Much of the existing philosophical literature on BDSM focuses on questions about the ethics of BDSM. But there is an underlying question here regarding the nature of BDSM, one which remains largely unaddressed. In this paper, I take that metaphysical question to be prior to the normative one. In other words: it will be important to have a clear view of what BDSM is before we go on to evaluate it. -/- This is a paper about the nature of BDSM (...) and BDSM activities: what they are like, what makes them unique, and the ways in which these activities might be valuable. Here, I work from the philosophical literature on games to analyze structured erotic encounters (or “scenes”) in BDSM. In the first half of the paper, I argue that BDSM scenes are games, and that understanding them in this way yields important insights into the roles of agency, autonomy, and value in BDSM. In the second half of the paper, I map points of connection between this view of scenes-as-games and the existing literature on BDSM in sexual ethics, in order to illuminate the ways in which a moral evaluation of BDSM scenes might proceed from this analysis. (shrink)

In this paper, I argue that the concept of normality in medical research and clinical practice is inextricable from the concept of ambiguity. I make this argument in the context of Edmund Pellegrino's call for a renewed reflection on medicine’s basic concepts and by drawing on work in critical disability studies concerning Deafness and body integrity identity disorder. If medical practitioners and philosophers of medicine wish to improve their understanding of the meaning of medicine as well as its concrete practice, (...) I contend that they should take seriously the import and centrality of ambiguity for biomedicine. (shrink)

: The idea of enhancing our mental functions through medical means makes many people uncomfortable. People have a vague feeling that altering our brains tinkers with the core of our personalities and the core of ourselves. It changes who we are, and doing so seems wrong, even if the exact reasons for the unease are difficult to define. Many of the standard arguments against neuroenhancements—that they are unsafe, that they violate the distinction between therapy and enhancements, that they undermine equality, (...) and that they will be used coercively—fail to show why the use of any such technologies is wrong in principle. Two other objections—the arguments that such changes undermine our integrity and that they prevent us from living authentic lives—will condemn only a few of the uses that are proposed. The result is that very few uses of these drugs are morally suspect and that most uses are morally permissible. (shrink)

Responding to Danaher et al. on self-tracking technologies, I argue that human lived experience is becoming increasingly mediated by generalized, statistical information, which I term our "infotality." Drawing on the work of Foucault, I argue that infotality is historically novel and best understood as the product of biopolitics, healthism, and informatics. I then critique the authors' "stance of cautious openness,” which misunderstands the aims of the technology in question and the fundamental ambiguity of the role information plays in the achievement (...) of human wellbeing. Self-tracking technologies are not primarily designed to change behavior; they are designed to create and sustain the desire for their use. I conclude by suggesting that infotality names a new way to fall for an old ruse: the promise that more information means more wellbeing. (shrink)

In "Frailty Triage: Is Rationing Intensive Medical Treatment on the Grounds of Frailty Ethical?," Wilkinson (2021) argues that the use of frailty scores in ICU triage does not necessarily involve discrimination on the basis of disability. In support of this argument, he claims, “it is not the disability per se that the score is measuring – rather it is the underlying physiological and physical vulnerability." While we appreciate the attention Wilkinson explicitly pays to disability in this piece, we find the (...) distinction between disability and underlying vulnerability untenable both theoretically and practically. In this peer commentary, we begin with a brief overview of research in philosophy of disability concerning the meaning of the concept itself. We argue that this research demonstrates that many forms of disability do not involve underlying vulnerabilities, and, furthermore, that Wilkinson equivocates between "disability" understood as a medical category vs. "disability" understood as a feature of lived experience. We reject Wilkinson’s distinction on these grounds and offer further considerations to avoid disability discrimination in emergency and crisis standards of care contexts. (shrink)

Adequate epistemic justification is best conceived as the appearance, over time, of knowledge to the subject. ‘Appearance’ is intended literally, not as a synonym for belief. It is argued through consideration of examples that this account gets the extension of ‘adequately justified belief’ at least roughly correct. A more theoretical reason is then offered to regard justification as the appearance of knowledge: If we have a knowledge norm for assertion, we do our best to comply with this norm when we (...) express as assertions only beliefs that appear to us to be knowledge. If we are doing our best, there is little point in further sanctions. So a norm of knowledge for assertion would lead to a secondary norm of justified belief as the appearance of knowledge, marking a point at which our assertions may be corrected but should not be blamed. (shrink)

