How should we respond to individuals with disabilities? What does it mean to be disabled? Over fifty million Americans, from neonates to the fragile elderly, are disabled. Some people say they have the right to full social participation, while others repudiate such claims as delusive or dangerous. In this compelling book, three experts in ethics, medicine, and the law address pressing disability questions in bioethics and public policy. Anita Silvers, David Wasserman, and Mary B. Mahowald test important theories of justice (...) by bringing them to bear on subjects of concern in a wide variety of disciplines dealing with disability. They do so in the light of recent advances in feminist, minority, and cultural studies, and of the groundbreaking Americans with Disabilities Act. (shrink)

Fifteen original essays open up a novel area of inquiry: the distinctively ethical dimensions of women's experiences of and in aging. Contributors distinguished in the fields of feminist ethics and the ethics of aging explore assumptions, experiences, practices, and public policies that affect women's well-being and dignity in later life. The book brings to the study of women's aging a reflective dimension missing from the empirical work that has predominated to date. Ethical studies of aging have so far failed to (...) emphasize gender. And feminist ethics has neglected older women, even when emphasizing other dimensions of 'difference.' Finally work on aging in all fields has focused on the elderly, while this volume sees aging as an extended process of negotiating personal and social change. (shrink)

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

A feminist ethics that bases morality on dependence or vulnerability challenges the moral priority of uniform over disparate treatment. Persons with disabilities resist equality's homogenization of moral personhood. But displacing equality in favor of caring or trust reprises the repression of those already marginalized. The ethics of difference proves an ineffective remedy for the negative consequences attendant on how historically marginalized groups are different. An historicized conception of equality resolves the dilemma.

Medical issues affecting health care have become everyday media events. In response to mounting public concern, growing numbers of bioethicists are being appointed to medical school faculties and public policy panels. However the ideas voiced in these forums are seldom informed by feminist perspectives. In this important book, a distinguished group of feminist scholars and activists discuss crucial bioethics topics in a feminist light. Among the subjects explored are the care/justice debates, transforming bioethics, practice, and reproduction. The book also covers (...) less commonly discussed issues, such as culturally appropriate responses to reproductive health problems in developing countries. (shrink)

Because medicine can preserve and restore health and function, it has been widely acknowledged as a basic good that a just society should provide its members. Yet there is wide disagreement over the scope of what is to be provided, to whom, how, when and why. In this uniquely comprehensive book some of the best-known philosophers, doctors, lawyers, political scientists, and economists writing on the subject discuss the concerns and deepen our understanding of the theoretical and practical issues that run (...) through the contemporary debate. The first section lays a broad theoretical basis for understanding the subject of justice, particularly as it relates to the distribution of health care. The second section critically examines how medical care is distributed in different countries around the world and the particular advantages and injustices associated with those systems. The third section draws attention to the special needs of different social groups and the specific issues of justice that are raised by the impact of various policies on health care distribution. The concluding section delves into the dilemmas that confront those designing health care systems - the politics, the priorities, and the place of desires as opposed to needs in a socially just scheme. (shrink)

Elizabeth Barnes’s recently proposed value-neutral model for disability provoked a familiar storm of oft-made objections from philosophers who appear committed to equating being disabled with being intrinsically or inescapably disadvantaged. Their narrow framing of the options for disabled people is influenced, I suggest, by purposes to which “disability” now is put. But there are both epistemic and moral reasons to refrain from importing the normative narrowness imposed by these purposes into our philosophical investigation of disability. Barnes’s ontological account opens up (...) our framing options. Developing a full institutional theory of disability that both rests on and extrapolates from a social ontology of disablement is a promising direction for exploration at the intersect of metaphysics and public policy in the new field of Philosophy and Disability. (shrink)

A feminist ethics that bases morality on dependence or vulnerability challenges the moral priority of uniform over disparate treatment. Persons with disabilities resist equality's homogenization of moral personhood. But displacing equality in favor of caring or trust reprises the repression of those already marginalized. The ethics of difference proves an ineffective remedy for the negative consequences attendant on how historically marginalized groups are different. An historicized conception of equality resolves the dilemma.

