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Very interesting post, Justin. I haven't been very active on Flickers but I've been thinking about these issues lately with my colleague Matt King here at UAB.

I tend to agree that the disorder isn't doing much of the work in Case 1b, but there certainly do seem to be cases in which the illness does a lot of work. Consider a disorder like Tourette's or Parkinson's, where the illness is arguably not very responsive to easily available treatments and can't easily be known to arise in specific circumstances. If someone with such a mental illnesses brings about a bad outcome unintentionally, there might not be any room to say they were being negligent or anything like that. They'd seem to be exculpated and the illness does a lot of the explanatory work because it caused an unintentional action.

So maybe it depends on whether the existence of the illness is paired with circumstances in which one can gain control over certain situations involving it. In that case, though, maybe the illness even plays an important role in your Case 1b as a contributing cause or enabling condition, since it's required in addition to the factors making one gain control over aspects of the illness. (I'm not responsible for acting badly *because* I can control the effects of a disorder I don't have.)

Perhaps the disorder isn't then exculpating "in itself," but I wouldn't expect as much on a strict reading of that anyhow. At the very least a disorder must be exculpating by causing certain thoughts or behaviors (perhaps in conjunction with some other factors).

Hi Josh, nice to meet you on here. UAB sounds like a fun place to do philosophy right now!

I'm with you on Parkinson's, I don't know enough about Tourette's, though, I did meet a fellow philosopher with Tourette's and we got to talking about culpability for his outbursts at a Pacific APA a few years back. He said he can refrain from certain outbursts as he can feel them come on but he can only hold them at bay for a limited time. Obviously, this is anecdotal and the disorder plays out differently for different people but for some at least the disorder is not necessarily exculpating. Anyway, I think we're on the same page. If you and/or Matt get to drafting anything up on this topic I would love to look it over!

I did have a comment regarding your last para. I agree that some disorders are exculpating because they *cause* thoughts or behaviors. But if that's right, then why isn't determinism exculpating as well? Given that each of our minds are limited in that we can only do one thing (or think one thought, etc.) at any moment (assuming determinism) why think that mental disorders are especially exculpating but determinism is not? What causes a person to think X in a determined world is not *up to them* just like the thought that popped into a person hallucinating might not be up to them. What's the salient difference? That's always been my concern when thinking through different disorders. If what's exculpating about the disorder in question is the fact that certain thoughts are caused and others are unavailable, then why not think determinism is as well given that determinism limits us in much the same way?

I mention this line of thinking in my short AJOB-Neuroscience piece on psychopathy:

Anyway, thanks for chiming in. The purpose of this post was for me to get a feel for how others are thinking through this.

Actually, I would regard the anxiety disorder in scenario 1B as relevant - pseudo-seizures (non-epileptic) are a pretty extreme presentation, so we are not talking about "ordinary" generalized anxiety. A past history of sexual trauma is common in these patients. I fear we then open up a whole can of worms regarding individual culpability in the situation where there are strong population-level causal associations between a particular predisposing class of event and a morally reprehensible behaviour.

Refusal to take prescribed medications is not restricted to florid exacerbations of schizophrenia - it is more likely when the individual is relatively well, but still affected by the negative features of the condition. I am willing to give severe anxiety, or even a personality disorder, a proportional contribution to causation.

Myself, I have difficulty thinking about responsibility when we can reliably predict the proportion of the population that will act in a certain way after a particular intervention.

Interesting way to press the point, Justin. I'll have to check out your AJOB-N paper, but one quick thought: I didn't mean to suggest that what makes an illness potentially exculpating is just that it's a cause of behavior, but rather that this leads to compromising control over one's actions. I did mean to suggest that the mere fact that it plays a casual role (in limiting control) makes it part of the explanation of the exculpation, but it's not the whole story.

After all, determinism and illnesses (or other antecedent causes) seem rather different. The core feature of determinism is that it limits options (in the future), not that it means our behavior is caused.. Even some libertarians agree that our behavior is caused, at least to avoid the luck problem. And, as Anscombe points out, it seems indeterministic processes can be causal processes. So, if the idea were that *any* causes exculpate, then it wouldn't really seem to matter whether determinism is true. Rather the concern would be more about whether one is an unmoved mover, right? And I certainly don't think this is a necessary condition on responsibility. That's at least why I'd prefer to explain the exculpating power of certain illnesses in terms of compromising control or something like that, rather than their being mere causes. But, in that case, determinism shouldn't be similarly exculpating.

