"The complete list of the works of Thomas S. Szasz": pages 237-253.

In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases). God, man's idea of moral perfection, judges human deeds without distinguishing between sane persons responsible for their behaviour and insane persons deserving to be excused for their evil deeds. It is hubris (...) to pretend that the insanity defence is compassionate, just, or scientific. Mental illness is to psychiatry as phlogiston was to chemistry. Establishing chemistry as a science of the nature of matter required the recognition of the non-existence of phlogiston. Establishing psychiatry as a science of the nature of human behaviour requires the recognition of the non-existence of mental illness. (shrink)

Obsessed with the twin beliefs that misbehavior is a medical disorder and that the duty of the state is to protect adults from themselves, we have replaced criminal-punitive sentences with civil-therapeutic 'programs.' The result is the relentless loss of individual liberty, erosion of personal responsibility, and destruction of the security of persons and property - symptoms of the transformation of a Constitutional Republic into a Therapeutic State, unconstrained by the rule of law.

I thank Professor Fulford for giving me an opportunity to comment on Bracken and Thomas’s essay. Unfortunately, this requires accepting the authors’ focus on discourses rather than deeds, on what psychiatrists say and how they say it rather than on what psychiatrists do and how they justify it. This I cannot do in good conscience. Nevertheless, out of respect to Professor Fulford and the journal Philosophy, Psychiatry, & Psychology, as well as a sense of professional obligation, I offer herewith (...) my brief comments. Bracken and Thomas are not the first persons to compare my work with Foucault’s, nor the first to comment on my writing style. In 2001, a pseudonymous blogger posted this comment (still .. (shrink)

Classically controversial Szasz here challenges "modern" science's attempts to define the human mind as merely a collection of brain functions.

This is a brief comment on Christopher Megone's essay appearing in this issue. Cells, tissues, organs, and human beings qua biological organisms have natural functions, but human beings qua agents do not. Persons-in-society, unlike organs-in-bodies, are the products of culture, not simply of nature. Bodily disease is defined as a deviation from an objectively identifiable biological norm. The natural function of the kidney is to secrete urine; uremia is a literal disease. The social function of adults in American society includes (...) mingling with others in places away from home; "agoraphobia" may thus be called a metaphorical disease. In short, typhoid fever is a literal illness or disease; spring fever is a metaphorical illness or nondisease. Megone, however, rejects the claim that literal diseases "are physical disorders." Would he regard spring fever as a "real disease"? If not, why not? (shrink)

The Council for Secular Humanism identifies Secular Humanism as a "way of thinking and living" committed to rejecting authoritarian beliefs and embracing "individual freedom and responsibility ... and cooperation." The paradigmatic practices of psychiatry are civil commitment and insanity defense, that is, depriving innocent persons of liberty and excusing guilty persons of their crimes: the consequences of both are confinement in institutions ostensibly devoted to the treatment of mental diseases. Black's Law Dictionary states: "Every confinement of the person is an (...) 'imprisonment,' whether it be in a common prison, or in private house, or in the stocks, or even by forcibly detaining one in the public streets." Accordingly, I maintain that Secular Humanism is incompatible with the principles and practices of psychiatry. (shrink)

The religious justification for male circumcision proffered by Jewish and Islamic parents is frequently overlooked in current secular (medical/hygienic) discussions that (1) challenge the moral justification of this ancient practice, and (2) question the decisions of today's parents who are committed, on the basis of their religious beliefs, to continue this practice. This paper reviews critically these conflicting values and arguments and calls for compromise in the face of potential state intervention to coerce parents to abandon this practice. Keywords: disease (...) prevention, medicalization, mutilation, religious values, routine neonatal circumcision, therapeutic state CiteULike Connotea Del.icio.us What's this? (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

The Council for Secular Humanism identifies Secular Humanism as a "way of thinking and living" committed to rejecting authoritarian beliefs and embracing "individual freedom and responsibility... and cooperation." The paradigmatic practices of psychiatry are civil commitment and insanity defense, that is, depriving innocent persons of liberty and excusing guilty persons of their crimes: the consequences of both are confinement in institutions ostensibly devoted to the treatment of mental diseases. Black's Law Dictionary states: "Every confinement of the person is an 'imprisonment,' (...) whether it be in a common prison, or in private house, or in the stocks, or even by forcibly detaining one in the public streets." Accordingly, I maintain that Secular Humanism is incompatible with the principles and practices of psychiatry. (shrink)

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

It is a matter of some irony that psychiatry's most trenchant critic for over four decades is himself a psychiatrist. I refer to Thomas S. Szasz. Szasz's core thesis may be succinctly rendered: mental illness is a “myth”, a “metaphor” which serves only to obscure the social and ethical “problems in living” we face as human beings. This paper reconsiders the conceptual bases of Szasz's assault on psychiatry and assesses recent counter-arguments of his critical interlocutors. It (...) presents a defence of the Szaszian conception and emphasises the continuing relevance of his earliest work. Additionally, the paper discusses Szasz's thesis in light of the work of the influential French philosopher of medicine, Georges Canguilhem. (shrink)

Whether psychopathy is a mental disease or illness can affect whether psychiatrists should treat it and whether it could serve as the basis for an insanity defense in criminal trials. Our understanding of psychopathy has been greatly improved in recent years by new research in psychology and neuroscience. This illuminating research enables us to argue that psychopathy counts as a mental disease on any plausible account of mental disease. In particular, Szasz's and Pickard's eliminativist views and Sedgwick's social constructivist (...) account of mental illness that might exclude psychopathy are not plausible, and there is no reason to exclude psychopathy under Boorse's and Scadding's biomedical accounts, Wakefield's harmful dysfunction account, and the DSM-IV-TR objective harm account of mental disease. The basic reason is that psychopathy involve neural dysfunction that increases risk of serious harm and loss to people with psychopathy. (shrink)

Thomas Szasz wrote over thirty books and several hundred articles, replete with mordant criticism of psychiatry. His works made him arguably one of the world's most recognized psychiatrists, albeit one of the most controversial. This book critically examines the legacy of a man who challenged the very concept of mental illness.

