It is suggested that the practice of attempting to normalise children with Down 's syndrome by subjecting them to major facial plastic surgery has no therapeutic benefit, and should be seen as mutilating surgery comparable to female circumcision.

Is there such a thing as a social conception of disability? Recently two writers in this journal have suggested not only that there is a coherent social conception of disability but that all non-social conceptions, or “medical models” of disability are fatally flawed. One serious and worrying dimension of their claims is that once the social dimensions of disability have been resolved no seriously “disabling” features remain. This paper examines and rejects conceptions of disability based on social factors but notes (...) that physical and mental conditions which disadvantage the individual have social dimensions. (shrink)

Many practical issues in medical ethics depend on an understanding of the concept of health. The main question is whether it is a purely descriptive or a partly evaluative or normative concept. After posing some puzzles about the concept, the views of C Boorse, who thinks it is descriptive, are discussed and difficulties are found for them. An evaluative treatment is then suggested, and used to shed light on some problems about mental illness and to compare and contrast it with (...) physical illness and with political and other deviancies which are not illnesses. (shrink)