John Z. Sadler - Böcker

Nature and Narrative is the launch volume in a new series of books entitled International Perspectives in Philosophy and Psychiatry. The series will aim to build links between the sciences and humanities in psychiatry. Our ability to decipher mental disorders depends to a unique extent on both the sciences and the humanities. Science provides insight into the 'causes' of a problem, enabling us to formulate an 'explanation', and the humanities provide insight into its 'meanings' and helps with our 'understanding'. Psychiatry, if it is to develop as a balanced discipline, must draw on input from both of these spheres. Nature (for causes) and Narrative (for meanings) will help define the series as a whole by touching on a range of issues relevant to this 'border country'. With contributions from an international star-studded cast, representing the field of psychiatry, psychology and philosophy, this volume will set the scene for this new interdisciplinary field. This will be of interest to all those with practical experience of mental health issues, whether as providers or as users/consumers of services, as well as to philosophers, social scientists, and bioethicists.

The public, mental health consumers, as well as mental health practitioners wonder about what kinds of values mental health professionals hold, and what kinds of values influence psychiatric diagnosis. Are mental disorders socio-political, practical, or scientific concepts? Is psychiatric diagnosis value-neutral? What role does the fundamental philosophical question "How should I live?" play in mental health care? In his carefully nuanced and exhaustively referenced monograph, psychiatrist and philosopher of psychiatry John Z. Sadler describes the manifold kinds of values and value judgements involved in psychiatric diagnosis and classification systems like the DSM. Professor Sadler takes the reader on a fascinating conceptual tour of the inner workings of psychiatric diagnosis, considering the role of science, culture, sexuality, politics, gender, technology, human nature, patienthood, and professions in building his vision of a more humane psychiatric diagnostic process.

Vice and Psychiatric Diagnosis begins with the simple question of why some categories of mental disorder include immoral or criminal conduct as diagnostic features, while most mental disorders in the DSM and ICD do not involve such "vice-laden" concepts. While this initial puzzle seems to concern only the limited domain of psychiatric nosology, Sadler's expansive scholarship reveals that this simple question leads inexorably to complex questions about the role of "madness and morality" in intellectual history, and to today's many conflicts and contradictions in the policy and culture of mental health, criminal justice, and related social welfare efforts. The book outlines the implications of vice concepts being incorporated into psychiatric diagnosis and clinical practice, leading to some of the vexing problems in mental health and social care. These issues include the fragmentation of care in social welfare efforts involving mentally ill people, criminal offenders, intellectually disabled individuals, and juvenile offenders. The analysis extends to cultural attitudes and policies as well: the insanity defense, managing the mentally ill criminal offender, the value of punishment in criminal justice, and derivative issues such as the ethics of forensic psychiatry, the growing problem of mass shootings, stigma, health literacy, and the difficulties in pursuing rigorous and consistent approaches to psychiatric diagnostic classification. In the pursuit of untangling these threads of vice and psychiatric diagnosis, Sadler provides a brief history of ideas about madness and morality, beginning in prehistory and extending into the late 20th century. The lessons from this history are applied in subsequent chapters, examining the "vice-mental disorder relationship" from the perspectives of philosophical/conceptual issues, the perspectives of criminal law and the criminal justice system, and the perspectives of public interest and public opinion. The concluding chapters formulate an alternative way of thinking about the vice-mental disorder relationship in clinical practice and public policy, culminating in "Forty Theses" which present the detailed conclusions and social implications for this monumental work.