This conference was held online September 9th-10th. Recordings of most talks are available as a playlist on ‘our’ YouTube channel. Below you find an overview of purpose, program and abstracts (corresponding to an initial call for registration).
Registration is free. If you want to attend, please mailto: jo.bervoets@uantwerpen.be. Zoom details will be sent to all registered participants a couple of days before the conference.
The conference is organized by the University of Antwerp’s Department of Philosophy, the KU Leuven’s Institute of Philosophy and the ERC Starting Grant Project NeuroEpigenEthics.
The main aim of the conference is to cross-fertilize research in what are up to now separate fields. On the one hand there is the blooming field where philosophy of responsibility meets theories of psychopathology, specifically addressing the question to what extent and in what way people diagnosed with a mental illness are to be excused for certain behaviors. On the other hand, there is an interesting line of psychological research on the link between stigma and neurological explanations of psychopathology.
We have selected 7 abstracts from 3 continents, considering the cases of delusions, autism & ADHD, as well as addressing topics as diverse as neurodiversity, Strawsonian approaches to responsibility and 4E approaches to mental illness. Unless otherwise noted (by a * after the talk title) the talks will be recorded and subsequently shared on the NeuroEpigenEthics Youtube channel.
This results in the following program (browse to bottom of the page to see abstracts):
(all times are CEST, keynotes: 45’+15′ Q&A, selected talks: 25’+15′ Q&A)
Thursday September 9th, AM Session:
Keynote:
09:00-10:00 AM: Prof. Nick Haslam, University of Melbourne *
Title: Folk Psychiatry and Stigma
Selected talks:
10:20-11:00: Anna Hartford: Behavioural Genetics & Assessments of Moral Responsibility *
11:20-12:00: Marie van Loon: Delusions Are Responsive to Reasons
12:20-13:00: Caroline Bollen: Towards an inclusive notion of empathy: addressing the paradox of empathy in autism research
Thursday September 9th, PM Session:
Keynote:
15:00-16:00: Prof. Hanna Pickard, Johns Hopkins University *
Title: Addiction and the Meaning of Disease
Selected talks:
16:20-17:00: Laura Matthews: A 4E Approach to Responsibility in Mental Disorder
17:20-18:00: August Gorman: Neurodiversity and Responsibility for Omissions
Friday September 10th, AM Session:
Keynote:
09:00-10:00: Prof. Maureen Sie, University of Tilburg *
Title: Playing Seriously. The Two Faces of our Moral Sentiments
Selected talks:
10:20-11:00: Sofia Jeppsson: Exemption, self-exemption, and compassionate self-excuse
11:20-12:00: Polaris Koi: Gradated participation
12:20-13:00: Jo Bervoets & Audun Benjamin Bengtson: Does Exculpation Stigmatize?
Friday September 10th, PM Session:
Open discussion/further work/follow-on conference:
15:00-16:00 CEST: all interested registered participants
Unfortunately, Prof. V. McGeer of Princeton University had to cancel her keynote because of a personal issue. We have added a closing talk by one of the organizers as a replacement.
Although the conference will be conducted online, the option is provided for participants to attend the conference physically at the University of Antwerp. These participants will follow all the presentations via Zoom in rooms provided by us and will, in between talks, be able to physically interact during breaks and lunch. If you are able and willing to attend physically in this way, please mention this explicitly in your registration mail.
The Organizing Committee: Prof. K. Schaubroeck (UA), Prof. P. Adriaens (KUL), Prof. K. Hens (NeuroEpigenEthics), Jo Bervoets (NeuroEpigenEthics)
Full Abstracts
(content is final, formatting to be optimized for easier browsing)
Keynotes (in order of presentation):
Prof. Nick Haslam, University of Melbourne
Title: Folk Psychiatry and Stigma
Abstract: In this talk I will present a line of research and theoretical work on what I call ‘folk psychiatry’. My model of folk psychiatry offers an account of the psychological processes that underpin laypeople’s thinking about mental illness. These processes are implicated in judgments of which behaviours and experiences are disordered (‘pathologising’) and in the explanations they provide for those phenomena. I propose that these explanations take three primary forms: ‘medicalising’ explanations grounded in essentialist thinking, ‘moralising’ explanations grounded in everyday folk psychology, and ‘psychologising’ explanations that invoke causal histories. These dimensions of folk psychiatry have complex and ambivalent implications for stigma, understood as a varied set of exclusionary or discrediting attitudes. ‘Medicalising’ explanations that invoke biogenetic causes may problematically increase social distancing from people with mental health conditions, but also beneficially diminish moral blame. ‘Moralising’ explanations, in contrast, may be more inclusive but also assign personal responsibility in demeaning ways. A greater tendency to view unusual experiences and actions as mental health problems may normalise mental illness and promote help-seeking, but also undermine agency. These claims will be supported by some meta-analytic work on the implications of genetic and neuroscientific explanations for mental illness stigma. I will conclude with some reflections on the role of essentialist and natural kind thinking in psychopathology, and on the mixed implications of continuum models of mental illness in that field.
