Going Beyond the Catch-22 of Autism Diagnosis and Research. The Moral Implications of (Not) Asking "What Is Autism?"

Jo Bervoets,Kristien Hens

doi:10.3389/fpsyg.2020.529193

Abstract

Psychiatric diagnoses such as Autism Spectrum Disorder (ASD) are primarily attributed on the basis of behavioral criteria. The aim of most of the biomedical research on ASD is to uncover the underlying mechanisms that lead to or even cause pathological behavior. However, in the philosophical and sociological literature, it has been suggested that autism is also to some extent a ‘social construct’ that cannot merely be reduced to its biological explanation. We show that a one-sided adherence to either a biological or a social explanation leads to a moral dilemma, a Catch-22, for autistics and for those living with them. Such explanations close the space for self-identifying as autistic and at the same time being considered to be in good mental health. They foreclose the possibility of making sense of the lived experience of (and with) autistics. In this paper we argue that such lack of space for moral imagination inherently leads to scientific stalemate. We propose that one can only go beyond this stalemate by taking an ethical stance in theorizing, one that enables better intersubjective understanding. Only on such a view can behavior and biology be linked without either disconnecting them or reducing the one to the other.

Highlights

Reviewed by: Dimitris Bolis, Max Planck Institute of Psychiatry (MPI), Germany John Robison, College of William & Mary, United States
An intuition at the center of the neurodiversity movement is that neurological diversity is a fact that should not be identified with psychiatric problems
We have shown that this ethical stalemate leads to scientific stalemate where different scientific disciplines claim precedence over the others, and where one is unable to do justice to the moral demand for an explanation of autism to achieve a better understanding of autistics

Summary

Introduction

As we mentioned, and will argue in more detail later, psychosocial explanations share the same lawlike (nomological) explanatory type of approach wherein autism is reduced to a mechanism, albeit in this case one where autistic behavior will be determined primordially by developmental psychology given certain social child rearing conditions. The pattern shows that theoretical progress is linked to a charitable everyday mutual understanding of autistic lived experience in line with the fundamental moral use of autism proposed above.

Results

Conclusion