the (...) principal modern ac-counts of authenticity within the analytic philosophical tradition. We argue that accounts based on autonomous, or wholehearted, endorsement of personal characteris-tics fail to provide an adequate analysis of authenticity in the context of mental disorder. Significant elements of true self accounts of authenticity are required. The concept of authenticity is a basic one that can be of particular value, in the context of self-development, to people with mental disorder and to others experiencing substantial inner conflict. (shrink)

The concept of “autonomy”, once at the core of the original enactivist proposal in The Embodied Mind, is nowadays ignored or neglected by some of the most prominent contemporary enactivists approaches. Theories of autonomy, however, come to fill a theoretical gap that sensorimotor accounts of cognition cannot ignore: they provide a naturalized account of normativity and the resources to ground the identity of a cognitive subject in its specific mode of organization. There are, however, good reasons for the (...) contemporary neglect of autonomy as a relevant concept for enactivism. On the one hand, the concept of autonomy has too often been assimilated into autopoiesis and the implications are not always clear for a dynamical sensorimotor approach to cognitive science. On the other hand, the foundational enactivist proposal displays a metaphysical tension between the concept of operational closure, deployed as constitutive, and that of structural coupling ; making it hard to reconcile with the claim that experience is sensorimotorly constituted. This tension is particularly apparent when Varela et al. propose Bittorio as a model of the operational closure of the nervous system as it fails to satisfy the required conditions for a sensorimotor constitution of experience. It is, however, possible to solve these problems by re-considering autonomy at the level of sensorimotor neurodynamics. Two recent robotic simulation models are used for this task, illustrating the notion of strong sensorimotor dependency of neurodynamic patterns, and their networked intertwinement. The concept of habit is proposed as an enactivist building block for cognitive theorizing, re-conceptualizing mental life as a habit ecology, tied within an agent’s behaviour generating mechanism in coordination with its environment. Norms can be naturalized in terms of dynamic, interactively self-sustaining, coherentism. This conception of autonomous sensorimotor agency is put in contrast with those enactive approaches that reject autonomy or neglect the theoretical resources it has to offer for the project of naturalizing minds. (shrink)

With the waves of reform occurring in mental health legislation in England and other jurisdictions, mental capacity is set to become a key medico-legal concept. The concept is central to the law of informed consent and is closely aligned to the philosophical concept of autonomy. It is also closely related to mental disorder. This paper explores the interdisciplinary terrain where mental capacity is located. Our aim is to identify core dilemmas and to suggest pathways for (...) future interdisciplinary research. The terrain can be separated into three types of discussion: philosophical, legal and psychiatric. Each discussion approaches mental capacity and judgmental autonomy from a different perspective yet each discussion struggles over two key dilemmas: whether mental capacity and autonomy is/should be a moral or a psychological notion and whether rationality is the key constitutive factor. We suggest that further theoretical work will have to be interdisciplinary and that this work offers an opportunity for the law to enrich its interpretation of mental capacity, for psychiatry to clarify the normative elements latent in its concepts and for philosophy to advance understanding of autonomy through the study of decisional dysfunction. The new pressures on medical and legal practice to be more explicit about mental capacity make this work a priority. (shrink)