Abstract
Name withheld
While acknowledging some interesting points, I am deeply concerned by the ‘flavour’ of the article by Don Browning (‘Internists of the mind or physicians of the soul: does psychiatry need a public philosophy?’ ANP April, 2003; 37:131–137) and especially the two commentaries that followed.
Browning rejects ‘… “nothing but” neurones and brain cells influence our thoughts and actions’. He adds: ‘The belief that psychiatry is morally and metaphysically neutral can give rise to a kind of negative normality’. Dr Quadrio comments: ‘Browning suggests that if psychiatric practice reduces psyche to brain biology then we “flatten life” and eliminate the bigger questions posed by religion and morality. I wish to make several points in reaction to these assertions. No, psychiatry should not be all about DSM codings and NO you can't treat everything with pharmacotherapy, but, yes it IS all about neurones and brain cells. If someone disagrees with this then fine, but at least there should be an attempt to refute current philosophical arguments about the interaction of the physical with the metaphysical, which can be found in any Philosophy 101 class. Furthermore, there was an implication that it is somehow narrow-minded to consider psychiatry as ultimately relating only to the brain and neurones. It is absolutely the opposite! Discovering how the brain ultimately leads to consciousness is the wonderful, fascinating challenge that we need to open our minds to. We have the opportunity to be part of a golden era of philosophy (the sharp end of philosophy). It is the refusal of this challenge, and the benefits it will bring, that is narrow-minded, or should I say too hard or too scary. To ignore the ultimate basis for consciousness and our existence as being the brain is to take a narrow view. If it is too difficult or distressing for members of our profession to accept that this is the most likely reality, then as we move inevitably forward, those same members will cast themselves into the sort of irrelevance as, say, homeopaths. It should be stressed, however, that reducing the human experience to the function of a biological organ (the brain) does not, for one moment, negate or reduce our concepts of ‘humanity’, compassion or respect for an individual.
Instead of quoting philosophers from centuries ago (who had none of the concepts regarding brain biology we have today) why didn't they challenge/refute/comment on the latest theories from modern philosophers and scientists. The second commentary revealed itself as more of a general mix of ‘visceral’ political feelings than a genuine philosophical commentary, especially when concepts of the ‘new right’ were introduced. By his brief description I question whether the author actually knows what the ‘new right’ is or what its origins are.
There were, of course, some important issues raised by the authors. The key one being the idea of psychiatry adopting a public philosophy. However, any philosophy needs to address (or at least include to some extent) the biological basis of thoughts and actions. What is someone's ‘free will’ (which is ultimately a biological function) and what is their ‘biology’. For example, what is the ‘person’ and what is their ‘disorder’. How should this be resolved?
I am disappointed that the journal did not find a broader, more rigorous and contemporary commentary to reply to the original article.