Disability

I argue that the concept of normality in medical research and practice is inextricable from that of ambiguity. I do so in the context of Edmund Pellegrino's call for a renewed reflection on medicine’s basic concepts and by drawing on work in critical disability studies concerning Deafness and body integrity identity disorder. If medical practitioners and philosophers of medicine wish to improve their understanding of the meaning of medicine as well as its concrete practice, they should take seriously the import (...) and centrality of ambiguity. (shrink)

The paper considers whether psychiatric kinds can be natural kinds and concludes that they can. This depends, however, on a particular conception of ‘natural kind’. We briefly describe and reject two standard accounts – what we call the ‘stipulative account’ (according to which apparently a priori criteria, such as the possession of intrinsic essences, are laid down for natural kindhood) and the ‘Kripkean account’ (according to which the natural kinds are just those kinds that obey Kripkean semantics). We then rehearse (...) a more permissive account: Richard Boyd’s ‘homeostatic property cluster’ (HPC) account. We argue that psychiatric kinds can in principle count as natural kinds on the HPC account. Moreover, specific psychiatric kinds (Tourette’s, schizophrenia, etc.) can be natural kinds even if the category psychiatric disorder is not itself a natural kind. (shrink)

Jaspers’s binary distinction between understanding and explanation has given way first to a proliferation of explanatory levels and now, in John Campbell’s recent work, to a conception of explanation with no distinct levels of explanation and no inbuilt rationality requirement. I argue that there is still a role for understanding in psychiatry and that is to demystify the assumption that the states it concerns are mental. This role can be fulfilled by placing rationality at the heart of understanding without a (...) commitment to the attempt to use rationality to shed light on interpretation and mindedness as though from outside those notions. Delusions still present a significant challenge to philosophical attempts at understanding, but this merely reflects the genuine clinical difficulties such states present. (shrink)

This paper argues that luck egalitarianism, especially in the guise of equality of opportunity for welfare, is in tension with the ideal of fair equality of opportunity in three ways. First, equal opportunity for welfare is compatible with a caste system in employment that is inconsistent with open competition for positions. Second, luck egalitarianism does not support hiring on the basis of qualifications. Third, amending luck egalitarianism to repair this problem requires abandoning fair access to qualifications. Insofar as luck egalitarianism (...) cannot support fair equality of opportunity, it cannot do justice to the claims of the disabled. Indeed, in the absence of fair equality of opportunity, disabled people are likely to be marginalized. (shrink)

Disability has been a topic of heightened philosophical interest in the last 30 years. Disability theory has enriched a broad range of sub-specializations in philosophy. The call for papers for this issue welcomed papers addressing questions on normalcy, medical ethics, public health, philosophy of education, aesthetics, philosophy of sport, philosophy of religion, and theories of knowledge. This issue of Essays in Philosophy includes nine essays that approach the philosophy of disability in three distinct ways: The first set of three essays (...) provide a careful analysis of John Rawls, and the application of his work in ethics and justice to societies in which persons with disabilities, especially cognitive disabilities, can take active part in the processes of civil society. The second set of three essays branch out into continental philosophy, and are especially engaged with issues of community membership, communication, translation, and hermeneutics. The third set of three essays address disability specifically through the arts and aesthetics; asking questions on the portrayal of disabled persons in the arts and its implications for normalcy, sexuality, beauty, and the sublime. (shrink)

In my essay I consider the imaginary case of a future mother who refuses to undergo genetic alteration on her germline although she knows that her, as yet unconceived, child will have a serious genetic disorder. I analyze the good and bad points of two branches of arguments directed against her decision, consequentialist and rights-based. Then I discuss whether accepting one line of these arguments or the other makes a difference in moral assessment. I conclude that, although from the preanalytical (...) perspective we strongly oppose the refusal of genetic treatment in my imaginary case, it is probably impossible to construct one coherent theory which embraces all possible moral dilemmas triggered by our actions which affect the number and the identity of future people. (shrink)

A History of Intelligence and “Intellectual Disability” examines how the concepts of intellectual ability and disability became part of psychology, medicine and biology. Focusing on the period between the Protestant Reform and 1700, this book shows that in many cases it has been accepted without scientific and psychological foundations that intelligence and disability describe natural or trans-historical realities.

