Body Integrity Identity Disorder (BIID) is a very rare condition describing those with an intense desire or need to move from a state of ability to relative impairment, typically through the amputation of one or more limbs. In this paper, I draw upon research in critical disability studies and philosophy of disability to critique arguments based upon the principle of nonmaleficence against such surgery. I demonstrate how the action-relative concept of harm in such arguments relies upon suspect notions of biological (...) and statistical normality, and I contend that each fail to provide normative guidance. I then propose a critical theory of harm, one marked by substantive engagement with both empirical and reflective inquiry across the sciences, social sciences, and humanities. I conclude by discussing the implications of this theory and how it might enrich ongoing debates in bioethics, philosophy of disability, and the health humanities. (shrink)

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)

Bioethics influences public policy, scientific research, and clinical practice. Thinkers in Continental traditions have increasingly contributed scholarship to this field, and their approaches allow new insights and alternative normative guidance. In this essay, examples of the following Continental approaches in bioethics are presented and considered: phenomenology and existentialism; deconstruction; Foucauldian methodologies; and biopolitical analyses. Also highlighted are Continental feminisms and the philosophy of disability. Continental approaches are importantly diverse, but those I focus upon here reveal embedded models of individualized autonomy (...) in medical discourses and encourage awareness of medicine's normalizing edges, thereby drawing attention to lacunae in traditional bioethical frameworks. (shrink)

The feminist charge that Michel Foucault's work in general and his history of sexuality in particular are masculinist, sexist, and reflect male biases vexes feminist philosophers of disability who believe his claims about (for instance) the constitution of subjects, genealogy, governmentality, discipline, and regimes of truths imbue their feminist analyses of disability and ableism with complexity and richness, as well as inspire theoretical sophistication and intellectual rigor in the fields of philosophy of disability and disability studies more generally. No aspect (...) of Foucault's corpus has been more consistently subjected to the charges of masculinism and male bias than his example of the nineteenth-century farmhand Charles Jouy who, at about forty years of age, engaged in sexual activity with a girl, Sophie Adam, was reported to authorities, and subsequently was incarcerated in Maréville for the rest of his days. My central aim in this paper is to interrupt the momentum of the accepted feminist interpretation of the Jouy case by advancing a feminist perspective on Jouy's identity and the incidents involving Jouy and Adam that takes seriously insights derived from philosophy of disability and critical disability theory and history. (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)

In this paper, I look at several examples that demonstrate what I see as a troubling tendency in much of mainstream bioethics to discount the views of disabled people. Following feminist political theorists who argue in favour of a stance of humility and sensitive inclusion for people who have been marginalized, I recommend that bioethicists adopt a presumption in favour of believing rather than discounting the claims of disabled people. By taking their claims at face value and engaging with disabled (...) people in open dialogue over impairment and disadvantage, bioethicists may take to heart an important lesson about human fragility and resilience. (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)

: 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)

Philosophical anthropology aims to discover what makes us human, but it has produced accounts that exclude some members of our species. It relies often on a non-naturalistic “philosophy of consciousness” and locates humanity in the cognitive capacity to objectively represent things, to reason teleologically and use tools, to use symbols and language, or to be self-conscious and question existence. This work pursues an alternative, thoroughly naturalistic philosophical anthropology in the tradition of Arnold Gehlen. Combining Gehlen’s theory of our behaviorally-detached and (...) culturally-determined impulses with Maurice Merleau-Ponty’s views on intersubjectivity, affect, sexuality, and social institutions, the present work locates the human within the unique structure of human feeling. This produces a truly inclusive account of “the human as the other” or Homo alter. The human is deeply and thoroughly dependent on affective, bodily, communicative bonds, in which others appear as sources of meaning, norms, pleasure, and approbation and disapprobation. This socio-biological account of the human makes institutionality central to our form of life but rejects any political anthropology that attempts to use human nature to prescribe a necessary form to institutions such as the home. Such a social and affective account of the human produces a novel approach to the affect of shame as the feeling of institutional rejection. Ultimately, this work uses philosophical anthropology to combat dehumanization. Our unique form of dependency on others and institutions is present, for example, in infants and the severely disabled who may not possess the forms of consciousness and cognition that traditionally are identified with being human. (shrink)

Spanish Translation of "He/She/They/Ze" (Ergo, 2018).

