Disability

Who is recognised as a philosopher and what counts as philosophy influence both the content of a philosophical education and academic philosophy’s continuing demographic skew. The “philosophical who” and the “philosophical what” themselves are a partial function of matters that have been passed over in collective silence, even if that now feels to some like a silence belonging to the distant past. This paper discusses some philosophical silences regarding race, gender, and disability in the context of reflection on philosophical education (...) and on philosophical practice in the public sphere. It focuses on Charles Mills’ writings on race, Susan Babbitt’s on race and gender, and on more collaboratively-generated work on eugenics and disability. (shrink)

This chapter provides a roadmap of ongoing conversations about cognitive disability and moral status. Its aim is to highlight the political stakes of these conversations for advocates for the cognitively disabled while at the same time bringing out how a fundamental point of divergence within the conversations has to do with what count as appropriate methods of ethics. The main divide is between thinkers who take ethical neutrality to be a regulative ideal for doing empirical justice to the lives of (...) people with cognitive disabilities and those who reject this methodological precept as unduly restrictive. What results is a debate between, on the one hand, fans of various familiar forms of moral individualism and Kantian approaches in ethics and, on the other, a range of disability scholars and activists who implicitly or explicitly make use of philosophically more radical methods. (shrink)

Transhumanist arguments in support of radical human enhancement are inimical to disability justice projects. Transhumanist thinkers, the strongest promoters of human enhancement, and fellow travelers who claim enhancement is a moral obligation, make arguments that rely on the denigration of disabled embodiment and lives. These arguments link disability with risk. The promotion of human enhancement is therefore open to significant disability critique despite transhumanism’s claims to allyship with disability justice activism. This chapter lays out such a disability critique of enhancement (...) and further supports its claims by describing bioethics, and therefore transhumanism, as biopolitical in the sense Michel Foucault uses the term. Finally, this chapter develops an alternative vision of enhancement. This alternative vision poses a disability-inclusive future, accepts the risks of embodiment, and lays groundwork for a counterdiscourse of enhancement. (shrink)

Cost-effectiveness analysis (CEA) is an analytical tool in health economics. One of the most important objections to it is that its use can lead to unjust discrimination against people with disabilities. This chapter evaluates this objection. It begins by clarifying its nature, then it examines some alleged forms of discrimination. It argues that they are either not cases of unjust discrimination, or they are based on misunderstandings of CEA. However, the chapter does point out that there is one case in (...) which the use of CEA may disadvantage people with disabilities. It goes on to consider several proposals for explaining the wrongness of discrimination but argues that none of them accommodates this case. It concludes that the case should not be thought as a matter of unjust discrimination; rather, it should be thought of as raising an issue for justice in the allocation of health-care resources. (shrink)

Is it possible that justice requires giving people with disabilities like autism sufficient opportunities to pursue a flourishing life by promoting accessibility at theme parks and other places of public accommodation? I explore this question by analyzing the ethical issues at play in a series of disability lawsuits against Disney Parks and Resorts. Drawing on the work of Martha Nussbaum and Chiara Cordelli, I argue that Disney has an obligation of justice to provide these plaintiffs with their requested disability modification. (...) I further articulate how public accommodations other than Disney should accommodate disabled customers, sometimes with government assistance. (shrink)

This article aims to explore the attitudes and behaviors of persons with intellectual and developmental disabilities (IDD) related to their information privacy when using information technology (IT). Six persons with IDD were recruited to participate to a series of 3 semistructured focus groups. Data were analyzed following a hybrid thematic analysis approach. Only 2 participants reported using IT every day. However, they all perceived IT use benefits, such as an increased autonomy. Participants demonstrated awareness of privacy concerns, but not in (...) situations involving the use of technology; their awareness is not transferred to the abstract context of IT use. Privacy breaches were revealed to be a major risk for persons with IDD, who did not seem to understand how their personal information was used. Most protection mechanisms and tools reported were those suggested and implemented by caregivers and close relatives who had a great influence on the participants’ attitudes and behaviors toward IT and privacy. Our findings suggest that when using IT, persons with IDD often experience the consequences of a trade-off between autonomy and privacy. Further research and action is needed to support persons with IDD to understand and balance the benefits of IT use and the inherent threats to information privacy. (shrink)

