Back to Christian Perring's Home Page

Dowling College        Fall 2003    Dr Christian Perring

PHL 4180 Philosophy of Psychiatry and Psychology

 

MW 100-220PM  RC 312

 

Office Hours: MTW 400-530PM

 

Office: 330B RC

Office Phone: 244-3349

Email: perringc@dowling.edu (Please put PHL4180 in the subject line of all emails.)

 

Required Book:

Ethics of Psychiatry: Insanity, Rational Autonomy, and Mental Health Care, edited by Rem B. Edwards. Prometheus Books, 1997. [EP]

 

 

Course Description:

This course will survey philosophical issues in psychiatry -- ethical, social, epistemological and metaphysical.  We will focus on the following five main areas:

  • We will look at the mind/body problem in philosophy, and its application in psychiatry, to the understanding of specific mental disorders, such as depression, schizophrenia, and attention deficit hyperactivity disorder.  One issue of particular relevance here is the pros and cons of understanding mental disorders as chemical imbalances.
  • We will look also at the issue of freewill, and consider how it applies to addiction and compulsions.  Can we make sense of a person having an irresistible craving?  Does the “philosophy” of Alcoholics Anonymous make sense?  Should we blame addicts, alcoholics, and pedophiles for their actions, or treat them as ill?
  • We will look at the rights of the mentally ill, and the standards of ethical treatment, including informed consent, the right to refuse treatment, and the boundaries between clinicians and patients.  We will pay particular attention to the ethics of psychiatric research and the issue of forcibly medicating patients in order to make them competent to stand trial.
  • We will pay particular attention to the treatment of the emotional, cognitive, and behavioral problems of children and adolescents.  We will consider the pros and cons of diagnosing children's problems as mental disorders,
  • We will look at the current state of the provision of mental health treatment, through managed care, health insurance, and Medicare and Medicaid.  We will ask whether this is a fair way to provide mental health care.  

Students will learn about some of the main debates in the philosophy of psychiatry and psychology.  Through writing reflection pieces and a long research paper, students will also develop their skills in comparing the strengths and weaknesses of different views in psychiatric controversies, analyzing particular cases and applying philosophical theories to their own experience. 

 

 

This class on the web: You will find this class on the web by going to http://webclasses.dowling.edu and I encourage you to use the links and discussion boards available on the class website. 

 

Links to useful websites: http://www.angelfire.com/ny/metapsychology/psypsylinks.html

 

Prerequisites: Any two classes in Philosophy, Psychology, Anthropology, or Sociology.

 

Your grade: Attendance and Participation 5%; Final exam (open book) 30%; 7 Reflection pieces 35%; Final paper 30%.

 

Attendance.  Attendance and participation are 5% of your grade. 

 

Extra credit: Students can get 5% extra credit by doing a 15-20 minute presentation.  This presentation must be of high quality: it cannot simply be read from a paper, it must be in the student’s own words, summarizing ideas and explaining them clearly.  Audiovisual aids can be useful, but should not dominate the presentation. 

 

Reflection pieces: 7 pieces, one every two weeks.  At least 500 words each: these can be personal or abstract; they should discuss issues raised in class or in the readings.  They can bring in your personal experience, discussions of novels, movies, TV shows, magazine and newspaper articles, as well as what the articles in the class books. 

 

Term Paper: Your research paper should be 12 pages, or about 3500 words.  It should discuss academic articles and scholarly books on an issue in the philosophy of psychiatry.  It can also discuss memoirs, novels, TV shows or movies.  It is your responsibility to come up with a topic.  I encourage you to write a draft, which is due by November 15; I will give you feedback on your draft.  It can be a survey of views in the field, or it can take a position and argue for it.  It is essential that your paper address a controversial issue in the philosophy of psychiatry, and that it demonstrates an understanding of the main views taken by academics who have addressed this issue.  All papers must be submitted electronically using turnitin.com.  The paper is due by noon on December 15.  Late papers lose 10% for each 24 hours late.  Papers must be submitted electronically, using Turnitin.com (class ID is 1108286) or by email.

 

Plagiarism and Cheating.  All research for papers must be carefully documented and footnoted.  Minor plagiarism will result in you receiving a zero grade for the work.  Major plagiarism will mean you fail the class.  All plagiarism will be documented and reported to the Dean of Students. 