Liberals often assume that once people see the costs of intolerance that they will come to embrace toleration and that once they can accept toleration as a modus vivendi, they will soon be able to see it as a good in its own right. But, I argue, that the logic that make in tolerance difficult to break also compel people to resist any attempts to make toleration more than a modus vivendi. True toleration will not be embraced unless the people (...) undergo a kind of conversion experience. (shrink)

In the world according to Hume, people are complicated creatures, with convoluted, often contradictory characters. Consider, for example, Hume's controversial assessment of Charles I: "The character of this prince, as that of most men, if not of all men, was mixed .... To consider him in the most favourable light, it may be affirmed, that his dignity was free from pride, his humanity from weakness, his bravery from rashness, his temperance from austerity, his frugality from avarice .... To speak the (...) most harshly of him, we may affirm, that many of his good qualities were attended with some latent frailty, which, though seemingly inconsiderable, was able, when seconded by the extreme malevolence of his fortune, to disappoint them of all their influence: His beneficent disposition was clouded by a manner not very gracious; his virtue was tinctured with superstition; his good sense was disfigured by a deference to persons of a capacity inferior to his own; and his moderate temper exempted him not from hasty and precipitate resolutions." This sketch shows Charles in all his complexities, with his virtues, near virtues, and contradicting virtues. I have quoted it at length because it is hard to summarize without losing the subtleties that lie within it. Hume's moral theory is based fundamentally on judgments of character, 2 so those subtleties are important to his view. The character sketches that pervade the.. (shrink)

Public health is concerned with increasing the health of the community at whole. Insofar as health is a ‘good’ and the community constitutes a ‘public’, public health by definition promotes a ‘public good’. But ‘public good’ has a particular and much more narrow meaning in the economics literature, and some commentators have tried to limit the scope of public health to this more narrow meaning of a ‘public good’. While such a move makes the content of public health less controversial, (...) it also strips important goals from the realm of public health, goals that traditionally have been, and morally should be, a part of it. Instead, I will argue, while public health should be defined by public goods, it should be defined by a broader conception of public goods that I shall call ‘normative public goods’, goods that ought to be treated as if they were public goods in the more narrow sense. (shrink)

Introductory and advanced textbooks in bioethics focus almost entirely on issues that disproportionately affect disabled people and that centrally deal with becoming or being disabled. However, such textbooks typically omit critical philosophical reflection on disability, lack engagement with decades of empirical and theoretical scholarship spanning the social sciences and humanities in the multidisciplinary field of disability studies, and avoid serious consideration of the history of disability activism in shaping social, legal, political, and medical understandings of disability over the last fifty (...) years. For example, longstanding discussions on topics such as euthanasia, physician aid-in-dying, pre-implantation genetic diagnosis, prenatal testing, selective abortion, enhancement, patient autonomy, beneficence, non-maleficence, and health care rationing all tend to be premised on shared and implicit assumptions regarding disability, especially in relation to quality of life, yet with too little recognition of the way that “disability” is itself a topic of substantial research and scholarly disagreement across multiple fields. This is not merely a concern for academic and medical education; as an applied field tied to one of the largest economic sectors of most industrialized nations, bioethics has a direct impact on healthcare education, practice, policy, and, thereby, the health outcomes of existing and future populations. It is in light of these pressing issues that the Disability Bioethics Reader is the first reader to introduce students to core bioethical issues and concepts through the lens of critical disability studies and philosophy of disability. The Disability Bioethics Reader will include over thirty-five chapters covering key areas such as: critical histories and state-of-the-field analyses of modern medicine, bioethics, disability studies, and philosophy of medicine; methods in bioethics; concerns at the edge- and end-of-life; enhancement; disability, quality of life, and well-being; prenatal testing and abortion; invisible disabilities; chronic illness; healthcare justice; genetics and genomics; intellectual disability and neurodiversity; ethics and diagnosis; and epistemic injustice in healthcare. (shrink)

advanced directivesend-of-life decisionsharming the deadposthumous reproductiontransplant ethics.

