Academic journal article The Hastings Center Report

Eternal Mysteries, Right Here. (from the Editor)

Academic journal article The Hastings Center Report

Eternal Mysteries, Right Here. (from the Editor)

Article excerpt

I went to graduate school in philosophy because I wanted to ponder the eternal mysteries. Once I got there, I did work in bioethics because I wanted to keep my feet on the ground. Questions in bioethics sometimes have to be answered, after all, even if we can't agree on any one right answer. And even when they don't have to be answered, talking about them still has us in touch with the pressing needs of specific people and communities. Bioethicists can't spend all their time reading Berkeley and agonizing over whether there's really any external world.

But neither does bioethics always get one off the hook. Sometimes the pressing needs of specific people are all tangled up with the eternal mysteries. That's the attraction, for me, of several articles in this issue.

The two lead articles consider some of the ramifications for health care and policy of the philosophical puzzle posed by free will. Psychiatrist Neil Scheurich suggests that this puzzle is at the root of a deep ambivalence we have about mental disorders. Treating mental disorders often fits with a deterministic view of the world. Treating patients as persons returns us to a world in which there is free will. But accepting that people are free to do as they choose, and are responsible for what they do, encourages skepticism about mental illness: it encourages clinicians to blame mentally ill patients for their behavior, and at the extreme end it encourages people to deny that there are such things as mental illness at all. And this is a problem, notes Scheurich, that in different versions affects not just psychiatrists, but all clinicians. Scheurich argues that good clinicians must hold these competing perspectives in tension, not allowing either one to squelch the other. But they must also somehow come to terms with that in a patient which they find blameworthy. …

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