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Clinical Atlas Prestige · Evidence-first

Psych MEQs / SAQsfoundations — philosophy of mind

Psych MEQs / SAQs · foundations — philosophy of mind

Philosophy of mind, multilevel explanation, and capacity (MEQ)

FRANZCP-style MEQ on philosophy of mind applied to formulation, free will rhetoric, BPS critique, and capacity.

20 marks20 min
On this page & tools

Target exams

FRANZCPMRCPsychABPNMD-DNB

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
You are teaching a first-year registrar after a ward round. A 34-year-old with first-episode psychosis says 'either my brain chemicals are broken or I am morally weak.' Family ask whether a brain scan will prove free will is absent so that legal responsibility disappears. The team has written a biopsychosocial formulation that lists 'bio / psycho / social' with no hypotheses. (i) Define philosophy of mind versus descriptive psychopathology for clinical work. (ii) Contrast substance dualism, physicalism, and functionalism in exam-usable sentences. (iii) Outline Kendler's multilevel / pluralist approach and the 'dappled causes' idea. (iv) Defend a non-empty biopsychosocial method against Ghaemi's critique. (v) Respond to the free-will and responsibility claim and outline capacity abilities if treatment consent is contested. (20 marks)

Model answer

Reveal model answer

(i) Definitions. Philosophy of mind asks what mental states are and how they relate to brain/body/world. Descriptive psychopathology names the form of experience and behaviour with clinical language before causal theory or diagnosis. Use form first, then philosophy-informed explanation.[3]

(ii) Stances. Substance dualism: mind and body as distinct substances. Physicalism: mental depends on or is physical. Functionalism: mental states defined by causal roles, not by 'stuff.' Clinical pay-off: avoid 'only weak-minded or only chemical' forced choice.[3]

(iii) Kendler. Prefer explanatory pluralism across levels (molecular to social) with only patchy reduction; causes of psychiatric illness are dappled — many kinds, not a clean organic-functional or hardware-software split. Each hypothesis must live at a named level with appropriate evidence.[3][4]

(iv) BPS. Engel challenged narrow biomedicine to include biological, psychological, and social data in clinical method. Ghaemi: the label often became empty eclectic checklists. Rescue: prioritised, testable multilevel hypotheses (not three blank boxes).[1][2]

(v) Free will and capacity. Neuroscience of volition is frequently over-read; a scan does not abolish responsibility frameworks or duty of care. Teach careful separation of causal explanation from legal/moral responsibility talk. If consent contested: assess understanding, appreciation, reasoning, and communicating a choice — decision-specific, not identical to insight or to free-will metaphysics. Do not invent statute numbers.[5][6]

Common errors

Empty BPS boxes; claiming fMRI settles free will and guilt; equating dualism with any psychological talk; skipping form of experience; equating lack of insight with incapacity; inventing legal sections.[2][5][6]

References

  1. [1]Engel GL The need for a new medical model: a challenge for biomedicine Science, 1977.PMID 847460
  2. [2]Ghaemi SN The rise and fall of the biopsychosocial model Br J Psychiatry, 2009.PMID 19567886
  3. [3]Kendler KS Toward a philosophical structure for psychiatry Am J Psychiatry, 2005.PMID 15741457
  4. [4]Kendler KS The dappled nature of causes of psychiatric illness: replacing the organic-functional/hardware-software dichotomy Mol Psychiatry, 2012.PMID 22230881
  5. [5]Appelbaum PS Clinical practice. Assessment of patients' competence to consent to treatment N Engl J Med, 2007.PMID 17978292
  6. [6]Pierre JM The neuroscience of free will: implications for psychiatry J Psychiatr Pract, 2014.PMID 24330830