This chapter argues for a normative distinction between disabilities that are inherently negative with respect to wellbeing and disabilities that are inherently neutral with respect to wellbeing. First, after clarifying terms I discuss recent arguments according to which possession of a disability is inherently neutral with respect to wellbeing. I note that though these arguments are compelling, they are only intended to cover certain disabilities, and in fact there exists a broad class regarding which they do not (...) apply. In section three I discuss two such problem cases: Locked-in Syndrome and the Minimally Conscious State. In section four I explain why these are cases in which possession of the disability makes one worse off overall. I do so by explicating the notion of control over one’s situation. I argue that disabilities that significantly impair control over one’s own situation – e.g., Locked-in Syndrome and the Minimally Conscious State – strongly tend to be inherently negative with respect to wellbeing, while disabilities that do not strongly tend to be inherently neutral. The upshot is that we must draw an important normative distinction between disabilities that undermine this kind of control, and disabilities that do not. (shrink)

This book meaningfully reflects upon difficult, timely, and debated ethics questions relating to people with intellectual disabilities (IDs) and autistic people. The book challenges now dated perceptions and introduces innovative ideas by leading scholars regarding some of the most complex, controversial, and relevant ethical dilemmas involving these neurodiverse populations. People with IDs and/or those on the autism spectrum continue to experience various forms of oppression and unjust treatment across the globe, despite the UN Convention on the Rights of Persons (...) with Disabilities (CRPD). The collection explores questions such as: Can people with IDs make informed decisions about their medical treatment, living circumstances, and overall life? What are the ethical implications of selective termination of pregnancy based on a gene linked to a condition conferring intellectual impairment? How can we ensure that people with IDs and autistic people are meaningfully included in research? Can people with IDs successfully parent? How can we support the capabilities of neurodiverse populations such that they enjoy the rights afforded by the CRPD? Each contributor critically examines how we can move forward to create a world that understands and respects the rights of every person with ID and/or autism. An indispensable read for bioethicists, ethics students, social justice scholars, and others interested in and working with people with IDs and autistic people. (shrink)

Book reviewed in this article: Mental Disabilities and Criminal Responsibility. By Herbert Fingarette and Ann Fingarette Hasse.

While organizational justice and corporate social performance are both part of the business and society field, these two approaches have not typically been integrated into the same analysis. We analyze an issue, learning disabilities in business, in which individual performance is affected both by individual differences and social interpretations of these differences which are manifested in the institution of business. We examine the reciprocating linkage between the individual and institutional levels in such issues by linking organizational justice and corporate (...) social performance into a single framework. (shrink)

The UN Convention on the Rights of Persons with Disabilities (CRPD) withits Optional Protocol is the first binding legal act and leading international instrumentregarding the rights of persons with disabilities. One of the principles of CRPDis “respect for inherent dignity, individual autonomy including the freedom to makeone’s own choices and independence”, whereby persons with disabilities are recognizedas holders of rights taking into account their specific situation. CRPD recognizes inArticle 6 that “women and girls with disabilities are (...) subject to multiple discrimination”and mandates signatory countries to “take measures to ensure their full and equalenjoyment of all human rights and fundamental freedoms.” The research was done inorder to examine the readiness of the state to institutionally cover the awareness of girlsand women with disabilities, their education on the issue of violence, access to servicesand information appropriate to the needs of each category separately, as well as systemicsolutions for their protection from violence. A qualitative research strategy was applied,and the research was conducted with representatives of the Centers for Social Work, representativesfrom the Ministry of Labor and Social Policy, professionals who are directproviders of services in the field of non-family protection, as well as the girls and womenwith disabilities themselves. The main conclusions that emerge from the research saythat girls and women with disabilities are more susceptible to violence, especially bytheir partners or family members. More awareness is needed to recognize and encouragereporting of violence. (shrink)

The Mental Capacity Act 2005 has stipulated that in England and Wales the ethical implications of carrying out research with people who are unable to consent must be considered alongside the ethical implications of excluding them from research altogether. This paper describes the methods that were used to enable people with severe and profound intellectual disabilities, who lacked capacity, to participate in a study that examined their experience of receiving intimate care. The safeguards that were put in place to (...) protect the rights and well-being of participants are described, and it is argued that the approaches used in this study met the requirements set out in the Mental Capacity Act 2005. Although this paper is based on research involving people with intellectual disabilities, it has implications for research involving other groups who may also lack capacity to consent, including people with mental health problems, head injuries and dementia. (shrink)