It is a familiar idea that showing respect for someone requires an effort to take account of how she sees the world. There is more than one way we might do this. Williams suggests that each person is owed an effort at identification, whereas Rawls remarks that “mutual respect is shown … in our willingness to see the situation of others from their point of view.” The author explores these ideas as they apply to people with profound and multiple learning (...) difficulties and disabilities (PMLD), whose condition raises special difficulties in the way of complying with the conduct described here. The author examines the ideas of having a point of view and identifying with the person whose point of view it is, and shows how much—and also how little—these views can contribute to a principle of respect that includes people with PMLD. (shrink)

This chapter asks what stance is morally appropriate as we consider when, whether, and how to assist persons experiencing physical, emotional, or intellectual disability. Appealing to a variety of intelligent and observant thinkers for inspiration (Ralph Barton Perry, Helen Keller, and Immanuel Kant), it argues that one important aspect of such a stance is an attitude of reciprocal beneficence. This has three central aspects: a perspective of fellowship acknowledging the disabled and the currently able as members of the community of (...) vulnerable human agents; a developed sympathy attuned to gaps in knowledge and failures of imagination and analogy; and a readiness to show gratitude or appreciation for what the currently disabled may teach about the vulnerable moral agency we share. The argument takes initial inspiration from Perry but owes most to its roots in Kantian moral and political theory. It also owes much to wise and insightful enrichments due to Keller. (shrink)

This chapter describes and illustrates ideals of appreciation and positive expressions of respect in personal relationships and then argues that these are distinct from beneficence, that they are aspects of a full recognition of human dignity, and that they have important general and special implications for relationships involving persons with disabilities. The chapter emphasizes that especially among family, friends, and caregivers, proper respect for persons calls for positive affirmations and being open to appreciate the good in others and their lives (...) and that appreciating them is more than respecting them and caring for their comfort and happiness. Respect and appreciation for and by us, as persons with disabilities, requires confronting and changing cultural stigmas that undermine these morally important attitudes. (shrink)

The following paper examines the cyberpunk transhumanist graphic novel Transmetropolitan through the theoretical lens of disability studies to demonstrate how science fiction, and in particular this series, illustrate and can influence how we think about disability, impairment and difference. While Transmetropolitan is most often read as a scathing political and social satire about abuse of power and the danger of political apathy, the comic series also provides readers with representations of impairment and the source of disability as understood by the (...) Social Model of Disability (SMD). Focusing on the setting and fictional world in which Transmetropolitan takes place, as well as key events and illustration styling, this paper demonstrates that the narrative in this work encompasses many of the same theoretical underpinnings and criticisms of society’s ignorance of the cause of disability as the SMD does. This paper aims, by demonstrating how Transmetropolitan can be read as an allegory for the disabling potential of society as experienced by individuals with impairments, to prompt readers into thinking more creatively about how narratives, seemingly unconcerned with disability, are informed and can be understood via disability theory. (shrink)

Is disability disadvantageous? Although many assume it is paradigmatically so, many disabled individuals disagree. Whom should we trust? On the one hand, pervasive mistrust of already underrepresented groups constitutes a serious epistemic injustice. Yet, on the other, individuals routinely adapt to mistreatment and deprivation and claim to be satisfied. If we take such “adaptive preferences” (APs) at face value, then injustice and oppression may not be recognized or rectified. Thus, we must achieve a balance between taking individuals’ preferences and self-assessment (...) as definitive, and ignoring them entirely. Furthermore, current accounts of APs suffer from an ambiguity: are APs an unreliable guide to individuals’ interests, or to just policy? This chapter argues that we should distinguish between those that are unreliable in the former sense (“well-being APs”), and the latter (“justice APs”). Although all APs are nonautonomous, only well-being APs are irrational. Thus, preferences may be diagnosed as unreliable from the perspective of justice without impugning individuals’ rational capacities. (shrink)