This essay investigates the demands on adult children to provide care for their elderly/ill parents from a socio-moral perspective. In order to narrow the examination, the question pursued here is agent-relative: What social and moral complexities are involved for the adult child when her parent(s) need care? First, this article examines our society’s expectation that adult children are morally obligated to provide care for their parents. Second, the essay articulates how transgressing against this normative expectation can inure significant moral criticism. (...) The final sections present these tensions within the context of disability. (shrink)

The question I want to answer is if and how the recognition approach, taken from the works of Axel Honneth, could be an adequate framework for addressing the problems of global justice and poverty. My thesis is that such a globalization of the recognition approach rests on the dialectic of relative and absolute elements of recognition. (1) First, I will discuss the relativism of the recognition approach, that it understands recognition as being relative to a certain society or a set (...) of institutions. The same is true for various forms of disrespect such as denigration or exclusion. The recognition approach is a form of internal reconstructive critique, which does not want to refer to absolute or ahistorical standards. (2) Second, I show that this relative understanding of recognition and disrespect rests on an absolute core of recognition, which transcends any given society. In short, this core is the possibility of undistorted self-realization, which is the main and universal element of a good life. Such an absolute core is necessary for distinguishing between justified and unjustified claims of relative recognition. It also serves as the normative benchmark for any society. (3) Finally, I will discuss the relation of these relative and absolute elements of recognition against the background of global justice. Claims of recognition can refer to this absolute core and demand that intersubjective conditions and social relations should change in order to make undistorted self-realization possible. This is the main point of reference for a recognition-based concept of global justice. (shrink)

Decisional capacity evaluations (DCEs) occur in clinical settings where it is unclear whether a consumer of medical services has the capacity to make an informed decision about the relevant medical options. DCEs are localized interventions, not the global loss of competence, that assign a surrogate decision maker to make the decision on behalf of the medical consumer. We maintain that one important necessary condition for a DCE to be morally justified, in cases of medical necessity, is that the health care (...) consumer under evaluation is incapable of expressing a preference for a certain outcome. (shrink)

Theorists of health have, to this point, focused exclusively on trying to define a state—health—that an organism might be in. I argue that they have overlooked the possibility of a comparativist theory of health, which would begin by defining a relation—healthier than—that holds between two organisms or two possible states of the same organism. I show that a comparativist approach to health has a number of attractive features, and has important implications for philosophers of medicine, bioethicists, health economists, and policy (...) makers. (shrink)

It is usually appropriate for adults to make significant decisions, such as about what kinds of medical treatment to undergo, for themselves. But sometimes impairments are suffered - either temporary or permanent - which render an individual unable to make such decisions. The Mental Capacity Act 2005 sets out the conditions under which it is appropriate to regard an individual as lacking the capacity to make a particular decision (and when provisions should be made for a decision on their behalf). (...) -/- To what extent does having capacity require the endorsement of certain values? Drawing on Owens et al (2009), I assess the extent to which understanding relevant information and weighing it in coming to a decision requires certain evaluative commitments. With reference to literature on anorexia nervosa and decisions informed by religious beliefs, I argue that it is difficult to avoid the conclusion that the conditions for capacity are value-laden, and that if this is so it is important to open discussion about which patterns of distorted valuing undermine capacity, and why. (shrink)

The question of why group-differentiated rights might be a requirement of justice has been a central focus of identity politics in recent decades. I attempt to bring some clarity to this discussion by proposing a typology to track the various ways in which individuals can be harmed or benefited as a consequence of their membership in social groups. It is the well-being of individuals that group-differentiated rights should be understood as protecting, and so clarity on the relationship between group membership (...) and well-being is vital. One of the problems with the way in which such justifications have often been formulated in the past has been that they inadvertently position the group as a handicap to be overcome, rather than a value to be protected. I seek to overcome this limitation by clearly specifying the circumstances under which group membership is a liability, and the circumstances under which it has value. While this distinction is important, in both cases there is a relevant interest at stake, and thus the groundwork can be laid for a defence of group-differentiated rights. (shrink)