Prof. Hanna Pickard, Johns Hopkins University
Title: Addiction and the Meaning of Disease
Abstract: Is addiction a brain disease? Cards on the table: I don’t know. The aim of this talk is to clarify what it would mean for the brain disease model of addiction (BDMA) to be true, rather than to argue decisively for or against it. This requires (1) distinguishing the question of whether addiction is a brain disease from the question of whether labelling it thus has beneficial consequences, such as, e.g., combatting addiction stigma; (2) differentiating possible models of disease and their relationship to the BDMA; (3) understanding the challenges of providing an account of normal brain function by which to measure brain dysfunction; and (4) addressing the complexity of establishing the hypothesis that brain dysfunction is the cause of the personal-level observable signs and experienced symptoms characteristic of addiction. I conclude by arguing for agnosticism and heterogeneity; in some cases addiction may be a brain disease, in others not. Either way, we should not rest our hopes on the brain disease label as a means of combatting addiction stigma, but rather fight directly against drug moralism and moralistic policies.
Prof. Maureen Sie, University of Tilburg
Title: Playing Seriously. The Two Faces of our Moral Sentiments.
Abstract: Kate Manne in her book on misogyny, criticizes “Oxford Don”-Strawson for only paying attention to the salutary aspects of the moral sentiments, resentment, blame, praise, gratitude and the likes of them (preface, Manne 2018). She points out that the moral sentiments can and often are used to uphold the existing social order which might be oppressive and unjust. Potentially aggravating this danger, social media has brought us a magnifying tool for what Linda Radzik has dubbed “informal social punishment,” a practice closely tied up with the moral sentiments, that, according to her, we desperately need to critically reflect on (Radzik 2020). As Radzik rightfully notes, this practice also targets those who, according to feminist and other activists, try to uphold an unjust, discriminatory, social order. So called social justice warriors one could say, use guerilla tactics of naming and shaming to set desperately needed change in motion; #metoo is a case in point. To set change in motions, as Calhoun has argued forcefully, might well be the whole point of moral responsibility (Calhoun 1989). It is clear that Strawson’s seminal essay Freedom and Resentment, managed to put the social dimension of our practices of moral responsibility firmly on the philosophical agenda (Strawson 1962, Cf Walker 2007, 34). In a wide array of philosophical discussions, the main issue of concern is not what conditions an agent has to fulfil in order to qualify as a responsible agent and whether these conditions obtain in our world, but rather about the value and disvalue of the moral sentiments to our society. In this talk I will elaborate on this social dimension building upon my own answer to the skeptical (pessimist) challenge Strawson originally addressed, emphasizing the value of understanding actions as potential disagreements with the normative expectations that regulate our shared practices (Sie 2005). In that view mental illness, like many other conditions put forward as candidates for exculpation, is not considered to be exculpating as such (Sie 2018). I proceed by explaining how we can understand the function of certain social and other categories that enable us to navigate our complex moral lives, and articulate what is worrisome about them as well, i.e., that they can lead to potentially harmful stereotypes, prejudices and stigma’s. I conclude by outlining two faces of the moral sentiments that seem to pull in opposite directions. On the one hand, the moral sentiments function as ammunition in the fight against or defence of certain moral frameworks, on the other hand as moves in an open, but serious dialogue about how to live our shared lives. Striking the right balance by no means is an easy task though a bit of playfulness (Lugones 1987), might help us get there.
Selected talks (in order of presentation):
Title: Behavioural Genetics & Assessments of Moral Responsibility
Abstract: Genetic attributions of certain behavioural conditions, such as addiction, have been shown to reduce ascriptions of blameworthiness. As evidence of genetic and gene-environment influences on human behaviour expands, some have speculated that genetic attributions of behaviour might have this effect across the board, and generate mitigation even for criminal and antisocial behaviour.Such evidence has increasingly been introduced in courts; a practice which may grow with new developments in genetics and gene technology. As various empirical studies have demonstrated, however, genetic attributes for behaviour play a much more complicated relationship to assessments of moral responsibility, and the empirical evidence generates a picture of “inconsistent, contradictory, or seemingly irrational intuitions” (Tabb et al, 2018).