This chapter examines the ways in which disabled people are subject to epistemic injustice. It starts by introducing how social epistemology models the creation of shared knowledge and then uses feminist epistemology to highlight the role of social and political power in producing epistemic privilege, exclusion, and oppression. The well-known concepts of testimonial and hermeneutic epistemic injustice are discussed in relation to disability, showing how these forms of injustice are frequently experienced within the lives of disabled people. In particular, disabled (...) experience has features that distinguish it from the experiences of sexism and racism most commonly used as illustrations of epistemic injustice. The chapter ends by arguing that the potential for epistemic injustice poses unprecedented risks for disabled people in the current context, which could be minimized by recognizing that ignorance about disabled lives is not inevitable, but something that can and should be challenged. (shrink)

The aim of this dissertation is to build a concept of epistemic responsibility that takes seriously insights from feminist epistemology, addiction studies, and disability theory. I use John Greco’s knowledge-as-achievement account as a starting point, and demonstrate how an ability-centred account such as Greco’s can be undergirded with these insights to create a concept of epistemic responsibility that better captures the complex social and political nature of our epistemic practices. I begin in Chapter 1 by outlining the contours of the (...) project and making an argument for the importance of projects that create porousness between feminist epistemology and mainstream epistemology. In Chapter 2 I outline five key insights in feminist epistemology that I use both in assessing Greco’s theory and in guiding reconstruction. I argue that accommodating these insights will require, at a minimum, a thoroughly social/non-individualistic concept of epistemic responsibility. The strategy that I take to build such a concept is threefold. First, in Chapter 3, I provide a theoretical background of currently existing social/non-individualistic concepts of responsibility that serve to lay a groundwork for my notion of epistemic responsibility. The goal is not to provide a comprehensive survey of the work on responsibility, but rather to draw out tools and frameworks that are helpful in thinking through epistemic responsibility. Second, in Chapter 4, I develop an extended analysis of a concrete phenomenon that I take to be a thoroughly social/non-individualistic context of responsibility ascription: responsibility for addiction, or rather for the harms associated with drug use. And finally, in Chapter 5, taking all of the insights and tools that I have gathered in Chapters 2-4, I embark on the project of theory reconstruction. I begin by outlining the strengths and weaknesses in Greco’s theory with respect to the insights I have highlighted. I then bring in disability theory in order to shore up the notion of ability operative in Greco’s account which I argue allows us to better account for the social and political complexities of epistemic practice. (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)

Contemporary research into the values, bias, and prejudices within “Artificial Intelligence” tends to operate in a crux of scholarship in computer science and engineering, sociology, philosophy, and science and technology studies (STS). Even so, getting the STEM fields to recognize and accept the importance of certain kinds of knowledge— the social, experiential kinds of knowledge— remains an ongoing struggle. Similarly, religious scholarship is still very often missing from these conversations because many in the STEM fields and the general public feel (...) that religion and technoscientific investigations are and should be separate fields of inquiry. Here I demonstrate that experiential knowledge and religious, even occult beliefs are always already embedded within and crucial to understanding the sociotechnical imaginaries animating many technologies, particularly in the areas of “AI.” In fact, it is precisely the unwillingness of many to confront these facts which allow for both the problems of prejudice embedded in algorithmic systems, and for the hype-laden marketing of the corporations and agencies developing them. This same hype then intentionally obfuscates the actions of both the systems and the people who create them, while confounding and oppressing those most often made subject to them. Further, I highlight a crucial continuity between bigotry and systemic social projects (eugenics, transhumanism, and “supercrip” narratives), revealing their foundation in white supremacist colonialist myths of whose and which kinds of lives count as “truly human.” We will examine how these myths become embedded into the religious practices, technologies, and social frameworks in and out of which “AI” and algorithms are developed, employing a composite theoretical lens made from tools such as intersectionality, ritual theory, intersubjectivity, daemonology, postphenomenology, standpoint epistemology, and more. This theoretical apparatus recontextualizes our understanding of how mythologies and rituals of professionalization, disciplinarity, and dominant epistemological hierarchies animate concepts such as knowledge formation, expertise, and even what counts as knowledge. This recontextualization is then deployed to suggest remedies for research, public policy, and general paths forward in “AI.” By engaging in both the magico-religious valences and the lived experiential expertise of marginalized people, these systems can be better understood, and their harms anticipated and curtailed. (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)