This paper argues that human agency is not simply a function of intrinsic properties about the agent, but that agency instead depends on the ecology that the agent is in. In particular, the paper examines ways that disabilities affect agency and shows how, by paying deliberate attention to structuring the social environment around people with disabilities, we can mitigate some of the agential impact of those disabilities. The paper then argues that the impact of one’s social environment (...) on agency isn’t restricted only to those agents that have disabilities, but also characterizes all human agency. All of our agency is environmentally dependent. (shrink)

Some disability activists argue that disability is merely a difference. It is often objected that this view has unacceptable implications, implying, for example, that it is permissible to cause disability. In reply, Elizabeth Barnes argues that viewing disability as a difference needn’t entail such implications and that seeing such implications as unacceptable is question-begging. We argue that Barnes misconstrues this objection to the mere difference view of disability: it’s not question-begging to regard its implications as unacceptable, and the grounds that (...) Barnes offers for potentially blocking some of these implications fail to explain our conviction that it’s impermissible to cause disability. (shrink)

Le présent article explore l’apport de l’approche par les capabilités d’Amartya Sen et d’autres auteurs pour effectuer des recommandations de politique publique dans le cas particulier de la politique du handicap. Après avoir passé en revue les modèles existants du handicap au regard de la mise en œuvre de politiques publiques et avoir souligné leurs limites, le présent article propose un nouveau modèle de représentation de l’approche par les capabilités, de collecte d’information et d’élaboration des politiques publiques en s’appuyant sur (...) les avantages de l’approche par les capabilités. La méthode proposée introduit en particulier une mesure des fonctionnements et des capabilités et explore les moyens de mesurer l’écart entre les deux. La possibilité d’élaborer un tel indicateur ouvre de nouveaux horizons de pensée pour les politiques publiques qui s’avère particulièrement intéressante pour les personnes handicapées souvent exclues des politiques de droit commun parce que leur capacité d’action n’est pas prise en considération par les décideurs politiques. (shrink)

Having and raising children is widely regarded as one of the most valuable projects a person can choose to undertake. Yet many disabled people find it difficult to share in this value because of obstacles that arise from widespread social attitudes about disability. A common assumption is that having a disability tends to make someone unfit to parent. This assumption may seem especially relevant as a factor in decisions about whether to allow, encourage and assist disabled people to reproduce and (...) raise children. Yet there are reasons to doubt whether there is such a close connection between having a disability and lacking the ability to raise a child well. The aims of this paper are, first, to identify and clarify some values that are relevant to questions about allowing, encouraging and assisting disabled people to procreate and raise children, second, to give an overview of how these values can help us to address certain legal questions that arise for disabled people who aim to procreate and parent, third, to raise concerns about how to properly assess the parenting capacities of people with disabilities, and fourth, to suggest some ways in which having a disability can actually make someone a better parent. (shrink)

There are two ways to tell the story of disability in the phenomenological tradition. On the first, disability has always been a theme, albeit often described using related terms such as impairment, illness, pathology, abnormality, or bodily variation. It has always been so in part because embodiment and its relationship to the social world regularly appear as a theme in the work of many central figures and across multiple debates in the tradition. On the second way of telling the story, (...) phenomenological analysis of disability is relatively new, kicked off by the work of S. Kay Toombs in the early 1990s. Phenomenologists historically ignored disability as a fundamental aspect of being human because they either ignored disabled people’s testimony concerning their experiences or because they understood the description, reconstruction, and resulting knowledge of variations of norms, normality, and the normate, however defined, as mere stepping stones on the way to understanding the general (normal) structures of lived experience. Instead of picking one way of telling the story over the other, I will thread the needle between these ways of framing the complex relationship between the phenomenological tradition and inquiry into disability, for each harbors important insights. (shrink)

