Abstract
The exercise of personal freedom involves decision-making capacity and behavior-actualization ability, both of which are subject to “inner” restrictions due to mental illness. In addition to changes in experience which may result, i.e., in preference reversal and hence unauthentic behavior, mental illnesses can also change one’s habituality, putting certain habits out of play or trigger acquisition of new habits.
Furthermore, the exercise of personal freedom involves negative freedom, since “outer” restrictions can further impair one’s decision-making capacity and behavior-actualization ability (i.e., inadequate information, stereotyping by relevant others, or non-barrier-free facilities). It is important to note that “outer” restrictions can become (the basis of) “inner” restrictions, especially by inducing certain habitualities or worldviews. On the other hand, “inner” restrictions caused by mental illness can be rendered less relevant for authenticity and personal freedom if counterbalanced by adequate support and/or circumstances. Therefore, “outer” restrictions can double the infringement of personal freedom already caused by “inner” restrictions due to mental illness. This calls for the empowerment of mentally ill persons and refers to the core of personal freedom, implying that no person can lose personal freedom completely simply because she is the active agent in her lifeworld.
References
Alexander BK, Coambs RB, Hadaway PF (1978) The effect of housing and gender on morphine self-administration in rats. Psychopharmacology 58:175–179
Alvarez-Jimenez M, Gleeson JF, Henry LP, Harrigan SM, Harris MG, Killackey E, Bendall S, Amminger GP, Yung AR, Herrman H, Jackson HJ, McGorry PD (2012) Road to full recovery: longitudinal relationship between symptomatic remission and psychosocial recovery in first-episode psychosis over 7,5 years. Psychol Med 42(3):595–606
Appelbaum PS (2007) Clinical practice. Assessment of patients’ competence to consent to treatment. N Engl J Med 357:1834–1840
Appelbaum PS, Grisso T (1995) The MacArthur treatment competency study. I. Mental illness and competence to consent to treatment. Law Human Behav 19:105–126
Beauchamp T, Childress J (2011) Principles of biomedical ethics, 5th edn. Oxford University Press, Oxford
Beck AT (1987) Cognitive models of depression. J Cogn Psychother 1:5–37
Blankenburg W (1971) Der Verlust der natürlichen Selbstverständlichkeit. Ein Beitrag zur Psychopathologie symptomarmer Schizophrenien. Enke, Stuttgart
Bock T (1997) Lichtjahre. Psychosen ohne Psychiatrie. Psychiatrie-Verlag, Bonn
Bolton D, Banner N (2012) Does mental disorder involve loss of personal autonomy? In: Radoilska L (ed) Autonomy and mental disorder. Oxford University Press, Oxford, pp 77–99
Bottlender R, Hloucal TM (2010) Krankheitseinsicht. Eine Übersicht über das Konzept mit Fokus auf schizophrene Erkrankungen. Psychiatr Prax 37:59–67
Buchanan AE, Brock DW (1989) Deciding for others. The ethics of surrogate decision making. Cambridge University Press, Cambridge
Camus A (1942) Le mythe de Sisyphe. Gallimard, Paris
Charland LC (2002) Cynthia’s dilemma. Consenting to heroin prescription. Am J Bioethics 2:37–47
Charland LC (2011) Decision-making capacity. Stanford encyclopedia of philosophy. Available via http://plato.stanford.edu/entries/decision-capacity. Accessed 3 Feb 2015
Davidson L, Rowe M, Tondora J, O'Connell MJ, Lawless MS (2009) A Practical Guide to Recovery-Oriented Practice. New York, Oxford University Press
Drummond JJ (2010) Self-responsibility and eudaimonia. In: Ierna C, Jacobs H, Mattens F (eds) Edmund Husserl 150 Years. Springer, Dordrecht, pp 411–430
Ehrenberg A (1998) La Fatigue d’être soi. Dépression et société. Odile Jacob, Paris
Elliott C (1997) Caring about risks. are severely depressed patients competent to consent to research. Arch Gen Psychiatry 54:113–116
Elster J (2000) Ulysses unbound. Cambridge University Press, Cambridge
Flanagan O (2011) What is it like to be an addict? In: Poland J, Graham G (eds) Addiction and responsibility. MIT Press, Cambridge, pp 269–292
Frankfurt HG (1999) Necessity, Volition, and Love. Cambridge University Press, Cambridge
Fulford KWM (2004) Ten principles of values-based medicine (VBM). In: Schramme T, Thome J (eds) Philosophy and psychiatry. De Gruyter, Berlin, pp 50–80
Golenkov A, Large M, Nielssen O, Tsymbalova A (2011) Characteristics of homicide offenders with schizophrenia from the Russian federation. Schizophr Res 133:232–237
Hindmarch T, Hotopf M, Owen GS (2013) Depression and decision-making capacity for treatment or research: a systematic review. BMC Med Ethics 14:54
Hippokrates (1933–1940) Die Werke des Hippokrates. Die hippokratische Schriftensammlung in neuer deutscher Übersetzung. In: R Kapferer (Ed and Trans). Hippokrates Verlag, Stuttgart
Jaspers K (1913) Allgemeine psychopathologie, 1st edn. Springer, Heidelberg
Jorgensen P (1994) Course and outcome in delusional beliefs. Psychopathology 27:89–99
Khantzian EJ (1985) The self-medication hypothesis of addictive disorders. Focus on heroin and cocaine dependence. Am J Psychiatr 142:1259–1264
Lee M, Gazini L (1994) The effect of recovery from depression on preferences for life-sustaining therapy in older patients. J Gerontol 49:M15–21
Meynen G (2011) Depression, possibilities, and competence. A phenomenological perspective. Theor Med Bioethics 32:181–193
Moller MD, Zauszniewski JA (2011) Psychophenomenology of the post-psychotic adjustment process. Archiv Psychiatr Nursing 25:253–268
Nixon G, Hagen B, Peters T (2010) Recovery from psychosis. A phenomenological Inquiry. Int J Ment Health Addict 8:620–635
Noiseux S, Tribble St-Cyr D, Corin E, St-Hilaire P-L, Morissette R, Leclerc C, Fleury D, Vigneault L, Gagnier F (2010) The process of recovery of people with metnal illness. BMC Health Services Research 10:161
Owen GS, David AS, Richardson G, Szmukler G, Hayward P, Hotopf M (2009) Mental capacity, diagnosis and insight in psychiatric in-patients. A cross-sectional study. Psychol Med 39:1389–1398
Pickard H (2012) The purpose of chronic addiction. AJOB Neurosci 3:40–49
Podvoll EM (2003) Recovering sanity. A compassionate approach to understanding and treating psychosis. Shambala, Boston and London
Poland J, Graham G (2011) Introduction. The makings of a responsible addict. In: Poland J, Graha G (eds) Addiction and responsibility. MIT Cambrige, Cambridge, pp 1–19
Ratcliffe M (2010) Depression, guilt and emotional depth. Inquiry 53:602–626
Ringel E (1954) Der Selbstmord. Abschluss einer krankhaften psychischen Entwicklung. Dietmar Klotz, Eschborn, Frankfurt/M
Rudnick A (2002) Depression and competence to refuse psychiatric treatment. J Med Ethics 28:151–155
Sass L (1994) The paradoxes of delusions. Cornell University Press, Ithaca
Schlimme JE (2010) Addiction and self-determination. A phenomenological approach. Theor Med Bioethics 31:49–62
Schlimme JE (2012) Lived autonomy and chronic mental illness. A phenomenological approach. Theor Med Bioethics 33:387–404
Schlimme JE (2013a) Sense of self-determination and the suicidal experience. A phenomenological approach. Med Health Care Philos 16:211–223
Schlimme JE (2013b) Depressive habit and altered valuings. A phenomenology of depressed mental life. J Phenom Psychol 44:92–118
Schlimme JE (2013c) Is acting on delusions autonomous? Philos Ethics Humanities Med 14:14
Schlimme JE, Brückner B (2015) Entaktualisierung und Orthostrophe. Zur phänomenologischen Psychopathologie des abklingenden Wahns Nervenarzt 86:872–883
Schlimme JE, Brückner B (2017) Die abklingende Psychose. Ein lebensweltliches Modell der Genesung. Unter Mitarbeit von Hans O, Hase B, Önal L, Palmer A, Peach P. Psychiatrie-Verlag, Bonn (in press)
Schlimme JE, Schwartz MA (2013) In recovery from schizophrenia. Regaining social cover. A phenomenological investigation. Psychopathology 46:102–110
Schlimme JE, Voss M (2017) Agency, accustomed behaviour, and autonomy in depression and addiction. In: Mishra AL, Corlett P, Fletcher P, Schwartz MA (eds) Phenomenological neuropsychiatry. Bridging clinic with clinical neuroscience. Springer, New York (in press)
Slaby J, Stephan A (2008) Affective intentionality and self-consciousness. Conscious Cogn 17:506–513
Sullivan MD, Younger SJ (1994) Depression. Competence and the right to refuse lifesaving medical-treatment. Am J Psychiatr 151:971–978
Tan JOA, Stewart A, Fitzpatrick R, Hope T (2007) Competence to make treatment decisions in Anorexia Nervosa: thinking processes and values. Philos Psychiatr Psychol 13:268–282
Trotter T (1804) An essay, medical, philosophical, and chemical, on Drunkenness, and its effects on the human body [used reference: Thomas Trotter (1821) Ueber die Trunkenheit und deren Einfluß auf den menschlichen Körper. Eine philosophische, medicinische und chemische Abhandlung, 1810. Memersche Hofbuchhandlung, Lemgo]
Ullrich S, Keers R, Coid JW (2013) Delusions, anger, and serious violence. New findings from the MacArthur violence risk assessment study. Schizophr Bull. doi:10.1093/schbul/sbt126
United Nations (2006) Convention on the rights of persons with disabilities. Retrieved 06-22-16 http://www.un.org/disabilities/convention/conventionfull.shtml
Vollmann J (2008) Patientenselbstbestimmung und Selbstbestimmungsfähigkeit. Kohlhammer, Stuttgart
Wiggins OP, Allen AC (eds) (2011) Clinical ethics and the necessity of stories. Essays in honor of Richard M. Zaner. Springer, Dordrecht
Yaffe G (2001) Recent work on addiction and responsible agency. Philos Public Aff 30:178–221
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Schlimme, J.E. (2016). Impairments of Personal Freedom in Mental Disorders. In: Schramme, T., Edwards, S. (eds) Handbook of the Philosophy of Medicine. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-8706-2_24-1
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