John Rawls’s use of the “fully cooperating assumption” has been criticized for hindering attempts to address the needs of disabled individuals, or non-cooperators. In response, philosophers sympathetic to Rawls’s project have extended his theory. I assess one such extension by Cynthia Stark, that proposes dropping Rawls’s assumption in the constitutional stage (of his four-stage sequence), and address the needs of non-cooperators via the social minimum. I defend Stark’s proposal against criticisms by Sophia Wong, Christie Hartley, and Elizabeth Edenberg and Marilyn (...) Friedman. Nevertheless, I argue that Stark’s proposal is crucially incomplete. Her formulation of the social minimum lacks accompanying criteria with which the adequacy of the provisions for non-cooperators may be assessed. Despite initial appearances, Stark’s proposal does not fully address the needs of non-cooperators. I conclude by considering two payoffs of identifying this lack of criteria. (shrink)

Societal aging raises challenging ethical questions regarding the just distribution of health care between young and old. This article considers a proposal for age-based rationing of health care, which is based on the prudential life span account of justice between age groups. While important objections have been raised against the prudential life span account, it continues to dominate scholarly debates. This article introduces a new objection, one that develops out of the well-established disability critique of social contract theories. I show (...) the implications of this critique for the prudential life span account and for the special case of age-group justice. The result is that age-based rationing based on the prudential life span approach is not supported, and that the prudential life span approach itself is not the best way to think about allocating health care between age groups. I propose an alternative approach that avoids the disability objection, and consider its implications for specific proposals for age-based rationing of health care. (shrink)

A society is said to age when its number of older members increases in relation to its number of younger members. The societies in most of the world’s industrialized nations have been aging since at least 1800. In 1800 the demographic makeup of developed countries was similar to that of many Third World countries in the early 1990s with roughly half the population under the age of 16 and very few people living beyond age of 60. Since that time, increases (...) in life expectancy, combined with declines in fertility rates, have dramatically increased the proportion of older persons in developed nations. The rapid increase in the number of older persons relative to younger ones carries important societal implications. In the domain of healthcare, societal aging will increase costs and exert greater pressure to ration services. It will, thus, bring to the fore questions, regarding a just distribution of healthcare between young and old age groups. This paper considers some of the most influential arguments to date for age-based rationing of health care. I show that these arguments fall short, and that the theoretical assumptions underlying them do not withstand careful scrutiny. (shrink)

Historically, philosophers have had little to say about justice and disability. However, in recent years and in response to disability rights movements, philosophers have started to consider the claims to justice of persons with mental and physical impairments. Importantly, some have charged that without extensive revision, social contract accounts of justice – which enjoy immense popularity among political philosophers – cannot address the needs and interests of persons with disabilities. In this article, I explain why social contract accounts are thought (...) to flounder when it comes to justice for persons with disabilities. Then I assess the merits of recent attempts to construct theories of justice inclusive of persons with disabilities. In particular, I consider Nussbaum’s capabilities approach, Kittay’s justice as caring, and various restatements of the social contract. (shrink)

Using birth stories as our object of inquiry, this article examines the ways in which normative discourses about gender, disability and Down syndrome construct the birth stories of three mothers of children with Down syndrome. Their stories are composed of the mothers’ recollections of the first hours after birth as a time when their infants are separated from them and their postpartum needs are ignored. Together, their stories illustrate socio-cultural tropes that position Down syndrome as a dangerous form of the (...) “other” and mothers who give birth to children with Down syndrome as implicated in transgressing cultural norms. (shrink)

This paper presents a new way of thinking about the relationship between humans and the nonhuman animals in their care. Most ethical analysis of the treatment of nonhuman animals has focussed on questions of moral status, justice, and the wrongness of harming them. This paper does something different, it examines the role played by trust in interspecies relationships. In both agriculture and laboratory settings, humans deliberately foster trusting relationships with nonhuman animals. An intrinsic feature of the trusting relationship in these (...) settings is that it is created in order to be exploited and betrayed. However, little consideration has been given to asking what a deliberate betrayal of another species says about the character of those who carry out the betrayals. This paper argues that regardless of the moral status of nonhuman animals, a willingness to foster trust in order to exploit the vulnerability of a nonhuman suggests a serious character flaw. Our failure thus far to apprehend systematic forms of betrayal indicates a moral blind-spot when it comes to other species. (shrink)