A crucial related question is how such information should affect assessments of responsibility. In the first place, there are significant empirical concerns regarding what can currently be determined from such evidence, and some have argued on this basis that it should have little or no bearing on our moral and legal assessments. But even where, and to the extent that, such information is, or becomes, genuinely predictive of behaviour, there is still no straightforward conclusion to be drawn with regards to moral responsibility.
This paper will consider the implications of behavioural genetics for prominent normative theories of moral responsibility, as well as with regard to positions concerning the minimal conditions for moral responsibility, including rational capacities, conscious control and moral competence.
As I will explore: given that different genetic information bears so differently on the various foundations for moral responsibility posited by these theories, there is no straightforward route from the fact of genetic attribution to any particular assessment with regard to moral responsibility. In particular, while some genetic attributions might undermine these foundations, other genetic attributions might underwrite them. In turn, even a theoretically and normatively cogent response to the significance of genetic attributions would not necessarily generate a uniform response with regards to its effects on assessments of moral responsibility.
I will further explore whether this normative and theoretical discussion sheds any light on some of the central inconsistencies, contradictions and “seemingly irrational intuitions” observed in empirical studies.
Title: Delusions Are Responsive to Reasons
Abstract: Delusional beliefs are often taken to be paradigmatic cases of belief for which subjects are not responsible. This very idea even motivates the thought that, in spite of beliefs not being under direct voluntary control, we should differentiate between beliefs for which we are responsible and beliefs for which we are not responsible. Prima facie, this idea seems more than fair. After all, delusions very often co-occur with severe mental disorders and common sense tends to closely associate pathology and lack of control. For example, in ordinary discourse when we call a certain behaviour “pathological”, what is being captured is that the behaviour in question seems compulsive, or that the agent has very little control over it. Such lay practices explain the intuition that we lack control over delusional beliefs in a way that is different than the way in which we lack control over beliefs according to the Doxastic Involuntarist thesis, where the lack of control over delusional beliefs is seemingly more coercive. This reasoning, I believe, motivates the thesis according to which we are not responsible for delusional beliefs.Yet, philosophers like Hanna Pickard and Quinn Hiroshi Gibson have urged that it is in fact important to be able to hold individuals with mental illnesses responsible for what they believe and what they do. Pickard stresses that this is especially crucial in the context of the relationship between psychiatric staff and patients. If Pickard and Gibson are correct, i.e. if we can legitimately hold individuals responsible for their behavior, and further for what they think, it must be possible for these individuals to fulfil conditions of doxastic responsibility.
In this paper, I will show that a dominant theory of doxastic responsibility, Epistemic Reasons- Responsiveness, is able to respond to the call to take cases of responsibility in mental illness seriously. According to Reasons-Responsiveness, a necessary condition for being responsible for a certain belief requires that the mechanism which produce this belief be sensitive to evidence. In certain cases of delusional belief, the mechanism of belief formation fulfils the reasons-responsiveness condition. Indeed, a widely shared view in the philosophy of psychiatry is that individuals become deluded as a result of undergoing an anomalous experience. For example, this view takes individuals with the Capgras delusion – where a person believes that a loved one has been replaced by an imposter – to fail to have the proper affective reaction to face recognition and as a result form the belief that the person they see and recognize is an imposter. I will argue that such anomalous experience may count as evidence and that therefore, in some cases of delusion, the subjects fulfils the Reasons- Responsiveness condition for doxastic responsibility.
Title: Towards an inclusive notion of empathy
Abstract: It is often held that persons on the autism spectrum lack (or have diminished) empathic capacities. This view excuses autistic persons when they exhibit non-empathic behaviors. This might seem like an accommodating move, but in doing so it stigmatizes autistic persons, even to the point of dehumanizing them. After all, empathy has a profoundly normative societal significance, often getting at the heart of what we think it means to be human.In my talk I show that this view, which at once excuses and stigmatizes autistic persons as non- empathic, stems from deeply confused conceptual and methodological approaches to empathy in autism research. The way empathy is being understood varies strongly, both in a descriptive sense (on what it means) and in a normative sense (on whether it is something virtuous or harmful). Some refer to empathy as co-feeling, some as mentalizing the context of the other, some define it as inherently good, others as inherently biased, etc. If these properties are not explicitly and critically reflected upon, this can lead to various (methodological) problems, and it already has.