In this article, I aim to demonstrate that moral responsibility theory produces, legitimates, and even magnifies the considerable social injustice that accrues to disabled people insofar as it implicitly and explicitly promotes a depoliticized ontology of disability that construes disability as a naturally disadvantageous personal characteristic or deleterious property of individuals rather than identifies it as an effect of power, an apparatus. In particular, I argue that the methodological tools of “analytic” philosophy that philosophers of moral responsibility theory employ to (...) establish the philosophical domain in which they engage have distinctly detrimental effects on disabled people. (shrink)

The harm usually associated with psychopathy requires therapeutically, legally, and ethically satisfactory solutions. Scholars from different fields have, thus, examined whether empirical evidence shows that individuals with psychopathic traits satisfy concepts, such as responsibility, mental disorder, or disability, that have specific legal or ethical implications. The present paper considers the less discussed issue of whether psychopathy is a disability. As it has been shown for the cases of the responsibility and mental disorder status of psychopathic individuals, we argue that it (...) is undecided whether psychopathy is a disability. Nonetheless, based on insights from disability studies and legislations, we propose that interventions to directly modify the propensities of individuals with psychopathic tendencies should be balanced with modifications of the social and physical environments to accommodate their peculiarities. We also suggest how this social approach in some practical contexts that involve non-offender populations might be effective in addressing some of the negative effects of psychopathy. (shrink)

If people are inclined to attribute race to humanoid robots, as recent research suggests, then designers of social robots confront a difficult choice. Most existing social robots have white surfaces and are therefore, I suggest, likely to be perceived as White, exposing their designers to accusations of racism. However, manufacturing robots that would be perceived as Black, Brown, or Asian risks representing people of these races as slaves, especially given the historical associations between robots and slaves at the very origins (...) of the project of robotics. The only way engineers might avoid this ethical and political dilemma is to design and manufacture robots to which people will struggle to attribute race. Doing so, however, would require rethinking the relationship between robots and “the social,” which sits at the heart of the project of social robotics. Discussion of the race politics of robots is also worthwhile because of the potential it has to generate insights about the politics of artifacts, the relationship between culture and technology, and the responsibilities of engineers. (shrink)

One challenge in providing an adequate definition of physical disability is unifying the heterogeneous bodily conditions that count as disabilities. We examine recent proposals by Elizabeth Barnes (2016), and Dana Howard and Sean Aas (2018), and show how this debate has reached an impasse. Barnes’ account struggles to deliver principled unification of the category of disability, whilst Howard and Aas’ account risks inappropriately sidelining the body. We argue that this impasse can be broken using a novel concept: marginalised functioning. Marginalised (...) functioning concerns the relationship between a person’s bodily capacities and their social world: specifically, their ability to function in line with the default norms about how people can typically physically function that influence the structuring of social space. We argue that attending to marginalised functioning allows us to develop, not one, but three different models of disability, all of which—whilst having different strengths and weaknesses—unify the category of disability without sidelining the body. (shrink)

Benjamin Bagley ('Properly Proleptic Blame', Ethics 127, July 2017) sets out a dilemma for addressed blame, that is, blame addressed to its targets as an implicit demand for recognition. The dilemma arises when we ask whether offenders would actually appreciate this demand, via a sound deliberative route from their existing motivations. If they would, their offense reflects a deliberative mistake. If they wouldn't, addressing them is futile, and blame's emotional engagement seems unwarranted. Bagley wants to resolve the dilemma in such (...) a way that addressed blame's distinctive elements of hostility and emotional engagement can be accounted for. I argue that Bagley's focus on the proleptic character of addressed blame helps to avoid the dilemma, but that Bagley has difficulties accounting for the element of hostility in addressed blame. I suggest that an alternative account of addressed blame makes better sense of Bagley's paradigm example, avoids Bagley's dilemma in the way Bagley's original solution does, because it preserves addressed blame's proleptic character, and can account for addressed blame's elements of emotional engagement and hostility. (shrink)