A brain-computer interface technology that can decode the neural signals associated with attempted but unarticulated speech could offer a future efficient means of communication for people with severe motor impairments. Recent demonstrations have validated this approach. Here we assume that it will be possible in future to decode imagined (i.e., attempted but unarticulated) speech in people with severe motor impairments, and we consider the characteristics that could maximize the social utility of a BCI for communication. As a social interaction, communication (...) involves the needs and goals of both speaker and listener, particularly in contexts that have significant potential consequences. We explore three high-consequence legal situations in which neurally-decoded speech could have implications:Testimony, where decoded speech is used as evidence;Consent and Capacity, where it may be used as a means of agency and participation such as consent to medical treatment; andHarm, where such communications may be networked or may cause harm to others. We then illustrate how design choices might impact the social and legal acceptability of these technologies. (shrink)

This essay explores various roles that philosophers occupy in relation to intellectual disability. In examining how philosophers define their object of inquiry as experts and gatekeepers, it raises critical questions concerning the nature of philosophical discourse about intellectual disability. It then goes on to consider three alternate positions, the advocate or friend, the animal, and the “intellectually disabled,” each of which points to new ways of philosophizing in the face of intellectual disability.

In this article I defend the capability approach by focusing on its built-in gender-sensitivity and on its concern with comprehensive outcomes and informationally-rich evaluation of well-being, two elements of Sen's work that are too rarely put together. I then try to show what the capability approach would have to gain by focusing on trans-positional objectivity (as Elizabeth Anderson does) and by leaving behind the narrow confines of states in favor of a more cosmopolitan stance. These preliminary discussions are followed by (...) two more precise applications. At first, I show how a gender-sensitive capability approach that respects the criteria of trans-positional objectivity and cosmopolitanism can enhance the agency of women inhabiting third-world societies. I turn next to show how mainstream feminism can insulate itself against criticisms such as bell hooks' by switching to trans-positional objectivity in public reasoning. (shrink)

This thesis focuses on what I call the question of exclusion. This question, I argue, is one that poses serious challenges to social contract approaches to justice and political legitimacy. In an intuitive way, the exclusion of some individuals seems to be a corollary of the social contractualist approach, which ascribes justice or legitimacy to a social arrangement insofar as it can be regarded as the product of the (actual – expressed or tacit – or hypothetical) consent of specified parties. (...) Consequently, this approach excludes those whose consent is not required in order to view an arrangement as legitimate or just. Given the enormous and continuing influence of John Rawls’s social contract theory, I take the Rawlsian view as my primary focus, concentrating on the way in which the question of exclusion raises challenges for Rawlsian contractualism. According to Rawls’s theory, those who participate in the hypothetical contract and to whom political power ought to be justifiable are reasonable and rational. They are reasonable in the sense that they understand and are willing to comply with the requirements of justice and they are rational in that they have the capacity to form, revise, and pursue a conception of the good. This gives rise to two categories of exclusion. In the first part of the thesis, I examine the exclusion of those who will develop the two moral powers sufficiently only if those who are represented in the social contract act (or refrain from acting) in certain ways. This category includes children, foetuses, and unreasonable citizens. Intuitively, justice issues in requirements in at least some of these cases, but it is hard to make sense of this on the Rawlsian approach. In the second part of the thesis, I address the question of exclusion regarding those who will never develop the two moral powers to the requisite degree, such as individuals with severe cognitive disabilities and non-human animals. Again, intuitively, justice issues in requirements here, but their justification is not clear on the contractualist approach. My conclusion is threefold. First, I argue that the problems the question of exclusion poses cannot be addressed by a single solution. Second, I safeguard Rawlsian contractualism by showing how each problem can be resolved. Third, I offer policy-prescriptions on a number of issues, such as education, abortion, and the criminal justice system. (shrink)

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)