This article offers the critical concept misfit in an effort to further think through the lived identity and experience of disability as it is situated in place and time. The idea of a misfit and the situation of misfitting that I offer here elaborate a materialist feminist understanding of disability by extending a consideration of how the particularities of embodiment interact with the environment in its broadest sense, to include both its spatial and temporal aspects. The interrelated dynamics (...) of fitting and misfitting constitute a particular aspect of world-making involved in material-discursive becoming. The essay makes three arguments: the concept of misfit emphasizes the particularity of varying lived embodiments and avoids a theoretical generic disabled body; the concept of misfit clarifies the current feminist critical conversation about universal vulnerability and dependence; the concept of misfitting as a shifting spatial and perpetually temporal relationship confers agency and value on disabled subjects. (shrink)

It is commonly believed that disability disqualifies people from full participation in or recognition by society. This view is rooted in eugenic logic, which tells us that our world would be a better place if disability could be eliminated. In opposition to this position, I argue that that disability is inherent in the human condition and consider the bioethical question of why we might want to conserve rather than eliminate disability from our shared world. To do (...) so, I draw together an eclectic, rather than systematic, configuration of counter-eugenic arguments for conserving disability. The idea of preserving intact, keeping alive, and even encouraging to flourish denoted by conserve suggests that disabilities would be better understood as benefits rather than deficits. I present, then, a reading of disability as a potentially generative resource rather than unequivocally restrictive liability. In other words, what I consider here is the cultural and material contributions disability offers to the world. (shrink)

The Rejected Body argues that feminist theorizing has been skewed toward non-disabled experience, and that the knowledge of people with disabilities must be integrated into feminist ethics, discussions of bodily life, and criticism of the cognitive and social authority of medicine. Among the topics it addresses are who should be identified as disabled; whether disability is biomedical, social or both; what causes disability and what could 'cure' it; and whether scientific efforts to eliminate disabling physical conditions are morally (...) justified. Wendell provides a remarkable look at how cultural attitudes towards the body contribute to the stigma of disability and to widespread unwillingness to accept and provide for the body's inevitable weakness. (shrink)

"In these essays, health care professionals, scholars, and members of the disability community debate the implications of prenatal testing for people with disabilitties and for parent-child relationships generally."--Cover.

In this paper I reflect upon my personal experience of chronic progressive multiple sclerosis in order to provide a phenomenological account of the human experience of disability. In particular, I argue that the phenomenological notion of lived body provides important insights into the profound disruptions of space and time that are an integral element of changed physical capacities such as loss of mobility. In addition, phenomenology discloses the emotional dimension of physical disorder. The lived body disruption engendered by loss (...) of mobility includes a change in the character of surrounding space, an alteration in one's taken-for-granted awareness of objects, the disruption of corporeal identity, a disturbance in one's relations with others, and a change in the character of temporal experience. The loss of upright posture is of particular significance since it not only concretely diminishes autonomy but affects the way one is treated by others. Such a change in posture is, therefore, particularly disruptive in the social world of everyday life. An understanding of the lived body disruption engendered by disability has important applications for the clinical context in devising effective therapies, as well as for the social arena in determining how best to resolve the various challenges posed by chronic disabling disorders. (shrink)

Given its subject matter, biological psychiatry is uniquely poised to lead STEM DEI initiatives related to disability. Drawing on literatures in science, philosophy, psychiatry, and disability studies, we outline how that leadership might be undertaken. We first review existing opportunities for the advancement of DEI in biological psychiatry around axes of gender and race. We then explore the expansion of biological psychiatry’s DEI efforts to disability, especially along the lines of representation and access, community accountability, first person (...) testimony, and revised theoretical frameworks for pathology. We close with concrete recommendations for scholarship and practice going forward. By tackling head-on the challenge of disability inclusion, biological psychiatry has the opportunity to be a force of transformation in the biological sciences and beyond. (shrink)