This paper will seek firstly to understand Deleuze’s main challenges to phenomenology, particularly as they are expressed in The Logic of Sense and What is Philosophy?, although reference will also be made to Pure Immanence and Difference and Repetition. We will then turn to a discussion of one of the few passages in which Deleuze directly engages with Merleau-Ponty, which occurs in the chapter on art in What is Philosophy? In this text, he and Guattari offer a critique of what (...) they call the “final avatar” of phenomenology – that is, the “fleshism” that Merleau-Ponty proposes in his unfinished but justly famous work, The Visible and the Invisible. It will be argued that both Deleuze’s basic criticisms of phenomenology, as well as he and Guattari’s problems with the concept of the flesh, do not adequately come to grips with Merleau-Ponty’s later philosophy. Merleau-Ponty is not obviously partisan to what Deleuze finds problematic in this tradition, despite continuing to identify himself as a phenomenologist, and is working within a surprisingly similar framework in certain key respects. In fact, in the more positive part of this paper, we will compare Merleau-Ponty’s notion of flesh, and Deleuze’s equally infamous univocity of being, as a means to consider the broader question of the ways in which the two philosophers consider ontological thought, its meaning and its conditions. It is our belief that through properly understanding both positions, a rapprochement, or at least the foundation for one, can be established between these two important thinkers. (shrink)

This paper argues that epistemic errors rooted in group- or identity- based biases, especially those pertaining to disability, are undertheorized in the literature on medical error. After sketching dominant taxonomies of medical error, we turn to the field of social epistemology to understand the role that epistemic schemas play in contributing to medical errors that disproportionately affect patients from marginalized social groups. We examine the effects of this unequal distribution through a detailed case study of ableism. There are four primary (...) mechanisms through which the epistemic schema of ableism distorts communication between nondisabled physicians and disabled patients: testimonial injustice, epistemic overconfidence, epistemic erasure, and epistemic derailing. Measures against epistemic injustices in general and against schema-based medical errors in particular are ultimately issues of justice that must be better addressed at all levels of health care practice. (shrink)

David Hume is an ardent supporter of the practice of religions toleration. For Hume, toleration forms part of the background that makes progress in philosophy possible, and it accounts for the superiority of philosophical thought in England in the eighteenth century. As he puts it in the introduction to the Treatise: “the improvements in reason and philosophy can only be owing to a land of toleration and of liberty”. Similarly, the narrator of part 11 of the First Enquiry comments.

Burke suggests that we should view society as a partnership between the past, the present, and the future. I defend this idea by outlining how we can understand the interests of the past and future people and the obligations that they have towards each other. I argue that we have forward-looking obligations to leave the world a decent place, and backward-looking obligations to respect the legacy of the past. The latter obligation requires an understanding of the role that traditions and (...) meta-traditions should (and should not) play in tying together societies—especially national societies—over time. (shrink)

After a long search, Jonathan has finally found someone willing to donate a kidney to him and thereby free him from dialysis. Meredith is Jonathan's second cousin, and she considers herself a generous person, so although she barely knows Jonathan, she is willing to help. However, as Meredith learns more about the donation process, she begins to ask questions about Jonathan: “Is he HIV positive? I heard he got it using drugs. Has he been in jail? He's already had one (...) live donor, so what happened to the first kidney? Did he forget to take his drugs or something?” The transplant center must, then, decide if Meredith is, in fact, entitled to answers to these kinds of questions. According to the Consensus Statement on the Live Organ Donor, “It is incumbent on the transplant center to provide full and accurate disclosure to potential donors of all pertinent information regarding risk and benefit to the donor and recipient.” But whether answers to the Meredith's questions count as “pertinent information regarding the risk and benefit” is the issue at hand. (shrink)

In this paper, we highlight some problems for accounts of disability and enhancement that have not been sufficiently addressed in the literature. The reason, we contend, is that contemporary debates that seek to define, characterise or explain the normative valence of disability and enhancement do not pay sufficient attention to a wide range of cases, and the transition between one state and another. In section one, we provide seven cases that might count as disability or enhancement. We explain why each (...) case might count, and on what basis, and why it is been neglected. Each case is explained as a transition in what we call capacity space. We then argue that no definition of disability or enhancement addresses all of these cases, except for strict welfarist accounts of disability that do not rely on a depiction of any particular capacity. We argue further, however, that this is a serious deficiency of welfarist conceptions of disability. We then address objections to our account. (shrink)

This essay considers the catastrophe of anthropogenic climate change in relation to two possible critical-theoretic dispositions. The first, represented by an emblematic passage from Adorno, retains the hope for the realization of a “rational society.” The second, represented by a complementary passage from Foucault, enjoins critical theory to abandon any ambition toward criticizing or transforming society at a totalizing level. We argue that the unfolding climate catastrophe demands a conception of critical theory more in line with the first disposition, and (...) that the relevance of the skeptical disposition is likewise seriously undermined if climate change is taken into account. (shrink)