The so-called Disability Paradox arises from the apparent tension between the popular view that disability leads to low well-being and the relatively high life-satisfaction reports of disabled people. Our aim in this essay is to make some progress toward dissolving this alleged paradox by exploring the relationship between disability and various “goods of life”—that is, components of a life that typically make a person’s life go better for her. We focus on four widely recognized goods of life (happiness, rewarding relationships, (...) knowledge, achievement) and four common types of disability (sensory, mobility, intellectual, and social) and systematically examine the extent to which the four disability types are in principle compatible with obtaining the four goods of life. Our findings suggest that that there is a high degree of compatibility. This undermines the widespread view that disabilities, by their very nature, substantially limit a person’s ability to access the goods of life, and it provides some guidance on how to dissolve the Disability Paradox. (shrink)

Marilyn Adams rightly pointed out that there are many kinds of evil, some of which are horrendous. I claim that one species of horrendous evil is what I call horrendous-difference disabilities. I distinguish two subspecies of horrendous-difference disabilities based in part on the temporal relation between one’s rational moral wishing for a certain human function F and its being thwarted by intrinsic and extrinsic conditions. Next, I offer a theodicy for each subspecies of horrendous-difference disability. Although I appeal (...) to some claims made by Marilyn Adams for this theodicy, I reject one particular claim. I deny that one must be aware that one participates in a horrendous evil when the horrific event occurs. To develop this point and its relevance for a theodicy for horrendous-difference disabilities, I engage with Andrew Chignell’s work on infant suffering. In doing so, I show that what partly motivates the claim is a time-bias, i.e., near-bias. By rejecting this time-bias, I show how it is possible, given post-mortem life, for persons with profound cognitive disabilities to participate in horrendous evils and how these might be defeated by God. (shrink)

Many social practices treat citizens with cognitive disabilities differently from their nondisabled peers. Does John Rawls's theory of justice imply that we have different duties of justice to citizens whenever they are labeled with cognitive disabilities? Some theorists have claimed that the needs of the cognitively disabled do not raise issues of justice for Rawls. I claim that it is premature to reject Rawlsian contractualism. Rawlsians should regard all citizens as moral persons provided they have the potential for (...) developing the two moral powers. I claim that every citizen requires specific Enabling Conditions to develop and exercise the two moral powers. Structuring basic social institutions to deny some citizens the Enabling Conditions is unjust because it blocks their developmental pathways toward becoming fully cooperating members of society. Hence, we have a duty of justice to provide citizens labeled with cognitive disabilities with the Enabling Conditions they require until they become fully cooperating members of society. (shrink)

Recent years have seen increased interest among 4E cognition scholars in physical disability, leading to the development of the EE-model of disability. This paper contributes to the literature on disability and 4E cognition in three key ways. First, it examines the relationship between the EE-model and social constructivist views that address the bodily reality of disablement, highlighting commonalities and distinctions. Second, it critiques the EE-model’s focus on individual strategies for expanding disabled persons’ affordance landscapes, arguing that disability policy should integrate (...) insights from both the EE-model and social constructivist approaches. Finally, it assesses the EE-model against the 'dogma of harmony'. We argue that while the EE-model’s focus on active human-environment collaboration is valuable, it can inadvertently perpetuate this dogma. We contend that integrating certain social constructivist insights can help the EE-model avoid the dogma of harmony. (shrink)

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both (...) distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision‐making related to their interests, including in crisis planning before, during, and after a pandemic like Covid‐19. (shrink)

Disability rights (DR) advocates have consistently opposed the legalization of physician-assisted dying (PAD) on the grounds that it wrongly discriminates against the disabled. This chapter distinguishes three variants of this objection. The first and perhaps primary one, based on “soft paternalism,” claims that PAD should not be legalized for the sake of those who might choose it. The second alleges that the laws harm all disabled people by encouraging support for PAD as the cheaper alternative to providing the disabled more (...) social support and protection from discrimination. The third alleges that legalized PAD harms all disabled people by expressing the denigrating message that their lives are less valuable than those of the able. The chapter finds that whatever the merits of the first two objections, DR advocates cannot consistently accept them while maintaining support for a legal right to reject unwanted treatment. It also finds grounds to doubt the cogency of the third objection. (shrink)