A specific problem surrounding this conceptual ambiguity is that a subset of popular understandings of empathy are founded upon, and support, a certain majority privilege towards neurotypicals. These favor specific modes of expression, behavior and perception by including them as prerequisites for something to be called empathy. Such underlying assumptions implicitly shape autism research, treatment and diagnosis. Consider, for example, negligence in establishing measurement invariance of empathy assessments that are created to assess “neurotypical empathy”. This is especially problematic because the concept of empathy is often value-laden in both academic and societal context. Being empathetic is most often seen as a virtue, a desirable characteristic, important or even essential in morality. Combining the use of an ableist conceptualization of empathy (which are, in fact, often not necessarily virtuous) with the normative connotation the concept enjoys in society supports stigmatization or even dehumanization of autistic persons.
This raises a pressing question for researchers working in this space: what does it mean to engage in such research responsibly? On the basis of my research I argue that the conceptual understanding and use of empathy in psychopathology ought to be reconsidered, learning from what it means to be suggested to be lacking this capacity. In this talk, I would like to present a proposal on this account, consisting of three parts. First, I will demonstrate various ways in which the currently existing confusion and even negligence in defining empathy and the appropriateness of assessment strategies harmfully shapes the understanding of autism in science and society. Second, I will describe and defend a certain normative understanding of empathy and how this ought to shape autism research; reframing empathy as a relational virtue. I will demonstrate how this would interfere with the current research landscape – both on existing theories of autism and methodological practices. Lastly, I will discuss how this conceptualization answers the issues that result from the currently existing ambiguity of the concept, making the focus on empathy in research inclusive and, in itself, empathetic.
Title: A 4E Approach to Responsibility in Mental Disorder
Abstract: Among academics and laypersons alike, neurological approaches to mental disorder are seen as a way of reducing stigma. The thought is that if mental disorders are understood as brain disorders, then subjects who suffer from mental disorders cannot be ridiculed or stigmatized for their symptoms or behavior any more than a cancer patient should be held responsible for losing her hair. However, in making this identification between mental disorders and brain disorders, and thereby equating mental disorders with other forms of illness, it is possible that we are also stripping away the subject’s agency. After all, if she cannot be held responsible for her behavior or symptoms, then she must not have any control over them. In this paper, I argue that both these views are mistaken. Mental disorders are not identical to neurological disorders because the mind is not identical to the brain. Recent 4E (embodied, embedded, enactive, extended) approaches to cognition show that the mind emerges from the relations between the brain, the body, and the environment, including the social environment. Mental disorders are then disorders of the subject’s embeddedness in a social context. They are modes of cognition that prevent the subject from autonomously pursuing her own well-being in an intersubjective world. Mental disorders arise from the dynamic relations between the brain, the body, and the social environment. Since mental disorders are dispersed throughout these various factors, responsibility must be dispersed as well. Various factors are at play, including genetic dispositions, neurological irregularities, behaviors that might foster or thwart disordered processes, relationships (in particular, familial relationships), and the support or lack thereof of one’s social environment. Most of what contributes to mental disorder is therefore out of the subject’s control, and the subject is therefore not to be held responsible for having a mental disorder or for struggling in the face of it. However, her behaviors can either contribute to the disorder or contribute to well-being, and we should emphasize the agency that is required for a person to do things like seek help, practice sleep hygiene, exercise, eat well, and refrain from self-medicating. Such an embedded approach to mental disorder allows us to empower the subject to seek her own well-being while also avoiding any ascription of total responsibility. This view reduces stigma, avoids assigning blame, but also promotes agency in the subject.