The Life Worth Living investigates the exclusion of and discrimination against disabled people across the history of Western moral philosophy. Building on decades of activism and scholarship, Reynolds shows how longstanding views of disability are misguided and unjust, and he lays out a vision for an anti-ableist moral future. The introduction and first chapter are available to download here. -/- Table of Contents: Introduction: The Ableist Conflation. Part I: Pain. 1. Theories of Pain. 2. A Phenomenology of Chronic Pain. (...) Part II: Disability. 3. Theories of Disability. 4. A Phenomenology of Multiple Sclerosis. Part III: Ability. 5. Theories of Ability. 6. A Phenomenology of Ability. Conclusion: An Anti-Ableist Future. (shrink)

In recent years, multiple authors have voiced discontent with the theoretical and practical neglect of the concept of ability. This includes, but is not limited to, philosophers of disability who have long assailed the implausible accounts of ability utilized by most social and political philosophers. Historically, most philosophers took it for granted that the meaning of ability will come easily, or is even a given, when higher-order questions are addressed. The aim of this chapter is to animate discussions about ability (...) trouble, which is to say, to animate (i) concern over the lack of philosophical inquiry that takes the concept of ability seriously as a problem in its own right and to animate (ii) novel interest in and further research on the concept of ability—and, correlatively, disability. We first analyze a famous argument concerning moral status that exemplifies how treating the concept of ability as a mere matter of common sense can lead philosophical inquiry awry. We then turn to the role of the concept of ability in an account that does, at least prima facie, take the concept seriously: Sen and Nussbaum’s capabilities approach. While better than common-sense approaches, we draw a cautionary tale, suggesting that even there the concept is simplified in theoretically and practically problematic ways. We conclude with a number of open questions offered in the hope of inspiring future non-ideal research on the topic. (shrink)

This paper studies the conflict between critical rationalism and critical theory in Karl Popper and Theodor Adorno’s 1961 debate by analyzing their shared rejection of Karl Mannheim’s sociology of knowledge. Despite the divergences in their respective projects of critical social research, Popper and Adorno agree that Mannheim’s sociology of knowledge is uncritical. By investigating their respective assessments of this research program I reveal a deeper similarity between critical rationalism and critical theory. Though both agree on the importance of critique, they (...) are less concerned with the development of critical consciousness as a focus of this project. In this way, Mannheim’s sociology of knowledge, particularly in its formative stages, revolves around a set of problems relatively inaccessible to critical rationalism and critical theory, since it is centrally concerned with identifying and cultivating the possibility of critique in society. In closing, I gesture to the importance of political education in Mannheim’s early work, suggesting that a return to these experimental texts will yield resources for political thought today. (shrink)

Insofar as many older adults fit some definition of disability, disability studies and gerontology would seem to have common interests and goals. However, there has been little discussion between these fields. The aim of this paper is to open up the insights of disability studies as well as philosophy of disability to discussions in gerontology. In doing so, I hope to contribute to thinking about the good life in late life by more critically reflecting upon the meaning of the body, (...) ability, and the variability of each. My central argument is that we should conceptualize age‐associated bodily variations and abilities not in terms of individual capacity, but in terms of what I call “the extended body.” It is in light of the meaning of embodiment and ability in general that we must think differently and more capaciously about the meaning of late life in particular. (shrink)

Despite its short historical moment in the sun, behaviorism has become something akin to a theoria non grata, a position that dare not be explicitly endorsed. The reasons for this are complex, of course, and they include sociological factors which we cannot consider here, but to put it briefly: many have doubted the ambition to establish law-like relationships between mental states and behavior that dispense with any sort of mentalistic or intentional idiom, judging that explanations of intelligent behavior require reference (...) to qualia and/or mental events. Today, when behaviorism is discussed at all, it is usually in a negative manner, either as an attempt to discredit an opponent’s view via a reductio, or by enabling a position to distinguish its identity and positive claims by reference to what it is (allegedly) not. In this paper, however, we argue that the ghost of behaviorism is present in influential, contemporary work in the field of embodied and enactive cognition, and even in aspects of the phenomenological tradition that these theorists draw on. Rather than take this to be a problem for these views as some have, we argue that once the behaviorist dimensions are clarified and distinguished from the straw-man version of the view, it is in fact an asset, one which will help with task of setting forth a scientifically reputable version of enactivism and/or philosophical behaviorism that is nonetheless not brain-centric but behavior-centric. While this is a bit like “the enemy of my enemy is my friend” strategy, as Shaun Gallagher notes (2019), with the shared enemy of behaviorism and enactivism being classical Cartesian views and/or orthodox cognitivism in its various guises, the task of this paper is to render this alliance philosophically plausible. Doi: 10.1007/s11229-019-02432-1. (shrink)

