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Dowling College Dr. Christian Perring Spring 2008
PHL/PSY 4180
Philosophy of Psychiatry and Psychology
CRN 21433/ 21620
RC 423 MW 01:00 pm-02:20 pm
E-mail: perringc at dowling.edu [All email to me should have "PHL/PSY 4180" in the subject line]
Office Phone: 244-3349
Office: 330B RC (next to the computer lab)
Office Hours: MW 10:00AM - 11:30AM; F 8:00-9:00AM, or by appointment
Required Textbook: An Anthology of Psychiatric Ethics, edited by Stephen Green and Sidney Bloch, Oxford University Press, 2006.
Course
requirements: (details to be specified later)
Attendance (3%)
Class Participation (5%)
Online Blackboard Participation (5%)
Reading notes (10%)
Student Presentation (7%)
Take home final exam (20%)
First paper (>1500 words, 2 scholarly refs) (15%)
Final paper (>3000 words, 4 scholarly refs, draft required) (35%)
Course Outcomes:
In this course, students will:
Reading Notes: you must make notes on the reading every week. Each class I will collect and review your reading notes. Each set is worth 0.5% of your final course grade and you must submit 20 sets. The notes should be at least 300 words, with benchmarks (page, section, or chapter markers), and should include some personal thoughts and reactions that strike you as you read. Since you either get full credit or no credit, you do not need to worry so much about spelling and grammar.
Plagiarism detection and prevention: All papers should be submitted via Turnitin.com or sent to me by email as an attachment in MS Word or RTF. I will give you information about how to use Turnitin.com. Note that I view any form of academic dishonesty very seriously, and if I find that you have engaged in any significant form of plagiarism or cheating I will fail you in this course and report my action to the Dean of Students.
Attendance: Attendance is required, including the first class. You need to be seated in the classroom by the start of the class period, when I will take attendance. If you are late to class, you need to speak to me at the end of class to explain why you were late and ask me to record your presence on my roster. If you need to miss a class, you should notify me by phone or email before the class. To get an absence excused, you must provide documentation of a medical reason. . Your attendance grade will suffer significantly if you miss classes without excuse.
Attendance grade: 0 absences =100; 1 absence =90; 2 absences=75; 3 absences=50; 4 or more = 0
Classroom Etiquette. All cell phones ringers should be turned off and you should never talk on your cell phone in class. You should not eat any food in class, especially food that others will notice through sound or smell. You should turn up on time to all classes. You are free to express your views and question the views of others, including your professor, and you can be passionate about your opinions. However, you must always treat others in the class with respect; you can criticize the views and arguments of others, but you cannot criticize them as persons. You should also make sure you are not dominating classroom discussion to the exclusion of other class members.
Participation: You are expected to participate in two ways. First, you need to contribute to class discussion. You should be engaged in the class, ready to answer questions and thinking of useful questions to ask. This means you have to do the reading ahead of time; I may well ask you to summarize the reading or give a reaction to it, and so you should be ready to do this. You must also participate on the Blackboard class discussion board. Since this is easy to quantify, the requirement is that you make at least 15 contributions to the various discussions, or start your own discussion topics, over the semester. You can do this by commenting on the readings, commenting on the ideas raised in class, commenting on what other people have said on the discussion board or in class, or posting recent news items and discussing their relevance to the class.
Academic and Personal Problems. If you have problems that cause you to be late with work or to miss a number of classes, please stay in communication by phone, email, or by meeting with me in person. I will be willing to work with you and sort out a way for you to still stay in the class and get a fair grade. If you miss a number of classes or fail to hand in work on time but don't give me any explanation then you risk failing the class.
Keeping Copies of Your Work. It is your responsibility to keep copies of all your work in this course until your final grade is submitted. You need to keep copies of your work in at least 3 different places, because all storage methods are fallible. Floppy disks are very unreliable and I recommend you don't use them. If you do use them, back them up every day. Better methods of storage are CD-ROMS, flashdrives or jumpdrives, zip-drives, hard disks, and emails to yourself with your work attached to the emails. It can be a good idea to print out your work and keep a hard copy. But remember that no method of data storage is perfect, which is why you should keep your work stored in at least 3 separate places.