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

The central issues raised in much of feminist literary theory's early scholarship remain prescient: how does narrative engage with the social‐historical? In what ways does it codify existing structures? How does it resist them? Whose stories are not being told, or read? In this article I use Doris Lessing's novel The Fifth Child (1988) as a text with which to begin to address the above questions by reading with attention to the mother story but also the ‘other’ stories operating both (...) within and outside of the novel; in particular I am concerned with the convergence of maternity, disability and narrative. The novel's co-implication of sexual difference and corporeal difference reveals the ways in which the mother's story is both made possible and authorized by the disabled body of her child, and by his inability to tell his own story. Yet, if The Fifth Child is a horror story that uses the disabled child's body as its ground, it is also about the horror of maternity, in its conception and attendant choices. In this fictional story as well as in the social‐historical narrative circulating at the time of its publication in the late 1980s, both child and mother are indicted in their otherness and it is ultimately impossible to separate one from the other. (shrink)

Recent research showed the potential benefits of robot-assisted therapy in treating children with Autism Spectrum Disorder. These children often have some form of Intellectual Disability too, but this has mainly been neglected by previous robotics research. This article presents an empirical evaluation of robot-assisted imitation training, where the child imitated the robot, integrated into the Treatment and Education of Autistic and related Communication handicapped Children program. The sample included six hospitalized children with different levels of ID, from mild to (...) profound. We applied mixed methods to assess their progress, during treatment and three months later. Results show increased Gross Motor Imitation skills in the children, except for those with profound ID and the therapists’ positive attitude towards the humanoid robot. Furthermore, the therapists suggest how a robot could be used to autonomously collect and analyze the information obtained in the rehabilitation training for a continuous evaluation of the participants. (shrink)

This article is a feminist intervention into the ways that disability is researched and represented in philosophy at present. Nevertheless, some of the claims that I make over the course of the article are also pertinent to the marginalization in philosophy of other areas of inquiry, including philosophy of race, feminist philosophy more broadly, indigenous philosophies, and LGBTQI philosophy. Although the discipline of philosophy largely continues to operate under the guise of neutrality, rationality, and objectivity, the institutionalized structure of (...) the discipline implicitly and explicitly promotes certain ontologies, epistemologies, and methodologies as bona fide philosophy, while casting the ontologies, epistemologies, and methodologies of marginalized philosophies as mere simulacra of allegedly fundamental ways of knowing and doing philosophy and thus rendering these marginalized philosophies more or less expendable. This article is designed to show that legitimized philosophical discourses are vital mechanisms in the problematization of disability. (shrink)

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)

In recent decades, the intertwining ideas of self-determination and well-being have received tremendous support in bioethics. Discussions regarding self-determination, or autonomy, often focus on two dimensions—the capacity of the patient and the freedom from external coercion. The practice of obtaining informed consent, for example, has become a standard procedure in therapeutic and research medicine. On the surface, it appears that patients now have more opportunities to exercise their self-determination than ever. Nonetheless, discussions of patient autonomy in the bioethics literature, which (...) focus on individual patients making particular decisions, neglect the social structure within which health-care decisions are made. Looking through the lens of disability and informed by the feminist conception of relational autonomy, this essay argues that the issue of autonomy is much more complex than the individualist model suggests. The social system and the ableist ideology impose various forms of pressure or oppressive power that can affect people’s ability to choose according to their value system. Even if such powers are not directly coercive, they influence potential parents’ decisions indirectly—they structure their alternatives in such a way that certain options are never considered as viable and other decisions must be made. This paper argues that, instead of only focusing on the individual act of decision-making, we need to pay attention to the social structure that frames people’s decision. (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)

Although laws have been passed to promote disability inclusion in French workplaces, many companies face challenges complying with the required quota of disabled workers. Workplace ableism hinders the implementation of disability laws. To move from apathy to increased compliance, insider activists took proactive action, uncovered ableist practices, and mobilized colleagues at different levels. In this article, I study how some disability rights activists managed to obtain positions as disability managers in their companies in the late 2000s, (...) gaining the ability to design inclusive policies for their organizations. Using ethnographic interviews, I explore how they use their own identities to address ableism, mobilize colleagues to promote the inclusion of disabled workers, and empower disabled employees to obtain accommodation. This study sheds light on the individual, relational, and structural work necessary to move from anti-ableist laws to a concrete and recoupled implementation in the workplace. This also explains why companies offer positions to activists to develop blueprints for compliance. Activists’ work was recognized because regulations were ambiguous but created financial sanctions for non-compliance; ableist cultures created distrust among disabled workers; and organizations needed activists’ extra work to design programs, build expertise, and develop tools to promote inclusion. (shrink)