Qualitative evidence concerning the relationship between QoL and a wide range of disabilities suggests that subjective judgments regarding other people’s QoL are wrong more often than not and that such judgments by medical practitioners in particular can be biased. Guided by their desire to do good and avoid harm, surgeons often rely on "the eyeball test" to decide whether a patient will or will not benefit from surgery. But the eyeball test can easily harbor a range of implicit judgments and (...) biases against patients with disabilities, including erroneous assumptions about QoL. We critique the use of the "eyeball" test and offer suggestions to reduce bias and ensure that patients’ values are more consistently prioritized in surgical decision-making. (shrink)

The role of the body in cognition is acknowledged across a variety of disciplines, even if the precise nature and scope of that contribution remain contentious. As a result, most philosophers working on embodiment—e.g. those in embodied cognition, enactivism, and ‘4e’ cognition—interact with the life sciences as part of their interdisciplinary agenda. Despite this, a detailed engagement with emerging findings in epigenetics and post-genomic biology has been missing from proponents of this embodied turn. Surveying this research provides an opportunity to (...) rethink the relationship between embodiment and genetics, and we argue that the balance of current epigenetic research favours the extension of an enactivist approach to mind and life, rather than the extended functionalist view of embodied cognition associated with Andy Clark and Mike Wheeler, which is more substrate neutral. (shrink)

An increasing number of scholars at the intersection of feminist philosophy and critical disability studies have turned to Merleau-Ponty to develop phenomenologies of disability or of what, following Rosemarie Garland-Thomson, I call "non-normate" embodiment. These studies buck the historical trend of philosophers employing disability as an example of deficiency or harm, a mere litmus test for normative theories, or an umbrella term for aphenotypical bodily variation. While a Merleau-Pontian-inspired phenomenology is a promising starting point for thinking about embodied experiences of (...) all sorts, I here draw a cautionary tale about how ableist assumptions can easily undermine accounts of non-normate experience. I first argue that the omission or misguided treatment of disability within the history of philosophy in general and the phenomenological tradition in particular is due to the inheritance of what I call “the ableist conflation” of disability with pain, suffering, and disadvantage. I then show that Merleau-Ponty’s famous reading of the blind man’s cane is problematic insofar as it omits the social dimensions of disabled experiences, misconstrues the radicality of blindness as a world-creating disability, and operates via an able-bodied simulation that confuses object annexation or extension with incorporation. In closing, I contend that if phenomenology is to overcome the errors of traditional philosophy, as Merleau-Ponty once hoped, it must heed the insights of “crip” or non-normate phenomenology, which takes the lived experience of disability as its point of departure. [French translation forthcoming in Pour une phénoménologie critique, ed. Donald A. Landes, Quebec City, Les Presses de l'Université Laval/Paris, J.Vrin]. (shrink)

In this paper, we give a flavour of how, against the odds, Reggio-Emilia-inspired pedagogical documentation can work in reconceptualizing environmental education, reconfiguring child subjectivity and provoking an ontological shift from autopoiesis to sympoiesis in teacher education. Working posthuman(e)ly and transdisciplinarily across three foundation phase teacher education courses at a university in South Africa, we situate our teaching within current environmental precarities. We show how we stirred up trouble in and outside our university classroom and provoked our students to “make kin” (...) with children, each other, other animals, and the more-than-human, but also to stay with the trouble, that is, to learn to be truly present in colonized spaces. (shrink)

The COVID-19 (Coronavirus disease of 2019) pandemic has led to intense conversations about ventilator allocation and reallocation during a crisis standard of care. Multiple voices in the media and multiple state guidelines mention reallocation as a possibility. Drawing upon a range of neuroscientific, phenomenological, ethical, and sociopolitical considerations, the authors argue that taking away someone’s personal ventilator is a direct assault on their bodily and social integrity. They conclude that personal ventilators should not be part of reallocation pools and that (...) triage protocols should be immediately clarified to explicitly state that personal ventilators will be protected in all cases. (shrink)

While there is a steadily growing literature on epistemic injustice in healthcare, there are few discussions of the role that biomedical technologies play in harming patients in their capacity as knowers. Through an analysis of newborn and pediatric genetic and genomic sequencing technologies (GSTs), I argue that biomedical technologies can lead to epistemic injustice through two primary pathways: epistemic capture and value partitioning. I close by discussing the larger ethical and political context of critical analyses of GSTs and their broader (...) implications for just and equitable healthcare delivery. (shrink)

