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Answering radical questions 

Answering radical questions
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date: 07 April 2020

The likeness argument dominates the dispute over the reality of mental illness. As a matter of fact, no one has yet produced a version of it which achieves what it aims and claims to be able to achieve, namely to answer the question whether or not conditions such as schizophrenia really are illnesses or not. Disputes continue on all sides about which likenesses and differences are to count, and what they are to count for.

I have argued that the likeness argument cannot close these disputes, because two of the assumptions it relies upon to do so do not stand up to scrutiny. In particular, the idea that the features that should decide the issue (as the first assumption states), are describable independently of views about the issue (as the second assumption states), is false. They are not; and so the likeness argument must fail.

The nature of the failure is, however, instructive. The likeness argument takes it for granted that the radical questions are about what we may observe or discover. Its failure is precisely on this point. Human agency is involved in the categorization of patterns of behaviour as illnesses such as ADHD, alcoholism, or schizophrenia. The rest of this book seeks to work out a conception of how this human role in creating mental illnesses might be understood in greater depth. How do the radical questions—and the various answers given to them—look if we accept that in some sense the answer to the questions lie with human decision, or human agency?

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