A computer can come to understand natural language the same way Helen Keller did: by using “syntactic semantics”—a theory of how syntax can suffice for semantics, i.e., how semantics for natural language can be provided by means of computational symbol manipulation. This essay considers real-life approximations of Chinese Rooms, focusing on Helen Keller’s experiences growing up deaf and blind, locked in a sort of Chinese Room yet learning how to communicate with the outside world. Using the SNePS computational knowledge-representation system, (...) the essay analyzes Keller’s belief that learning that “everything has a name” was the key to her success, enabling her to “partition” her mental concepts into mental representations of: words, objects, and the naming relations between them. It next looks at Herbert Terrace’s theory of naming, which is akin to Keller’s, and which only humans are supposed to be capable of. The essay suggests that computers at least, and perhaps non-human primates, are also capable of this kind of naming. (shrink)

There appears to be a tension between two commitments in liberalism. The first is that citizens, as rational agents possessing dignity, are owed a justification for principles of justice. The second is that members of society who do not meet the requirements of rational agency are owed justice. These notions conflict because the first commitment is often expressed through the device of the social contract, which seems to confine the scope of justice to rational agents. So, contractarianism seems to ignore (...) the justice claims of the severely cognitively impaired. To solve this problem, Martha Nussbaum proposes the capabilities approach. The justifiability condition, on this approach, is met by the idea of overlapping consensus. This essay argues that overlapping consensus cannot meet liberalism’s justifiability condition, nor is it more inclusive of the cognitively impaired. Therefore, we have reason to retain the contract device and look for another way to ensure that liberalism respects the justice claims of all. (shrink)

Until now, philosophical debate about human embryonic stem cell (hESC) research has largely been limited to its ethical dimensions and implications. Although the importance and urgency of these ethical debates should not be underestimated, the almost undivided attention that mainstream and feminist philosophers have paid to the ethical dimensions of hESC research suggests that the only philosophically interesting questions and concerns about it are by and large ethical in nature. My argument goes some distance to challenge the assumption that ethical (...) considerations alone must be foregrounded in philosophical discussions about hESC research by introducing a critical stance on the epistemological and ontological assumptions that underlie and condition it. A central aim of the paper is to show how Foucault's insights into knowledge-power, taken in combination with Hacking's claims about styles of reasoning, can make these assumptions evident, as well as cast light on their potentially deleterious implications for disabled people. Arguing in this way also enables me to draw out constitutive effects of research on stem cells, that is, to indicate how the discursive practices surrounding research on stem cells, as well as the technology itself, contribute to the constitution of impairment. (shrink)

Frontiers of Justice: Disability, Nationality, Species Membership, by Martha Nussbaum, Harvard University Press, 2006. How should we measure human development? The most popular method used to be to focus on wealth and income, as when international development agencies rank countries according to their per capita gross domestic product. Critics, however, have long noted shortcomings with this approach. Consider for example a wealthy person in a wheelchair: her problem is not a financial one, but a lack of access to public spaces. (...) Even if she were to hire porters to carry her in and out of stores and libraries, that would not really address her situation. There is a basic sense of dignity and self-respect that comes with being able to move around on one’s own. Even for a disabled millionaire, that will only be possible when public buildings are wheelchair accessible. To fully grasp what the handicapped need, we have to look beyond purely economic measures of well-being, and take into account the actual capabilities people can exercise in their daily lives. The example of the well-off person in a wheelchair illustrates what Martha Nussbaum calls the capabilities approach to human development. It was first pioneered in economics by Amartya Sen (who came up with the wheelchair example), and Nussbaum has for years been associated with a more philosophical variation, which uses the idea of capabilities to outline basic political principles. In Frontiers of Justice: Disability, Nationality, Species Membership Nussbaum takes this project even further, and applies the capabilities approach to issues of justice involving not only the disabled and the global poor, but animals as well.Yet for a philosophy called the capabilities approach, it is surprising how little theoretical work capabilities do in Nussbaum’s overall account. (shrink)

In recent decades, the intertwining ideas of self-determination and well-being have received tremendous support in bioethics. Discussions regarding self-determination, or autonomy, often focus on two dimensions—the capacity of the patient and the freedom from external coercion. The practice of obtaining informed consent, for example, has become a standard procedure in therapeutic and research medicine. On the surface, it appears that patients now have more opportunities to exercise their self-determination than ever. Nonetheless, discussions of patient autonomy in the bioethics literature, which (...) focus on individual patients making particular decisions, neglect the social structure within which health-care decisions are made. Looking through the lens of disability and informed by the feminist conception of relational autonomy, this essay argues that the issue of autonomy is much more complex than the individualist model suggests. The social system and the ableist ideology impose various forms of pressure or oppressive power that can affect people’s ability to choose according to their value system. Even if such powers are not directly coercive, they influence potential parents’ decisions indirectly—they structure their alternatives in such a way that certain options are never considered as viable and other decisions must be made. This paper argues that, instead of only focusing on the individual act of decision-making, we need to pay attention to the social structure that frames people’s decision. (shrink)