Individuals with body integrity identity disorder seek to address a non-delusional incongruity between their body image and their physical embodiment, sometimes via the surgical amputation of healthy body parts. Opponents to the provision of therapeutic healthy-limb amputation in cases of BIID make appeals to the envisioned harms that such an intervention would cause, harms such as the creation of a lifelong physical disability where none existed before. However, this concept of harm is often based on a normative biomedical model (...) of health and disability, a model which conflates amputation with impairment, and impairment with a disability. This article challenges the prima facie harms assumed to be inherent in limb amputation and argues in favour of a potential treatment option for those with BIID. To do this, it employs the social model of disability as a means to separate the concept of impairment and disability and thereby separate the acute and chronic harms of the practice of therapeutic healthy-limb amputation. It will then argue that provided sufficient measures are put in place to ensure that those with atypical bodily constructions are not disadvantaged, the chronic harms of elective amputation would cease to be. (shrink)

This paper concerns the question of what makes disability discrimination morally objectionable. When I refer to disability discrimination, I am focusing solely on a failure or denial of reasonable accommodations to a disabled person. I argue a failure to provide reasonable accommodations is wrong when and because it violates principles of relational equality. To do so, I examine four accounts of wrongful discrimination found in the literature and apply these theories to disability discrimination. I argue that all (...) of these accounts leave us wanting because they have implausible implications or other limitations. I then defend my relational egalitarian theory of wrongful disability discrimination. I argue why principles of relational equality can explain the wrongness of failing to accommodate a disabled person. I will then illustrate how my account can identify plausible instances of disability discrimination while avoiding implausible implications. Finally, I discuss some further complications with my account while highlighting its benefits. Importantly, my argument can capture the distinctive wrongness of disability law and policy’s reasonable accommodation mandates. (shrink)

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

abstract Emerging from the political activism of disabled people's movements and mainly theorised by the scholar Michael Oliver, the social model of disability is central to current debates in Disability Studies as well as to related perspectives on inclusive education. This article presents a philosophical critique of the social model of disability and outlines some of its theoretical problems. It argues that in conceptualising disability as unilaterally socially caused, the social model presents a partial and, to (...) a certain extent, flawed understanding of the relation between impairment, disability and society, thus setting a framework that needs clarifications and extensions and presents limits to the achievement of its own aim of inclusion. This article concludes by suggesting that, despite its theoretical limits, the social model acts as a powerful and important reminder to face issues of inclusion as fundamental, moral issues. (shrink)

Policy motives for work for people with a disability (PWD) are divergent along two discourses: work as a right vs norm. Work as a right, based on the UN Convention on the Rights of Persons with Disabilities (UNCRPD), portrays work as a potential gateway for inclusion. Work as a norm fits a neoliberal agenda. It considers labor market participation of all, including PWD, as a civil responsibility crucial for economic welfare. Critics argue that the work as a norm discourse (...) presents a risk for inclusion of PWD. Work is seen as a necessary condition for and not one of many ways to inclusion in society. To make the right to work for PWD work, critical scholars call to unravel whether and how the discourses of work as a right and norm for PWD become intertwined in policy. In response and through the lens of recontextualization, we study how discourses of work as a right and norm for PWD are received, reproduced and reworked in political debate in Flanders (Belgium) over time. We examine policy texts and parliamentary questions of four government terms (2004–2024). The findings illustrate how the work as a right discourse is gradually recontextualized into the work as a norm discourse to legitimize neoliberal policies of strict activation. In accordance, we see a gradual move towards neoliberal-ableism. Although the UNCRPD aims to eradicate ableism, its recontextualization and appropriation reinforces neoliberal-ableism. (shrink)

The relationships between socioeconomic and biogenetic reproduction are always socially constructed but not always acknowledged. These relationships are examined as they apply to an instance of infertility and assisted reproduction presented in a seventeenth-century English play, Thomas Middleton’s 1613 comedy, A Chaste Maid in Cheapside. Middleton’s satirization of the effects of secrecy on the category of reproductive disability is analyzed and its applicability to our own time considered. The discussion is in four parts, focusing on: the attribution of disabled (...) status to one member of the couple, the wife; the use of this attribution to protect the husband’s reputation for sexual and reproductive health; the concealment of the nature of assisted reproduction; and the interests of the child conceived with such assistance. (shrink)