Persons with intellectual disabilities are more exposed to violence than other citizens. When they seek help or report to the police, their disability may, however, pass unidentified, which means that their needs cannot be met. Methods for identifying these persons are therefore required. This study aimed to understand whether the Intellectual Disability Screening Questionnaire (IDSQ), developed in the UK, is useful in Sweden. Workshops were conducted with professionals representing the Police authority, health care units, social service units, persons with (...) intellectual disabilities, and relatives. The results showed that participants perceived the identification of intellectual disabilities among victims of violence and crime as important, and they found IDSQ useful. The participants appreciated that IDSQ can be used in flexible ways, and that contextual factors can be acknowledged, which enhance the possibilities to support victims of crime throughout legal processes, and provide care. They sensed that structured methods, such as IDSQ, must be accompanied by a person-centered perspective, and clients must be approached with ethical awareness. However, the participants found the manual complicated and stressed the importance of adapting IDSQ to professionals’ routines. More work is needed if IDSQ is to be implemented in Sweden. (shrink)

This chapter canvases a number of ways that issues surrounding disability intersect with social epistemology. We begin with a discussion of how social epistemology as a field and debates concerning epistemic injustice in particular would benefit from further (a) engaging the fields of disability studies and philosophy of disability and (b) more directly addressing the problem of ableism. In section two, we turn to issues of testimony, “intuitive horribleness,” and their relationship to debates concerning disability and well-being. We address how (...) the regular lack of uptake of disabled people’s testimony can lead to a number of structural rather than merely individual epistemic injustices, and we also consider how the very nature of some disabilities make testimonial issues more complicated. We conclude by discussing various norms of social interaction and how they can systematically disadvantage Autistic people in particular with respect to all the issues discussed herein. (shrink)

People with cognitive disabilities and their advocates often express uneasiness about prenatal testing and the selective termination of pregnancies because the fetus has a cognitively disabling condition. There are high rates of abortion in such circumstances, and new forms of noninvasive prenatal testing (NIPT) have been introduced to improve the detection of genetic conditions. This chapter argues that the feeling of disquiet about prenatal testing and selective termination is justified. Philosophers working in the field of bioethics often offer reassurance (...) that such feelings are unjustified. This chapter shows that such reassurances fail and presents an argument that bias against people with cognitive disability plays a role in prenatal decision-making. Feelings of disquiet are justified because it is justified to object to bias that is otherwise directed at oneself. (shrink)

Since the early 1990s, one of the most prominent objections to the use of prenatal or pre-implantation testing to prevent the birth of children with disabilities has focused on the negative judgments it expresses to and about existing persons with disabilities. Commonly known as the expressivist objection, it is based on the conjunction of two key claims: (1) the use or provision of tests to select against disability in offspring expresses negative judgments about existing persons with disabilities; (...) and (2) the expression of these judgments itself constitutes a wrong to those persons. Despite depending on both claims, however, philosophical discussion of the expressivist objection has largely centred on the first: while commentators continue to debate whether disability screening does or does not express negative judgments, relatively little attention has been paid to explaining how the expression of those judgements wrongs persons with disabilities. In this paper, I argue both that whether or not the expressivist objection succeeds will ultimately depend on whether a plausible explanation can be supplied for how persons with disabilities are wronged by the expression of negative judgments, and that the existing literature surrounding relational egalitarianism can provide such an explanation, albeit with important limitations. (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)

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)

When thinking about disability in the context of justice, our focus should not be on the ways in which people’s bodies and minds function differently. Instead, we should shift our focus to the limitations that this leads to—for particular people, in particular contexts. And, at least from the perspective of justice, only a subset of these limitations matter. Specifically, those that prevent individuals from having control in certain domains of their life, by restricting the availability of acceptable options or the (...) ability to choose between them. Our theory of justice should be concerned with the lives individuals can lead, and not with whether their bodies and minds function typically. What matters is that people can be mobile, form relationships, engage in leisure, and so on—not how they achieve these things. The problem that disability raises is not the mere fact of difference, but the ways in which that difference is accommodated (or not) and the limitations it may cause. Indeed, on my definition of disability, to be disabled just is to be unable to exercise the control over our life that everyone should be able to. Our focus, then, should not be on whether someone has received a particular diagnosis, or on the most visible deviations from what we take to be the species norm, but on whether people have access to central capabilities. Achieving justice does not require ‘normalisation’, or the elimination of difference, but enabling all individuals to control their lives as they choose. (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)

