Cambridge Quarterly of Healthcare Ethics


Divided Minds and Successive Selves: Ethical Issues in Disorders of Identity and Personality, by Jennifer Radden. Cambridge, MA: MIT Press, 1996. 296 pp. $55.00.

David M.  Adams  a1
a1 California State Polytechnic University, Pomona

Jennifer Radden's subtitle nicely summarizes the set of concerns that animate this rich and provocative book. Radden's aims are at once conceptual and normative. What degree of continuity (over time) or unity (at a time) do selves or persons really possess? And how ought healthcare professionals and others deal with individuals whose selves become “fragmented” or “divided” in various ways? Radden's analysis blends theoretical investigations in the philosophy of mind and metaphysics with key findings in abnormal psychology and psychotherapy to illuminate a nest of issues: Can we legitimately speak of one body housing or supporting more than one “person”? To what extent does our normatively charged notion of “person” presuppose a self that is integrated by continuities of memory, experience, and agency? Must legal conceptions of individual responsibility for civil or criminal wrongs be construed to require a continuous and unified “self” who is accountable? Are paternalistically motivated therapeutic interventions justifiable when dealing with dissociative-identity disorder on the grounds that they protect one “self” from another? Ought psychiatric advance directives be enforceable? What should be the normative goals of therapeutic practice with regard to individuals whose selves are fragmented?