Title: Neurodiversity and Responsibility for Omissions
Abstract: According to one prominent tradition in the literature on moral responsibility, behavior that a person is responsible for communicatively expresses something about that person. This is most explicit in cases in which we are holding someone responsible for a failure to act rather than for acting. For example, you might blame a friend who forgets to call on your birthday because, you think, if she cared enough about me, she would have remembered. In this way, her silence expresses her lack of care.In this talk I propose that we ought to be more cautious in our interpretive inferences of this kind. I argue that there is no simple algorithm by which you can directly infer a person’s failure to care from her failure to act; by this I mean that you can’t ‘read off of’ a person’s inaction alone that she had an insufficient degree of concern. While how much a person cares about doing something certainly bears some correlation with how likely they are do it, differences in individual patterning of attention, memory, and executive functioning complicate this simple story
We have, I argue, been (mis)led to believe that a simple picture of responsibility for omissions that neglects these factors is sound due to two primary factors. First, we have accepted a paradigm according to which people whose agential functioning differs significantly from the neurotypical norms are seen as outlier cases that may be safely bracketed off when setting our norms of assigning responsibility. There are some people, it is assumed, who are dysfunctional to the point that we simply can’t hold them for responsible for what they do or don’t do since they lack control. Second, the existence of the interpretive norm that ties degree of care so strongly to the likelihood of acting creates a feedback loop: people will use indirect strategies to try to make their behavior conform to the expectation.
For example, it is hypothesized that people with ADHD have attentional systems in which attention is naturally drawn towards what they find most interesting rather than what they take to be most important. But a person with ADHD might try to make a task more interesting that they want to remember to focus on because they know their ability to focus on that task will be interpreted as having a direct correlation with how much they care about it. Given this feedback loop, a person with ADHD’s failure to attend to something may provide a somewhat reasonable (though defeasible) guide to what she most cares about, but operating with this norm puts a disproportionately high burden of psychological management on people who happen to have a certain psychological configuration rather than another.
I show how once we destigmatize differences in memory and executive functioning, this problem generalizes; what we set as our default assumptions about what certain omissions reveal about a person is partly a political matter. I conclude by briefly sketching how we might reconfigure our practices to more justly distribute these burdens.
Title: Exemption, self-exemption, and compassionate self-excuse
Abstract: Moral philosophers traditionally distinguish between excuses and exemptions. In the Strawsonian tradition, this distinction is often framed in terms of the participant and objective attitudes (Strawson 1962). We can excuse someone and still see them as a participant in normal human relationships, but when we exempt someone, we rather see them as an object to be managed and handled. Serious mental disorders are typically assumed to ground exemptions, not excuses.In the moral responsibility literature, it is normally assumed that exemptions apply only to other people, not the readers and writers of philosophy. We discuss whether to take an objective attitude towards them. But what if I have a serious mental disorder myself? Should I, then, take up an objective attitude towards myself, and exempt myself from any wrongful actions, instead of feeling guilty? This is easier said than done.
I can sometimes regard future time-slices of myself, or certain aspects, somewhat like objects to be managed and handled, but I cannot consistently see myself this way. Whenever I choose and act, I experience myself as an agent, and my agency also looms large in memories of what I have previously done (Korsgaard 1996: 162; Jeppsson 2020). I can certainly try to stop feeling guilty and being angry with myself by adopting an objective attitude, but I am doomed to slipping out of it over and over. Every time I do, guilt and self-directed anger threaten to rush back in.
I argue that it is better to opt for compassionate self-excuses than self-exemption. Instead of taking up a detached and objective view on my own past wrongdoings, I should dive into my memories and fully appreciate how difficult certain things were and how much I struggled. Wrongdoing is less blameworthy when abstaining from doing wrong requires a huge effort and/or comes at a serious cost (Nelkin 2016; Wolf 1990: 86-87). Thus, I might often find that I have grounds for a partial or even full excuse for my mentally disordered wrongdoing, while still seeing myself as an agent, not an object to be managed. Furthermore, compassionate and understanding excuses allow for more nuance and growth than blanket exemptions do.
Philosophers have previously argued that mental disorders might ground excuses rather than exemptions, but with a focus on milder cases only (Kozuch and McKenna 2016). I stress that compassionate self-excuse is often a better alternative than self-exemption even for psychosis disorders, and other serious cases. Even in the grip of psychosis, people often make choices and exercise their agency in various ways (Jeppsson forthcoming; Jones and Shattell 2016; Jones et al 2016).
Finally, I discuss neurodiversity as an ideal, and the possibility that some – albeit not all – of my supposedly wrongful actions should be considered justified rather than excused.
