The author examines the existential, historical, and political roots of psychiatric power, locating them, respectively, in the universality of guilt feelings and the desire to escape them, in psychiatry (replacing religion) as an institution offering surcease from such (and similar disturbing) feelings, and in the alliance, in modern societies, between psychiatry and the state. Clinical psychiatry and psychoanalysis, each in its own distinctive way, have served to legitimize the uses of psychiatric power. Liberty from coercive psychiatry requires destroying the legitimacy, (...) and hence power, of coercive psychiatric principles and practices. (shrink)

Thomas Szasz''s emphasis on goal-oriented behavior and moral responsibility has raised profound theoretical questions about an ancient and enduring problem in philosophy, the relationships amongfree will, determinism, and moral responsibility. Two early thinkers, Jonathan Edwards and Aristotle, have both contributed to an understanding of this dilemma. Edwards (1754) demonstrated that the concept of man as a moral agent and the doctrine of philosophical necessity are inextricably intertwined, in opposition to the tenets of contingency, moral indifference, and self-determining volition. However, his (...) argument rested on efficient causationalone. For further light on the problem we can turn to Aristotle''s writings, notably the distinguishing criteria of the practical sciences (including psychology) as opposed to the theoretical and the productive sciences; and multiple causation, one of the most powerful tools for intellectual analysis ever invented, which includes material, formal, and final causes as well as the efficient cause. The implications of Szasz''s work force a re-examination of the contributions of both Edwards and Aristotle and make them relevant to contemporary psychiatry. (shrink)

Thomas Szasz's emphasis on goal-oriented behavior and moral responsibility has raised profound theoretical questions about an ancient and enduring problem in philosophy, the relationships amongfree will, determinism, and moral responsibility. Two early thinkers, Jonathan Edwards and Aristotle, have both contributed to an understanding of this dilemma. Edwards (1754) demonstrated that the concept of man as a moral agent and the doctrine of philosophical necessity are inextricably intertwined, in opposition to the tenets of contingency, moral indifference, and self-determining volition. However, his (...) argument rested on efficient causationalone. For further light on the problem we can turn to Aristotle's writings, notably the distinguishing criteria of the ‘practical’ sciences (including psychology) as opposed to the theoretical and the productive sciences; and multiple causation, one of the most powerful tools for intellectual analysis ever invented, which includes material, formal, and final causes as well as the efficient cause. The implications of Szasz's work force a re-examination of the contributions of both Edwards and Aristotle and make them relevant to contemporary psychiatry. (shrink)

My interest is in the application of Rawls’ principles of distributive justice to the allocation of health care. In developing an interpretation of those principles I encountered the problem I present below. Although this issue is problematic for Rawlsian theories, it also has implications for any distributive theory that measures the impact of health care distribution via the mechanism of incremental movements in health or its absence.