Rocco J. GennaroStill, some think that a responsible agent must have conscious access to moral reasons along
with the ability to understand how such reasons fit together with one’s behavior (Fischer
and Ravizza 1998). Psychopaths are puzzling for many reasons, for example, they seem to be
rational in one sense but also mentally ill at the same time. Reactive attitude theorists have
thus argued that psychopaths should be excused from moral responsibility given their diffi-
culty in distinguishing between moral and conventional norms and since they are not prop-
erly sensitive to moral reasons (Fischer and Ravizza 1998; Russell 2004). It would therefore be
inappropriate to express reactive attitudes toward psychopaths, perhaps analogous to getting
angry at a lion for killing someone after escaping from the zoo. However, others do think
that psychopaths can and should be held accountable for their actions. Shoemaker (2011),
for example, has argued that: “[a]s long as [the psychopath] has sufficient cognitive develop-
ment to come to an abstract understanding of what the laws are and what the penalties are
for violating them, it seems clear that he could arrive at the conclusion that [criminal] actions
are not worth pursuing for purely prudential reasons, say. And with this capacity in place,
he is eligible for criminal responsibility” (Shoemaker 2011: 119). Shoemaker may be correct
with respect to legal responsibility, but the main problem for philosophers is whether or not
psychopaths are morally responsible for their actions.^10
Some of the related interdisciplinary work in this area is termed “philosophy of psychiatry”
and centers around the very nature of mental illness. There are some who argue that our cur-
rent diagnostic categories, as found in the Diagnostic and Statistical Manual of Mental Disorders, the
DSM-5 (American Psychiatric Association, 2013), are faulty because, among other things, they
are derived only from symptoms rather than underlying physical pathologies (Poland 2014).
Genuine mental illnesses are not just symptoms but destructive pathological processes which
occur in biological systems. So, some have doubted the very existence of mental illnesses as they
are often understood (Szasz 1974). Still, it is generally accepted that mental illnesses are real and
involve serious disturbances of consciousness which cause significant impairment in people,
sometimes even leading to self-destructive behavior and suicide. The most serious mental ill-
nesses, such as schizophrenia, bipolar disorder, depression, and schizoaffective disorder, are often
chronic and can cause serious disability.^11
5 Brief SummaryThis chapter explored the growing and cutting edge interdisciplinary field called “philosophical
psychopathology,” along with the related “philosophy of psychiatry,” which covers the overlap-
ping topics of mental illness, psychopathy, and moral responsibility. Numerous abnormal phe-
nomena were explained with the focus on how they negatively impact consciousness, such as
somatoparaphrenia, visual agnosia, and schizophrenia. For example, a number of psychopatholo-
gies are commonly viewed as pathologies of self- or body-awareness in some way. Many of these
disorders forced us to discuss the importantly related philosophical problems of personal identity,
the unity of consciousness, and free will and moral responsibility.^12
Notes1 Such as Stephens and Graham (2000), Farah (2004), Feinberg and Keenan (2005), Graham (2013), and
Gennaro (2015a).
2 For further discussion on personal identity, see Kind “Consciousness, Personal Identity, and Immortality,”
this volume, and Kind (2015).
3 See also Schechter (2012) and Brook (2015) for critical discussion of Bayne’s view. For much more on
split-brain cases and the unity of consciousness, see Schechter (2018) and her chapter in this volume.