| Abstract [eng] |
In medicine, some personality traits, involving specific patterns of thought, feeling, and behavior, are considered to be pathological. Personality types, characteristic of such pervasive and maladaptive traits, are known under the term “personality disorders.” However, these pathological traits seem to largely describe morally bad behavior: a lack of remorse or empathy, inappropriate anger, deceptiveness, failure to fulfill obligations, arrogance, and, among other things, acting in a sexually provocative way. These particular traits are considered diagnostic of so-called Cluster B personality disorders. Hence, the question arises as to how such amoral behavior could be framed also as a medical problem. Moreover, it is not immediately clear whether persons with these disorders could be held responsible for their immoral actions. Three different views on these matters are explored in this paper. According to the “moralization” account, persons with Cluster B personality disorders should be conceived not as treatable patients but rather as morally and legally responsible subjects. The “medicalization” account, on the contrary, tends to view these disorders as genuine medical problems, not as a matter of accountability or blame. Lastly, the mixed account, while refusing to blame mentally ill people, regards these personality disorders as a question of both personal responsibility and medical concern. Having examined these diverging views, it is argued for the latter of the approaches, thereby suggesting that Cluster B personality disorders are best understood as both a moral and medical problem. The rationale for such a conclusion is threefold. First, it is shown that “disease” (as well as “illness” and “disorder”) is an inherently value-laden concept. Next, it is argued that alongside medical means, there is a need for the recovery-conducive notion of responsibility in the treatment of Cluster B personality disorders. Finally, by drawing on one of the normative ethical theories – virtue ethics – it is claimed that medicine is no less a moral endeavor than a scientific one. It is maintained that mental health, morality, and social welfare are closely intertwined. Thus, the paper demonstrates how the problem of compatibility between medical treatment, moral change, and responsibility could be resolved. |
