Several studies have shown that nondisabled people—especially healthcare professionals—tend to judge the quality of life of disabled people to be much lower than disabled people themselves report. In part, this is due to dominant narratives about disability. Teachers of biomedical ethics courses have the opportunity to help students to think critically about disability. This may involve interrogating our own assumptions, given the pervasiveness of ableism. This article is intended to facilitate reflection on narratives about disability. After discussing two readings that (...) illustrate the medical and social models of disability, I share my own approach to teaching on disability in my biomedical ethics course. I include student responses to the readings and ways that they report their thinking about disability changed through engagement with the medical and social models. (shrink)

We need a feminist theory of disability, both because 16 percent of women are disabled, and because the oppression of disabled people is closely linked to the cultural oppression of the body. Disability is not a biological given; like gender, it is socially constructed from biologically reality. Our culture idealizes the body and demands that we control it. Thus, although most people will be disabled at some time in their lives, the disabled are made "the other," who symbolize failure of (...) control and the threat of pain, limitation, dependency, and death. If disabled people and their knowledge were fully integrated into society, everyone's relation to her/his real body would be liberated. (shrink)

In this paper I reflect upon my personal experience of chronic progressive multiple sclerosis in order to provide a phenomenological account of the human experience of disability. In particular, I argue that the phenomenological notion of lived body provides important insights into the profound disruptions of space and time that are an integral element of changed physical capacities such as loss of mobility. In addition, phenomenology discloses the emotional dimension of physical disorder. The lived body disruption engendered by loss of (...) mobility includes a change in the character of surrounding space, an alteration in one's taken-for-granted awareness of objects, the disruption of corporeal identity, a disturbance in one's relations with others, and a change in the character of temporal experience. The loss of upright posture is of particular significance since it not only concretely diminishes autonomy but affects the way one is treated by others. Such a change in posture is, therefore, particularly disruptive in the social world of everyday life. An understanding of the lived body disruption engendered by disability has important applications for the clinical context in devising effective therapies, as well as for the social arena in determining how best to resolve the various challenges posed by chronic disabling disorders. (shrink)

It surely would lighten the tasks of feminism tremendously if we could cut to the quick of women's lives by focusing on some essential "woman- ness." However, though all women are women, no woman is only a woman. Those of us who have  ...

Liberalism welcomes diversity in substantive ideas of the good but not in the process whereby these ideas are formed. Ideas of the good acquire weight on the presumption that each is a person's own, formed independently. But people differ in their capacities to conceptualize. Some, appropriately characterized as cerebral, are proficient in and profoundly involved with conceptualizing. Others, labeled cognitively disabled, range from individuals with mild limitations to those so unable to express themselves that we cannot be sure whether their (...) behavior is mediated by concepts at all. Constricted cognitive capacities have been thought to prevent participation in the prescribed process for forming personalized ideas of the good. So liberal theory, when formulating principles and practices of justice, often disregards cognitively disabled peoples' perspectives. We put aside metaphysically driven notions about personhood and show how interpersonal processes of “prosthetic” thinking (different from surrogacy) can satisfy liberalism's standards, positioning cognitively disabled individuals as fully participating subjects of justice. (shrink)

Disagreement about the properattitude toward disability proliferates. Yetlittle attention has been paid to an importantmeta-question, namely, whether ``disability'' isan essentially contested concept. If so, recentdebates between bioethicists and the disabilitymovement leadership cannot be resolved. Inthis essay I identify some of the presumptionsthat make their encounters so contentious. Much more must happen, I argue, for anydiscussions about disability policy andpolitics to be productive. Progress depends onconstructing a neutral conception ofdisability, one that neither devaluesdisability nor implies that persons withdisabilities are inadequate. So, (...) first, I clearaway the conceptual underbrush that makes usthink our idea of disability must bevalue-laden. Second, I sketch someconstituents of, and constraints upon, aneutral notion of disability. (shrink)

(2001). A Neutral Ethical Framework for Understanding the Role of Disability in the Life Cycle. The American Journal of Bioethics: Vol. 1, No. 3, pp. 57-58.