One criticism of medical aid in dying (MAID) is the expressivist objection: MAID is morally wrong because it expresses judgments about disabilities or persons with disabilities, that are offensive, disrespectful, or discriminatory. The expressivist objection can be made at the level of individual patients, medical providers, or the state. The expressivist objection originated with selective abortion, and responses to it in that context typically claim either that selective abortion does not express specific judgments about disabilities, or that (...) any judgments expressed are not offensive. This response is inadequate: MAID often does express negative judgments about disabilities, which could reasonably be seen as offensive. But, does this offensiveness make MAID wrong? Drawing on Joel Feinberg’s account of offense, I argue that it is unlikely that the offensiveness of the judgments expressed by individuals who seek MAID or through the state’s legalization of MAID is enough to make it morally impermissible. (shrink)

Introduction ADAM CURETON AND KIMBERLEY BROWNLEE Disability and disadvantage are interrelated topics that raise important and sometimes overlooked issues in...

A range of collaborative approaches to address complexity in the business environment including strategic alliances, public private partnerships, issues management alliances, innovation and enterprise zones, supply chain certification and partnerships, industry self‐regulatory systems, and technology incubators are evidence of collaboration across sectors. This paper suggests that these may be part of a bigger adaptation. Such new models may be critical in addressing challenging issues of immigration and workforce development, disruptive technologies, globalization, corruption, and sustainability. The paper builds the case that (...) these collaborative responses are not simply new forms but represent a new logic and values. They incorporate a “both and” logic and a more ecological perspective. They recognize that going it alone may not be sufficient. Partnering with NGOs, third‐party organizations, and even government agencies may lead to better solutions. Finally, they challenge leadership to generate new conversations and ask different questions. The paper provides three detailed cases that illustrate collaborative responses to issues and new forms of adaptation including industry self‐regulation, recycling, and employment programs for persons with disabilities. It concludes with suggestions for future research. (shrink)

The development of the CRISPR gene editing technique has been hyped as a technique that could fundamentally change scientific research and its clinical application. Unrecognized is the fact that it joins other technologies that have tried and failed under the same discourse of scientific hype. These technologies, like gene therapy and stem cell research, have moved quickly passed basic research into clinical application with dire consequences. Before hastily moving to clinical applications, it is necessary to consider basic research and determine (...) how CRISPR/Cas systems should be applied. In the case of single gene diseases, that application is expected to have positive impacts, but as we shift to more complex diseases, the impact could be unintentionally negative. In the context of common disabilities, the level of genetic complexity may render this technology useless but potentially toxic, aggravating a social discourse that devalues those with disabilities. This paper intends to define the issues related to disability that are associated with using the CRIPSR/Cas system in basic research. It also aims to provide a decision tree to help determine whether the technology should be utilized or if alternative approaches beyond scientific research could lead to a better use of limited funding resources. (shrink)

This study aimed to identify the level of learning disabilities and school-related psychological adjustment disorders among academically underachieving students, to analyze the nature of the relationship between them, to examine the contribution of adjustment disorders in predicting school failure, and to investigate differences in school failure trajectories according to the severity of learning disabilities. The study adopted a descriptive correlational–predictive design and was conducted on a sample of 105 students from primary and middle schools in educational institutions in (...) Sidi Bel Abbès Province. The Learning Disabilities Diagnostic Inventory (LDDI) developed by Hammill and Bryant and a scale of school psychological adjustment disorders were used. The results indicated that the overall level of learning disabilities among the sample was high, with reasoning difficulties recording the highest mean score, followed by mathematics and reading difficulties. The findings also revealed a high level of school psychological adjustment disorders, particularly in the dimensions of low self-esteem and school anxiety. Pearson correlation coefficients showed positive and statistically significant relationships between all dimensions of learning disabilities and psychological adjustment disorders, with the strongest correlation observed for reasoning difficulties. Simple linear regression analysis indicated that psychological adjustment disorders accounted for 32% of the variance in school failure. Oneway analysis of variance further revealed statistically significant differences in the level of school failure according to the severity of learning disabilities, with school failure increasing as the severity of learning difficulties increased. The study concluded that school failure among students with learning disabilities results from a complex interaction between cognitive and psychological factors, highlighting the need for comprehensive diagnostic and intervention approaches that integrate psychological and educational dimensions within educational institutions. (shrink)

