The traditional paradigm of equality combines a focus on the goals of democratic institutions with the equality of resources position. The goal of distributive justice in this picture is to put citizens on equal footing in mutually accountable relationships by ensuring each has access to the kinds of things that serve as all-purpose means for pursuing their interests, like money. This approach, with its overt focus on providing citizens all-purpose means, however, pays insufficient attention to our neuro-psychological differences. In many (...) ways, the capabilities approach to equality is designed to incorporate issues of diversity, including neurodiversity. The capabilities approach gives issues of diversity a pride of place by starting from the fact of individual’s variable capability to develop a sense of the good or use resources. For the capabilities approach, however, the question of limits looms large. In what sense can we attain equality on a functioning approach when the fact of neurodiversity highlights a wide range of neurological difference, both in kind and degree? How many resources can justly be spent on the project? I suggest the best current approach to equality brings together elements from the capabilities framework, which better accounts for what to equalize in light of neurodiversity, and an institutional framework more readily aligned with the traditional paradigm, which provides a more principled basis for establishing limits on the demands of justice. (shrink)

With the new and highly accurate noninvasive prenatal test, new options for screening become available. I contend that the current state of the art of NIPT is already in need of a thorough ethical investigation and that there are different points to consider before any chromosomal or subchromosomal condition is added to the screening panel of a publicly funded screening program. Moreover, the application of certain ethical principles makes the inclusion of some conditions unethical in a privately funded scheme, even (...) if such screening would enhance a woman’s reproductive autonomy. On the one hand, a screening program aimed solely at the detection of Down syndrome is subject to the technological imperative and should be reassessed in the light of technologies that allow for the detection of conditions that are at least as severe. On the other hand, some chromosomal conditions should not be included in any screening programs, because this would violate certain ethical principles, such as the right of the future child to genetic privacy. (shrink)