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Disabled – therefore, Unhealthy?

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Abstract

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 (a) one can be disabled only because limited by false social perception of impairment and (b) 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.

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Notes

  1. None of these highly capable people emphasize ‘disability’ in their self-description; but most seem willing to accept the label where it is useful (to, e.g., highlight solidarity with other disabled people) (Grandin 2006, 2007; Matlin 2007; McFadden 2014).

  2. References below, throughout.

  3. More will be said later about the notion of ‘abnormal’ function; for now, I mean to use it in the standard medical sense explicated in (Boorse 1977) Boorse’s theory is of course controversial; I rely on it, arguendo, because it is the account of normal function least likely to support healthy disability. For a particularly trenchant line of criticism of Boorsean views, here, see (Amundson 2000).

  4. A locus classicus for this view is (Oliver 1990) Oliver theorizes the classical ‘British’ social model powerfully expressed in: Union of the Physically Impaired Against Segregation, Fundamental principles of disability, (London: Union of the Physically Impaired Against Segregation, 1976). Cf. (Wasserman et al. op. cit. For discussion of further varieties of the social model.

  5. Americans with Disabilities Act of 1990. Public Law 101–336. §§ 12,102. 108th Congress, 2nd session (July 26, 1990).

  6. Nb.: Baron-Cohen uses ‘disability’ to mean what I mean by ‘impairment’.

  7. Compare, on race: (Haslanger 2000).

  8. Again, I presuppose this Boorsean view of health arguendo.

  9. Note that, if this claim is mistaken, and ‘healthy’ is actually more like ‘tall’, then the conclusion of this section follows without the foregoing complications: there is in that reason not even prima facie reason to think that anyone with an impairment is ‘unhealthy’ because less healthy than they can be.

  10. Cf. here Peter Unger on knowledge; (Unger 1975); also Kennedy (op. cit.).

  11. Made in various places, but deployed and explained for purposes most clearly related to the present ones in “Elusive Knowledge” op. cit.

  12. By ‘healer’ I mean: physician, dentist, nurse, physical therapist, etc.

  13. Cf. again (Lewis 1996), on knowledge.

  14. I owe this point to David Wasserman.

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Acknowledgments

Thanks to David Wasserman, Steve Campbell, and several blind reviewers for helpful comments on drafts. Thanks also to the members of the NIH Department of Bioethics, for many useful discussions. N.b.: the views propsed here do not represent the views of said Department; the NIH, or the US Federal Government.

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Aas, S. Disabled – therefore, Unhealthy?. Ethic Theory Moral Prac 19, 1259–1274 (2016). https://doi.org/10.1007/s10677-016-9735-4

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