Drawing upon disability studies and theories of relational autonomy, this essay illustrates how somatic oppression may affect one’s autonomy — conceptualized as a socially contextualized competency — in the context of Medical Aid in Dying (MAiD), in ways that are not captured by current safeguards focused on protecting free and informed consent. From a relational standpoint, securing free and informed consent fails to protect individual autonomy, and instead we need to examine how medical and social relationships, practices, and institutions can (...) hinder or enable the development and practice of autonomy. I conclude that oppression poses a credible threat to the autonomy of MAiD patients and thus warrants further attention. (shrink)

The concept of disability is used across a variety of contexts to describe different phenomena and prescribe distinct behaviors or norms. The definitional challenge is not only that the category of “disabled people” is heterogenous, but also that what “disability” should denote, primarily or exclusively, is controversial among both theorists and practitioners. This conceptual breadth is far from innocuous: disability models have the potential to influence public policies, culture, and interactions by suggesting what rights, duties, and social expectations disability entails. (...) Instead of examining those various definitions and arguing in favor of one, this chapter considers the unavoidable cultural polysemy of disability and contrasts the appeal and limitations of the main theoretical strategies to manage it. Some disability models deny that competing understandings of disability are valid, others seek to determine procedures through which disabilities will be defined and assessed, and still others conceptualize disability in a more culturally malleable way. (shrink)

German idealist philosophers Kant and Hegel, who have had a significant influence on contemporary social and political theory, both insist on universal human freedom and dignity. However, they maintain teleological frameworks of human development which depend on distancing free and rational human agency from nature, leaving animality and “savageness” behind for a rational and spiritually developed future. This has implications for their implicit and explicit accounts of disability, which risk being reiterated today: insofar as disability is associated with being a (...) static product of nature, these frameworks situate it at best as that which must be overcome, and at worst as something that bars someone from full humanity. Recognizing and understanding the place of disability within their work is vital if we want to avoid their exclusions in our inherited ideas. (shrink)

Discrimination is an important real-life issue that affects many individuals and groups. It is also a fruitful field of study that intersects several disciplines and methods. This Special Section brings together papers on discrimination and prioritization in healthcare from leading scholars in bioethics and closely related fields.

Epistemic Injustice in the Education of People with Mental Disabilities. This article offers a perspective on inclusive education based on Fricker's conception of epistemic injustice. What is the relationship between inclusive education and epistemic injustice in the case of students with mental deficiencies? By adapting Fricker's thesis to this extreme case, epistemic injustice can be explored via the social model of disability (SMD). Accordingly, we propose that epistemic injustice harms the entire educational community and society. -/- Mental Disability. Epistemic Injustice. (...) Inclusive Education. Social Model of Disability. (shrink)

RESUMEN ‒ Injusticias Epistémicas en la Educación de Personas con Dis- capacidad Mental. Se ofrece en este artículo una perspectiva de la educa- ción inclusiva a partir de la concepción de las injusticias epistémicas de Fricker. Se pregunta cuál es la relación entre la educación inclusiva y la in- justicia epistémica en el caso de estudiantes con deficiencias mentales. Es necesario adaptar las tesis de Fricker a este caso límite, por lo que se debe pensar la injusticias epistémicas a partir (...) del modelo social de la discapaci- dad. Se propone que la injusticia epistémica perjudica a toda la comunidad educativa y a la sociedad. -/- . (shrink)

