Myers Neely Anne Laurenzo
Southern Methodist University
Transcult Psychiatry. 2016 Aug;53(4):427-44. doi: 10.1177/1363461516663124.
Moral agency has been loosely defined as the freedom to aspire to a "good life" that makes possible intimate relationships with others. This article uses ethnographic research to further the discussion of the role of moral agency in mental health recovery. This article attends to the ebb and flow of moral agency in the life stories of three people diagnosed with a serious psychiatric disability at different stages in their individual recoveries to illustrate particular aspects of moral agency relevant for recovery. From these, a more complex notion of moral agency emerges as the freedom not only to aspire to a "good life," but also to achieve a "good" life through having both the intention to aspire and access to resources that help bring one's life plans to fruition. Each storyteller describes an initial Aristotelian peripeteia, or "breach" of life plan, followed by an erosion of moral agency and sense of connection to others. The stories then diverge: some have the resources needed to preserve moral agency, and others attempt to replenish moral agency that has been eroded. In these stories, the resources for preserving and nourishing moral agency include the ability to cultivate the social bases of self-respect, autobiographical power, and peopled opportunities. These stories cumulatively suggest that without such resources one's attempts to preserve or nourish the moral agency needed for recovery after the peripeteia, which is often perpetuated by the onset and experience of serious mental illness, may fall short.
道德能动性被宽泛地定义为追求“美好生活”的自由,这种自由使与他人建立亲密关系成为可能。本文运用人种志研究方法,进一步探讨道德能动性在心理健康康复中的作用。本文关注三位被诊断患有严重精神疾病的患者在各自康复不同阶段的人生故事中道德能动性的起伏,以阐明与康复相关的道德能动性的特定方面。由此,一个更为复杂的道德能动性概念浮现出来,即不仅有追求“美好生活”的自由,还包括通过既有追求的意图又有获取有助于实现人生计划的资源,从而实现“美好”生活的自由。每位讲述者都描述了最初类似亚里士多德式的命运逆转,或人生计划的“破灭”,随后是道德能动性的削弱以及与他人联系感的丧失。这些故事随后出现分歧:一些人拥有维持道德能动性所需的资源,而另一些人则试图恢复已被削弱的道德能动性。在这些故事中,维持和滋养道德能动性的资源包括培养自尊的社会基础、自传体力量以及人际机会的能力。这些故事共同表明,如果没有这些资源,一个人在命运逆转(这通常因严重精神疾病的发作和经历而持续)后试图维持或滋养康复所需的道德能动性的努力可能会失败。