The implication is not that this idea should be dropped. Rather, the paper is undertaking the necessary step of clearing the ground for further progress to take place on the question of what role the idea of social pathology can and should play in Critical Theory. The paper is critical in nature (and relentlessly so), but ultimately serves a constructive purpose.

BackgroundIs the nature of decision-making capacity (DMC) for treatment significantly different in medical and psychiatric patients?AimsTo compare the abilities relevant to DMC for treatment in medical and psychiatric patients who are able to communicate a treatment choice.MethodA secondary analysis of two cross-sectional studies of consecutive admissions: 125 to a psychiatric hospital and 164 to a medical hospital. The MacArthur Competence Assessment Tool - Treatment and a clinical interview were used to assess decision-making abilities (understanding, appreciating and reasoning) and judgements of DMC. We limited analysis to patients able to express a choice about treatment and stratified the analysis by low and high understanding ability.ResultsMost people scoring low on understanding were judged to lack DMC and there was no difference by hospital (P = 0.14). In both hospitals there were patients who were able to understand yet lacked DMC (39% psychiatric v. 13% medical in-patients, P<0.001). Appreciation was a better ‘test’ of DMC in the psychiatric hospital (where psychotic and severe affective disorders predominated) (P<0.001), whereas reasoning was a better test of DMC in the medical hospital (where cognitive impairment was common) (P = 0.02).ConclusionsAmong those with good understanding, the appreciation ability had more salience to DMC for treatment in a psychiatric setting and the reasoning ability had more salience in a medical setting.

With the waves of reform occurring in mental health legislation in England and other jurisdictions, mental capacity is set to become a key medico-legal concept. The concept is core to the law of informed consent and is closely aligned to the philosophical concept of autonomy. It is also closely related to mental disorder. This paper explores the interdisciplinary terrain where mental capacity is located. Our aim is to identify core dilemmas and to suggest pathways for future interdisciplinary research.The terrain can be separated into three types of discussion: philosophical, legal and psychiatric. Each discussion approaches mental capacity and judgmental autonomy from a different perspective yet each discussion struggles over two key dilemmas: whether mental capacity and autonomy is/should be a moral or a psychological notion and whether rationality is the key constitutive factor.We suggest that further theoretical work will have to be interdisciplinary and that this work offers on opportunity for the law to enrich its interpretation of mental capacity; for psychiatry to clarify the normative elements latent in its work and for philosophy to advance understanding of autonomy through the study of decisional dysfunction. The new pressures on medical and legal practice to be more explicit about mental capacity make this work a priority.3

Adorno notoriously asserted that there is no 'right' life in our current social world. This assertion has contributed to the widespread perception that his philosophy has no practical import or coherent ethics, and he is often accused of being too negative. Fabian Freyenhagen reconstructs and defends Adorno's practical philosophy in response to these charges. He argues that Adorno's deep pessimism about the contemporary social world is coupled with a strong optimism about human potential, and that this optimism explains his negative views about the social world, and his demand that we resist and change it. He shows that Adorno holds a substantive ethics, albeit one that is minimalist and based on a pluralist conception of the bad - a guide for living less wrongly. His incisive study does much to advance our understanding of Adorno, and is also an important intervention into current debates in moral philosophy.

We report on an interview-based study of decision-making capacity in two classes of patients suffering from depression. Developing a method of second-person hermeneutic phenomenology, we articulate the distinctive combination of temporal agility and temporal inability characteristic of the experience of severely depressed patients. We argue that a cluster of decision-specific temporal abilities is a critical element of decision-making capacity, and we show that loss of these abilities is a risk factor distinguishing severely depressed patients from mildly/moderately depressed patients. We explore the legal and clinical consequences of this result.