This chapter considers some epistemic aspects of interactions with those who are believed to be delusional. The chapter makes five main claims: first, for the day-to-day purposes of most individuals, it is helpful to understand delusions as extreme epistemic failures, failures that all are guilty of to some degree. Second, one should be cautious when attributing delusions to others because to call someone delusional can act to discredit them, and this can be especially dangerous when applied to members of oppressed (...) groups. Third, delusional individuals can indeed be wronged by epistemic injustice. Fourth, epistemic responsibility for delusions needs to be extended beyond the individual holding delusional beliefs to the conditions that shape those beliefs. Finally, the virtue of epistemic humility offers several important epistemic benefits in interactions with delusional others. (shrink)

Meier et al. describe a pilot study that developed METHAD, an AI-based Medical Ethics Advisor tool that draws on the principlism approach and was tested using text-book cases and clinical et...

Short overview of the From Small Beginnings Project and its relevance for resisting eugenics in contemporary society.

This dissertation takes up questions of access at the level of language itself, as well as in the context of cultural institutions in emerging global communities. Using the texts of James Joyce, Samuel Beckett, and Shani Mootoo, I argue experimental narrative techniques develop new understandings of mental disability by pushing against the limits of language, particularly in relation to mentally disabled women. The novels and plays examined function as creative objects that refigure the reader’s relationship to mental disability through embodied (...) reading practices. In resisting previous tendencies to read literary representations of mental disability as metaphor, I offer an alternative framework for understanding mental disability as an ongoing interactive process between bodies. Drawing on work from disability studies, critical gender studies, and trauma theory, I call for approaches to mental disability in literature that understand reading as an interactive process between reader and text, proposing a methodology for understanding how embodied reading practices inspire new understandings of mental disability and trauma in emerging global communities. In appreciating mental disability as an ongoing interactive process between bodies, readers can better attend to the nuanced ways in which complex embodiment calls for innovative modes of storytelling that challenge histories of representation. (shrink)

With increased frequency, reproductive technologies are placing prospective parents in the position of choosing whether to bring a disabled child into the world. The most well-known objection to the act of “selecting against disability” is known as the Expressivist Argument. The argument claims that such acts express a negative or disrespectful message about disabled people and that one has a moral reason to avoid sending such messages. We have two primary aims in this essay. The first is to critically examine (...) the standard Expressivist Argument, which we analyze in terms of the expression of ableist attitudes. We distinguish three interpretations of the argument and argue that each version faces serious objections. Our second aim is to articulate two distinct but closely related arguments that also pertain to expressed ableist attitudes. The Expressive Harms Argument maintains that there is a moral reason to avoid actions that give rise to the perception of ableist attitudes in cases where this is likely to have negative consequences for disabled people. The Ableist Motivation Argument speaks against selecting against disability in cases where one would be motivated by ableist attitudes. While these two arguments face various objections, we seek to establish that they are more promising than the most natural interpretations of the Expressivist Argument. (shrink)

In the essay “Cézanne’s Doubt,” Merleau-Ponty explores the relationship between Paul Cézanne’s art and his embodiment. The doubt in question is ultimately about the meaning of his disabilities. Should Cézanne’s disabilities or impairments shape how we interpret his art or should they instead be treated as incidental, as mere biographical data? Although Merleau-Ponty's essay isn’t intended to be phenomenological, its line of questioning is as much about lived experience as it is about art criticism, art history, and aesthetics. I here (...) offer a reading of “Cézanne’s Doubt” as an exploration of one of the more fundamental issues for phenomenological methodology: the relationship between normality and the normate. I first defend this phenomenological and disability-centric or crip reading of the essay. I then argue that insofar as one takes oneself to be “normal” and insofar as doing so underwrites phenomenological inquiry, the problematic of the normate, not just that of normality, is central to phenomenology. (shrink)