This paper charts the concepts of grip and the bodily auxiliary in Maurice Merleau-Ponty to consider how they find expression in disability narratives. Arguing against the notion of “maximal grip” that some commentators have used to explicate intentionality in Merleau-Ponty, I argue that grip in his texts functions instead as a compensatory effort to stave off uncertainty, lack of mastery, and ambiguity. Nearly without exception in Phenomenology of Perception, the mobilization of “grip” is a signal of impending loss, and is (...) offered as a strategy for managing failure rather than as an example of sure-footed mastery. I read Merleau-Ponty alongside Mary Felstiner's Out of Joint: A Public and Private Story of Arthritis to explore these other, attenuated dimensions of grip. Finally, the paper turns to Harriet McBryde Johnson's memoir Too Late to Die Young as an example of a way of thinking disabled embodiment otherwise. (shrink)

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)

Drawing upon feminist, queer, and crip phenomenology, this essay argues that the distinct temporality of the lived, stuttering body disturbs the normalized “choreography” of communication and thereby threatens the disabled speaker's recognition as a speaking subject. Examined through the phenomenology of Maurice Merleau-Ponty and Alfred Schutz, the disabled speaking body is temporally “out of step” with the normalized bodily rhythms and pace of communicative practices in relation to both lived and objective time. Disciplined for his incalculable and therefore irrational bodily (...) choreography, the disabled speaker is foregrounded against an objective, instrumentally ordered world constituted by a disembodied and hegemonic “straight-masculine” time. Although dominant communicative choreographies may often be unlivable for disabled speakers, cripping communicative time rejects the cardinal value of futurity and invites interlocutors to gather in a noninstrumentalized and nonproductive present. This reshaping of communicative space enacts new modes of relationality and opens up an array of communicative futures suppressed or cut off by straight-masculine time. (shrink)

: The effects of head injury, even mild traumatic brain injury, are wide-ranging and profound. Persons with adult-onset head injury offer feminist philosophers important perspectives for philosophical methodology and philosophical research concerning personal identity, mind-body theories, and ethics. The needs of persons with head injury require the expansion of typical teaching strategies, and such adaptations appear beneficial to both disabled and non-disabled students.

The effects of head injury, even mild traumatic brain injury, are wide-ranging and profound. Persons with adult-onset head injury offer feminist philosophers important perspectives for philosophical methodology and philosophical research concerning personal identity, mind-body theories, and ethics. The needs of persons with head injury require the expansion of typical teaching strategies, and such adaptations appear beneficial to both disabled and non-disabled students.

In this article I examine the proposition that severe cognitive disability is an impediment to moral personhood. Moral personhood, as I understand it here, is articulated in the work of Jeff McMahan as that which confers a special moral status on a person. I rehearse the metaphysical arguments about the nature of personhood that ground McMahan’s claims regarding the moral status of the “congenitally severely mentally retarded” (CSMR for short). These claims, I argue, rest on the view that only intrinsic (...) psychological capacities are relevant to moral personhood: that is, that relational properties are generally not relevant. In addition, McMahan depends on an argument that species membership is irrelevant for moral consideration and a contention that privileging species membership is equivalent to a virulent nationalism (these will be discussed below). In consequence, the CSMR are excluded from moral personhood and their deaths are less significant as their killing is less wrong than that of persons. To throw doubt on McMahan’s conclusions about the moral status and wrongness of killing the CSMR I question the exclusive use of intrinsic properties in the metaphysics of personhood, the dismissal of the moral importance of species membership, and the example of virulent nationalism as an apt analogy. I also have a lot to say about McMahan’s empirical assumptions about the CSMR. (shrink)

In this article I examine the proposition that severe cognitive disability is an impediment to moral personhood. Moral personhood, as I understand it here, is articulated in the work of Jeff McMahan as that which confers a special moral status on a person. I rehearse the metaphysical arguments about the nature of personhood that ground McMahan’s claims regarding the moral status of the “congenitally severely mentally retarded” (CSMR for short). These claims, I argue, rest on the view that only intrinsic (...) psychological capacities are relevant to moral personhood: that is, that relational properties are generally not relevant. In addition, McMahan depends on an argument that species membership is irrelevant for moral consideration and a contention that privileging species membership is equivalent to a virulent nationalism (these will be discussed below). In consequence, the CSMR are excluded from moral personhood and their deaths are less significant as their killing is less wrong than that of persons. To throw doubt on McMahan’s conclusions about the moral status and wrongness of killing the CSMR I question the exclusive use of intrinsic properties in the metaphysics of personhood, the dismissal of the moral importance of species membership, and the example of virulent nationalism as an apt analogy. I also have a lot to say about McMahan’s empirical assumptions about the CSMR. (shrink)

In a critical intervention into the bioethics debate over human enhancement, philosopher Melinda Hall tackles the claim that the expansion and development of human capacities is a moral obligation. Hall draws on French philosopher Michel Foucault to reveal and challenge the ways disability is central to the conversation. The Bioethics of Enhancement includes a close reading and analysis of the last century of enhancement thinking and contemporary transhumanist thinkers, the strongest promoters of the obligation to pursue enhancement technology. With specific (...) attention to the work of bioethicists Nick Bostrom and Julian Savulescu, the book challenges the rhetoric and strategies of enhancement thinking. These include the desire to transcend the body and decide who should live in future generations through emerging technologies such as genetic selection. Hall provides new analyses rethinking both the philosophy of enhancement and disability, arguing that enhancement should be a matter of social and political interventions, not genetic and biological interventions. Hall concludes that human vulnerability and difference should be cherished rather than extinguished. -/- This book will be of interest to academics working in bioethics and disability studies, along with those working in Continental philosophy (especially on Foucault). (shrink)