If we were to write down all those things that we ordinarily categorise as disabilities, the resulting list might appear to be extremely heterogeneous. What do disabilities have in common? In this paper I defend the view that disabilities should be understood as particular kinds of inability. I show how we should formulate this view, and in the process defend the view from various objections. For example, I show how the view can allow that common kinds of inability are not (...) disabilities, can allow that minor kinds of inability are rightly not described as disabilities, and can allow that socially imposed inabilities need not be disabilities. In the second half of the paper, I show that this theory is superior to rival theories. I criticize the wellbeing theory of disability (Kahane and Savulescu 2009, Savulescu and Kahane 2011, Harris 2001) and conventionalist theories of disability (e.g. Barnes 2016). Finally, I show how the inability theory is consistent with the best versions of the social model of disability. (shrink)

The purpose of this paper is to contribute to the ongoing analyses that aim to confront the problem of marked variation. Negatively marked differences are those natural variations that are used to cleave human beings into different categories (e.g., of disablement, of medicalized pathology, of subnormalcy, or of deviance). The problem of marked variation is: Why are some rather than other variations marked as epistemically or culturally significant or as a diagnostic of pathology, and What is the epistemic background that (...) makes these—rather than other variations—marked as subnormal? For Wilson (2018a), critical examination of the problem of marked variation is central to understanding the epistemology of medicalized pathology that made the history of eugenics possible. My aim is to explore the role marked variation plays in eugenic and other problematic classifications and the inferences they appear to license. I pay particular attention to the normative valuations of marked variations, how these valuations affect the inferences that are made by others about those possessing the variation, and how those possessing the variation perceive themselves. In the final sections, I illustrate this by critically discussing three putative kinship conceptions of race. I rely on these to extend the scope of the puzzle of marked variation from the context of historic and current markings of an individual’s variation as disability in the eugenics movement to historic and current markings for assigning putative racial ascriptions to individuals and groups. Lastly, I suggest that the problem of marked variation is a problem that looms over any epistemic account that is dependent upon sorting or classifying. (shrink)

This article is a feminist intervention into the ways that disability is researched and represented in philosophy at present. Nevertheless, some of the claims that I make over the course of the article are also pertinent to the marginalization in philosophy of other areas of inquiry, including philosophy of race, feminist philosophy more broadly, indigenous philosophies, and LGBTQI philosophy. Although the discipline of philosophy largely continues to operate under the guise of neutrality, rationality, and objectivity, the institutionalized structure of the (...) discipline implicitly and explicitly promotes certain ontologies, epistemologies, and methodologies as bona fide philosophy, while casting the ontologies, epistemologies, and methodologies of marginalized philosophies as mere simulacra of allegedly fundamental ways of knowing and doing philosophy and thus rendering these marginalized philosophies more or less expendable. This article is designed to show that legitimized philosophical discourses are vital mechanisms in the problematization of disability. (shrink)

Annotated bibliography on eugenics and philosophy.

Projects of human improvement take both individual and intergenerational forms. The biosciences provide many technologies, including prenatal screening and the latest gene editing techniques, such as CRISPR, that have been viewed as providing the means to human improvement across generations. But who is fit to furnish the next generation? Historically, eugenics epitomizes the science-based attempt to improve human society through distinguishing kinds of people and then implementing social policies—from immigration restriction to sexual sterilization and euthanasia—that influence and even direct what (...) sorts of people populate our future. Despite recognition of the horrors of the eugenic extremes of the past and of the subhumanizing of those sufficiently below appearance or ability norms to be viewed as “defective” or “unfit”, many people continue to be drawn to strands of eugenic thinking. (shrink)

With a few notable exceptions disability studies has not taken account of intersexuality, and it is principally through the lenses of feminist and queer-theory oriented ethical discussions but not through ‘straight’ bioethics that modes valuing intersex difference have been proposed. Meanwhile, the medical presupposition that intersex characteristics are inherently disabling to social viability remains the taken-for-granted truth from which clinical practice proceeds. In this paper I argue against bioethical perspectives that justify extensive and invasive pre- and post-natal medical interference to (...) eradicate intersex. I argue instead that to constitute the necessary conditions for the recognition of the intersexed child as a person, a life valid in its own right, clinicians must refrain from aggressive interference. Clinical specialists presuppose that intersexed children will be socially disabled and unrecognizable as persons; frustrated by the general failure of traditional interventions to assign a sex, clinicians are now pursuing prenatal technologies, including selective termination, to erase intersex. (shrink)