Because contractarians see justice as mutual advantage, they hold that justice can be rationally grounded only when each can expect to gain from it. John Rawls seems to avoid this feature of contractarianism by fashioning the parties to the contract as Kantian agents whose personhood grounds their claims to justice. But Rawls also endorses the Humean idea that justice applies only if people are equal in ability. It would seem to follow from this idea that dependent persons (such as the (...) disabled) lack claims of justice. It appears, then, that the Kantian and Humean themes in Rawls conflict. I present a reading of Rawls that resolves this tension between the Kantian and Humean themes. The first theme, I argue, allows Rawls to maintain that persons as such are owed justice regardless of their ability to engage in social cooperation. The second theme, I argue, allows him to retain Hume's connection between justice and reciprocity, but confines the reciprocity condition to relations among nondependents. I conclude that Rawls's approach permits him to rebut recent criticisms leveled by disability theorists and others who claim that his theory excludes dependents. (shrink)

This paper argues that, with modification, Rawls's social contract theory can produce principles of distributive justice applying to the severely disabled. It is a response to critics who claim that Rawls's assumption that the parties in the original position represent fully cooperating citizens excludes the disabled from the social contract. I propose that this idealizing assumption should be dropped at the constitutional stage of the contract where the parties decide on a social minimum. Knowing that they might not be fully (...) capable of social cooperation, the parties will choose a social minimum that is as high and comprehensive as is compatible with the difference principle. This will ensure that the disabled have an adequate income. (shrink)

: This article critically examines the constitution of impairment in prenatal testing and screening practices and various discourses that surround these technologies. While technologies to test and screen prenatally are claimed to enhance women's capacity to be self-determining, make informed reproductive choices, and, in effect, wrest control of their bodies from a patriarchal medical establishment, I contend that this emerging relation between pregnant women and reproductive technologies is a new strategy of a form of power that began to emerge in (...) the late eighteenth century. Indeed, my argument is that the constitution of prenatal impairment, by and through these practices and procedures, is a widening form of modern government that increasingly limits the field of possible conduct in response to pregnancy. Hence, the government of impairment in utero is inextricably intertwined with the government of the maternal body. (shrink)

Feminists have indicated the inadequacies of bioethical debates about human embryonic stem cell research, which have for the most part revolved around concerns about the moral status of the human embryo. Feminists have argued, for instance, that inquiry concerning the ethics and politics of human embryonic stem cell research should consider the relations of social power in which the research is embedded. My argument is that this feminist work on stem cells is itself inadequate, however, insofar as it has not (...) incorporated an analysis of disability into its considerations of the ethical and political issues that surround the phenomena. Thus, I consider claims that disability theorists and anti-disability activists have made about the research. I conclude by indicating that stem cell research must be situated within a cultural matrix that operates in the service of normalisation. (shrink)

The argument for vegetarianism from overlapping species goes like this. Every individual who is the subject of a life has a right to life. Some humans—e.g., the severely congenitally cognitively limited—lack language, rationality, autonomy, and self-consciousness, and yet they are subjects of a life. Severely congenitally cognitively limited humans have a right to life. Some animals—e.g., all mammals—lack language, rationality, autonomy, and self-consciousness, and yet they are subjects of a life. We ought to treat like cases alike. The cases of (...) some humans are like the cases of some animals. Therefore, some animals have a right to life. -/- The argument seems not to have moved many people to change their diets. The reason, I suggest, is not because the argument is unsound but because our ability to change our dietary practices is difficult and we lack the imaginative resources to see the world from a nonhuman perspective. -/- I suggest that creative artists are of great value here, and I provide an example by referring to the work of the American novelist, Cormac McCarthy. (shrink)