The Papers. Note that I have given minimum lengths for the 2 papers, and a minimum number of scholarly references. Be clear that this does not mean that any paper of the necessary length is automatically of passing quality. Some papers can be short and of high quality, and other papers can be longer and yet very poor. It is important that your paper be written well: you need to write in clear grammatical English. Badly written papers will be penalized and read uncharitably. So if writing papers is not one of your strengths, you would be well advised to start your papers early and get feedback from me or writing tutors. You need to take a clear position and argue for it. You can find several guides to writing philosophy papers online: I recommend Jim Pryor's, the Dartmouth Writing Program guide, and Peter Horban's suggestions, among others. If you need to write a longer paper than the minimum in order to provide a strong defense of your thesis, then your paper will need to be longer than the minimum. Papers should be in APA style; no title page is necessary; pages should be numbered; you do not need to submit a hard copy; and I generally recommend that your paper is divided up into different clear sections, and it can be helpful to give each section its own title. Your first paper and final paper cannot be on the same topic. You should start thinking about your paper topics very early in the semester, and talk with me about it in my office hours.
Presentation
You can either do a presentation during the semester, setting out the basic ideas in one of the assigned readings, or you can do a presentation at the end of the semester setting out some aspect of one of your papers. I will mainly judge your presentation on its clarity, professionalism, and helpfulness for the class. It should be 8-12 minutes long.
Tentative
Schedule
W 1/30/08
Introduction,
NY Times Locked Away Sex Offenders and Civil Commitment
M 2/4
Adam J Falk: Sex offenders, mental illness and criminal responsibility:
American Journal of Law and Medicine; 1999; 25, 117-47
(Available on Blackboard)
Also relevant:
W 2/6
Reading:
Paul Chodoff: Involuntary Hospitalization of the Mentally Ill as a Moral Issue (192)
Thomas Szasz: The Case Against Suicide Prevention (196)
M 2/11
Reading
CW Van Staden: Incapacity to give informed consent owing to mental disorder (201)
M Munetz et al: The Ethics of Mandatory Community Treatment (204)
W 2/13
Reading
Gerald Klerman: The Psychiatric Patient's Right to Effective Treatment (219)
Donaldson v. O'Connor (210)
Possible First Paper
Topics given out
M 2/18 President's Day: No Class
W 2/20
Reading
Peter Jensen: Ethical and Pragmatic Issues in the Use of Psychotropic Agents in Young Children
R Fisher & S Fisher: Antidepressants for Children (239)
M 2/25
Reading
Peter Kramer: The Valorization of Sadness (242)
Carl Elliott: Pursued by Happiness and Beaten (246)
W 2/27
Reading
Jeremy Holmes: Values in Psychotherapy (254)
Allen Bergin: Psychotherapy and Religious Values (270)
Harry Aponte: The Negotiation of Values in Therapy (276)
M 3/3
Reading:
Richard Epstien and Robert Simon: The Exploitation Index (53)
S Freud: The Dynamics of the Transference (50)
W 3/5
Reading
Thomas G. Gutheil and Glen Gabbard: The Concept of Boundaries in Clinical Practice (60)
Glen Gabbard: Psychotherapists Who Trangress Sexual Boundaries with Patients (67)
Additional Topic: The Place of Psychotherapy in Political and Social Theory.
Reading: Constructing the Self, Constructing America: A Cultural History of Psychotherapy, by Philip Cushman.
M 3/10
Reading
Sissela Bok: The Limits of Confidentiality (156)
Douglas Black: Absolute Confidentiality (163)
Tarasoff (167)
W 3/12
Reading
A Defense of Unqualified Medical Confidentiality
by Kenneth Kipnis
AJOB 2006; 6(2):7 (On Reserve)
G. Szmukler and S Bloch: Family Involvement in the Care of People with Psychoses (171)
E Pellegrino: Secrets of the Couch and the Grave (175)
Work Due: First Paper
Possible
Final Paper Topics given out.