The medical and social model of disability is discussed and debated among researchers, scholars, activists, and people in general. It is common to hold a mixed view and believe that some disabled people suffer more from social obstacles and others more from medical problems inherent in their bodies or minds. Rachel Cooper discusses possible ‘test environments’, making explicit an idea which likely plays an implicit part in many disability discussions. We place or imagine placing the disabled person in a range (...) of different environments. If there is a relevant test environment in which they do fine, their problem was societal/external; if there is not, it was medical/internal. Cooper admits that deciding on the appropriate range of test environments is an ethical and political question. In this chapter, I argue that we often ought to widen our scope when discussing psychiatric disabilities. (shrink)

This thesis argues that the nature of disability is, currently, fundamentally misunderstood. Current approaches to disability are nounal and seek to determine the locus of disability with the intention of better understanding the phenomenon of disability. In contrast, this thesis offers an adverbial perspective on disability and shows how disability is experienced as an increased and personally irremediable impediment to daily-living tasks or broader goals. This thesis holds that impediment is not a function of either biological individuality or the Social, (...) but of a specific relation between the individual and their environment. The following delineates the Picture Theory of Disability — a mechanism for the evaluation of the experience of disability and a heuristic device for the proper interpretation of disability. The theory is born of Humean sentimentalism and elements of Wittgenstein’s Picture Theory of Language, and shows when, where, and how disability is experienced. (shrink)

This paper assesses how views of disability and enhancement can combine. It is hard to maintain that disabilities and enhancements are both undesirable. Disability-positive views can combine with support for or opposition to enhancement, but not with the view that enhanced traits reliably increase well-being. It is consistent to hold that disability is bad and enhancement good; the plausibility of this combination depends on whether it is better to have more options and fewer limitations. Understanding these combined positions makes it (...) easier to check for consistency by evaluating positions on disability and enhancement against each other. (shrink)

This dissertation contributes to the development of philosophy of disability by drawing on disability studies, feminist philosophy, phenomenology, and philosophy of biology in order to contest epistemic and ontological assumptions about disability within biomedical ethics as well as within philosophical work on the body, demonstrating how philosophical inquiry is radically transformed when experiences of disability are taken seriously. In the first two chapters, I focus on epistemological and ontological concerns surrounding disability within biomedical ethics. Although disabled people and their advocates (...) have been quite vocal regarding their views on disability and in critiquing bioethicists’ approaches to issues that affect them, the interests, knowledge, and experiences of disabled people have had minimal impact on discussions within biomedical ethics textbooks. The risks of making problematic assumptions about disability are high within this subfield insofar as bioethicists impact practices within medical facilities, public policy, and, through student engagement with their texts in biomedical ethics courses, the views of potential health care professionals. All of these, in turn, affect the care provided to disabled people and potential/actual parents of disabled children. Chapter three raises ontological issues related to disability theory, examining the role of the impairment/disability distinction in framing discussions of the body as well as the status of experience. I discuss two approaches to incorporating subjective experiences of the body in disability, arguing that neither is sufficient. I examine debates within feminist theory on questions related to experience. I argue that a feminist phenomenological approach that builds on Merleau-Ponty’s work offers the best way to address bodily experiences in disability theory. The assumptions that disability theorists and Merleau-Ponty make about disability are often at odds. Chapter four points out the ableism in Merleau-Ponty’s use of a case study and considers some of the oversights within Phenomenology of Perception. In spite of my critique, I argue that his approach to phenomenology—with appropriate modifications—is useful not only for theorizing the experiences of disabled people but also for addressing other types of marginalized embodiment. Chapter five applies this method to body integrity identity disorder (BIID), arguing that combining Merleau-Ponty’s insights with those of disability theory allows us to address lived experiences of BIID and to identify assumptions about disability within research on this condition. (shrink)

I explore the usefulness of Martha Nussbaum's capabilities approach in regard to the UN Convention on the Rights of Persons with Disabilities (CRPD). The CRPD aims at empowering people with disabilities by granting them a number of civil and political, but also economic, social and cultural rights. Implementing the CRPD will clearly be politically challenging and also very expensive for states. Thus, questions might arise as to whether the requirements set in the CRPD can be justified from an ethical perspective. (...) I will first investigate if Nussbaum's capabilities approach provides support for the rights claimed in the CRPD. Second, I will investigate to what extent Nussbaum's capabilities approach is a useful tool to set priorities among rights in the course of the implementation of the convention. This is an urgent question because seen realistically, it will not be possible to realize all rights at once and thus some rights need to receive greater priority than others. I will argue that the capabilities approach can be regarded as supporting the rights specified in the CRPD, but that it proves unable to guide the implementation process due to an insufficient grounding of the capabilities. Employing the capabilities approach thus leads to only limited results. (shrink)