Disability has been a topic in multiple areas of philosophical scholarship for decades. However, it is only in the last ten to fifteen years that philosophy of disability has increasingly become recognized as a distinct field. Engaging a range of canonical texts across the Western intellectual tradition, I argue that the foundational question of continental philosophy of disability is the question of the meaning of ability. I then explore three pathways toward this question: the verdict of bodies, the bind of (...) bodies and worth, and the dogma of individual ability. I contend that unlike the question of the meaning of being, the question of the meaning of ability is not simply a problem of forgetting but instead primarily a problem of dehumanization. (shrink)

As neither a classical naturalist nor a non-naturalist, Merleau-Ponty appears to be a moderate or liberal naturalist. But can a phenomenologist really be a naturalist, even a liberal one? A lot hinges on how we tease this out, both as to whether it is plausible to claim Merleau-Ponty as a liberal naturalist (I argue it is), and as to whether it is an attractive and coherent position. Indeed, despite its important challenges to orthodox naturalism, there are arguably two traps to (...) avoid. If it becomes too liberal, we get: dualism or an ontological pluralism that is difficult to distinguish from a constructivism; or, in seeking to sidestep that metaphysical dilemma, there is sometimes an insistence on an overly neat methodological separation between description/understanding and explanation that is belied in practice (both scientific and philosophical). It is doubtful that such positions can legitimately claim to be naturalist in orientation, liberal or not. Merleau-Ponty’s philosophy avoids these traps, however, and it is thus a useful resource for contemporary work trying to navigate between scientific naturalism and non-naturalism. (shrink)

The historical relationship between health care professionals and people with disabilities is fraught, a fact all the more troubling in light of the distinctive roles clinicians play in both establishing and responding to that which is considered normal or abnormal by society at large. Those who wish to improve their clinical practice might struggle, however, to keep up with developments across numerous disability communities as well as the ever-growing body of disability studies scholarship. To assist with this goal, I offer (...) an overview of recent disability theory, outline a set of responsibilities clinicians have to disability communities, and provide recommendations for clinicians who hope to justly treat patients with disabilities and improve their care and health outcomes. (shrink)

Most readers of Sartre focus only on the works written at the peak of his influence as a public intellectual in the 1940s, notably "Being and Nothingness". "Jean-Paul Sartre: Key Concepts" aims to reassess Sartre and to introduce readers to the full breadth of his philosophy. Bringing together leading international scholars, the book examines concepts from across Sartre's career, from his initial views on the "inner life" of conscious experience, to his later conceptions of hope as the binding agent for (...) a common humanity. The book will be invaluable to readers looking for a comprehensive assessment of Sartre's thinking - from his early influences to the development of his key concepts, to his legacy. (shrink)

[This piece is written for those working in communication studies and in healthcare writ large, with the aim of bringing insights from disability studies and philosophy of disability to bear on discussion concerning disability in those fields.] Despite being assailed for decades by disability activists and disability studies scholars spanning the humanities and social sciences, the medical model of disability—which conceptualizes disability as an individual tragedy or misfortune due to genetic or environmental insult—still today structures many cases of patient–practitioner communication. (...) Synthesizing and recasting work done across critical disability studies and philosophy of disability, I argue that the reason the medical model of disability remains so gallingly entrenched is due to what I call the “ableist conflation” of disability with pain and suffering. In an effort to better equip healthcare practitioners and those invested in health communication to challenge disability stigma, discrimination, and oppression, I lay out the logic of the ableist conflation and interrogate examples of its use. I argue that insofar as the semiosis of pain and suffering is structured by the lived experience of unwelcome bodily transition or variation, experiences of pain inform the ableist conflation by preemptively tying such variability and its attendant disequilibrium to disability. I conclude by discussing how philosophy of disability and critical disability studies might better inform health communication concerning disability, offering a number of conceptual distinctions toward that end. (shrink)

Beginning with the influential discussion of the dialectic of progress found in Amy Allen’s The End of Progress, this paper outlines some difficulties encountered by critical theories of normative justification drawing on the early Frankfurt School. Characterizing Adorno and Horkheimer’s critical social theory as a dialectical reflection eschewing questions of normative foundations, I relate their well-known treatment of the dialectic of enlightenment reason and myth to their critique of capitalist society as a negative totality. By exploring the concepts of historical (...) development used by Adorno and Horkheimer to describe both the progressive domination of capitalism, and the formation and cultivation of reflective consciousness, I trace the importance of progression and its inseparable relationship to regression in these early versions of critical theory. The dialectical social theory found here recognizes the persistence of social contradictions on both a methodological level and on the level of theory’s development and expression, a connection potentially obscured by a division of historical progress according to its temporal orientation. Particularly in Adorno’s later work, an opposition to the negative social totality requires notions of cultivation and learning which work against the prevailing forms of conceptual thinking, including the concern for the stability of rational foundations. (shrink)