Con el objetivo de diseqar una propuesta de modificacisn al programa de la formacisn de enfermeros y sugerir la inclusisn de temas sobre la discapacidad infantil, que permitan instruir al personal en formacisn, se realizs un estudio descriptivo cualitativo, en dos etapas, en la primera, mediante entrevistas se recogis la opinisn del claustro de profesores de la Licenciatura en Enfermerma de la Universidad de Ciencias Midicas de Camag|ey, en una segunda etapa se aplics el mitodo de Panel de Expertos, en (...) el que participaron diez expertos seleccionados de manera intencional a partir de su prestigio, experiencia y vinculacisn a la docencia, en lo referido al tema. Se analizaron los programas rectores de la carrera de formacisn en Enfermerma. El analisis de los mismos permitis apreciar aspectos tan importantes como el trabajo con la familia del discapacitado, o los procedimientos propios del manejo en el domicilio del discapacitado, los cuales no son objeto de estudio en la carrera. Se diseqs una estrategia curricular teniendo en cuenta los objetivos pedagsgicos a cumplimentar con las modificaciones propuestas. Se impone la necesidad de incluir en los programas de estudios aspectos relacionados con esta compleja tematica. Constituye un reto entonces para la universidad continuar desarrollando estrategias que permitan el desarrollo del proceso docente educativo y garanticen calidad en el egresado. In order to design a modification proposal to the nurses training program and suggest the inclusion of topics on the child disability, enabling to instruct staff in training, a qualitative descriptive study was carried out in two stages. In the first stage, opinions through interviews to the staff of the Nursing Faculty of the University of Medical Sciences of Camag|ey were collected. In the second stage, the method of Experts Panel was applied. Ten experts were chosen intentionally taking into account their prestige, experience and links to teaching in regard to the subject. Guiding programs of the career of nursing training were analyzed. This analysis gave the possibility to appreciate important aspects, such as the work with the family of disabled children, and management procedures in their home, which are not the object of study in the career. A curricular strategy was designed taking into account the educational objectives to be fulfilled with the proposed modifications. It is necessary to include those aspects related to this complex subject in the programs. To continue developing strategies that allow improving the educational teaching process and ensuring the quality of graduated students represents a challenge to the University. (shrink)

This paper charts the concepts of grip and the bodily auxiliary in Maurice Merleau-Ponty to consider how they find expression in disability narratives. Arguing against the notion of “maximal grip” that some commentators have used to explicate intentionality in Merleau-Ponty, I argue that grip in his texts functions instead as a compensatory effort to stave off uncertainty, lack of mastery, and ambiguity. Nearly without exception in Phenomenology of Perception, the mobilization of “grip” is a signal of impending loss, and (...) is offered as a strategy for managing failure rather than as an example of sure-footed mastery. I read Merleau-Ponty alongside Mary Felstiner's Out of Joint: A Public and Private Story of Arthritis to explore these other, attenuated dimensions of grip. Finally, the paper turns to Harriet McBryde Johnson's memoir Too Late to Die Young as an example of a way of thinking disabled embodiment otherwise. (shrink)

In this paper I look at the much-discussed case of disabled parents seeking to conceive disabled children. I argue that the permissibility of selecting for disability does not depend on the precise impact the disability will have on the child’s wellbeing. I then turn to an alternative analysis, which argues that the permissibility of selecting for disability depends on the impact that disability will have on the child’s future opportunities. Nearly all bioethicists who have approached the (...) issue in this way have argued that disabilities like deafness unacceptably constrain a child’s opportunities. I argue, however, that this conclusion is premature for several reasons. Most importantly, we don’t have a good way of comparing opportunity sets. Thus, we can’t conclude that deaf children will grow up to have a constrained set of opportunities relative to hearing children. I conclude by suggesting that bioethicists and philosophers of disability need to spend more time thinking carefully about the relationship between disability and opportunity. (shrink)

This article argues that state laws banning abortions for disability violate reproductive justice for parents with disabilities. These bans deprive people with disabilities of choices that may be important to their possibilities of becoming parents, including possibilities for abortion of pregnancies that have become risky to continue. Far from protecting disability civil rights, these state law bans restrict the abilities of people with disabilities to choose to have children and to parent.