Philosophical interest in disability is rapidly expanding. Philosophers are beginning to grasp the complexity of disability--as a category, with respect to well-being and as a marker of identity. However, the philosophical literature on justice and human rights has often been limited in scope and somewhat abstract. Not enough sustained attention has been paid to the concrete claims made by people with disabilities, concerning their human rights, their legal entitlements and their access to important goods, services and resources. This book discusses (...) how effectively philosophical approaches to distributive justice and human rights can support these concrete claims. It argues that these approaches often fail to lend clear support to common disability demands, revealing both the limitations of existing philosophical theories and the inflated nature of some of these demands. Moving beyond entitlements, the author also develops a unique conception of dignity, which she argues illuminates the specific indignities experienced by people with disabilities in the allocation of goods, in the common experience of discrimination and in a wide range of interpersonal interactions. Disability with Dignity offers an accessible and extended philosophical discussion of disability, justice and human rights. It provides a comprehensive assessment of the benefits and pitfalls of theories of human rights and justice for advancing justice for the disabled. It brings the moral importance of dignity to the centre, arguing that justice must be pursued in a way that preserves and promotes the dignity of people with disabilities. (shrink)

This book explores our ethical responsibilities regarding health in general and disabilities in particular. Disability studies and human enhancement stand out as two emerging areas of research in medical ethics, prompting debates into ethical questions of identity, embodiment, discrimination, and accommodation, as well as questions concerning distributive justice and limitations on people’s medical rights. Edited by two ethicist philosophers, this book combines their mastery of the theoretical debates surrounding disability and human enhancement with attention to real world questions that health (...) workers and patients may face. By including a wide range of high-quality voices and perspectives, the book provides an invaluable resource for scholars who are working on this important and emerging area of leadership and health care ethics. (shrink)

The Bad-Difference View of disability says, roughly, that disability makes one worse off. The Mere-Difference View of disability says, roughly, that it doesn’t. In recent work, Barnes – a MDV proponent – offers a detailed exposition of the MDV. No BDV proponent has done the same. While many thinkers make it clear that they endorse a BDV, they don’t carefully articulate their view. In this paper, I clarify the nature of the BDV. I argue that its best interpretation is probabilistic (...) and comparative: it is the view that a person is likely to be, all things considered, worse off with a disability than without. As such, Barnes – who criticises the version of the BDV that disability by itself, intrinsically or automatically makes a person worse off – misses an opportunity to attack the most plausible and relevant version of the BDV, and the best version remains unchallenged. (shrink)

This article asks whether personal ventilators should be redistributed to maximize lives saved in emergency condition, like the COVID-19 pandemic. It begins by examining extant claims that items like ventilators are literally parts of their user’s bodies. Arguments in favor of incorporation for ventilators fail to show that they meet valid sufficient conditions to be body parts, but arguments against incorporation also fail to show that they fail to meet clearly valid necessary conditions. Further progress on this issue awaits clarification (...) of difficult normative, conceptual, and metaphysical questions about the possible boundaries of a person’s body. Rather than relying solely on incorporation arguments, we propose an argument against reallocation from widely accepted anti-discrimination principles. Possession of a personal ventilator is an obvious marker of disability identity; thus, reallocating ventilators from those that already possess them discriminates on the basis of a stigmatized trait – a paradigm case of presumptively wrongful discrimination. This discrimination claim, taken together with uncertainty about the bodily status of ventilators, yields a strong presumption against personal ventilator reallocation. (shrink)

Tamamlayıcı ve alternatif tıp (TAT) uygulamaları temel tıbbi tedaviye ek ya da temel tıbbi tedavinin yerine kullanılan, uygulamaları genelde konvansiyonel tıp tarafından tedavi olarak kabul edilmeyen çeşitli tıbbi ve sağlık bakım sistemi, pratikleri ve ürünleri olarak tanımlanmaktadır (Hossein et al., 2014, Amira ve Okubadejo, 2007; National Institutes of Health [NIH], 2018). TAT konusunda yapılan araştırmalar Afrika, Asya ve Latin Amerika gibi gelişmemiş ya da gelişmekte olan ülkelerde hastaların bazı tedavi ihtiyaçlarını karşılamak amacıyla geleneksel uygulamalara başvurmaları doğrultusunda geleneksel tıp teriminin tamamlayıcı (...) ve alternatif tıpa karşılık gelecek şekilde kullanıldığını da göstermektedir. (shrink)

