Reductionism is usually taken for granted in many areas of science, neuroscience and psychology being no exceptions. It is often assumed as scientific orthodoxy that human behavior can be reduced to "what the brain does" without recourse to a consideration of cognition. Although many philosophers and ethicists may seek to reduce or eliminate the concept of mind, other philosophers and ethicists have continually pointed out the logical inconsistencies of such an approach. Via a discussion of efficient and final causes in Aristotelian philosophy, I seek to argue that the understanding of human beings as rational and social creatures has guided and should continue to guide our approach to the care and treatment of the mentally ill. Observations concerning rational behavior and cognition, by necessity, have provided the benchmarks by which clinicians evaluate the effectiveness of somatic/pharmacological or psychological/ behavioral interventions: Eliminative reductionism is inappropriate in this area. In approaching issues pertaining to the relationship between human cognitive functioning and neural functioning, the distinction between capacity and vehicle will be used. However, the fact that mental and behavioral functioning can alter neuronal functioning (and vice versa) necessitates that those working with the mentally ill need to know both the efficient causes-the vehicles of certain capacities-and the role of the capacities themselves and how they relate to possible final causes in giving explanations for behavior. These issues become more significant when considering the ethics of treatment choice for those with mental disorders.
Keywords: Aristotelian; cognitive; human nature; mental health; neuroethics; psychological disorder
In our day to day lives, we live as individuals embedded in a social framework, thinking about the significance of the past, making decisions and acting upon them, planning for the future, and evaluating the behavior and intentions of others. This is a realm of logic, induction and deduction, teleology, as well as ethics and morals. Working within this realm, we judge the correctness of actions and debate issues such as neurological and mental health ethics. And yet there is also the realm of the human brain as organ, a world of neurochemicals and hormones, synapses, cellular machinery, and gene expression, a world seemingly governed not by the reason and logic of the human level but by the laws of physics and chemistry and the electrochemical equations of neurophysiology. Between these two worlds, there appears to be a chasm that is conceptually difficult to cross, giving rise to the "mind-body" or the "mind-brain" problem (Armstrong, 1987).
The philosophical solutions to such an apparent dichotomy have been rather stark, and many attempts to resolve the debate have been based on an open denial of any distinct causal role for human agency based on intentions, reasons, or goals. This approach reduces all human activity to "nothing but" the pure mechanism of the material of the organism, especially the central nervous system (Churchland, 1986). The common "folk psychology" rooted in any manner of belief or telos can and must be dispensed with as prescientific, especially if behavior can be explained via recourse to physiological mechanisms. This reductive principle is perhaps the central dogma of eliminative materialism, and the result is the assertion that there are no such things as beliefs or reasons. At best, such constructs are epiphenomena produced by neural functioning. However, as is quite easy to intuit, such an approach seemingly removes the logical foundation from under the materialist making the statement, for such an assertion cannot really mean anything-to either the person writing it or the person reading it (Bennett & Hacker, 2003).
If eliminative materialism as a solution to the mind-body problem seems somewhat distasteful, so too have been solutions based on a strong dualism of mind as something distinct and separate from the body. …