This essay re-examines the disability critique of prenatal and pre-implantation screening in light of evidence about the larger context in which fertility and reproductive healthcare is rendered in the U.S. It argues that efforts to identify acceptable criteria for trait-based selection or otherwise impose reasons-based limitations on reproductive choice should be avoided because such limitations tend to perpetuate the discrimination encountered by adults with disabilities seeking fertility and reproductive health services.

When examining the history of early imperial China one is struck by the number of important personages, from Han Feizi 韓非子 and Yang Xiong 揚雄 to Guo Pu 郭璞 and Wang Wei 王微, who are described in biographical records as kouji 口吃. This paper contextualizes these descriptions by examining both the hermeneutical tradition regarding the language used to describe this condition and its evolving understanding in the traditional Chinese medical records. These two broad bodies of social understanding provide a compelling (...) tool for interpreting and contextualizing the many descriptions of individuals in the early imperial biographical tradition. It becomes clear when taken in this larger context and as a collective that this condition is not just a random oddity to be included in a biography as merely an outlying feature of an individual, but that disfluency was understood in the much more highly charged realm of language production and moral practice. It spoke to the long-standing tension over rhetorical skill versus moral intent, form versus content. Finally, what also emerges from the collective is a clearer understanding of the range of strategies that individuals with this disability found to navigate the specific social context of early imperial elite culture. It is out of these dual views, collective-moral and individual-functional, that this study provides insights into the lives of these highly influential individuals and adds layers to our understanding of the social and medical context for individuals with disabilities in early imperial China. (shrink)

British equality law protections for sex and gender reassignment have grown fraught as activists tussle over legal and social categories of gender, gender transitioning, and sex. This article considers the future of gender-related equality protections in relation to ‘decertification’—an imagined reform that would detach sex and gender from legal personhood. One criticism of decertification is that de-formalising gender membership would undermine equality law protections. This article explores how gender-based equality law could operate in conditions of decertification, drawing on legal thoughtways (...) developed for two other protected characteristics in equality law—religion and belief, and disability—to explore the legal responses and imaginaries that these two grounds make available. Religious equality law focuses on beliefs, communities, and practices, deemed to be stable, multivarious, and subject to deep personal commitment. Disability equality law focuses on embodied disadvantage, approached as social, relational, and fluctuating. While these two equality frameworks have considerable limitations, they offer legal thoughtways for gender oriented to both its hierarchies and its expression, including as disavowal. (shrink)