Disability rights activists often claim that disability is not—by itself—something that makes disabled people worse off. A popular objection to such a view of disability is this: were it correct, it would make it permissible to cause disability and impermissible to cause nondisability. The aim of this article is to show that these twin objections don’t succeed.

In recent decades in North American social and moral philosophy, alongside the development and discussion of widely influential theories of justice, taken as Rawls takes it as the ‘first virtue of social institutions,’ there has been a counter-movement gathering strength, one coming from some interesting sources. For some of the most outspoken of the diverse group who have in a variety of ways been challenging the assumed supremacy of justice among the moral and social virtues are members of those sections (...) of society whom one might have expected to be especially aware of the supreme importance of justice, namely blacks and women. Those who have only recently won recognition of their equal rights, who have only recently seen the correction or partial correction of long-standing racist and sexist injustices to their race and sex, are among the philosophers now suggesting that justice is only one virtue among many, and one that may need the presence of the others in order to deliver its own undenied value. Among these philosophers of the philosophical counterculture, as it were - but an increasingly large counterculture - I include Alasdair MacIntyre, Michael Stocker, Lawrence Blum, Michael Slote, Laurence Thomas, Claudia Card, Alison Jaggar, Susan Wolf and a whole group of men and women, myself included, who have been influenced by the writings of Harvard educational psychologist Carol Gilligan, whose book In a Different Voice caused a considerable stir both in the popular press and, more slowly, in the philosophical journals. (shrink)

In recent decades in North American social and moral philosophy, alongside the development and discussion of widely influential theories of justice, taken as Rawls takes it as the ‘first virtue of social institutions,’ there has been a counter-movement gathering strength, one coming from some interesting sources. For some of the most outspoken of the diverse group who have in a variety of ways been challenging the assumed supremacy of justice among the moral and social virtues are members of those sections (...) of society whom one might have expected to be especially aware of the supreme importance of justice, namely blacks and women. Those who have only recently won recognition of their equal rights, who have only recently seen the correction or partial correction of long-standing racist and sexist injustices to their race and sex, are among the philosophers now suggesting that justice is only one virtue among many, and one that may need the presence of the others in order to deliver its own undenied value. Among these philosophers of the philosophical counterculture, as it were - but an increasingly large counterculture - I include Alasdair MacIntyre, Michael Stocker, Lawrence Blum, Michael Slote, Laurence Thomas, Claudia Card, Alison Jaggar, Susan Wolf and a whole group of men and women, myself included, who have been influenced by the writings of Harvard educational psychologist Carol Gilligan, whose book In a Different Voice caused a considerable stir both in the popular press and, more slowly, in the philosophical journals. (shrink)

by MICHEL FOUCAULT Everyone knows that in France there are few logicians but many historians of science; and that in the 'philosophical establishment' - whether teaching or research oriented - they have occupied a considerable position. But do we know precisely the importance that, in the course of these past fifteen or twenty years, up to the very frontiers of the establishment, a 'work' like that of Georges Canguilhem can have had for those very people who were separ ated from, (...) or challenged, the establishment? Yes, I know, there have been noisier theatres: psychoanalysis, Marxism, linguistics, ethnology. But let us not forget this fact which depends, as you will, on the sociology of French intellectual environments, the functioning of our university institutions or our system of cultural values: in all the political or scientific discussions of these strange sixty years past, the role of the 'philosophers' - I simply mean those who had received their university training in philosophy department- has been important: perhaps too important for the liking of certain people. And, directly or indirectly, all or almost all these philosophers have had to 'come to terms with' the teaching and books of Georges Canguilhem. From this, a paradox: this man, whose work is austere, intentionally and carefully limited to a particular domain in the history of science, which in any case does not pass for a spectacular discipline, has somehow found him self present in discussions where he himself took care never to figure. (shrink)

In a challenge to current thinking about cognitive impairment, this book explores what it means to treat people with intellectual disabilities in an ethical manner.

Where society is viewed as an association of equal and autonomous persons, the work of caring for dependents, "love's labors", figure neither in political ...

Through a series of essays contributed by clinicians, medical historians, and prominent moral philosophers, Cognitive Disability and Its Challenge to Moral ...