One way to determine whether a mental condition should be considered a disorder is to first give necessary and sufficient conditions for something to be a disorder and then see if it meets these conditions. But this approach has been criticized for begging normative questions. Concerning autism (and other conditions), a neurodiversity movement has arisen with essentially two aims: (1) advocate for the rights and interests of individuals with autism, and (2) de-pathologize autism. We argue that denying autism’s disorder status (...) could undermine autism’s exculpatory role in cases where individuals with autism are charged with a crime. Our argument raises a dilemma for the neurodiversity movement: advocating for the rights and interests of individuals with autism may require viewing autism as a condition that can be inherently disabling (at least for some individuals). If this is right, autism’s disorder status might be maintained (again, at least for some individuals) without deriving this result from any general account of disorder. (shrink)

Neuroscience has substantially advanced the understanding of how changes in brain biochemistry contribute to mechanisms of tolerance and physical dependence via exposure to addictive drugs. Many scientists and mental health advocates scaffold this emerging knowledge by adding the imprimatur of disease, arguing that conceptualizing addiction as a brain disease will reduce stigma amongst the folk. Promoting a brain disease concept is grounded in beneficent and utilitarian thinking: the language makes room for individuals living with addiction to receive the same level (...) of compassion and access to healthcare services as individuals living with other medical diseases, and promotes enlightened social and legal policies. However such claims may yield unintended consequences by fostering discrimination commonly associated with pathology. Specifically, the language of neuroscience used to describe addiction may reduce attitudes such as blame and responsibility while inadvertently identifying addicted persons as neurobiological others. In this paper, we examine the merits and limitations of adopting the language of neuroscience to describe addiction. We argue that the reframing of addiction in the language of neuroscience provides benefits such as the creation of empowered biosocial communities, but also creates a new set of risks, as descriptive neuroscience concepts are inseparable from historical attitudes and intuitions towards addiction and addicted persons. In particular, placing emphasis on the diseased brain may foster unintended harm by paradoxically increasing social distance towards the vulnerable group the term is intended to benefit. (shrink)

Neurodiversity has remained a controversial concept over the last decade. In its broadest sense the concept of neurodiversity regards atypical neurological development as a normal human difference. The neurodiversity claim contains at least two different aspects. The first aspect is that autism, among other neurological conditions, is first and foremost a natural variation. The other aspect is about conferring rights and in particular value to the neurodiversity condition, demanding recognition and acceptance. Autism can be seen as a natural variation on (...) par with for example homosexuality. The broad version of the neurodiversity claim, covering low-functioning as well as high-functioning autism, is problematic. Only a narrow conception of neurodiversity, referring exclusively to high-functioning autists, is reasonable. We will discuss the effects of DSM categorization and the medical model for high functioning autists. After a discussion of autism as a culture we will analyze various possible strategies for the neurodiversity movement to claim extra resources for autists as members of an underprivileged culture without being labelled disabled or as having a disorder. We will discuss their vulnerable status as a group and what obligation that confers on the majority of neurotypicals. (shrink)

The diagnosis of autism is on the rise. Autistic people, parents, professionals, and policy makers alike face important questions about the right approach toward autism. For example, there are questions about the desirability of early detection, the role and consequences of underlying cognitive theories, and whether autism is a disorder to be treated or an identity to be respected. How does the fact that autism is a heterogeneous concept affect the answers to these questions? Who has the authority or knowledge (...) to speak on behalf of people with autism? In this paper, we describe a cluster of research topics which should be on the agenda of the emerging field of autism ethics. These topics include the very concept of autism itself, the question whether autism is primarily an identity or a disorder, the ethical questions that parents of autistic children face, metaethical questions, the ethical consequences of epistemological questions, and a cluster of questions related to social justice, stigma, and paternalism. (shrink)

In this paper, we want to take a critical stance towards Tsou’s recent proposal that a neuro-oriented version of the homeostatic property cluster kind model (MPCK) should be an ideal for the DSM. Our strategy will be to discuss the creation of the Social Pragmatic Communication Disorder (SPCD) in DSM-5 to show the limits of MPCK as an ideal for the next DSM deliberations over a set of diagnoses revisions. We argue that an ideal model for the DSM should address (...) the issues of deep uncertainties and pragmatic considerations to be useful in this context. (shrink)

Substantial research efforts have been devoted to developing a cure for autism, but some advocates of people with autism claim that these efforts are misguided and even harmful. They claim that there is nothing wrong with people with autism, so there is nothing to cure. Others argue that autism is a serious and debilitating disorder and that a cure for autism would be a wonderful medical breakthrough. Our goal in this essay is to evaluate what assumptions underlie each of these (...) positions. We evaluate the arguments made on each side, reject those that are implausible and then highlight the key assumptions of those that remain. (shrink)