Consider: You can save either a human or a normal adult dog from a burning building (with no risk to yourself and at little cost), but not both. However, the human is a human with a severe intellectually disability (or, as we shall say, a “SID”). -/- Which one should you save? There is disagreement in the literature about which this issue. Two opposing camps exist, which we call “the intrinsic property camp ” and “the special relations camp.” Those (...) in the intrinsic property camp think that in most cases it is equally permissible to save either the dog or the human, and that in fact in some cases you should save the dog and not the human. Those in the special relations camp, by contrast, maintain that you should always save the human and not the dog. There is disagreement between these two camps about the answer to this question because there is disagreement between them about the moral significance of SIDs. Those in the intrinsic property camp believe that the moral value of a human with a SID is equal to (and in some cases less than) the moral value of a nonhuman animal such as a dog. (They thus believe that the value of a human with a SID is strictly less than the value of a normal adult human.) Those in the special relations camp believe that the value of a human with a SID is strictly higher than the value of a nonhuman animal. (But they are not thereby committed to, but may nonetheless believe, that a human with a SID has equal moral value to a normal adult human.) The questions we address in this chapter include: 1. Why do those in each camp hold the view that they do? 2. Which camp is right? (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Pathology of the Mind: Disorder Versus DisabilityRichard G. T. Gipps (bio)Keywordsorder, disorder, ability, disability, mental illnessAlfredo Gaete (2008) describes mental disorders as impairments in intentionality, phenomenal consciousness, and intelligence that cause harm to the affected person. I found persuasive Gaete’s claim that the concept of ‘mental disorder’ is best understood as nontheoretical and nontechnical. I also find compelling his argument that a previous contribution of my own—which relied (...) in part on specifying different senses of ‘disorder’ in psychological, physiological, and social cases—was misguided. Further, his suggestion that we ought at least to attempt analysis in terms of necessary and sufficient conditions before we seek out less definitive characterizations (in terms of family resemblances) also persuades me, although I find myself less sanguine than he about the general possibility of achieving such analyses.One of Gaete’s principal claims is that mental disorder is helpfully understood in terms of an absence of a capacity—that is, as a disability. There are two related objections—or two aspects of the same objection—that I would like to offer the author with respect to this claim. These may well not be conclusive, but will I hope at least function as foils against which the author can usefully sharpen his argument. One objection suggests that there is a viable distinction between the concepts of mental disorder and mental disability, as commonly used in clinical contexts, which the account offered seems unable to respect. The second suggests that the account may not be able to theorize what is argued to be the essential contribution of the concepts of order and disorder (as opposed to ability and disability) to the everyday concept of mental disorder. Accordingly, it questions the power of a disability approach such as Gaete’s to capture the essential nature of mental disorder.In his paper, Gaete classifies mental retardation and developmental, or (what in the United Kingdom are known as) learning, disabilities (autism, etc.) as cases of mental disorder. I found this surprising because it is not common linguistic practice in the psychological circles in which I operate. It would also seem to make a nonsense of commonly accepted ideas like: “Mental disorders are more likely to occur in patients with developmental disabilities (e.g., in autism, Asperger, or Down syndrome) than in the general population.” (For an example, see Campbell and Malone [1991]). On Gaete’s classification, it would appear that people with autism eo ipso have a mental disorder, and [End Page 341] hence the commonly accepted idea would need to be interpreted as merely a statement about comorbidities of different disorders of the same general (i.e., mental) type. But that is not, I believe, how the term is commonly used, and Gaete’s suggestion must therefore be treated as revisionary rather than descriptively analytical.One way of reconstructing a rationale underlying the distinction between mental disabilities and mental disorders is as follows. A developmental disability involves a failure of (certain aspects of) the mind to grow and reach an expected level or type of organization. A mental disorder by contrast involves a disturbance or disorganization (not simply an impoverishment) within the mind at whichever level of organization it has reached. As the mind develops, and reaches new levels or types of organization, the forms which mental disorders may take accordingly change.Autism and schizophrenia provide helpful illustrations of this distinction. Autism represents a failure of (among other things) the social mind to develop in childhood. The person with moderate to severe autism may attain at best a very shaky grasp on the realities of other minds and social conventions. That is, the degree of mental structure they obtain—their social competencies or capacities—will likely remain limited. It is this fundamental deficit that marks out the disability, and not the social anxieties or other such disturbances that can beset the autistic person.Schizophrenia, by contrast, tends to occur at late adolescence, when the individual has developed higher levels of—albeit often fragile—mental structure. Yet it is not the fragility of such mental structure, but rather the disruptions that can occur within such structures as have developed, that mark them out... (shrink)

This book offers new direction in disability studies, by integrating the medical and social model of disability. The first aim is to provide an integral approach to thinking about impairment and disability through the integrative lens of being vulnerable. The second aim is to transcend the normative trap which impairment and disability debate finds itself locked in. Disability debate is trapped in a normative struggle to escape oppressive norms. Either, by legitimizing the desire to be (...) free from impairment, where a legitimization identity is promoted through the medical model. Or, by resisting discriminative social norms, where the desire is to be free from oppressive social barriers that exist on top of having impairment. Identifying with one’s vulnerability, or embodied uncertainty, allows for the possibility of forging meaning and building new identity. It allows freedom to express embodied difference, rather than to transform or defend it. (shrink)

Persons with dementia often prefer to participate in decisions about their health care, but may be prevented from doing so because healthcare decision-making law facilitates use of advance directives or surrogate decision makers for persons with decisional impairments such as dementia. Federal and state disability law provide alternative decision-making models that do not prevent persons with mild to moderate dementia from making their own healthcare decisions at the time the decision needs to be made. In order to better promote (...) autonomy and wellbeing, persons with dementia should be accommodated and supported so they can make their own healthcare decisions. (shrink)

The exclusion of the elderly and people with disabilities from cancer clinical research without appropriate justification is discriminatory and is at odds with the ethos of EU principles, laws and research regulations. It further limits study generalizability. Several primary EU laws fronted by the European Charter prohibit engaging in disparate impact discrimination on the grounds of age and disability in all of EU tasks.