ABSTRACT In this article, I indicate how the naturalized and individualized conception of disability that prevails in philosophy informs the indifference of philosophers to the predictable COVID-19 tragedy that has unfolded in nursing homes, supported living centers, psychiatric institutions, and other institutions in which elders and younger disabled people are placed. I maintain that, insofar as feminist and other discourses represent these institutions as sites of care and love, they enact structural gaslighting. I argue, therefore, that philosophers must engage in (...) conceptual engineering with respect to how disability and these institutions are understood and represented. To substantiate my argument, I trace the sequence of catastrophic events that have occurred in nursing homes in Canada and in the Canadian province of Ontario in particular during the pandemic, tying these events to other past and current eugenic practices produced in the Canadian context. The crux of the article is that the COVID-19 pandemic has thrown into vivid relief the carceral character of nursing homes and other congregate settings in which elders and younger disabled people are confined. -/- KEYWORDS carceral, conceptual engineering, nursing home-industrial-complex, philosophy of disability, structural gaslighting. (shrink)

Ethical debates about liberal eugenics frequently focus on the supposed unnaturalness of its means and possible harm to autonomy. I present a Nietzsche-inspired critique focusing on intention rather than means and harm to abilities rather than to autonomy. I first critique subjective eugenics, the selection of extrinsically valuable traits, drawing on Nietzsche’s notion of ‘slavish’ values reducible to the negation of another’s good. Subjective eugenics slavishly evaluates traits relative to a negatively evaluated norm (eg, above-average intelligence), disguising a harmful intention (...) to diminish the relative value of that norm. I then argue there is no objective form of eugenics on the Nietzschean ground that abilities are not valuable intrinsically; they are valuable only if one possesses the relative power to exercise them. Abilities frustrated by conflict with other abilities or environment are harmful, while disabilities that empower one’s other abilities are beneficial. Consequently, all forms of eugenics are subject to the prior ethical critique of subjective eugenics. (shrink)

Disorders of Consciousness (DoCs) raise difficult and complex questions about the value of life for persons with impaired consciousness, the rights of persons unable to make medical decisions, and our social, medical, and ethical obligations to patients whose personhood has frequently been challenged and neglected. Recent neuroscientific discoveries have led to enhanced understanding of the heterogeneity of these disorders, and focused renewed attention on the medical and ethical problem of misdiagnosis. -/- This book examines the entanglement of epistemic and ethical (...) uncertainty in DoCs and other medical contexts, and how they interact to create both epistemic and ethical risks. Philosopher and bioethicist L. Syd M Johnson pulls together multiple threads in this work: the ontological mysteries of consciousness, medical uncertainty about unconsciousness, ableist bias, withdrawal of treatment in neurointensive care, and the rarely questioned view that consciousness is essential to personhood and moral status. Johnson challenges longstanding bioethical dogmas about DoC patients, and argues for an ethics of uncertainty for contexts where there is a need for decisive action in the presence of unavoidable uncertainty. The ethics of uncertainty refocuses ethical inquiry concerning persons with DoCs, placing less emphasis on their contested personhood, and more on inductive risk and uncertainty, on respect for autonomy, and especially on epistemic justice. With applications to various decisional contexts where uncertainty and ethical risk interact, this ethical approach enables surrogate decision makers facing fraught and risky choices to fulfill their obligations as moral and epistemic agents. (shrink)