Title: Gradated participation
Abstract: A large body of empirical research indicates that behavioral traits that are symptoms for psychiatric categories (henceforth Traits Of Interest, TOI) are continuously and unevenly distributed throughout the population. For example, TOI associated with autism are concentrated on the families of autistic people, including on family members who are not classified as autistic. It is not unusual to refer to such family members as being ‘somewhere on the spectrum’, a phenomenon also referred to as ‘the broader autism phenotype’. Similarly, the notion of the schizophrenia spectrum indicates that the lines between schizophrenia and other diagnoses on the psychotic spectrum are blurred, and that TOI associated with these diagnoses, such as hallucinations, also occur in the subclinical population. In brief, it is uncontroversial that TOI occur in the general population; though only under the clinical gaze are these traits labelled as symptoms. And it is furthermore uncontroversial that the extent to which persons have TOI admits of degrees.How we ought to interpret this continuous, uneven distribution of traits is however not clear. Should participation in a disorder category track participation in associated TOI? If yes, then the possibility of gradated participation in psychiatric categories follows. Whether this result is desirable, however, is highly controversial.
There are two main reasons to resist gradated participation in psychiatric categories and to hold that participation in psychiatric categories should be binary. The first is that gradated participation may result in harms to psychiatric subjects. These include, e.g., harms from stigma or trivialization. Indeed, phrases like ‘he’s a little ADHD’ or ‘I get pretty OCD sometimes’ are often found inappropriate. They can obscure the fact that for autistic people and persons with Attention Deficit Hyperactivity Disorder, Major Depressive Disorder, their disability or illness results in real, significant burdens and requires corresponding accommodations. Secondly, gradated participation can be resisted for reasons that have to do with the aims of psychiatry. Realists about mental disorder categories may worry that gradated participation obscures the joints at which nature ought to be carved; whereas a concern for pragmatists is whether gradated participation would decrease the clinical efficacy of categories qua instruments of diagnostic practice.
However, these worries cut both ways. In this paper, I argue that subclinical TOI is no trivial phenomenon. Rather, for some people, subclinical TOI result in real, significant burdens (e.g., social, well-being, economical). Furthermore, these burdens do not neatly track the degree of participation in TOI. Rather, factors such as overall health, socioeconomic status, and intersectional disadvantage may cause vulnerability due to which quantitatively small participation in TOI results in burdens on par with quantitatively much greater participation. People with subclinical TOI, however, receive neither acknowledgment nor accommodations for that burden. And given these burdens, psychiatry ought to be conceptually equipped to identify subclinical TOI.
I conclude that the above arguments against gradated participation in psychiatric categories fail, and that gradated participation in TOI ought to be acknowledged. However, it does not follow that gradated participation in psychiatric categories would track gradated participation in TOI. Rather, there are multiple ways to conceptualize the relationship of participation in TOI and in psychiatric categories. As TOI-associated burdens demonstrate, however, a need for acknowledgment and accommodations may cross diagnostic boundaries.
Jo Bervoets & Audun Benjamin Bengtson
Title: Does exculpation stigmatize?
Abstract: Biological accounts of psychopathology have been positively received for their exculpatory potential. However, recent experimental surveys showed that biomedical accounts result in a mixed blessing: this type of exculpation seems to come with a stigma of dehumanization. In this paper we address three closely related issues posed by these experimental results. First, in what theoretical framework can these results be predicted? Second, is there a way out of the mixed blessing for those diagnosed with a psychopathology? Third, how can we empirically verify such a way out given the experimental results forming our starting point?Our answers are respectively: 1. the leading ethical framework to discuss issues related to exculpation and moral participation: Strawson’s seminal paper Freedom and Resentment (2008/1962), 2. the novel Wittgensteinian interpretation of Strawson’s core methodological idea allows for a grammar of exculpation without dehumanization, and, 3. in line with such a Wittgensteinian approach, a ‘therapeutic’ understanding of experimental philosophy per Fischer (2018) makes it possible to dissolve the mixed blessing by demonstrating that it is a pseudo-problem resulting from the misuse of the technical concept ‘biomedical’.
Our argument is developed based on the specific case of Tourette Syndrome. It shows the empirical method required to dissolve the problem needs to start from qualitative research. Anchoring empirical research in the responsibility practice of those directly confronted with psychopathology aligns with the methodological concept-practice reversal of Strawson and Wittgenstein. Truly empirical philosophy of medicine can therefore never be reduced to the quantitative experimental method. Based on our example of Tourette Syndrome, we show that the empirical issue hinges precisely on correctly conceptualizing ‘biomedical’ in a case like ‘Tourette Syndrome’. The static (genetic) conceptualization leads to the mixed blessing whilst a dynamic (epigenetic) conceptualization leads to awarding those diagnosed the full moral responsibility without attracting undeserved blame. To resolve this issue we need to look at ‘all the facts’, including those of everyday practice of living with (Tourettic) people.