 

Week 1

Introduction

Show video from library on Bellevue

Bellevue [videorecording (VHS)] : inside out / a film by Maryann De Leo ; produced by Sarah Teale.  RC445.N67 B45  (ISBN 0783120028)

History of Psychiatry

 

Visiting Speaker: Diane Gidding, of Clubhouse of Suffolk (www.clubhouseofsuffolk.com)

 

Weeks 2 & 3

Agency

Disorders of agency

Changes of agency in mental illness

Involuntary action -- alcoholism and addition.

Changes of agency in treatment and therapy                    

 

Reading:

September 17

Philosophy, Psychiatry, & Psychology 3.2 (1996) 75-90

"Free Will in the Light of Neuropsychiatry"

Sean A. Spence 

http://muse.jhu.edu/journals/philosophy_psychiatry_and_psychology/v003/3.2spence01.html

 

September 22

Philosophy, Psychiatry, & Psychology 7.2 (2000) 107-119

"Diagnosing Agency"

P. G. Campbell 

http://muse.jhu.edu/journals/philosophy_psychiatry_and_psychology/v007/7.2campbell01.html

 

Louis Charland: "Cynthia's Dilemma: Consenting to Heroin Prescription"

http://muse.jhu.edu/journals/american_journal_of_bioethics/toc/ajb2.2.html

 

September 29

Robert Wright: "Alcohol and Free Will" in EP, pp. 130-135

 

George Graham and G. Lynn Stephens, "Mind and Mine," in George Graham and G. Lynn Stephens (editors), Philosophical Psychopathology (MIT Press, 1994.)

 

Weeks 4

Mind & Personal Identity

The Mind-Body Problem

Multiple Selves

Multiple Personality

Hearing Voices

Psychopharmacology

 

Reading:

October 1

Paul R. McHugh and Phillip R. Slavney, The Perspectives of Psychiatry.  Second edition.  (Johns Hopkins University Press, 1998).  Chapter 1: The Mind-Brain Problem and a Structure for Psychiatry.

 

Visiting Speaker October 2: Elizabeth Donaldson: Mad Justice: Involuntary Medication in the Courts

 

October 6: No Class

 

October 8: HTA Conference 930-1130AM

Go to presentation: Perring: Prozac: Technology of the Self.

Reading:

Peter Kramer: Listening to Prozac, Chapter 1: Makeover.  (Viking, 1993).

Carl Elliott: Better Than Well.  Chapter 2: The True Self.  (WW Norton, 2003).

 

Weeks 5 & 6

Science

Reductionism and brain science

First-person accounts versus medical descriptions

 

Reading:

October 13

Robert Veatch, "The Medical Model, It's Nature and Problems," EP, pp 108-129

Paul R. McHugh and Phillip R. Slavney, The Perspectives of Psychiatry.  Second edition.  (Johns Hopkins University Press, 1998).  Chapter 2: Factionalism: The Other Source of Disarray in Psychiatry. 

October 15

Samuel B. Guze.  Why Psychiatry Is a Branch of Medicine.  (Oxford University Press, 1992).  Chapters 1, 4, & 6. 

October 20

Joseph Martin, "The Integration of Neurology, Psychiatry, and Neuroscience in the 21st Century," Am J Psychiatry, 159"5, May 2002

http://ajp.psychiatryonline.org/cgi/content/full/159/5/695

Peter Zachar, Psychological Concepts and Biological Psychiatry (John Benjamins, 2000).  Chapter 8: Diagnosis, Behavior, and First-Person Information.

October 22

Gerrit Glas, "Anxiety--animal reactions and the embodiment of meaning" (from Bill Fulford et al, Nature and Narrative: An Introduction to the New Philosophy of Psychiatry, Oxford University Press, 2003)

 

Weeks 7 & 8

Classification

The definition of mental disorder:

Childhood mental disorders and relational disorders.
Are learning disorders real?

Homosexuality, Intersexuality, and Hermaphrodites.

 

Reading:

October 27

Thomas Szasz, "The Myth of Mental Illness," EP, pp. 22-32

Michael S. Moore, "Some Myths about 'Mental Illness," EP, pp. 33-49

October 29

Rem Edwards, Mental Health as Rational Autonomy," EP, pp. 50-62.

