The development of new therapeutic methods for intervening in brain function has the potential to influence aspects of a person’s agency, including their autonomy and authenticity. To determine whether or not this is the case, we need an assay that can measure aspects of agency before and after neurointervention. This chapter introduces a framework for thinking about agency as a multidimensional construct, and describes a research project aimed at measuring agency. The authors develop an Agency Assessment Tool (AAT) using survey methods and present preliminary results from the project that shows that the AAT can characterize control and patient groups along several dimensions with a factor analysis; the results show some interesting patterns among putative conceptual dimensions with network analysis. Although the data do not go so far as to include interventions to help understand causal relations, the authors discuss the prospects for using data-driven tools to come up with ontologies of agency.

In a thoughtful essay that follows, Peter Zachar interweaves several philosophical issues that relate to classification in general and psychiatric classifications specifically. I think it will be most useful to interested readers if, in this introduction, I steer away from a largely conceptual/philosophical critique of Zachar’s essay and rather comment from the perspective of a working clinician and psychiatric nosologist who has, for better or worse, spend several decades working on various versions of the DSM – the accepted nosology for American psychiatry.

The Prologue gives examples of various kinds of hiddenness, focusing especially on the way the artist or the author is both indicated by and hidden behind a work.

Introduction. The Introduction sets out the aims of the book. No attempt has previously been made to investigate the detailed operations of any major figure as evidenced by his or her day-to-day practice. This is an effort to fill that gap by exploring the career of Edmund Curll, and to go beyond the mainly biographic treatment he has received so far. It describes how the succeeding pages seek to consider various aspects of Curll’s publications in the context of the London publishing industry as it then operated. An account is given of the content of various chapters, as this will be given in the abstracts below. Among topics briefly outlined are the range of Curll’s lists, his dealings with the law, his connections with contemporary authors (major and minor), with a review the most important scholarship on the condition of publishers in the eighteenth century.

In their chapter, Roskies, Busch, and Walton present the first phase of a very ambitious project aiming at examination of the causal role of agency in mental disorders. The project is daunting because there are several unknowns. First, there is an issue of making a definition of agency and its variants. Next, it would be necessary to examine those variants across different clinical populations. Finally, there is a need to see whether modulating agency through brain stimulation leads to changes in the psychiatric condition. The authors frame their project within the model of interventionist approach. It is a complex project because this approach requires that all confounding and correlated influences and effects are kept under control. Moreover, it is not clear that the efficacy of deep brain stimulation, which is so successful in the treatment of chronic dystonia, Parkinson’s disease, and some forms of epilepsy, is equally effective in treating mental disorders such as depressive disorder, schizophrenia, or obsessive-compulsive disorder (OCD).

Over time, United Nations human rights treaty bodies (UNTBs) have developed an admissibility requirement that individuals’ allegations be ‘sufficiently substantiated’ or ‘not manifestly unfounded’. Explanations of these terms have varied, but States, treaty body members and scholars have equated them with a prima facie threshold. Among international tribunals, prima facie is commonly understood to require the complainant to make a plausible claim. However, review of UNTB decisions indicates that application of this requirement clashes with the accepted meaning of prima facie by: (1) often requiring the complainant to present convincing allegations; (2) taking into account – or giving greater weight to – the state’s arguments and evidence at the admissibility stage; and 3) sometimes requiring the complainant to pre-emptively overcome the state’s possible defences. This chapter seeks to identify relevant trends in order to both better understand current UNTB practice and illuminate paths to greater consistency and clarity in admissibility determinations.

In his chapter, Ken Kendler set out to explore the prospects of evidential pluralism in a field that admittedly has not been explored in the literature so far: psychiatry. I find it thoroughly impressive how Kendler has engaged with the literature on evidential pluralism, and I fully agree with his words of caution and caveats about mechanisms. In this commentary, I will try to think along with Kendler and offer pointers to other places in this broad area of evidential pluralism that might be of help to those interested in psychiatry.

Before accessing the UN treaty bodies’ individual communications procedure, a complainant must have exhausted domestic remedies. This admissibility rule exists for good reasons, but it has limits. In particular, exemptions must be recognised in respect to domestic remedies which lack effectiveness, including accessibility. Regrettably, UNTBs are currently reverting to a formalistic and mechanical application of this admissibility rule. What justice requires, however, is the opposite: an expansive consideration of the plethora of barriers that prevent access to domestic justice, as well as a reflection about how each barrier can realistically be evidenced by a complainant. This can be achieved, this chapter argues, through an individual-centred, contextual approach, which achieves the aim of preventing the state from escaping international scrutiny, while highlighting the crucial role domestic justice should play in remedying human rights wrongs.

Precision psychiatry, as part of precision medicine, centers its analysis on biomarkers (genes), environment, and lifestyle. In descriptions of precision psychiatry, however, the roles played by environmental factors, lifestyle, and subjective experience are quickly downplayed, especially if such things cannot be easily translated into computational data. This is very clear in the following characterization.

Over decades of reviewing individual communications, the Human Rights Committee (HRC) has developed greater consistency when shifting the evidentiary burden between the author and the state in its decisions on individual communications. The grounds on which this shift is made, including the nature of the allegations, the evidence used to corroborate the allegations, and the extent to which the state engages with the process, seem to impact the articulation of the shifted burden in certain cases. To effect this burden shift, the chapter explains that the HRC appears to follow three steps when assessing claims of a breach of the prohibition against torture: (1) the allegations must be corroborated by some level of evidence; (2) the HRC applies a rebuttable presumption that the author’s alleged facts are true; unless (3) the state offers evidence in direct response to the specific allegations of torture.

It is a pleasure to be commenting on James Woodward’s characteristically magisterial chapter. I’ll remark on three topics: (1) where things stand now with what Woodward calls “the interventionist framework” for discussing causation; (2) whether the idea of stability has any role in establishing causal relations, particularly in psychiatry; and (3) whether the strategies Woodward outlines in his chapter have any place for one kind of causal thinking that seems essential to psychiatric practice, that of the therapist achieving an understanding of the origin of the content of the patient’s delusions.