The traditional legal verdict of not guilty by reason of insanity as well as the more recent verdict of guilty but mentally ill rest on often unquestioned epistemological assumptions about human behavior and its causes, unjustified reliance on forensic psychiatrists, and questionable, if not deplorable ethical standards. This paper offers a critique of legal perspectives on insanity, historical and current, based on the altermative epistemological and ethical assumptions of Thomas S. Szasz. In addition, we examine Szasz''s unique (...) rhetorical analysis of mental illness and its implications for forensic psychiatry. (shrink)

Digital technologies can be an asset to serving communities and societies through data analytics and management to achieve greater good. However, care must be exercised in that societies without digital access do not get overlooked or, worse, face abuses of privacy disclosure or exploitation. Regulations exist to prevent this happening, but ethical considerations are important in deciding in what is allowable and what is not. The further risk of artificial intelligence where computers start to make autonomous decisions and the vulnerabilities (...) we are exposed to is considered. Steps are proposed to develop an ethics-based digital strategy and how to mitigate cyber risk. (shrink)

This book contains the text of Thomas Kuhn's unfinished book, The Plurality of Worlds: An Evolutionary Theory of Scientific Development, which Kuhn himself described as "a return to the central claims of The Structure of Scientific Revolutions, and the problems that it raised but did not resolve." The Plurality of Worlds is preceded by two related texts that Kuhn publicly delivered but never published in English: his paper "Scientific Knowledge as a Historical Product" and his Shearman Memorial Lectures, "The (...) Presence of Past Science." The book opens with an introduction by the editor that describes the origins and structure of The Plurality of Worlds, and sheds light on its central philosophical problems. Kuhn's aims in his last writings are bold. He sets out to develop an empirically grounded theory of meaning that would allow him to make sense of both the possibility of historical understanding and the inevitability of incommensurability between past and present science. Moreover, he intends to show that incommensurability is fully compatible with a robust notion of a real world that science investigates, with the rationality of scientific belief change, and with the idea that scientific development is progressive. This is a must-read follow-up to The Structure of Scientific Revolutions, one of the most important books of the twentieth century. (shrink)

Thomas S. Kuhn's classic book is now available with a new index.

The significance of the plurality of the Copernican Revolution is the main thrust of this undergraduate text In this study of the Copernican Revolution, the ...

Divided into three parts, this work is a record of the direction Kuhn was taking during the last two decades of his life. It consists of essays in which he refines the basic concepts set forth in "Structure"--Paradigm shifts, incommensurability, and the nature of scientific progress.

Steven Vogel’s Thinking like a Mall, which continues themes developed in his previous work Against Nature: The Concept of Nature in Critical Theory, is clearly intended to provok...

A highly condensed account of the author's present view of some philosophical problems unresolved in The Structure of Scientific Revolutions. The concept of incommensurability, now considerably developed, remains at center stage, but the evolutionary metaphor, introduced in the final pages of the book, now also plays a principal role.

The aim of this critical commentary is to distinguish and analytically discuss some important variations in which legal moralism is defined in the literature. As such, the aim is not to evaluate the most plausible version of legal moralism, but to find the most plausible definition of legal moralism. As a theory of criminalization, i.e. a theory that aims to justify the criminal law we should retain, legal moralism can be, and has been, defined as follows: the immorality of an (...) act of type A is a sufficient reason for the criminalization of A, even if A does not cause someone to be harmed. In what follows, I critically examine some of the key definitions and proposals that have, unfortunately, not always been carefully distinguished. Finally, I propose a definition that seems to capture the essence of what many philosophers refer to when they talk about legal moralism, while also providing more clarity. (shrink)

A highly condensed account of the author's present view of some philosophical problems unresolved in The Structure of Scientific Revolutions. The concept of incommensurability, now considerably developed, remains at center stage, but the evolutionary metaphor, introduced in the final pages of the book, now also plays a principal role.

The author's concept of incommensurability is explicated by elaborating the claim that some terms essential to the formulation of older theories defy translation into the language of more recent ones. Defense of this claim rests on the distinction between interpreting a theory in a later language and translating the theory into it. The former is both possible and essential, the latter neither. The interpretation/translation distinction is then applied to Kitcher's critique of incommensurability and Quine's conception of a translation manual, both (...) of which take reference-preservation as the sole semantic criterion of translational adequacy. The paper concludes by enquiring about the additional criteria a successful translation must satisfy. (shrink)

In Patricia Churchland's 2006 essay on free will, she cites the case of a middle-aged man who, without any prior history of misbehavior, suddenly became obsessed with child pornography and started to molest his 8-year-old stepdaughter. He was subsequently discovered to have a brain tumor affecting the frontal lobes, and when it is successfully treated his aberrant behavior stopped.Thomas Szasz is famous for his denunciation of the concept of mental illness, and his critique is partly responsible for instigating (...) an enduring philosophical discourse about the nature of mental disorder. Szasz's key insight was the recognition that we find it important to distinguish between situations that are characterized by... (shrink)