Jerome Wakefield, "The Concept of Mental Disorder," EP, pp. 63-97

November 3

Richard Friedman and Jennifer Downey, "Homosexuality," in EP, pp. 136-55.

Stephen Wilkinson, "Is 'Normal Grief' A Mental Disorder?" The Philosophical Quarterly, 50: 200, 2000.  pp. 288-304

 

November 3: Visiting Speaker: Robert Whitaker: Mad in America

 

November 5

Patricia Greenspan: Good Evolutionary Reasons: Darwinian Psychiatry and Women's Depression

http://www.philosophy.umd.edu/Faculty/PGreenspan/Res/evol.html

 

Weeks 9, 10 & 11

Ethics

Involuntary hospitalization and treatment: legal and moral issues, ECT cases, informed consent for the mentally ill taking neuroleptics

Psychopathy and moral responsibility

Abuse excuses, battered wife syndrome

Mental disorder and moral responsibility.

The rights of the cognitively impaired.

Psychotropics drugs and performance enhancement. 

Safety of antipsychotic drugs and informed consent.

Informed consent and psychiatric treatment. 

 

Reading.

November 10

Insanity Defense Work Group, "APA Statement on the Insanity Defense," EP, pp. 493-508

Lawrie Reznek, "Psychiatry and Responsibility," EP, pp. 509-518

November 12

A. Louis McGarry, "The Nature of Competency to Stand Trial," EP, pp. 519-523

Karl Williams, "Right of a Defendant to Refuse Antipsychotic Medication During a Criminal Trial," pp. 524-529.

James Drane, "The Many Faces of Competency" in EP, pp 206-17

 

November 13: Visiting Speaker: Melvin Woody: The Competency of the Unabomber to Stand Trial

 

November 17

Heather Sones, "The Right to Refuse Psychotropic Drugs," EP 218-224

Bruce Winick, “The Right to Refuse Mental Health Treatment," EP, pp. 225-245

Stephen H. Behnke, Michael L. Perlin, and Marvin Bernstein.  The Essentials of New York Mental Health Law: A Straightforward Guide for Clinicians of all Disciplines.  (New York: WW Norton, 2003).  Chapter 5: "Civil Commitment"

 

Mental Competence in Question / Doctors: Man not fit to refuse shock treatment:[NASSAU AND SUFFOLK Edition]

Zachary R. Dowdy. STAFF WRITER. Newsday. (Combined editions).Long Island, N.Y.: Mar 16, 2001. 

http://pqasb.pqarchiver.com/newsday/69739852.html?MAC=2dfc64225aa48c884ed9780c0dc8ced0&did=69739852&FMT=FT&FMTS=FT&PMID=&printformat=&desc=Mental+Competence+in+Question+%2f+Doctors:+Man+not+fit+to+refuse+shock+treatment

 

Man Says More Rights Violated:[NASSAU AND SUFFOLK Edition]

Zachary R. Dowdy. STAFF WRITER. Newsday. (Combined editions).Long Island, N.Y.: Mar 28, 2001. 

http://pqasb.pqarchiver.com/newsday/70095173.html?MAC=b06228c350bf5fb163a4aa1d594635a7&did=70095173&FMT=FT&FMTS=FT&PMID=&printformat=&desc=Man+Says+More+Rights+Violated

 

Judge: Continue Electroshocks / Pilgrim wins right to treat patient:[NASSAU AND SUFFOLK Edition]

Zachary R. Dowdy. STAFF WRITER. Newsday. (Combined editions).Long Island, N.Y.: Apr 17, 2001. 

http://pqasb.pqarchiver.com/newsday/71376921.html?MAC=319ce9f37c3990a59cb89106f8970005&did=71376921&FMT=FT&FMTS=FT&PMID=&printformat=&desc=Judge:+Continue+Electroshocks+%2f+Pilgrim+wins+right+to+treat+patient

 

Shocking Treatment / Electroconvulsive therapy's return stirs debate on use:[ALL EDITIONS]

Valerie Burgher. ALBANY BUREAU. Newsday. (Combined editions).Long Island, N.Y.: Jul 22, 2001.

