Rebecca Roache’s Posts

The dappled causal world for psychiatric disorders: implications for psychiatric nosology

On Thursday 16th October, Professor Kenneth Kendler delivered his second (and final) Loebel Lecture, entitled ‘The dappled causal world for psychiatric disorders: implications for psychiatric nosology’. You can view it online here or listen here.

Whilst Kendler’s first lecture – summarised by Roger Crisp here - focused on empirical issues, the second lecture was more philosophical. Kendler’s key question in the second lecture could perhaps be formulated as: Given the complex aetiology of mental disorders, how can we best understand and explain how they arise? Continue reading

Should we do more to help paedophiles?

By Rebecca Roache

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Luke Malone has published an extremely moving, disturbing, and distressing article in Medium, entitled ‘You’re 16. You’re a pedophile. You don’t want to hurt anyone. What do you do now?’ (warning: Malone’s article contains a graphic description of child abuse). The article focuses on ‘Adam’, a young man who, aged 16, was horrified to discover that he was sexually attracted to children. Disturbed by his sexual desires, and desperate to avoid acting on them, he suffered depression and initially used child pornography as an outlet for his feelings. (He subsequently stopped doing this.) Adam describes how he eventually went to see a therapist, who was unsympathetic, inexperienced in this area, and ultimately of little help. It turns out that, despite the fact that paedophilia is recognised as a mental disorder, there are major obstacles to helping people who, like Adam, are desperate to avoid harming children. Malone summarises some of the main problems: Continue reading

Tidying up psychiatry

By Rebecca Roache

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This is a cross post with psychiatricethics.com

 

Psychiatry’s progress lags behind that of other areas of medicine: the last half-century has seen impressive gains in life expectancy and reductions in mortality for most infectious and cardiovascular diseases and some cancers, yet suicide rates—which are associated with depression—have steadily increased, and longevity for those with serious mental illness falls more than two decades short of the general population. (Colton and Manderscheid 2006; Insel 2013; WHO 2002, 2012). What can we do about this? Continue reading

What if schizophrenics really are possessed by demons, after all?

By Rebecca Roache

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Is there anything wrong with seriously entertaining this possibility? Not according to the author of a research article published this month in Journal of Religion and Health. In ‘Schizophrenia or possession?’,1 M. Kemal Irmak notes that schizophrenia is a devastating chronic mental condition often characterised by auditory hallucinations. Since it is difficult to make sense of these hallucinations, Irmak invites us ‘to consider the possibility of a demonic world’ (p. 775). Demons, he tells us, are ‘intelligent and unseen creatures that occupy a parallel world to that of mankind’ (p. 775). They have an ‘ability to possess and take over the minds and bodies of humans’ (p. 775), in which case ‘[d]emonic possession can manifest with a range of bizarre behaviors which could be interpreted as a number of different psychotic disorders’ (p. 775). The lessons for schizophrenia that Irmak draws from these observations are worth quoting in full:

As seen above, there exist similarities between the clinical symptoms of schizophrenia and demonic possession. Common symptoms in schizophrenia and demonic possession such as hallucinations and delusions may be a result of the fact that demons in the vicinity of the brain may form the symptoms of schizophrenia. Delusions of schizophrenia such as “My feelings and movements are controlled by others in a certain way” and “They put thoughts in my head that are not mine” may be thoughts that stem from the effects of demons on the brain. In schizophrenia, the hallucination may be an auditory input also derived from demons, and the patient may hear these inputs not audible to the observer. The hallucination in schizophrenia may therefore be an illusion—a false interpretation of a real sensory image formed by demons. This input seems to be construed by the patient as “bad things,” reflecting the operation of the nervous system on the poorly structured sensory input to form an acceptable percept. On the other hand, auditory hallucinations expressed as voices arguing with one another and talking to the patient in the third person may be a result of the presence of more than one demon in the body. (p. 776)

Irmak concludes that ‘it is time for medical professions to consider the possibility of demonic possession in the etiology of schizophrenia’ and that ‘it would be useful for medical professions to work together with faith healers to define better treatment pathways for schizophrenia’ (p. 776). Continue reading

More cyborg justice: André interviews Rebecca Roache about the future of punishment

by Rebecca Roache

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My original blog post about the future of punishment can be found here. I clarified my view and provided links to media and blog coverage of these ideas here.