In this open peer commentary, we concur with the three target articles’ analysis and positions on abortion in the special issue on Roe v. Wade as the exercise of reproductive liberty essential for the bioethical commitment to patient autonomy and self-determination. Our proposed OPC augments that analysis by explicating more fully the concept crucial to Roe of fetal personhood. We explain that the development and use of predictive reproductive technologies over the fifty years since Roe has changed the literal image, (...) and thereby the epistemological landscape, through which a prospective parent comes to know the fetus. The logic of Roe required a legal and ethical denial of fetal personhood to prioritize maternal autonomy over claims to fetal moral personhood. Our claim is that such a denial may be more complicated today. The fetal person genetic testing and reproductive imaging now presents to prospective parents has become an increasingly individualized, distinct medicalized picture of a developing person with which a parent can either identify or differentiate. In contrast, the fetal person of Roe was an abstract and vague figure stripped of most human particulars, a pregnancy rather than the specific individualized human entity reproductive technology now presents as a person to prospective parents. We discuss the implications of this shift and call for a more capacious analysis of reproductive ethics that works towards both reproductive and disability justice. (shrink)

This piece lays out the framework for a special issue on the topic of "Fits and Misfits," published as volume 7, issue 1 of Puncta: A Journal of Critical Phenomenology. We discuss the relationship between the concept of misfitting, coined by Rosemarie Garland-Thomson, and debility, coined by Jasbir Puar, in relationship to scholarship on Merleau-Ponty. We then introduce each of the eight articles in the special issue: Rosemarie Garland-Thomson's "What Misfitting Makes," Susan Bredlau's "Conversational Accessibility: Healthcare, Community, and the Ethics (...) of Everyday Encounters," Helen A. Fielding's "Being Touched by Wellness: Merleau-Ponty, Nancy, and the Intensive Care Unit," Ann Murphy's "The Spirited Interworld: Caregiving and the Liminal Phenomenology of Dementia," Rachel Elliott's "Sharing Time with Misfits: We-Experience across Bodily Difference," David Morris's "An-Archic Time: Melting the Clock as Hypernorm of the I Can -- and Philosophy," Rebecca Longtin's "Merleau-Ponty's Cézanne as Misfit Artist," and, finally, Laura McMahon's "The Politics of Vulnerability and the School for Peace: Insights from Butler, Merleau-Ponty, and Family Systems Theory.". (shrink)

On September 26th, 2023, the National Institute on Minority Health and Health Disparities (NIMHD) officially designated disabled people as a health disparity population, marking the most significant event for disabled people's health as it relates to the NIH. In this paper, I discuss the larger socio-political context as well as the clinical import of this historic decision.

In this paper I return to Hubert Dreyfus’ old but influential critique of artificial intelligence, redirecting it towards contemporary predictive processing models of the mind (PP). I focus on Dreyfus’ arguments about the “frame problem” for artificial cognitive systems, and his contrasting account of embodied human skills and expertise. The frame problem presents as a prima facie problem for practical work in AI and robotics, but also for computational views of the mind in general, including for PP. Indeed, some of (...) the issues it presents seem more acute for PP, insofar as it seeks to unify all cognition and intelligence, and aims to do so without admitting any cognitive processes or mechanisms outside of the scope of the theory. I contend, however, that there is an unresolved problem for PP concerning whether it can both explain all cognition and intelligent behavior as minimizing prediction error with just the core formal elements of the PP toolbox, and also adequately comprehend (or explain away) some of the apparent cognitive differences between biological and prediction-based artificial intelligence, notably in regard to establishing relevance and flexible context-switching, precisely the features of interest to Dreyfus’ work on embodied indexicality, habits/skills, and abductive inference. I address several influential philosophical versions of PP, including the work of Jakob Hohwy and Andy Clark, as well as more enactive-oriented interpretations of active inference coming from a broadly Fristonian perspective. (shrink)

