Diagnostic reasoning and denial of privileged access in psychiatry

To diagnose, a psychiatrist has to come to conclusions about the mental state of patients in a reasoned and evidence-based way. First-person introspective reports by patients are still used, but "privileged access” is not necessarily granted. Instead, third- and second-person methods (EEG, fMRI, behavior, etc.) and higher-order evidence (likelihood or coherence of reports) are consulted as well.

How are these different intro- and extrospective sources weighed and compared in psychiatric reasoning? The project intends to analyse its underlying structure with current philosophical tools and investigates under which circumstances correcting or overwriting introspective reports of a patient by a psychiatrist is justifiable - and when it is not. The goal is to produce steps towards general models of psychiatric reasoning or the machinery underlying introspection, in part by focusing on concrete examples like the distinction between Charles-Bonnet- or Anton’s Syndrome as well as the distinction between hallucination and cognitive delusion. Cooperation with the psychiatrists of the Charité is planned.