Many bloggers responded to the interview that Anders Sandberg, Hannah Maslen, and I gave in Aeon last month. Among those bloggers was André at Rogue Priest, who wrote a  ‘particularly sarcastic, critical review’ (his words, not mine) of my ideas. In response to my comment on his post, André asked if I would answer some questions about my views on punishment. I agreed, and he sent me a wonderful list of thought-provoking questions. He has since published the interview in a new blog post. I’m posting it here, too.

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Crowd homebuying (or: How to own a home with no savings and no mortgage)

by Rebecca Roache

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I originally posted this on my own blog. It’s not the usual sort of post I write for Practical Ethics, in that it’s not going to involve any ethical debate. But neither is it an ethically irrelevant topic, since I’m hoping that what I describe could help make life better for many people. I hope you’ll let me know what you think.

 

People rent rather than buy their homes for various reasons. Renting is more convenient and flexible than buying, since it’s easier to become a tenant than an owner, and easier to move on from a rented property than from one that you own. But a major reason that many people rent rather than buy is because they have no choice: they cannot afford to buy.

I want to challenge this view. I will argue that it is only because of the way in which our current system of buying and selling property works that many people cannot easily invest in property. This system is outdated. Overhauling it would make owning property easier for people not currently on the property ladder and more profitable for current homeowners. It would also give homeowners the flexibility and convenience currently enjoyed by renters, and it would give renters the security and investment opportunity currently enjoyed by owners. Further, overhauling the current system need not be complicated at all: it can be done by implementing tried-and-tested practices that are already used for other purposes.

A disclaimer before I start: I am a philosopher, not an expert on the property market. Reading about financial matters sends me to sleep. Whilst, as a reluctant tenant, I have given this matter a great deal of thought, these ideas are going to be half-baked. I know this already, so you don’t need to leave a comment to point it out. If you know more about how this could work than I do, please help educate me and help develop this idea by sharing your expertise in a comment. I may update this post to reflect improvements suggested by commenters.

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The future of punishment: a clarification

By Rebecca Roache

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I’m working on a paper entitled ‘Cyborg justice: punishment in the age of transformative technology’ with my colleagues Anders Sandberg and Hannah Maslen. In it, we consider how punishment practices might change as technology advances, and what ethical issues might arise. The paper grew out of a blog post I wrote last year at Practical Ethics, a version of which was published as an article in Slate. A few months ago, Ross Andersen from the brilliant online magazine Aeon interviewed Anders, Hannah, and me, and the interview was published earlier this month. Versions of the story quickly appeared in various sources, beginning with a predictably inept effort in the Daily Mail, and followed by articles in The TelegraphHuffington PostGawkerBoing Boing, and elsewhere. The interview also sparked debate in the blogosphere, including posts by Daily NousPolaris KoiThe Good Men ProjectFilip SpagnoliBrian LeiterRogue PriestLuke Davies, and Ari Kohen, and comments and questions on Twitter and on my website. I’ve also received, by email, many comments, questions, and requests for further interviews and media appearances. These arrived at a time when I was travelling and lacked regular email access, and I’m yet to get around to replying to most of them. Apologies if you’re one of the people waiting for a reply.
I’m very happy to have started a debate on this topic, although less happy to have received a lot of negative attention based on a misunderstanding of my views on punishment and my reasons for being interested in this topic. I respond to the most common questions and concerns below. Feel free to leave a comment if there’s something important that I haven’t covered. Continue reading

Is unwanted pregnancy a medical disorder?

by Rebecca Roache

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Abortion is often in the news. Yesterday, The Atlantic Wire reported a poll of Americans’ moral views, which found just under half of Americans believe abortion is morally wrong. Today, The Sun is running an article on the devastating effects on women of having abortions. And, a couple of weeks ago, the law in Ireland was changed to allow abortion under certain circumstances.