This paper investigates the interaction of gender, disability and education in rural Iran, which is a relatively unexplored field of research. The responses of 10 female students with disabilities from Isfahan indicated that the obstacles they faced included marginalization, difficulties in getting from home to school, difficulties within the school building itself, and discrimination by teachers, classmates and school authorities. The data collected for the study contain a wide range of conservative gendered discourses, and show how traditional gender beliefs (...) interact with disability to aggravate the problems faced in education by young women with disabilities. It is hoped that the findings will raise awareness among policy-makers of the many formidable obstacles that make it difficult for young women with disabilities to achieve their full potential in education. (shrink)

This paper argues that disabled people can be healthy. I argue, first, following the well-known ‘social model of disability’, that we should prefer a usage of ‘disabled’ which does not imply any kind of impairment that is essentially inconsistent with health. This is because one can be disabled only because limited by false social perception of impairment and one can be, if impaired, disabled not because of the impairment but rather only because of the social response to it. Second, I (...) argue that it is often wrong to use the term ‘healthy’ in a way that makes health inconsistent with any degree whatsoever of health-relevant bodily dysfunction. Whether someone is ‘healthy’ properly-so-called depends on standards of health presupposed in conversational context. Sometimes, I argue, these standards are or ought to be lax enough to allow some people with some health deficits still to count as ‘healthy’ per se. Taking inspiration from David Lewis and Mary Kate Mcgowan, I go on to argue that denying that someone is ‘healthy’ in a context typically succeeds in shifting going presuppositions to require standards strict enough to make that denial acceptable. And this, I conclude by arguing, often constitutes an abuse of conversational power. (shrink)

The medical model of disability views disabilities as biological dysfunctions of the individual’s body. Historically, this has been unpopular in the literature, but that is at least partly because it has also been associated with objectionable moral or political ideas. As such, it’s not clear that the core view about the nature of disability has received a fair hearing. This paper meets the medical model on its own terms. I argue that there is no available naturalistic account of biological (...) functioning such that disabilities can plausibly be understood as biological dysfunctions. (shrink)

The strategy of developing an ontology or models of disability as a prior step to settling ethical issues regarding disabilities is highly problematic for two reasons. First, key definitional aspects of disability are normative and cannot helpfully be made value-neutral. Second, if we accept that the contested concept of disability is value-laden, it is far from obvious that there are definitive reasons for choosing one interpretation of the concept over another. I conclude that the concept of disability is better (...) left ethically open-ended or broad enough to encompass the examination of various ethical issues. Alternatively, the concept of disability could be altogether abandoned in order to focus on specific issues without being hindered by debates about the nature of disability. Only political costs, rather than conceptual considerations internal to the models, could be weighed against such a conclusion. (shrink)

The question of how to treat people with cognitive disabilities (PCDs) poses an important problem for Rawlsian theories of justice because it is unclear whether PCDs are included within the scope of moral personhood. Rawls’s Standard Solution focuses on nondisabled adults as the fundamental case, while later addressing PCDs as marginal cases. I claim that the Standard Solution has two weaknesses. First, it relies on a dichotomy between nondisabled and disabled that is tenuous and difficult to defend. Second, it (...) makes the theory circular in a vicious way.I argue that Rawls’s theory can be revised so that it solves the problem of how to treat PCDs while avoiding the two weaknesses of the Standard Solution. There are three constraints on any successfully revised Rawlsian theory: 1) it must be resourcist rather than welfarist; 2) it must provide some principled basis for limiting our obligations to PCDs; and 3) it must address the whole range of PCDs, including the most severely disabled individuals. (shrink)

Philosophers have debated on the “mere‐difference” view of disability, according to which disability as such is neutral in terms of well‐being, just like race and gender. It is contrasted with the “bad‐difference” view, which holds that disability is bad for its possessor even in a non‐ableist situation. We first illustrate how neither view can be sensitive to the diversity of disabled people and their disabilities. Subsequently, we propose an alternative outlook—the conditional bad‐difference view of disability: a disability is bad (...) for its possessor if and only if it hampers her aspired way of life, even without ableism. In addition to being theoretically moderate and thus more plausible than the existing outlooks, this view also offers a robust ethical case for policies and practices catering to the varying needs and values of disabled people, such as personalized healthcare and the user‐led research of assistive technologies. (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.