Also, FYI, Tim Schroeder has more than an anecdote to support that sort of account of (many) Tourettic tics.

Ah, thanks for clarifying Josh. And thanks for the Schroeder reference!

Quick thought: if mental illness exculpates because it "compromises control" (I like this talk better than the causal talk, so thanks), then why think determinism doesn't similarly compromise control given that it limits our options to 1. How much "control" do we have if we can't do other than what we do? FWIW, I think many illnesses are exculpating but I also think determinism is a major problem as well. Compatibilists on the other hand don't see determinism as a problem yet they see mental illnesses as exculpating. I'm trying to make sense of that stance.

Also, and for the record, I'm not an unmoved mover sort of libertarian nor do I think that *any* cause other than the agent's doing exculpates either. My view is somewhere in the vicinity of the agent being part of the causal process but that involvement is not itself determined (the decision to act was settled by the agent (settled in a strong agent-causal sense) even if the choices themselves were determined (or random).

The causal talk was not clear, my apologies. What I was trying to say was that if the past and the laws cause me to do X then why is that not exculpating but some illnesses are? Put differently: On the one hand the illness causes me to do X (due to hallucinations) so we say not morally responsible, on the other hand the past and the laws cause me to do X, but some say morally responsible. I don't see what warrants the asymmetry here. So, I guess my issue is with compatibilists who want to exculpate on grounds of mental illness but not on grounds of determinism. I'm trying to get a better grip on what's doing the work for pulling the two apart. Though, I now see how cashing this out in causal terms muddies the waters.

You say: After all, determinism and illnesses (or other antecedent causes) seem rather different. The core feature of determinism is that it limits options (in the future), not that it means our behavior is caused.

I agree. But if determinism limits our option to X and mental illness limits our option to X why think mental illness is exculpating but determinism is not?

David, I get that we are not talking about your garden variety anxiety case (if there is such a case) but that was intentional. The point for me was to see why some illnesses exculpate and others do not *in specific cases*. An extreme case like this I thought would be a good place to start. If we can't agree on these cases, then we won't make any progress (at least that was my thought).

You say: Refusal to take prescribed medications is not restricted to florid exacerbations of schizophrenia - it is more likely when the individual is relatively well, but still affected by the negative features of the condition. I am willing to give severe anxiety, or even a personality disorder, a proportional contribution to causation.

I am willing to grant that refusal to take meds is not restricted to "florid exacerbations of scizophrenia". But, my worry is that we lose agency altogether when we start to point to the illness for any action that occurs. It seems like you are suggesting we take some objective stance toward anyone with mental illness, this is worrisome. If the particular example doesn't work for you I can try to come up with another. But, I think the dialectic will not change. If the move is to point to the illness as the cause when there was something the person could have done instead (as stipulated in my example), then that's just to deny that people with mental illness are ever culpable. But, I thought my example was a bit more nuanced than that. Notice I also stated that the person felt the seizure coming on but decided to try and make it to their destination instead of pulling over. I didn't couch everything in the refusal to take the drug in order to prevent the rebuttal that you gave, but, maybe that's on me to be a bit more clear.

Anyway, thanks for the comment David.

I completely agree that there is a perfectly ordinary sense of "control" that determinism can reasonably seem to threaten. In fact, I raise exactly this worry for one of Murray & Nahmias's questions they posed to their participants in one of their studies (the No Control question). I worry that participants might understand what determinism is completely but also be inclined to agree to some extent that an agent in such a world has lacks "control over what they do." (Murray and Nahmias assume otherwise.) See my "On the Very Concept of Free Will" at pp. 2863-4 (or p. 15 in the draft):

With that said, I think compatibilists might be able to reply to your challenge and properly distinguish determinism from illness. But I don't have it all worked out. One simple idea might just be that determinism is compatible with performing intentional actions, but some illnesses aren't (consider seizures or alien hand syndrome). That's probably not going to capture all the cases, but it shows that there are ways to try to do it in terms of different kinds of antecedent mental causes. But this relies on the compatibilist idea that lacking robust alternative possibilities doesn't undermine control and that we'll find the exculpating factors elsewhere (primarily in one's psychology). So I doubt any response will satisfy a committed libertarian. Dialectical stalemate again, maybe?