Critical diversity studies (CDS) can be found within “traditional,” or “established,” university disciplines, such as philosophy, as well as in relatively newer departments of the university, such as African studies departments, women’s and gender studies departments, and disability studies departments. In this article, therefore, I explain why philosophy of disability, an emerging subfield in the discipline of philosophy, should be recognized as an emerging area of CDS also. My discussion in the article situates philosophy of disability in CDS by both (...) distinguishing this new subfield’s claims about disability from the arguments about disability that mainstream philosophers make and identifying the assumptions about social construction and antiessentialism that philosophy of disability shares with other areas of CDS. The discussion is designed to show that a (feminist) philosophy of disability that draws upon the work of Michel Foucault will transform how philosophers understand the situation of disabled people. By drawing upon Foucault, that is, I offer philosophers of disability and other practitioners of CDS a new understanding of disability as an apparatus of power relations. -/- . (shrink)

An increasing number of scholars at the intersection of feminist philosophy and critical disability studies have turned to Merleau-Ponty to develop phenomenologies of disability or of what, following Rosemarie Garland-Thomson, I call "non-normate" embodiment. These studies buck the historical trend of philosophers employing disability as an example of deficiency or harm, a mere litmus test for normative theories, or an umbrella term for aphenotypical bodily variation. While a Merleau-Pontian-inspired phenomenology is a promising starting point for thinking about embodied experiences of (...) all sorts, I here draw a cautionary tale about how ableist assumptions can easily undermine accounts of non-normate experience. I first argue that the omission or misguided treatment of disability within the history of philosophy in general and the phenomenological tradition in particular is due to the inheritance of what I call “the ableist conflation” of disability with pain, suffering, and disadvantage. I then show that Merleau-Ponty’s famous reading of the blind man’s cane is problematic insofar as it omits the social dimensions of disabled experiences, misconstrues the radicality of blindness as a world-creating disability, and operates via an able-bodied simulation that confuses object annexation or extension with incorporation. In closing, I contend that if phenomenology is to overcome the errors of traditional philosophy, as Merleau-Ponty once hoped, it must heed the insights of “crip” or non-normate phenomenology, which takes the lived experience of disability as its point of departure. (shrink)

I attempt to adjudicate the disagreement between those who seek to reconceptualize disability as mere difference and their opponents. I do so by reviewing a central conviction motivating the resistance, concerning the relationship between disability and well-being. I argue that the conviction depends on further considerations about the costs and extent of change involved in accommodating individuals with a particular disability trait. I conclude by considering three pay-offs of this clarification.

This brief monograph was written in an attempt to discover the general situation of Disability Studies, given that this appears to have become a growth area in academia with various typically illiberal aspects. The findings bear out the initial impression. There is a style of argument, even propaganda (for there is usually little genuine engagement with opposing liberal views), that can be seen in many other areas of academia. It amounts to a relatively new ‘progressive’ industry with various fashionable keywords, (...) phrases and ideologies—often not obviously related to disabilities in any serious way—indicating the nature of the beast: ‘progressive’, ‘radical’, ‘oppression’, ‘bourgeois’, ‘empowerment’, ‘rights’, ‘equal opportunities’, ‘discrimination’, ‘prejudice’, ‘citizenship’, ‘social justice’, ‘socially constructed’, ‘Marxism’, ‘Post Modernism’ and ‘Feminism’. The overall picture is that disability has become increasingly politicised along politically correct lines to the detriment of society as a whole and, eventually, even to the disabled themselves. This is largely caused by the endemic trahison des clercs in our tax-consuming and coercively monopolised university system. (shrink)

As a result of vocal autism activists pushing against traditional views of autism, there is a bilateral debate that reflects a deeper philosophical divide between medical and social definitions of disability. Both sides seek to determine the manner in which autistics and their communities view autism, and thus influence the manner in which cures or treatments are sought, dispensed and taken up. Through an investigation of this debate, this project will explore the practical benefits and ethical obligations of accommodating autistic (...) differences. One side of this debate, which we will call the cure theory approach, seeks treatments that will eradicate or at least minimize autistic symptoms. The philosophical assertion that lies behind this objective is that autistic differences, particularly disruptive autistic differences, ought to be removed. The other side of the debate, which we will call the neurodiverse perspective, seeks to define autism as neurological difference, that is relationally determined, rather than a disorder or a syndrome. The neurodiversity movement recommends educating autistics and their communities regarding how to fully accommodate autistic differences. The underlying philosophical commitment of the neurodiverse perspective is that it is in the best interests of autistics and their communities to accommodate differences, rather than seek treatments that encourage conformity. I will argue that these two sides are not mutually exclusive. Through a synthesis of the neurodiverse and cure theory points of view I will enable the development of a method, which facilitates justice for autistics and their communities. This synthesis garners the maximum capabilities that the expression of autistic differences can offer, and maintains the freedom for all community members to actualize their capabilities. (shrink)