M 3/17 Recess: No Class
M 3 19 Recess: No Class
M 3/24
Reading
Thomas Szasz: The Myth of Mental Illness (104)
D.L. Rosenhan: On Being Sane in Insane Places (123)
Christopher Boorse: What a Theory of Mental Health Should Be (108)
W 3/26
Reading
Jerome Wakefield: The Concept of Mental Disorder (130)
Patricia Ross: Values and Objectivity in Psychiatry Nosology, in John Sadler (ed), Descriptions and Prescriptions (Johns Hopkins University Press) [On Reserve] [Also available online through Dowling Library]
M 3/31
Reading
Symposium: Should Homosexuality be in the APA Nomenclature? Robert Stoller et al (116)
This American Life Episode 204: "81 Words" (1/18/2002) http://thislife.org/Radio_Episode.aspx?episode=204
W 4/2
Reading
What's Normal?.Jerome Groopman. The New Yorker 83.7 (April 9, 2007): p28. (4573 words) [On Blackboard]
Jerome Wakefield: Values and the Validity of Diagnostic Criteria: Disvalued vs Disordered Conditions of Childhood and Adolescence, in John Sadler (ed), Descriptions and Prescriptions (Johns Hopkins University Press) [On Reserve] [Also available online through Dowling Library]
M 4/7
Reading
Christian Perring: Medicating Children: The Case of Ritalin: Bioethics (1997) 11 (3-4), 228–240. [On Reserve]
John Pearce: Consent to Treatment During Childhood (290)
Work Due: Draft of
Final Draft (>1500 words)
W 4/9
Reading
Marcie Kaplan: A Woman's View of DSM-III (99)
“Premenstrual Mental Illness”: The Truth About Sarafem, by Paula J. Caplan, Ph.D. http://paulajcaplan.net/files/Nwhn_sarafem_ar.doc
M 4/14
Reading:
Kenneth Kendler: A Psychiatric Dialog on the Mind Body Problem (142)
Peter Zachar and Kenneth S. Kendler "Psychiatric Disorders: A Conceptual Taxonomy". Am J Psychiatry 164:557-565, April 2007 [On Blackboard] [Also available online through Dowling Library]
Peter Zachar, "The Classification of Emotion and Scientific Realism" Journal of Theoretical and Philosophical Psy. Vol. 26, No. 1, 2006 [On Blackboard]
Guest Lecture by Peter Zachar. "Categories of Mental Disorders. Carving Nature at Its Joints?"
W 4/16
Reading
Dinesh Bhugra: Racism in Psychiatry: Paradigm Lost--Paradigm Regained (308)
"Diseases and Peculiarities of the Negro Race," by Dr. Cartwright
http://www.pbs.org/wgbh/aia/part4/4h3106t.html
M 4/21
Reading
Joanne Thakker and Tony Ward: Culture and classification The cross-cultural application of the DSM-IV
Clinical Psychology Review: Volume 18, Issue 5, August 1998, Pages 501-529
Charles Waldegrave & Kiwi Tamasese: Some Central Ideas in the 'Just Therapy' Approach (313)
W 4/23
Reading
Ronald Dworkin: Autonomy and the Demented Self (293)
Rebecca Dresser: Dworkin on Autonomy (297)
M 4/28
Reading
Bart Collopy: Autonomy in Long Term Care: Some Crucial Distinctions (302)
Laura Weiss Roberts: Informed Consent and the Capacity for Voluntarism (466)
W 4/30
Reading
Richard J. Bonnie: The Moral Basis of the Insanity Defense (373)
Paul Appelbaum: The Parable of the Forensic Psychiatrist (325)
Work Due: Final Paper
M 5/5 No Class: Take Home Exam
W 5/7 No Class: Online Class Discussion Required
M 5/12 Student Presentations
W 5/14 Student Presentations
Links to useful websites: http://alien.dowling.edu/~cperring/philosophy-psychiatry-resources.html
Links
National Association of State Mental Health Program Directors
POSITION STATEMENT ON LAWS PROVIDING FOR THE
CIVIL COMMITTMENT OF SEXUALLY VIOLENT CRIMINAL OFFENDERS
http://www.nasmhpd.org/general_files/position_statement/sexpred.htm
The Dictionary of Disorder: How one man revolutionized psychiatry.
