Mental Illness and Moral Responsibility

Posted on January 25, 2015 by

My 6th post is up over at flickers. I have copied and pasted it below for those not interested in clicking again.

Mental illness affects how we perceive the actions of others and with good reason. Consider two scenarios. In scenario 1 a person crashes into you because they had a non-epileptic seizure while driving. The seizure was due to an undiagnosed anxiety disorder (the person never had a seizure prior to this one). In scenario 2 a person  crashes into you because they want to harm you, they do not have a mental illness of any kind (let’s assume). Surely, almost everyone would agree that we are more likely to deem the agent in scenario 2 as morally responsible for crashing into you but not the agent in scenario 1 (MR skeptics aside). I would cite the anxiety order as the exculpating factor in this scenario. The illness left the agent without control over their actions. Now, this is not to say that I think anxiety disorders exculpate in every scenario, far from it! But rather than get bogged down with the details of any one disorder I’d like to speak in more general terms to get the conversation going (though I’d be happy to discuss such details when explaining why we think some disorders exculpate and others do not).

In the last post I focused on psychopathy. My claim was that psychopaths are morally responsible because their disorder does not leave them without requisite control or with an inability to meet one’s favored epistemic condition. In my previous line of work I worked with many that were afflicted with addiction, PTSD, depression, various mood disorders, anxiety disorders, psychosis, schizophrenia, ADHD, and others. Many of these disorders are on a spectrum and some are more dehabilitating than others. Now, I ask you all: which disorders are exculpating and why? For me, disorders that have as part of their diagnosis hallucinations seem to be exculpating in many scenarios (but not all). But the fact that a person has any particular disorder is not exculpating in itself (or is it?), and I think this is an important point. Consider scenario 1 again. This time, let’s build into the case that the agent has had 3 such episodes in the last few weeks (call this scenario 1B). Let’s further stipulate that the agent can sense when a seizure is coming on and that such seizures can be prevented by taking medication and that the doctor recommended that the agent not drive until the agent had a month without seizures (just to be safe and to make sure the medication was working). Now, it seems that if the agent wasn’t taking their meds (because they simply did not want to) and they were feeling as if a seizure was on the verge of coming on but decided to drive anyway, then this agent is morally responsible. Thus, the disorder in and of itself is not doing the work here, at least it doesn’t seem to be. Notice that the same thing occurred in scenario 1 and 1B, an agent crashed into an innocent person due to a cognitive disorder that the person was not culpable for (the agent did not ask to have this disorder). In other words, that the agent has this disorder is not *their fault* in either case. What is the agent’s fault in scenario 1B, at least at first glance, was a failure to adhere to doctor’s orders and for risking driving when the agent felt the seizure coming on. Do folks think that the anxiety disorder exculpates in scenario 1B? These sorts of questions can be generated with any mental illness/disorder and I find it fruitful to use such scenarios to get a grip on what it is about any one disorder that exculpates. I also think that this gets us to deeper questions about the nature of morally responsible agency as well.

Please feel free to discuss variants of the case I mention with other disorders. I find that the thought experiment is helpful to get clear on the disorder in question as well as getting clear on what we find salient in the moral responsibility literature more generally.

Before concluding I’ll ask some further questions (just in case the previous one’s were not interesting to you all): (1) Do disorders determine how we will perceive things? Or, do they limit or constrain our salient choices? (2) What is it about an illness that exculpates the person with the disorder?
PS: My stint as FA is coming to a close. However, I do plan on posting a couple more times before handing over the reigns. I’m thinking something on Helen Steward’s work re: Agency Incompatibilism, and, a sketch of an epistemic argument against FWskepticism that I’m still working out and would love some feedback on.