The practice of terminating a pregnancy following the diagnosis of a fetal abnormality raises questions about notions of bodily normality and the ways these shape ethical decision-making. This is particularly the case with terminations done on the basis of ostensibly minor morphological anomalies, such as cleft lip and isolated malformations of the limbs or digits. In this paper, I examine a recent case of selective termination after a morphology ultrasound scan revealed the fetus to be missing a hand . Using (...) the work of Georges Canguilhem, I show that a person with acheiria could be considered normal. Further, I show that this case reveals a kind of “undecidability” in the significance of fetal sex/gender and disability in termination. From this, I consider the conceptual interaction of disability with sex/gender, to argue that the ethics of disability termination are not as distinct from those of sex/gender selection as is commonly supposed. (shrink)

How do religions and social order interact with each other? Scholars of religions have repeatedly explored this question from numerous perspectives. However, they have yet to utilise the approach of disability studies, which focuses on disability as a social ordering process, to address this question. As such, not only have the manifold empirical relationships between religions and disability often been disregarded, but a great theoretical potential also remains untapped. In this paper, I demonstrate what the study of religions can gain (...) from analysing processes of disablement. In doing so, I introduce the concept of dis/abling religion, which integrates the study of religions and disability studies, making it possible to systematically grasp the entanglements between religions, disability, and social order. (shrink)

This paper argues that there are reasons to believe that there is no single concept or category which demarcates all individuals who have a disability from those individuals who do not. The paper begins by describing that I call ‘a Unified Concept View of Disability’ and the role that such a view plays in debates about the nature of disability. After considering reasons to think that our concept of disability is not unified in the way that the Unified Concept View (...) assumes, I outline what a non-unified approach to disability might look like. The paper concludes by considering implications of rejecting the Unified Concept View of disability. (shrink)

In 2014 Jennifer Cramblett, a white lesbian, filed a Complaint for Wrongful Birth alleging that the Midwest Sperm Bank mistakenly provided sperm from an African–American donor. In this article, we trace the complex and overlapping lines of legal and social inheritance that have conditioned not only the possibility of such a lawsuit, but also the legal language and arguments within the Complaint itself. First, we trace the racial politics of homonormativity, which set the conditions of possibility for an out, white (...) lesbian to bring this case forward. Second, we trace the inheritance of wrongful birth tort law, reviewing its prior race and disability-related uses, and its basis in feminist reproductive rights. Third, we trace how disability, race and sexuality interlock within the eugenic inheritance of both ‘wrongful birth’ and reproductive technologies. Finally, we follow traces of racial inheritance, namely, the loss of white property and proximity to whiteness. (shrink)

I argue that, if it is thought desirable to avoid the collapse of disability into generic social disadvantage, it is necessary to draw a distinction between impairment (a bodily configuration) and disability (the way in which the environment prevents someone with an impairment from undertaking certain kinds of activities), as in social models of disability. I show how to draw such a distinction by utilizing a distinction between intrinsic and extrinsic properties. I argue further that, using this distinction, it is (...) possible to define ‘impairment’ in ways that do not appeal to notions of the normal, and to define ‘disability’ in terms of ‘impairment.’. (shrink)

Continuing tensions exist between mainstream bioethics and advocates of the disability rights movement. This paper explores some of the grounds for those tensions as exemplified in From Chance to Choice: Genetics and Justice by Allen Buchanan and coauthors, a book by four prominent bioethicists that is critical of the disability rights movement. One set of factors involves the nature of disability and impairment. A second set involves presumptions regarding social values, including the importance of intelligence in relation to other human (...) characteristics, competition as the basis of social organization, and the nature of the parent–child relationship. The authors’ disapproval of certain aspects of the disability rights movement can be seen to be associated with particular positions regarding these factors. Although the authors intend to use a method of ‘broad reflective equilibrium,’ we argue that their idiosyncratic commitment to particular concepts of disability and particular social values produces a narrowing of the moral significance of their conclusions regarding disability rights. (shrink)