by Alix Spiegel
New Yorker, January 3, 2005
http://www.newyorker.com/archive/2005/01/03/050103fa_fact?printable=true
Psychiatric Advanced
Directives
Advance Directives, by Ronald S. Honberg, National Director for Policy and Legal Affairs, NAMI
Law & Psychiatry: Psychiatric Advance Directives and the Treatment of Committed Patients, by Paul S. Appelbaum, M.D. , Psychiatr Serv 55:751-763, July 2004
National
Resource Center on Psychiatric Advance Directives
Advance directives in psychiatric care: a narrative approach, by G. Widdershoven and R. Berghmans, J Med Ethics. 2001 April; 27(2): 92-97.
Advance Psychiatric Directives, Bazelton Center for Mental Health Law
|
Big Bucks, Big Pharma |
A Research Agenda for DSM-V?
: You can download the book for free by registering at the website.
NARTH : An
association of psychologists who aim to provide cures for homosexuality.
Dr. H. Anonymous Speaks (Gay Rights
and the APA)
Dr. John Fryer, in disguise, spoke in May 1972 before the annual American Psychiatric Association?s conference held in Dallas. It
was the first time a gay psychiatrist addressed the group, and was part of the
gay-rights activism targeting the APA that led to the removal of homosexuality
as a diagnosis in its Diagnostic and Statistical Manual.
PBS Frontline: 2008: The Medicated Child
PBS Frontline: 2001: Medicating Kids
The Lobotomist:
PBS American Experience documentary
Alzheimer's Documentary on
YouTube.com
American Psychological Association 2002 Code
of Ethics
Why I Resigned from the American Psychological Association by Kenneth S. Pope, Ph.D. , ABPP
The medicalization of unhappiness by R Dworkin: Dworkin is a doctor at the
conservative think tank Hudson Institute
In Praise of Melancholy by Eric G.
Wilson: From his new book,
Against Happiness (FSG, 2008)
Daring to Think Differently About
Schizophrenia: NY Times
Murder Case Focuses New Attention on Mental
Illness Treatment: NY Times
Mental Health: A Report of the Surgeon
General
|
Sources on Informed Consent |
|
Tennessee Dept of Children's Serivces:
Informed Consent for Psychotropic Medication : http://www.state.tn.us/youth/providers/training/InformedConsentforPsychotropicMedication.pdf |
|
Informed Consent for the Use of Psychotropic Medication (San Diego
Country, CA?) : http://www2.sdcounty.ca.gov/hhsa/documents/9_B.pdf |
|
City and County of San Francisco: Department of Public Health: Informed
Consent for Psychiatric Medications: http://www.sfdph.org/dph/files/CBHSPolProcMnl/MedicationConsentForm-062004rev.pdf |
|
INFORMED CONSENT FOR THE ADMINISTRATION OF PSYCHOTROPIC MEDICATION(S): http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_FILE&RevisionSelectionMethod=LatestReleased&Rendition=Primary&allowInterrupt=1&noSaveAs=1&dDocName=dhs_id_057141 |
|
Sources on the Recovery Movement |
|
Recovery Movement Gains Influence In
Mental Health Programs : Kate Mulligan : Psychiatric News January 3, 2003 : http://pn.psychiatryonline.org/cgi/content/full/38/1/10 |
|
Recovery Model Will Strengthen
Psychiatrist-Patient Relationship : Steven Sharfstein,
M.D. :http://pn.psychiatryonline.org/cgi/content/full/40/20/3 |
|
Wikipedia Entry for
Recovery Model : http://en.wikipedia.org/wiki/Recovery_model |
|
US Dept of Veteran
Affairs: Recovery Resources : http://www.mirecc.va.gov/Recovery_Resources.asp |
On Reserve at the
Dowling Library
Robert Guthrie, Even the Rat Was White: A Historical View of Psychology. Allyn & Bacon, 2003.
