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42 - Commentary on Stephan Heckers, ‘Psychiatric Discourse: Scientific Reductionism for the Autonomous Person’

from Section 14

Published online by Cambridge University Press:  02 April 2020

Kenneth S. Kendler
Affiliation:
Virginia Commonwealth University
Josef Parnas
Affiliation:
University of Copenhagen
Peter Zachar
Affiliation:
Auburn University, Montgomery
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Summary

I very much admire Stephan Heckers’ framing of ‘four forms of scientific reductionism in psychiatry’ and their relation to the autonomy of the patient.Stephan seems to be using ‘reductionism’ in a legitimate, but perhaps non-standard way.‘Reduction’ in his sense has to do with loss of information.There is, first, the ‘clinical encounter’ in which the patient’s lived experience is translated into the third-person account given by the therapist.Then there is classification, identification of a biological problem, and causal implications.Each of these steps misses out something about the ‘lived experience’ of the patient.I find the discussion somewhat tantalizing, and suggest the real reason for acknowledging autonomy may be the need for a ‘Jaspersian engagement’ with the patient, which identifies the one-off idiosyncracies of the patient’s mental life, rather than merely those aspects that fall under generalizations.

Type
Chapter
Information
Levels of Analysis in Psychopathology
Cross-Disciplinary Perspectives
, pp. 510 - 516
Publisher: Cambridge University Press
Print publication year: 2020

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References

Slade, M. (2017) ‘Implementing shared decision making in routine mental health care.’ World Psychiatry, 16, 146153.CrossRefGoogle ScholarPubMed
Slade, M., Amering, M., Farkas, M., Hamilton, B., O’Hagan, M., Panther, G. et al. (2014) ‘Uses and abuses of recovery: Implementing recovery-oriented practices in mental health systems.’ World Psychiatry, 13, 1220.Google Scholar

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