School of Humanities

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Craig Edwards


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Start date

Jan 2007

Submission date

Mar 2012

Craig Edwards

Thesis

The Ethics of Psychiatric Paternalism: a collection of essays examining the ethical justifications for restriction of liberties of the mentally ill, through paternalism and social protection in a liberal society.

Summary

This thesis consists of a series of essays divided into two parts. The first part examines the moral concepts that inform the process of psychiatric paternalism, such as the concepts of mental illness and mental competence, as well as the liberal traditions upon which restrictions upon medical paternalism have been groudned. I reach the conclusion that both mental illness and mental competence are, in an importance sense, normative concepts. Unlike early normative critiques of psychiatric paternalism, I do not make this claim as part of a skeptical argument against psychiatric paternalism, but instead illustrate how the proper scope of civil commitment requires moral and social debate, informed by scientific expertise but not delegated entirely to psychiatry without broader community consultation.

In the second part, I seek to apply the accounts of medical liberalism and paternalism that I have developed, to a series of practical problems in applied bioethics. That is, I apply it to the apparently exceptional policiy of hard paternalism with regard to suicidality, the problem of personality-altering conditions that are not coherently resolved by traditional concepts of mental competence, the use of advance directives to govern treatment choices where a patient is permanently incapacitated by mental impairment, and the prevention of violence through civil commitment on paternalistic grounds (rather than the morally questionable justification of mitigating risk to others).

Why my research is important

This research seeks to advance both the theoretical and applied ethics in relation to psychiatric paternalism. It seeks to correct long-standing and influential errors in the way that we conceive of mental illness and, more importantly, mental incompetence. In turn, by applying these advancements in theory to common issues in psychiatric practice, it has the capacity to correct injustice at a direct and practical level, by reforming the justifications for civil commitment.

Funding

  • APA Scholarship (prior to shifting to part-time and taking extended sick leave, due to serious illness during 2010-2011)