The 1990 Americans with Disabilities Act enacted a conceptual shift in the meaning of ‘disability.’ Rather than defining ‘disability’ as a disadvantageous physical or mental deficit of persons, it codifies the understanding of ‘disability’ as a defective state of society which disadvantages these persons. In contrast, the standard medical model incorrectly conceptualizes disabled persons as biologically inferior, and thus confines them to the role of recipients of benevolence or care. Turning to an ethic of caring yields counter-intuitive results that conflict (...) with the conceptual apparatus of the ADA. It is argued that in order to liberate social thought from this medical model and thus move the disabled from being socially marginalized to being socially enabled, one must re-conceptualize current practice by adopting the ADA's conceptual framework. Keywords: caring, disability, equality, ethics, health care polic CiteULike Connotea Del.icio.us What's this? (shrink)

BackgroundEnd-of-life decision making constitutes a major challenge for bioethical deliberation and political governance in modern democracies: On the one hand, it touches upon fundamental convictions about life, death, and the human condition. On the other, it is deeply rooted in religious traditions and historical experiences and thus shows great socio-cultural diversity. The bioethical discussion of such cultural issues oscillates between liberal individualism and cultural stereotyping. Our paper confronts the bioethical expert discourse with public moral attitudes.MethodsThe paper is based on a (...) qualitative study comprising 12 focus group discussions with religious and secular persons in the USA, Germany, and Israel. Considering the respective socio-political and legal frameworks, the thematic analysis focuses on moral attitudes towards end-of-life decision making and explores the complex interplay between individual preferences, culture, and religion.ResultsOur findings draw attention to the variety and complexity of cultural and religious aspects of end-of-life decision making. Although there is local consensus that goes beyond radical individualism, positions are not neatly matched with national cultures or religious denominations. Instead, the relevance of the specific situatedness of religious beliefs and cultural communities becomes visible: Their status and role in individual situations, for example, as consensual or conflicting on the level of personal perspectives, family relationships, or broader social contexts, e.g., as a majority or minority culture within a political system.ConclusionsAs the group discussions indicate, there are no clear-cut positions anchored in “nationality,” “culture,” or “religion.” Instead, attitudes are personally decided on as part of a negotiated context representing the political, social and existential situatedness of the individual. Therefore, more complex theoretical and practical approaches to cultural diversity have to be developed. (shrink)

To some students with disabilities who take philosophy classes, and even to some professors with disabilities who teach philosophy, the discipline is not welcoming. Philosophical theory traditionally recognizes so-called normal people and common modes of functioning but seems to ignore or disparage biologically anomalous individuals. The adequacy of our epistemological and ethical philosophies is a pressing reason for us to acknowledge disability in philosophical theorizing. And there are equally pressing reasons to acknowledge that students with various kinds of disabilities are (...) members of our classes. In this special issue of Teaching Philosophy the authors reflect on how disability is engaged with in their philosophy classrooms for and by their students, and in the philosophy they teach. (shrink)

Giubilini and Minerva ask why birth should be a critical dividing line between acceptable and unacceptable reasons for terminating existence. Their argument is that birth does not change moral status in the sense that is relevant: the ability to be harmed by interruption of one's aims. Rather than question the plausibility of their position or the argument they give, we ask instead about the importance to scholarship or policy of publishing the article: does it to any extent make a novel (...) or needed addition to the literature? Giubilini and Minerva's argument is remarkably similar to one advanced by Michael Tooley in ‘Abortion and Infanticide,’ almost 40 years ago. There have been immense changes in the intervening 40 years: in the ability to diagnose conditions early in pregnancy, in genetics and in the availability of in vitro fertilization; in understanding of the capabilities of persons with disabilities; in law; in economic support and access to healthcare for pregnant women and their children; in social customs and arrangements; and even in philosophy, with developments in feminist thought, bioethics and cognitive science. Some of these changes have been for the better, but others, such as the unravelling of social safety nets, have arguably been for the worse. Any or all of these changes might give rise to moral reasons for the relevance of birth that were not available 40 years ago. These changes might also be relevant to the identification of cases, if any, in which ‘after-birth abortion’ might be considered. If context is relevant to the applicability of moral reasons—as for theorists of justice in the non-idealised world it surely should be—it is questionable whether a view of the birth-line that ignores contextualising change can be adequate. (shrink)

(2001). No Basis for Justice: Equal Opportunity, Normal Functioning, and the Distribution of Healthcare. The American Journal of Bioethics: Vol. 1, No. 2, pp. 35-36.

Proponents of using medical technology for enhancement sometimes misunderstand how the biology of enhancement works. Appreciation of biological diversity supports a program of enhancement. Acknowledging a liberty right to be biologically different addresses worries abut enhancement’s being undemocratic. Doing so also suggests changes in emphasis to strengthen the case for enhancement.

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