Self-control is that which is enacted to align our behaviour with intentions, motives, or better judgment in the face of conflicting impulses of motives. In this paper, I ask, what explains interpersonal differences in self-control? After defending a functionalist conception of self-control, I argue that differences in self-control are analogous to differences in mobility: they are modulated by inherent traits and environmental supports and constraints in interaction. This joint effect of individual biology and environmental factors is best understood in terms (...) of access to self-control behaviours. I sketch an account of access as including the three criteria of means, awareness, and non-excessive effort. I further demonstrate that people with disorders such as ADHD have limited access to self-control behaviours and stand therefore at a disadvantage with regard to self-control. (shrink)

This commentary continues an exchange on eugenics in Monash Bioethics Review between Anomaly (2018), Wilson (2019), and Veit, Anomaly, Agar, Singer, Fleischman, and Minerva (2021). The eponymous question, “Can ‘Eugenics’ be Defended?”, is multiply ambiguous and does not receive a clear answer from Veit et al.. Despite their stated desire to move beyond mere semantics to matters of substance, Veit et al. concentrate on several uses of the term “eugenics” that pull in opposite directions. I argue, first, that Veit et (...) al. (2021) makes much the same error as does Anomaly (2018) in characterizing eugenics; second, that the paper misunderstands the relationship between eugenics and enhancement; and third, that it distorts the views expressed in my “Eugenics Undefended”. (shrink)

This is the introduction to the inaugural issue of The Journal of Philosophy of Disability.

It may appear that there are grounds for an alliance between opponents of enhancement and disability advocates. People from both camps condemn parents who aspire to improve the physical and psychological traits their children would otherwise be born with, a condemnation often expressed as an accusation of eugenics. Despite these superficial appearances, the author will argue that disability advocates have nothing to applaud in Michael Sandel’s critique of enhancement, which is based on false and sometimes pernicious claims about the value (...) of ‘normal’ human beings. However, they will also argue that disability advocates fail to provide convincing reasons for condemning parental decisions to avoid or eliminate certain traits their children would otherwise be born with. Contrary to what disability advocates and opponents of enhancement suggest, it is often a violation rather than an instantiation of parental virtue to abandon judgements about whether one’s children’s biological givens should be changed. (shrink)

It has been argued that dignity is a useless concept that adds nothing to existing moral vocabulary: it is just a slogan. In this chapter, it is argued that only a concept of dignity can adequately explain a serious moral wrong inflicted on people with disabilities, namely their relegation to inferior social status. Far from being useless, it uniquely explains why fundamental changes to social relations are needed to secure justice. Moreover, dignity matters just as much for people with cognitive (...) impairments as it does for everyone else. As such, fraught debates about the moral standing of people with severe cognitive impairment are largely irrelevant to explaining why they, too, should be treated as social equals. (shrink)

Individuals suffering from anorexia-nervosa experience dysmorphic perceptions of their body and desire to act on these perceptions by refusing food. In some cases, anorexics want to refuse food to the point of death. In this paper, I answer this question: if an anorexic, A, wants to refuse food when the food would either be life-saving or prevent serious bodily harm, can A’s refusal be valid? I argue that there is compelling reason to think that anorexics can validly refuse food, even (...) in these extreme circumstances. (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)

The harm usually associated with psychopathy requires therapeutically, legally, and ethically satisfactory solutions. Scholars from different fields have, thus, examined whether empirical evidence shows that individuals with psychopathic traits satisfy concepts, such as responsibility, mental disorder, or disability, that have specific legal or ethical implications. The present paper considers the less discussed issue of whether psychopathy is a disability. As it has been shown for the cases of the responsibility and mental disorder status of psychopathic individuals, we argue that it (...) is undecided whether psychopathy is a disability. Nonetheless, based on insights from disability studies and legislations, we propose that interventions to directly modify the propensities of individuals with psychopathic tendencies should be balanced with modifications of the social and physical environments to accommodate their peculiarities. We also suggest how this social approach in some practical contexts that involve non-offender populations might be effective in addressing some of the negative effects of psychopathy. (shrink)