Bellevue [videorecording (VHS)] : inside out / a film by Maryann De Leo ; produced by Sarah Teale.
Available on
Blackboard
Mental disorder and cross-cultural psychology A constructivist perspective
Joanne Thakker, Tony Ward, and K. T. Strongman
Clinical Psychology Review
Volume 19, Issue 7, November 1999, Pages 843-874
Thakker, J.. & Ward, T. (1998). Culture and classification:
The cross-cultural application of the DSM- IV. Clinical
Psychology Review, 18, 501-529.
The Need for Coherence: States' Civil Commitment of Sex Offenders in the Wake of Kansas v. Crane
Peter C. Pfaffenroth*
Stanford Law Review, 2003
Papers
First Paper
This paper should be at least 1500
words. Papers that are too short will be penalized.
It should have at least 2 scholarly
references that are not already included in the course textbook. It can
refer to the textbook papers and non scholarly works too, so long as there is a
good reason to do so. You should use APA Style formatting for your
references.
It is due by 11:59 pm on March 12. It
needs to be submitted via Turnitin.com. The class ID is 2185311 and the password is "philosophy".
Note that at least half your paper should
be philosophical in nature; your paper should do more than simply set out facts
about mental illness and its treatment. You should argue for a
conclusion, and not just state an opinion. Good papers will also consider
the faults in arguments for conflicting conclusions. For guidelines about
writing a philosophy paper, I recommend the following sites:
http://www.jimpryor.net/teaching/guidelines/writing.html
http://www.sfu.ca/philosophy/writing.htm
http://www.phil.ucalgary.ca/undergrad/howtowrite.html
Answer 1 question.
1. Is it ethical to involuntary hospitalize people who have been convicted of sexual crimes after
they have served prison sentences for their crimes if there is not a similar
policy to hospitalize murderers after they have served their time.
2. In M Munetz et
al: "The Ethics of Mandatory Community Treatment," the authors claim
that mandatory community treatment can be ethically preferable to involuntary
hospitalization. Spell out what kind of treatment the Recovery model
recommends, and discuss whether in the case of involuntary treatment, it would
be ethically better than traditional hospitalization.
3. Some critics of psychiatry have
argued that unhappiness is a normal condition, especially when it is a reaction
to one's circumstances, and that far too often people who are just unhappy
are diagnosed with depression. Discuss whether the critics have
a strong case.
Final paper
At least 3000 words. 4 scholarly articles or book
chapters must be discussed. Due April 30.
Draft due April 7. Must
be at least 1500 words.
Answer one of these questions or get
another question approved by me.
1. Is there a non-arbitrary way
to draw boundaries in interactions between psychotherapists and their clients
to make sure that the relationship is not exploitative and yet is supportive
and therapeutic?
2. Should psychiatry have a category
of antisocial personality disorder, or should people who behave in the way
described by the disorder simply be categorized as morally bad?
3. Is there good reason to think that
childhood depression and bipolar disorder is an underdiagnosed
or overdiagnosed medical problem?
4. What is the relation between
pharmaceutical companies and psychiatric diagnostic categories and psychiatric
diagnostic trends, for diagnoses such as ADHD, dysthymia,
or Pre-Menstrual Dysphoric Disorder? What
reasons are there to be suspicious or critical of big pharma?
What reasons are there to admire the ways that medications help people
diagnosed with these disorders? Overall, should we allow the
pharmaceutical industry to keep on operating as it does?
5. How does the controversy over
whether homosexuality should be classified as a mental disorder relate to the
debate over the concept of a disorder or disease and how to define what counts
as normal? Is the judgment that homosexuality is normal or abnormal a
scientific judgment, an ethical one, or both? Who should get to decide
whether to include or exclude homosexuality from the DSM?