Ethical recommendations for music therapy in neurorehabilitation: impure a priori foundations and transpersonal holism

Abstract

Music therapy has been proven useful in the treatment of a wide range of disorders, even if often in only an auxiliary role. Its use for patients requiring neurological rehabilitation is rather recent and its effectiveness has been assessed both qualitatively and quantitatively. Practitioners must undergo rigorous training to obtain certification and must be able to combine a high level of therapeutic and artistic skills. As members of multidisciplinary teams, music therapists are expected to (1) justify their participation by employing the most effective methods at their disposal; (2) adapt or even create musical material best suited to patients’ needs; and (3) strive for a theoretical understanding of what their intervention is trying accomplish. These recommendations emerge from concrete realities that we could not take cognizance of purely a priori. An attempt to ground them post hoc in an abstract universal conception of human dignity realized in Kant’s practical reason, attractive as that might seem philosophically, is ridden with logical gaps (non-sequiturs) and circularity (Rorty). Moral concepts ought rather to be understood as impure a priori criteria for moral judgment acquired and negotiated through linguistic socialization (Herder, Piaget, Vygotsky, Wittgenstein, Habermas). The collective construction of a future neuroethics makes sense as a humanitarian plea (Herder’s Humanitat) following the jurisprudential practice of English common law rather than the top-down imposition of a global civil code. In so far as music therapy is concerned, it will most likely remain embedded in the moral anthropological context of local languages, cultures and traditions, albeit with some foreign influences caused by international exchange.