Whether (and under what circumstances) abortion is ethical, and whether (and under what circumstances) it should be permitted by law, are two of the most well known and fiercely debated issues of our age. I do not wish to engage with them here. Instead, I will argue as follows:

  1. Abortions cause suffering, and neither permitting them nor banning them is likely to reduce this suffering to an acceptable level.
  2. The best way of reducing the suffering caused by abortion is to reduce unwanted pregnancies.
  3. Current attempts to reduce unwanted pregnancies in the UK do not work well enough.
  4. Viewing unwanted pregnancy as more like a medical disorder and less like a social problem is likely to enable more effective measures to address it.

I then propose such a measure, and defend it against some possible objections.

Continue reading

Enhanced punishment: can technology make life sentences longer?

by Rebecca Roache

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Edit 26th March 2014: It’s been pointed out to me by various people that this blog post does not make adequately clear that I don’t advocate the punishment methods described here. For a clarification of my views on the subject, please go here. For a Q&A, see here.

Today, the mother and stepfather of Daniel Pelka each received a life sentence for his murder. Daniel was four when he died in March last year. In the last few months of his short life, he was beaten, starved, held under water until he lost consciousness so that his mother could enjoy some ‘quiet time’, denied medical treatment, locked in a tiny room containing only a mattress on which he was expected both to sleep and defecate, humiliated and denied affection, and subjected to grotesquely creative abuse such as being force-fed salt when he asked for a drink of water. His young sibling, who secretly tried to feed and comfort Daniel, was forced to witness much of this; and neighbours reported hearing Daniel’s screams at night.

Daniel’s mother, Magdelena Luczak, and stepfather, Mariusz Krezolek, will each serve a minimum of thirty years in prison. This is the most severe punishment available in the current UK legal system. Even so, in a case like this, it seems almost laughably inadequate. The conditions in which Luczak and Krezolek will spend the next thirty years must, by law, meet certain standards. They will, for example, be fed and watered, housed in clean cells, allowed access to a toilet and washing facilities, allowed out of their cells for exercise and recreation, allowed access to medical treatment, and allowed access to a complaints procedure through which they can seek justice if those responsible for their care treat them cruelly or sadistically or fail to meet the basic needs to which they are entitled. All of these things were denied to Daniel. Further, after thirty years—when Luczak is 57 and Krezolek 64—they will have their freedom returned to them. Compared to the brutality they inflicted on vulnerable and defenceless Daniel, this all seems like a walk in the park. What can be done about this? How can we ensure that those who commit crimes of this magnitude are sufficiently punished? Continue reading

Does Madeleine McCann deserve never to be found?

by Rebecca Roache

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Several news sources reported today that Scotland Yard has launched a formal investigation into the disappearance of Madeleine McCann, following the emergence of ‘new evidence and new theories’. Madeleine disappeared from her family’s holiday apartment in Portugal in 2007, a few days before her fourth birthday. Her parents had left her and her siblings alone in the apartment one evening while they dined with friends at a restaurant. The years since her disappearance have seen a botched Portuguese police investigation, the arrest and release of Madeleine’s parents, various unconfirmed sightings and false leads, a private investigation commissioned by the McCanns, a Scotland Yard case review, and a massive media campaign driven by the McCanns. The case is controversial: among other things, various people have complained that attention to it eclipses other abducted children, and have suggested that media interest in it is partly due to the fact that Madeleine is from a respectable, educated, white, middle-class family.

Perhaps some of this criticism is warranted—I don’t wish to engage with it here. Personally, I am happy that Madeleine’s disappearance is to be investigated, and I hope that it sends a clear indication that this sort of crime will be taken seriously even when a child disappears outside his or her community, with all the difficulties this raises for any investigation. I wish, instead, to focus on a particular complaint about Madeleine’s case that arises again and again each time the case reappears in the news: the view that the case is undeserving of serious attention because the fact that Madeleine’s parents left her unsupervised means that they are partly to blame for her disappearance. This complaint appears many times in comments on a recent Daily Mail story about Madeleine. Continue reading

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