I hate choices sometimes!

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Wed, 2009-02-11 09:51

I am in the process of deciding on the title of my dissertation for my Bioethics MA. I have two proposals and can't decide between them!

One is to focus on ethics of neurotechnologies and the other looks at the ethics of coercive psychiatric intervention.

I have a lot of interest in both areas. If I followed the neurotechnologies route, I am particularly interested in nootropics and cognitive enhancement (on which much has been written including a new book by Savelescu); and having spent some years as a marketeer in the advertising arena I am also interested in the ethics of neuromarketing, where brain imaging and physiological responses are used to measure and improve the effectiveness of marketing stimuli ( a subject where less has been written).

The psychiatry topic has arisen partly from the research I have been doing for my latest essay on the legitimacy of coercive suicide prevention. I would seek to expand to cover the legitimacy of all forced psychiatric intervention. Whilst there has been a great deal written on the matter, very little has a strong philosophical approach. Even the most well known anti-coercive-psychiatry academic Thomas Szasz gives little consideration to the philosophy behind his libertarian viewpoints focussing instead on social issues, the place of medicine and American ideals & politics. As well as taking a strong philosophical approach I would also seek to engage with the amendments to the 1983 act (and 2007 act)

I think I am tipping towards the coercive psychiatry option since it will contain a strong legal element which is of interest to me as well as science and ethics!

Which of these two subjects would interest you the most?!

Wed, 2009-02-11 12:35

Dendrite

I think coercive psychiatry is the more interesting of these two, although after reading your post twice I don't know if you are for or against. I am a very light reader on this, but in general agree with Sarbin that the "disease model" needs to be at least updated. In my experience, and again in a really general way, much mental illness diagnosis seems to track from the inability/refusal/resistance of the subject to engage in what can best be defined as groupthink, which I think leads to cascading coping and functional skills. The relationship of the individual to society is endlessly interesting, especially when looking at outliers. I like the notion of joining a philosophical/ethical dimension to psychiatry and it’s great you are doing this intriguing work. Note again I am only an interested layman in all this.

Wed, 2009-02-11 19:23

jxmartin

Jude, I am sure you will settle on the appropriate topic soon enough. Your commentary brings to mind George Orwell and his rather intriguing works. At what point does the ethically slippery slope become a more acceptable route in determining acceptable behavior patterns? Who decides what the line is and when we need to say enough? Your theme has endless possibilities as to possible paths that a government might take and the rationale behind them. At what point does liberty become license and how does a society rectify the behavioral swing? Or does it at all? Is Social Darwinism the natural order? What does Hobbes have to say? Locke? Who decides which way the scales tip and then the utilitarian methods of tipping them?Do technicians have an ethical responsibility? Will "I was only following orders" cut it at the last judgement? The Neuremberg trials thought the argument had little merit. Does the Victor get to set the ethical scale or is there a greater standard from which to judge things? I think you will enjoy writing this Treatise regardless of the opinion you choose to support. Buona Fortuna, J.X.M

Wed, 2009-02-11 21:15

poetjude

Thanks for the feedback. As you point out, the issues could span several Phd theses so I am going to have to focus in on one aspect to pack in to my little 20k word dissertation! I am in favour of neurotechnologies such as cognitive enhancement and don't believe that neuro-marketing compromises our essential free-will. I have mixed feelings about coercive psychiatric intervention. I think those who clearly pose a danger to others can legitimately be sectioned but I am opposed to treatment as a covert form of social control. I think forced drug treatment under the guise of ‘Supervised Community Treatment' amounts to 'chemical battery' - it is a loathesome double standard that medics not give ECT without consent under any circumstances but are able in certain circumstances can give drugs without consent. I think involuntary detention of those who only pose a danger to themselves (i.e. those with strong self-harming or suicidal tendancies) can only be justified if the person is delusional (and I do not count emotional distortion as a qualifying delusion). I am convinced that suicide is not a medical matter (though it may or may not have a medical cause) and people should have the freedom to take their own lives. A person can refuse treatment for a physical ailment if they are competent, even if their reasoning is irrational, bizarre or obviously untrue and their refusal leads to harm or even death. This basic liberty does not extend to those diagnosed with a mental disorder again, indicitive of double standards at play. A depressed person is competent though perhaps irrational and there is no justification in incarcerating them even to save them. Two books I thoroughly recommend are 'The Theology of Medicine' and 'Fatal Freedom' both by Thomas Szasz. I think I am more in touch with my disapproval than I am with my support, another factor tipping me to the psychiatry option! jude

Wed, 2009-02-11 22:38

brooosh

As a non academic the issue for me would be which of these topics would most likely form the basis for an international bestseller. Surely it would have to be the neurotechnologies one?

Thu, 2009-02-12 00:49

jxmartin

Jude, You have strong feelings on several very emotional issues. It raises the problem of "who is right?" and "Who gets to choose?" These might be areas for exploration. What is the rational basis for policy establishment? Is it a function of local custom or medical opinion which itself can be colored by subjectivity? I think you can choose any side of this thesis and make a case for its "correctness," leaving room for another generation to upend anything already in place. Ethical and moral relativity are tricky and elusive concepts, well worth pondering. J.X.M

Thu, 2009-02-12 10:23

poetjude

JXM, It is true that anyone can convincingly argue their point of view but to gain a distinction (that is a mark above 70%) thorough consideration has to be given to the opposing viewpoint and all objections explored and defended against. I also try to present counter-counter-arguments (counter arguments to the counter-arguments) although one has to draw the line somewhere! Of course it is not possible to be completely objective but if a paper is filled with blatant subjectivity and rhetoric (views which lack supporting evidence) then it won't gain marks much above 60 ( a borderline merit). You are right that these are things worth pondering and entering into dialogue over. I think Szasz' 'under fire' book where he responds to thirteen well-respected academic critics is excellent. I believe a good academic relishes criticism and objection because i) it enable them to refine their argument and ii) they remain open to the possibility that they may be wholly or partially wrong! j

Thu, 2009-02-12 10:31

poetjude

Broosh, I think the neurotechnologies one certainly has more potential in this sense. In a future world where over 90% of the population has severe fertility problems, Al Pacino heads up an evil corporation who offer miracle fertility treatment. Unknown to the parents, during the treatment, the company manipulate the embryos so that children are neurologically susceptible to subliminal neuro-marketing. Keanu Reeves would play such a child who grows up to discover the truth and destroys the corporation. or something. jude

Thu, 2009-02-12 19:54

brooosh

Wow Jude. That has the makings of a great thriller. Delete the comment before someone steals it and write the screenplay, or a treatment at the very least.

Mon, 2009-02-16 00:54

#10

justyn_thyme

"The Manchurian Consumer" It has promise!

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