http://pqasb.pqarchiver.com/newsday/75773365.html?MAC=bef6b28671ea2628e324f815cd2d27b2&did=75773365&FMT=FT&FMTS=FT&PMID=&printformat=&desc=Shocking+Treatment+%2f+Electroconvulsive+therapy%27s+return+stirs+debate+on+use

 

Shock Therapy Patient Released:[NASSAU AND SUFFOLK Edition]

Zachary R. Dowdy. STAFF WRITER. Newsday. (Combined editions).Long Island, N.Y.: Sep 21, 2001.  

http://pqasb.pqarchiver.com/newsday/81701976.html?MAC=0755e5d0bc2faee3381acd412fa2cf66&did=81701976&FMT=FT&FMTS=FT&PMID=&printformat=&desc=Shock+Therapy+Patient+Released

 

November 19

Thomas Szasz, "Involuntary Civil Commitment," EP pp. 423-436

Donald Hermann, "A Critique of Revisions in Procedural, Substantive, and Dispositional Criteria in Involuntary Civil Commitment," EP, pp. 462-483

Thomas Grisso and Paul Appelbaum, "Is It Unethical to Offer Predictions of Future Violence?," EP, pp. 446-461

 

November 24

Paul Appelbaum, "The Duty to Protect Potential Victims of Patients' Violence, EP pp 246-262

Robert Wettstein, "Confidentiality," EP, pp. 263-281

The Tarasoff Trial.

Stephen H. Behnke, Michael L. Perlin, and Marvin Bernstein.  The Essentials of New York Mental Health Law: A Straightforward Guide for Clinicians of all Disciplines.  (New York: WW Norton, 2003).  Chapter 2: "Tarasoff and Its New York Progeny"

VITALY TARASOFF et al. v. THE REGENTS OF THE UNIVERSITY OF CALIFORNIA et al., Supreme Court of California, December 23, 1974, July 1, 1976

 

Week 12

Social Issues

The care of the mentally ill: abuses: NY scandals

Justice and mental health care.  Managed care. 

 

Reading:

December 1

Paul S. Appelbaum, "Crazy in the Streets" in EP pp. 537-48

Philip Boyle and Daniel Callahan.  "Managed Care and Mental Health: The Ethical Issues" Health Affairs, 14, no. 3 (Fall, 1995): 7-22

http://web.lexis-nexis.com/universe/document?_m=872cf6edc0cbd95adf1b99c6081f05ee&_docnum=11&wchp=dGLbVlb-zSkVb&_md5=d589bfaec42b1d1bee0e6641a9b8f0c4

HEADLINE: For Mentally Ill, Death and Misery

SERIES: BROKEN HOMES -- First of three articles: A Final Destination

BYLINE:  By CLIFFORD J. LEVY

http://web.lexis-nexis.com/universe/document?_m=76ceb4323f9c7bc3d2d25b452f17f218&_docnum=47&wchp=dGLbVzb-zSkVb&_md5=6dfc702bc5a6ccaa8345065dbf22949f

HEADLINE: Here, Life Is Squalor and Chaos

SERIES: BROKEN HOMES: Second of three articles: Where Hope Dies

BYLINE:  By CLIFFORD J. LEVY

http://web.lexis-nexis.com/universe/document?_m=76ceb4323f9c7bc3d2d25b452f17f218&_docnum=45&wchp=dGLbVzb-zSkVb&_md5=49901a2bcbc4ab63bf95bc667016576d

HEADLINE: Voiceless, Defenseless And a Source of Cash

SERIES: BROKEN HOMES -- Last of three articles: The Operators

BYLINE:  By CLIFFORD J. LEVY

http://web.lexis-nexis.com/universe/document?_m=76ceb4323f9c7bc3d2d25b452f17f218&_docnum=44&wchp=dGLbVzb-zSkVb&_md5=984dcc78375cbef0bac6c36decc5773a

 

Week 13:

Cognitive Disability

December 3

Visiting Speaker: Parnell Wickham (Dowling School of Education)

Reading: "The Disability Gulag," by HARRIET McBRYDE JOHNSON

New York Times Sunday Magazine, November 23, 2003.

http://www.nytimes.com/2003/11/23/magazine/23DISABILITY.html

 

December 8

Reading:

Sophia Wong, The Moral Relevance of Cognitive Disability,"" http://www.nyas.org/aeb/neuroethics/archives/wong062402.pdf

 

Links: