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Classification, Disease and Evidence pp 131–145Cite as

Power, Knowledge, and Laughter: Forensic Psychiatry and the Misuse of the DSM

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Part of the book series: History, Philosophy and Theory of the Life Sciences ((HPTL,volume 7))

Abstract

This essay examines the relation between the DSM and forensic psychiatry. Psychiatrists, lawyers and philosophers often assume that the forensic legitimacy of the DSM hinges on finding an objective definition of mental disorder. In the first part of this essay I show that the DSM’s quest for objectivity has never been successful. In the second part I argue that even if an objective definition could be found, the DSM should have no role to play in the courtroom. Today, the lawyers and forensic psychiatrists who rely on the DSM to give weight to their legal opinions and judgments are making a conceptual mistake: they conflate the concepts of disease and incapacity. Once these concepts are disentangled, it becomes apparent that the DSM (which classifies diseases) should have no business meddling with the law (which is concerned with incapacities). In the third and final part I describe the positive consequences for both parties of the divorce between the DSM and forensic psychiatry.

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Notes

  1. 1.

    The 1970s philosophical debate about the nature of health and disease was in great part motivated by a fear of what Christopher Boorse called the “psychiatric turn,” i.e., the “strong tendency … to debate social issues in psychiatric terms” (1975, p. 49).

  2. 2.

    See his blog at www.psychologytoday.com/blog/dsm5-in-distress

  3. 3.

    See for instance Derek Bolton (2008, p. 131): “for the vast majority of syndromes in the manuals we just do not know whether they involve failure of a natural designed function or whether they are designed or acquired strategic responses to environmental conditions, or indeed whether they are designed adaptive responses.”

  4. 4.

    For a general critique of evolutionary psychology and of its uses, see Kitcher (1985) and Dupré (2001).

  5. 5.

    See for instance Wakefield (1997, p. 256): “We do not have to know the details of evolution or of internal mechanisms to know … that typical cases of thought disorder, drug dependence, mood disorders, sexual dysfunction, insomnia, anxiety disorders, learning disorders, and so on, are failures of some mechanisms to perform their designed functions; it is obvious from surface features.” For a criticism of Wakefield on this point, see Demazeux (this volume; 2010); Murphy (2006, p. 44); Murphy (2011, p. 128). See also Demazeux’s similar criticism of Boorse in Demazeux (2011, pp. 375–6). John Z. Sadler (1999, p. 434) rightly remarks that Wakefield’s early work was more prescriptive than it is today: “It appears [Wakefield] has gone from evaluating categories for assignment of disorder status to explaining, post hoc, why the status quo is the status quo.”

  6. 6.

    On SVP laws, see in particular Janus (2009).

  7. 7.

    This particular point is reaffirmed in Kansas v. Crane (2002).

  8. 8.

    For a criticism of this statement, see Singy (forthcoming).

  9. 9.

    This would mark the end of a relationship that in fact has been going south for a while. Since the DSM-III the successive editions of the DSM have increasingly warned against the problems associated with its forensic use. See Shuman (2002, pp. 217–8).

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Authors and Affiliations

  1. Union College, Schenectady, NY, USA

    Patrick Singy

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  1. Patrick Singy
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Correspondence to Patrick Singy .

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Editors and Affiliations

  1. IHPST, CNRS/Université Paris I/ENS, Paris, France

    Philippe Huneman

  2. Centre Cavaillès, Ecole Normale Supérieure, Paris, France

    Gérard Lambert

  3. Éditions Matériologiques, Paris, France

    Marc Silberstein

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Singy, P. (2015). Power, Knowledge, and Laughter: Forensic Psychiatry and the Misuse of the DSM . In: Huneman, P., Lambert, G., Silberstein, M. (eds) Classification, Disease and Evidence. History, Philosophy and Theory of the Life Sciences, vol 7. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-8887-8_6

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