The guiding premise from which this special report begins is the conviction and hope that justice is at the normative heart of medicine and that it is the perpetual task of bioethics to bring concerns of justice to bear on medical practice. On such an account, justice is medicine's lifeblood, that by which it contributes to life as opposed to diminishing it. It is in this larger, historical, intersectional, critical, and ethically minded context that we must approach pressing questions facing (...) medicine, including the question of the import and role of genomic knowledge for human life. The second premise is that, at least in principle, the knowledge generated by genomics can be a gift or a weight, or both at the same time. That is to say that, on the one hand, genomic knowledge is a gift, creating novel insights into the genetic drivers of disease and into the geographical paths of our ancestors. And on the other hand, it is a weight, creating new obligations, new forms of social classification, and new forms of surveillance. Because it is in many ways the “common sense” of the day that genomic knowledge is a gift, this special report, which contains nine essays, concentrates on the ways in which such knowledge can be a weight, a weight that has the potential to thwart—and historically has thwarted—medicine from genuinely advancing justice . (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)

This paper examines the differences and affinities between Karl Popper’s critical rationalism and Theodor Adorno’s critical theory through renewed attention to the original documents of their 1961 debate. While commentaries often describe the Popper-Adorno encounter as a theoretical disappointment, I reveal a confrontation between conceptually opposed programs of social research. Though both theorists are committed to critique as a political and epistemological struggle for human freedom, their conceptions of this struggle are starkly different. In the original seminar papers, we find (...) a conflict between critique as a practice of social rationality (Popper) and a critique of social rationality itself (Adorno). The versions of critical rationalism and critical theory meeting in this debate thus emphasize opposite dimensions of a reflexive practice of immanent critique. In closing, I suggest dissolving this conceptual tension by recovering the educational orientation of critique. (shrink)

Most interpreters of Heidegger’s reflections on the body maintain that—whether early, middle, or late in the Gesamtausgabe—Dasein’s or the mortal’s openness to being/beyng is the ground of the fleshly or bodily (das Leibliche), but not the reverse. In this paper, I argue that there is evidence from Heidegger’s own oeuvre demonstrating that this relationship is instead mutually reciprocal. That is to say, I contend that corporeal variability is constitutive of Dasein’s openness to being just as Dasein’s openness to being is (...) constitutive of its corporeal variability. Understood in this way, Heidegger’s thinking puts forward what I call a corpoietic understanding of the body and of the meaning of ability. I show that, despite the ableist assumptions at play in much of Heidegger’s work, such an understanding is nevertheless grounded in the idea of access, a central concept in philosophy of disability and disability studies. After developing this idea of ability as access, I close by addressing the larger political stakes of using Heidegger’s work to think about embodiment and disability given the Third Reich’s mass slaughter of people with disabilities. (shrink)

This paper studies the relationship between consciousness and social existence in Georg Lukács’ early Marxist works through a consideration of his concept of reification. Understanding reification as the process underlying capitalist society’s immediate form of objectivity, I designate dereification as the cultivation of a mediated form of consciousness. In order to better understand the experiential aspects of this cultivation, I supplement my reading of Lukács’ theory of reification with attention to Walter Benjamin’s treatment of experience in capitalist society. I argue (...) that Benjamin’s distinction between experience as the shock of isolated events [Erlebnis] and experience as a long-term practice [Erfahrung] helpfully illuminates Lukács’ conception of dereification, allowing us to see the latter as a long process of cultivation. This account ultimately leads to a consideration of the formal role played by the party—as the facilitator of the working class’s self-education—in Lukács’ philosophy of social praxis. (shrink)

Despite rarely explicitly thematizing the problem of dirty hands, this essay argues that Merleau-Ponty’s political work can nonetheless make some important contributions to the issue, both descriptively and normatively. Although his political writings have been neglected in recent times, his interpretations of Marxism and Machiavelli enabled him to develop an account of political phronesis and virtù that sought to retain the strengths of their respective positions without succumbing to their problems. In the process, he provides grounds for generalizing the problem (...) of “dirty hands” beyond Michael Walzer’s influential understanding that pertains primarily to “emergencies” and singular time-slice actions, and addresses concerns about the coherence of the very idea that there is justified action that one ought to do which remains wrong. Merleau-Ponty does this by emphasizing the diachronic relationship between theoretical principles and concrete political action over a period of time, thus imbuing the problem of dirty hands with a historicity that is not sufficiently recognized in the more static and action-focused discussions. (shrink)

Drawing upon the life and work of S. Kay Toombs, I explore the impact and import of phenomenological accounts of disability for the existentialist tradition. Through the case of multiple sclerosis, a noncongenital, late-onset, and degenerative disability, I show how the general structures that emerge from its lived experience largely support a mere-difference view of disability and highlight the need for an equitably habitable world. I further argue that phenomenological accounts of disability demonstrate accessibility to be the defining feature of (...) what it means to be embodied as we are. I conclude with a discussion of the more general philosophical relationship between disability, embodiment, and existentialism. (shrink)