Safeguarding against the medical treatment of homosexuality
In the past, homosexuality, masturbation, being a runaway slave and being a political dissident have all been considered to be mental disorders and medically treated on this basis. The medical treatment of these conditions seems to be an example in which psychiatry has been used as a guise for social control. If the medical treatment of these conditions can be safeguarded against, then future misuses of psychiatric treatment might also be safeguarded against. This thesis considers whether the misuse of medical treatment of these and other conditions can be safeguarded against by showing that the following two criteria are fulfilled: 1. Only mental disorders may be medically treated on the basis of being mental disorders, and 2. These conditions are not mental disorders in any society. The thesis shows that there is a pragmatic (c.f. prescriptive) link between the way the concept mental disorder is ordinarily used and medical treatment, and so the first criterion is fulfilled. For the second criterion to be true, it needs to be shown that the extension of mental disorder is: 2.1 Static between societies, and 2.2 Excludes homosexuality, masturbation, being a runaway slave and being a political dissident. Three potential ways of achieving both 2.1 and 2.2 are considered – basing the extension of mental disorder on ordinary language, natural kinds or evaluations. Firstly, the way mental disorder is ordinarily used by health professionals and informed lay-people in the developed world does exclude homosexuality and the other conditions mentioned earlier. However, ordinary language does not make the extension of mental disorder static between societies, and so does not fulfil criterion 2.1. Secondly, the ordinary use of mental disorder does not pick out a natural kind, so the extension of mental disorder cannot be fixed in this sense. If dysfunction (being a component of mental disorder) picks out a natural kind, then the extension of mental disorder might be partly static i.e. criterion 2.1 might be fulfilled. However, it is shown (using revisionist and conservative naturalism) that if criterion 2.1 is met, then criterion 2.2 cannot be met and vice versa. This applies whether dysfunction picks out a family resemblance natural kind or an essentialist natural kind. Thirdly, as disvalue is a necessary component of the ordinary sense of mental disorder (as used by health professionals and informed lay-people), there might be Rawlsian primary goods concerning the extension of mental disorder. While Graham’s (2013) basic psychological capacities might be primary goods, their expansiveness means that they are highly unlikely to fix the extension of mental disorder i.e. meet criterion 2.1. As none of these approaches fulfil both components of the second criterion, the thesis has not shown that the medical treatment of homosexuality, masturbation, being a runaway slave and being a political dissident can be safeguarded against by showing, for once and for all, that they are not mental disorders.
Advisor: Pickering, Neil; McMillan, John
Degree Name: Doctor of Philosophy
Degree Discipline: Bioethics Centre
Publisher: University of Otago
Keywords: homosexuality; medical treatment; mental disorder; philosophy of psychiatry; concepts; philosophy of science; ordinary language philosophy; Jerome Wakefield; drapetomania; sluggish schizophrenia; masturbation
Research Type: Thesis