Moral Responsibility & Mental Illness: A Call for Nuance

Abstract

• Key Question: Does having a mental disorder affect moral responsibility?

• Common Belief: Many believe mental disorders mitigate responsibility.

• Argument: A nuanced account is necessary because mental illness affects behavior in diverse ways.

• Keywords: free will, accountability, blame, excuse, psychopathology, mental disorders

1. Introduction

Andrea Yates Case

• In 2001, Andrea Yates drowned her five children in Texas.

• Her psychiatrist had recently taken her off anti-psychotic medication.

• Pleaded not guilty by reason of insanity; jury agreed.

• Public Reaction: Verdict seen as a watershed event in understanding mental illness and free will.

Eddie Ray Routh Case

• In 2013, Eddie Ray Routh killed two men, including sniper Chris Kyle.

• Diagnosed with PTSD and schizophrenia; insanity defense was rejected.

• District Attorney Statement: Mental illness does not exempt one from accountability.

2. Understanding Mental Illness and Responsibility

Key Questions

• Main Inquiry: When does mental illness sufficiently undermine moral responsibility?

• Relevant to legal discussions, assigning praise and blame, and forming public health policy.

Historical Context

• Philosophers traditionally focused on determinism as a threat to free will.

• Some have shifted focus to psychopathology’s impact on moral responsibility.

• Walter Glannon’s View: Brain dysfunction is a major threat to free will.

Narrowing Focus

• The focus should be on the operation of symptoms in specific situations rather than categorizing disorders.

• Consideration of how different mental disorders affect agency and responsibility.

3. The Naïve View

General Assumptions

• Mental illness is widely seen as mitigating responsibility (Edwards, 2009).

• Exemptions from Responsibility

  • Considered similarly to childhood, addiction, and other states impacting free will.

• Certain philosophers advocate that a mental disorder generally excuses moral failings (Levy, 2003).

Critique of Naïve View

• Pathological Argument: Being labeled a disorder suggests a lack of control, but this does not guarantee lack of responsibility.

• Sourcehood View: Responsibility tied to the sources of an action, which may apply unequally across mental health status.

• Exemptions Argument: Individuals with mental disorders might be excluded from typical moral reactions but this is difficult to justify.

4. Nuanced Account of Responsibility

Proposal for Change

• No General Relationship: No mental disorder uniformly affects moral responsibility.

• Case-by-Case Assessment: Each disorder must be evaluated based on its unique effects on agency.

• Categories of Symptoms: Symptoms may enhance or diminish moral responsibilities based on context.

Examples of Differentiation

• OCD Example: Compelled actions may complicate responsibility evaluation based on symptoms’ influence.

• ADHD Example: Symptom expression varies widely, affecting moral consideration.

Theoretical Considerations

• Different theories of moral responsibility (control, choice, coherence) may respond variably to symptoms of mental disorders.

5. Bypassed or Diminished Agency

Importance of Agency

• Moral responsibility relies on an agent's abilities to believe, intend, and enact actions.

• Moral justification hinges on understanding the relationship between mental disorders and action execution.

Illustrative Cases

• Narcolepsy Example: Bypassing agency through sudden lapses illustrates clear ground for excusal due to the disorder.

• Schizophrenia Example: Awareness and treatment adherence complicate discussions about responsibility during violent episodes.

6. Hypothetical Enhancements

Symptomatic Enhancements

• Symptoms can enhance certain capacities, possibly increasing responsibility.

• Delusions: Can act as coping mechanisms that allow patients to operate within their context.

• Bipolar Disorder: Hypomanic episodes may lead to increased productivity but also possible irresponsibility.

Nuanced Perspective

• Not all disorders universally excuse behavior; some mental disorders can paradoxically enhance responsibilities.

• Consideration of Specifics: Evaluating symptoms needs to align with behavior outcomes in respective contexts.

Conclusion

• Final Argument: The correlation between psychopathology and moral responsibility is complex and case-dependent.

• Legal Considerations: The law evaluates individual circumstances rather than broadly accepting mental disorders as excuses for behavior.

• Recommendation: Shift from broad generalizations to nuanced evaluations of individual cases, recognizing diverse influences from mental disorders on moral agency.