Julia Kristeva shines in this book. The review makes a case for us studying Kristeva as the most relevant psychoanalyst of our time. She should be read over Lacan. Her understanding of this century is more incisive than any other psychoanalytic thinker alive today. At least, in this book. Kristeva's contention is that hatred gives way to paranoia.

ABSTRACT: With this article, I advance a historicist and relativist feminist philosophy of disability. I argue that Foucault’s insights offer the most astute tools with which to engage in this intellectual enterprise. Genealogy, the technique of investigation that Friedrich Nietzsche famously introduced and that Foucault took up and adapted in his own work, demonstrates that Foucault’s historicist approach has greater explanatory power and transgressive potential for analyses of disability than his critics in disability studies have thus far recognized. I show (...) how a feminist philosophy of disability that employs Foucault’s technique of genealogy avoids ahistorical, teleological, and transcultural assumptions that beleaguer much work in disability studies. The article also situates feminist philosophical work on disability squarely in age-old debates in (Eurocentric) Western philosophy about universalism vs. relativism, materialism vs. idealism, realism vs. nominalism, and freewill vs. determinism, as well as contributes to ongoing discussions in (Western) feminist philosophy and theory about (among other things) essentialism vs. constructivism, identity, race, sexuality, agency, and experience. (shrink)

What is so striking about Breaking Bad is how centrally impairment and disability feature in the lives of the characters of this series. It is unusual for a television series to cast characters with visible or invisible impairments. On the rare occasions that television shows do have characters with impairments, these characters serve no purpose other than to contribute to their ‘Otherness.’ Breaking Bad not only centralizes impairment, but impairment drives and sustains the story lines. I use three interrelated themes (...) from Disability Scholarship to analyze Breaking Bad. The first theme, Bodily Control, is that good bodies are controlled bodies and that uncontrolled, messy bodies are frightening, bad bodies. Indeed, the messiness of impairment and disability is so bad, that impaired and disabled individuals are excluded or shut out or excluded from many areas of public life. The second theme, Normalcy, is that the effect of hiding away impairment, of attempting to conceal disability, is that society becomes defined by, and structured around, the concept of normalcy. Normalcy, being normal, attaining and maintaining normalcy, is the preoccupation of most in society. To fail to be normal, or to fall from what is considered to be normal, is a source of tremendous anxiety for most people. These two themes, Bodily Control and Normalcy are conceptually connected: impairment, disease and dying are so feared because they are socially invisible and, therefore unknown and unknowable. They are the undiscussable taboos. The third theme, Bodily Realism, is that having a realistic view of the body, which would at minimum require accepting the fact that human bodies are fragile things, prone to disease and accident and are ultimately destined to die, makes one more at ease in the world, and able to live better lives and live as a better person. Indeed, so the argument goes, our lives would be richer, more rewarding—emotionally and morally—if we cared less about normalcy because of a dread of abnormalcy, but instead learned to accept if not positively value the physical variability of human existence. (shrink)

A number of cognitive and behavioral variables influence the performance in tasks of theory of mind (ToM). Since two of the most important variables, memory and explicit expression, are impaired in schizophrenic patients, the ToM appears inconsistent in these patients. An ideal instrument of ToM should therefore account for deficient memory and impaired ability of these patients to explicitly express intentions. If such an instrument is developed, it should provide information that can be used not only to understand the pathophysiology (...) but also to monitor patients. (shrink)

Disability-positive philosophers often note a troubling tendency to dismiss what disabled people say about their well-being. This chapter seeks to get clearer on why this tendency might be troubling. It argues that recent appeals to lived experience, testimonial injustice, and certain challenges to adaptive-preference reasoning do not fully explain what is wrong with questioning the happiness of disabled people. It then argues that common attempts to debunk the claim that disabled people are happy are worrisome because they threaten everyone’s well-being (...) and are further challenged by an argument from moral risk. (shrink)