Thanks for that, Josh!

I think you're right, we might be approcaching another stalemate :)

This one was relatively quick (only 8-9 comments deep compared to 50+ before reaching that conclusion in other threads).

I think your approach will work for cases you mention (phantom limb syndrome and cases involving seizure) but I wonder why the schizophrenic is not acting "intentionally". I think that there might be a story to tell but one that will likely not be satisfying to the libertarian (like you say).

Regardless, thanks for the references and for the continued engagement. This is all very helpful to me even if we end in a stalemate. I very much appreciate the back and forth!

Lack of control won't explain all the illnesses, but there may be ordinary excuses in the ballpark. So, delusional conditions (e.g., schizophrenia) could be explained by reference to non-culpable mistakes.

I'm not sure I how compatibilists and incompatibilists face different pressures here. Suppose a compatibilist says that mental illness diminishes control (for at least a representative subset of illnesses). The incompatibilists says, sure, but so does determinism. And then the compatibilists says, "sure, but not in the ways that undermine responsibility, whereas mental illness does. The disagreement here is just whether control-based compatibilist accounts have a sufficiently robust notion of control, but that was the disagreement before we examined cases of mental illness.

Hi Justin.

It's probably not very useful to you for me to expand on my comments (I will anyway!), but I mentioned drug non-compliance in schizophrenia because of your implicit suggestion that disorders of perception were clear cut MR mitigating factors, but not thought disorders. Hallucinations are quite common in the "well" general population, the problem in schizophrenia being that they are taken seriously by the sufferer because they coincide with other cognitive deficits. Studies do find non-compliance is correlated with presence of negative symptoms. All this is tangled up by worries about infringing on patient autonomy, especially given the side effects of treatment (it may or may not be rational to prefer hallucinations to akathisia - I have met patients successfully living with the former, although they seem rare). There are structural changes in the schizophrenic brain that start in utero, but this is also true of anxiety disorders. That is, the impairment of control could be just as great, even if we see one condition as "neurotic", and the other "psychotic".

I don't worry that we lose agency altogether when we start to point to the illness, because if we have a quantitative model of causation, we can be nuanced about attribution. In the progression of a dementia, we can easily say that there are mild impairments in decision making and impulse control early in the condition, and severe deficits later on. Even early in the course, most people will excuse lapses characteristic of the illness as not being an authentic representation of that person's premorbid personality.

As David suggests, it seems that the degree of mitigation/exculpation from mental illness is thought to track the extent to which the wrong-doing is a function of a disease or defect, such that the offense isn’t "an authentic representation of that person's premorbid personality." If we can demonstrate any contribution of the illness in producing the act, then punishment should be reduced (mitigation), and if it accounts for the act entirely, then the offender is excused from punishment (exculpation). Teasing apart the relative contributions of illness versus character to an offense is of course dicey.

Psychopathy is pretty much an integral part of a psychopath's personality, so doesn’t mitigate or exculpate on this principle, even though the psychopath doesn't have normal control capacities due to no fault of his own (imo, see ). Other people who aren’t psychopaths likewise have diminished control capacities as a well-integrated character trait, but due to childhood and adolescent exposure to certain family/peer/social environments (no fault of their own), not a congenital brain defect. This suggests to me the principle, when expressed in terms of blameworthiness and desert – desert tracks the contribution of character to an act – is either faulty or incomplete. Why does someone *deserve* punishment - why should they should be punished independently of any consequentialist considerations – just because their personality or character contributed to the offense?

Justin, given that you’re an agent-causal libertarian, I’m still curious about the question I posed in the other thread on psychopathy. I asked if you knew of any evidence-based proposals for how a sufficiently severe mental disease or defect undermines libertarian free will; that is, what the mechanism might be such that we could, with enough neuroscientific knowledge, confidently say that particular individuals don't have the unconditional ability to do otherwise and thus are not MR.

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