The long standing and still highly influential mindreading framework claims that social cog- nition is best understood as an ability to predict and explain others’ behavior in terms of their mental states. This ability is explained by appealing to mental representations and inferential reasoning via rule-based knowledge. However, recent enactive work on social cognition questions most, if not all, of the main assumptions on which mindreading is founded. Enac- tivism’s emphasis on the structural coupling of the brain-body-world constitutes the foundation (...) of the framework, which rejects the representational and inferential reasoning claims of the mindreading framework. For enactivists, social cognition is best explained in terms of the direct embodied and embedded interactions an agent has with her socio-material world. In continuing this work, the thesis provides new developments of the enactive project for investigating and explaining social cognition. The thesis utilizes two approaches to achieve this goal. First, it dialectally defends enactivism vis-a-vis the mindreading framework. It does this by both securing established enactive claims from criticism, and by developing new objections against the mindreading framework. Secondly, the thesis offers new enactive interpretations of empirical developmental data, and presents new ways of investigating three central areas of debate within the field of social cognition: the metaphysical basis of social cognitive processes, the false-belief test literature, and the concept of empathy in relation to therapeutic practices and autism. The thesis is composed of five different, but thematically intertwined papers. The first paper targets the constitutive basis of social cognition by attempting to dissolve the causal-constitutive fallacy through appealing to a diachronic conception of constitution. This move both secures established enactive claims and develops a more thorough account of what is meant by enactive constitutive claims. The second paper then examines infant social cognitive capacities, arguing cognitivist explanations of these capacities rely on fallacious as- sumptions regarding the nature of perception. The paper then offers an alternative enactive and ecological account of these capacities. The third paper argues both innate and construc- tivist mindreading accounts of the folk psychological know-how required to reliably succeed on false-belief tests fall prey to an infinite regress problem. The paper ends by briefly pre- senting an alternative enactive, narrative explanation of the empirical data. The fourth paper then shifts focus to examine the concept empathy and practice of empathizing. It argues there are advantages to conceiving of empathy as enactive and exploratory, in the sense that when we empathize with others we understand them in a deeper and richer way, through exploring their self-authored narratives. Finally, the fifth paper re-examines our understand- ing of autism by integrating the enactive framework with a neurodiversity approach to cognition. It argues this integration can help us better understand how neurotypical social practices and institutions effect the development, and well-being, of autistic individuals. Through these substantial expansions of established enactivist accounts, and by offering new objections to the mindreading framework, the thesis provides reasons to prefer an enactivist framework in exploring human abilities for social cognition. (shrink)

This dissertation explores philosophical issues in autism and defends a new version of the enactive approach to autism and social cognition. The discussion in this dissertation centres around the question “why do autistics encounter social interaction problems?”, addressing this question in ways that raise broader philosophical issues. Within the philosophy of mind, these include the problem of other minds, the nature of emotions, and narratives and their role in understanding the self. Beyond cognition, such issues are intertwined with questions in (...) metaphysics, philosophy of science, sociopolitical and moral philosophy, and disability studies. In responding to the question “why do autistics encounter social interaction problems?”, I argue that autistic social interaction problems result from the sensorimotor differences between autistics and non-autistics. This contrasts with the response to this question given by widely-endorsed views that emphasize instead the cognitive deficits that autistic people have. Such cognitivist views, such as the theory theory and simulation theory, are the focus of my first two critical chapters. I go on to offer a critique of two approaches that go beyond the focus on mindreading in appealing to sensorimotor problems as lying at the heart of the problem. These views, interaction theory and the original enactive approach, are the focus of the next two chapters. I then turn to defend a novel form of the enactive approach in the last part of the dissertation by emphasizing the role of emotions as the capacity for us to make sense of the world and to construct the sense of self from narratives. My new approach shifts the explanatory focus from perception and motion to emotion. This maintains the advantage of the original enactive approach, while avoiding its behaviouristically limited descriptions. My account thus expands the theory’s capacity to describe and explain internal states important to self-understanding and self-expression. This allows one to approach autistic social difficulties by attending to the first-person perspective, cohering with my reliance on first-person autistic narratives as a major source of evidence that supplements traditional scientific research on autism. (shrink)

This paper surveys some philosophical issues with the language surrounding mental illness, but is especially focused on pejoratives relating to mental illness. I argue that though 'crazy' and similar mental illness-based epithets (MI-epithets) are not best understood as slurs, they do function to isolate, exclude, and marginalize members of the targeted group in ways similar to the harmfulness of slurs more generally. While they do not generally express the hate/contempt characteristic of weaponized uses of slurs, MI-epithets perpetuate epistemic injustice by (...) portraying sufferers of mental illness as deserving minimal credibility. After outlining the ways in which these epithets can cause harm, I examine available legal and social remedies, and suggest that the best path going forward is to pursue a reclamation project rather than aiming to censure the use of MI-epithets. (shrink)