The historical relationship between health care professionals and people with disabilities is fraught, a fact all the more troubling in light of the distinctive roles clinicians play in both establishing and responding to that which is considered normal or abnormal by society at large. Those who wish to improve their clinical practice might struggle, however, to keep up with developments across numerous disability communities as well as the ever-growing body of disability studies scholarship. To assist with this goal, I offer (...) an overview of recent disability theory, outline a set of responsibilities clinicians have to disability communities, and provide recommendations for clinicians who hope to justly treat patients with disabilities and improve their care and health outcomes. (shrink)

In this paper I look at the much-discussed case of disabled parents seeking to conceive disabled children. I argue that the permissibility of selecting for disability does not depend on the precise impact the disability will have on the child’s wellbeing. I then turn to an alternative analysis, which argues that the permissibility of selecting for disability depends on the impact that disability will have on the child’s future opportunities. Nearly all bioethicists who have approached the issue in this way (...) have argued that disabilities like deafness unacceptably constrain a child’s opportunities. I argue, however, that this conclusion is premature for several reasons. Most importantly, we don’t have a good way of comparing opportunity sets. Thus, we can’t conclude that deaf children will grow up to have a constrained set of opportunities relative to hearing children. I conclude by suggesting that bioethicists and philosophers of disability need to spend more time thinking carefully about the relationship between disability and opportunity. (shrink)

Insofar as many older adults fit some definition of disability, disability studies and gerontology would seem to have common interests and goals. However, there has been little discussion between these fields. The aim of this paper is to open up the insights of disability studies as well as philosophy of disability to discussions in gerontology. In doing so, I hope to contribute to thinking about the good life in late life by more critically reflecting upon the meaning of the body, (...) ability, and the variability of each. My central argument is that we should conceptualize age‐associated bodily variations and abilities not in terms of individual capacity, but in terms of what I call “the extended body.” It is in light of the meaning of embodiment and ability in general that we must think differently and more capaciously about the meaning of late life in particular. (shrink)

I attempt to adjudicate the disagreement between those who seek to reconceptualize disability as mere difference and their opponents. I do so by reviewing a central conviction motivating the resistance, concerning the relationship between disability and well-being. I argue that the conviction depends on further considerations about the costs and extent of change involved in accommodating individuals with a particular disability trait. I conclude by considering three pay-offs of this clarification.

Does disability make a person worse off? I argue that the best answer is yes and no, because we can be worse off in two conceptually distinct ways. Disabilities usually make us worse off in one way (typified by facing hassles) but not in the other (typified by facing loneliness). Acknowledging two conceptually distinct ways to be worse off has fundamental implications for philosophical theories of well-being.

In this peer commentary on L. Syd M. Johnson’s “Inference and Inductive Risk in Disorders of Consciousness,” I argue for the necessity of disability education as an integral component of decision-making processes concerning patients with DOC and, mutatis mutandis, all patients with disabilities. The sole qualification Johnson places on such decision-making is that stakeholders are educated about and “understand the uncertainties of diagnosis and prognosis.” Drawing upon research in philosophy of disability, social epistemology, and health psychology, I argue that this (...) educational qualification is insufficient to address systemic ableism and other forms of epistemic bias in quality of life judgments. (shrink)

Consider two commonly cited requirements of love. The first is that we should love people for who they are. The second is that loving people should involve concern for their well-being. But what happens when an aspect of someone’s identity conflicts with her well-being? In examining this question, I develop an account of loving someone in spite of something. Although there are cases where loving in spite of is merited, I argue that we generally do wrong to love people in (...) spite of who they are, even where it appears that some aspect of their identity is in tension with their well-being. (shrink)

Much academic work (in philosophy, economics, law, etc.), as well as common sense, assumes that ill health reduces well-being. It is bad for a person to become sick, injured, disabled, etc. Empirical research, however, shows that people living with health problems report surprisingly high levels of well-being - in some cases as high as the self-reported well-being of healthy people. In this chapter, I explore the relationship between health and well-being. I argue that although we have good reason to believe (...) that health problems causing pain and death typically do reduce well-being, health problems that limit capabilities probably don't reduce well-being nearly as much as most people suppose. I then briefly explore the consequences of this conclusion for political philosophy and ethics. If many health problems don't significantly reduce well-being, why should governments go to great expense to prevent or treat them? Why should parents be obliged to ensure the health of their children? (shrink)