First Department of Psychiatry, Eginition Hospital, Athens University Medical School, Vas. Sofias Av. 72-74, 11528 Athens, Greece.
Theor Med Bioeth. 2012 Oct;33(5):343-57. doi: 10.1007/s11017-012-9224-2.
According to the predominant view within contemporary philosophy of psychiatry, mental disorders involve essentially personal and societal values, and thus, the concept of mental disorder cannot, even in principle, be elucidated in a thoroughly objective manner. Several arguments have been adduced in support of this impossibility thesis. My critical examination of two master arguments advanced to this effect by Derek Bolton and Jerome Wakefield, respectively, raises serious doubts about their soundness. Furthermore, I articulate an alternative, thoroughly objective, though in part normative, framework for the elucidation of the concept of mental disorder. The concepts of mental dysfunction and impairment of basic psychological capacities to satisfy one's basic needs are the building blocks of this framework. I provide an argument for the objective harmfulness of genuine mental disorders as patterns of mental dysfunctions with objectively negative biotic values, as well as a formally correct definition of the concept of mental disorder. Contrary to the received view, this objective framework allows for the possibility of genuine mental disorders due to adverse social conditions, as well as for quasi-universal mental disorders. I conclude that overall, the project of providing an objective account of the concept of mental disorder is far from impossible, and moreover, that it is, at least in principle, feasible.
根据当代精神病学哲学的主流观点,精神障碍本质上涉及个人和社会价值观,因此,精神障碍的概念即使在原则上也不能以一种完全客观的方式阐明。为了支持这种不可能性论点,已经提出了几个论据。我对德里克·博尔顿和杰罗姆·韦克菲尔德分别提出的这方面的两个主要论据进行了批判性考察,对它们的合理性提出了严重质疑。此外,我阐述了一种替代的、完全客观的、但部分规范性的框架,用于阐明精神障碍的概念。精神功能障碍和满足基本需求的基本心理能力受损的概念是该框架的基石。我为真正的精神障碍作为具有客观负生物价值的精神功能障碍模式的客观危害性提供了一个论据,以及一个正式正确的精神障碍概念的定义。与公认的观点相反,这个客观框架允许由于不利的社会条件而产生真正的精神障碍的可能性,以及准普遍的精神障碍的可能性。我的结论是,总的来说,提供对精神障碍概念的客观解释的项目远非不可能,而且,至少在原则上,是可行的。