The Theoretical Marginalization of Patients with Severe Mental Illnesses in Bioethical Discourse
Friday, October 13, 2023
5:00 PM – 6:15 PM ET
Location: Essex C (Fourth Floor)
Right around the same time bioethicists moved to institutionalized positions from the margins of philosophical discourse, the severely mentally ill were removed from their institutions to decentralized and underfunded treatment settings outside of the clinic. In my talk, I will argue that there is more to these concurrent processes than coincidence. In so far that the institutionalization of bioethics heralded an autonomy-centered approach to patient rights, individuals with psychiatric disabilities were bound to be left theoretically marginalized by this new discourse. Lacking a clear standing with regards to their autonomous status, persons with fluctuating decision-making capacity find themselves at the margins of society not merely on account of the vulnerabilities consequent to their condition, but because philosophical concepts that successfully advanced the moral standing of most patients were a poor match to their moral needs. In my talk, I will trace the exclusion of psychiatric patients from equitable moral consideration in the space of bioethical discourse to the early history of healthcare ethics and in particular to the theorization of the concept of vulnerability in protections created for vulnerable patient populations. Then, through a critical examination of the contemporary literature calling for returning the treatment of severe mental illnesses to safe and humane asylums, I will identify opportunities to transcend these historical disciplinary biases and to create a bioethics more inclusive of those who live with severe or treatment-resistant psychotic disorders.