This chapter seeks to advance two central claims: 1) that the therapy-enhancement distinction is not an absolute one; and 2) that the social model of disability can be applied as at least one possible criterion for evaluating the ethics of enhancement. First, I address the limits of the therapy-enhancement distinction by showing that some accepted forms of therapy are indeed enhancements in their own right. The line between enhancement and therapy in medicine is therefore not clear-cut, but nor is (...) the difference between enhancement and disability straightforward either, as I argue. I discuss how some forms of apparent enhancement may in fact make people disabled from a social point-of-view, for they would not be able to function well in a society “fine-tuned” towards the current average range of abilities. Enhancement is therefore a slippery notion, and one that brings into relief questions of equity and of oppression. If enhancement is meant to be a key stepping stone on the path towards a posthuman condition, as some claim, then the ambiguous nature of enhancement surely throws into the question the coherence of the “post” in “posthuman.”. (shrink)

In recent years, the question of whether prospective parents might have a moral obligation to select against disability in their offspring has piqued the attention of many prominent philosophers and bioethicists, and a large literature has emerged surrounding this question. Rather than looking to the most common arguments given in support of a positive response to the abovementioned question, such as those focusing on the harms disability may impose on the child created, duties and role-specific obligations, and impersonal (...) ‘harms’, a less commonly made set of arguments is focused upon which looks to the harms that a decision not to select against disability may impose on others. Three different possible arguments supporting a limited duty of disability avoidance are thus identified and subsequently explored: harms to parents themselves, harms to existing family members, and harms to other existing members of society. (shrink)

“Gut issues” refers to any condition that affects our digestive systems and that causes pain or discomfort. The term points to the experience of our gut being an issue for us – interfering with our plans, undermining our bodily self-control, threatening our well-being. This paper aims to do three things: (1) to introduce and justify a disability theory approach to gut issues; (2) to use this lens to argue that the experience of gut issues has a social and relational (...) dimension that could be otherwise; and (3) to argue for a shared responsibility to ameliorate this dimension. (shrink)

Abstract and Keywords Mainstream philosophers take for granted that disability is a prediscursive, transcultural, and transhistorical disadvantage, an objective human defect or characteristic that ought to be prevented, corrected, eliminated, or cured. That these assumptions are contestable, that it might be the case that disability is a historically and culturally specific, contingent social phenomenon, a complex apparatus of power, rather than a natural attribute or property that certain people possess, is not considered, let alone seriously entertained. This chapter (...) draws on the insights of Michel Foucault to advance a historicist and relativist conception of disability as an apparatus (dispositif) of power and identify mechanisms of power within philosophy that produce the underrepresentation of disabled philosophers in the profession and the marginalization of philosophy of disability in the discipline. -/- Keywords: disability, Michel Foucault, apparatus, historicist, relativist, underrepresentation of disabled philosophers. (shrink)

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

While copious quantities of ink have been spilled on the topic of autonomy in the context of health care, little has been written about autonomy in relation to intellectual disability. After presenting the received account of capacity, we argue that it cannot account for the moral permissibility of limiting an individual with intellectual disability’s access to diet soda. In cases of preventative medicine and intellectual disability, the philosophical motivation for the received account of capacity is incompatible with (...) the actions it recommends. We consider and reject several potential solutions; then, drawing on applied behavior analysis and the phenomenon of automatic reinforcement, we propose our own solution. The article concludes by considering the broader implications of our discussion. (shrink)

Since its outbreak, the COVID-19 pandemic has generated discourses and practices that directly refer to the semantic universe usually connected to disability and illness. Words such as ‘pre-existing conditions’, ‘risk groups’, ‘accessibility’, and ‘vulnerability’ have become everyday elements of official and informal communications across the globe. In this article, I explore the contradictions that arise from such uses through the lens of crip studies. In the first part, I observe how the idea of vulnerability became mainstream, moving from being (...) usually attached to disability and illness to being depicted as a universal condition. Such a shift serves the double purpose of reinstating the predominance of able-bodiedness as the preferable normalcy and invisibilising the particular conditions of disabled and chronically ill people in the pandemic. In the second part, I discuss the perverse use of the expressions ‘risk group’ and ‘underlying conditions’ as biopolitical tools to reinforce already existing forms of oppression. The third part comprises a reflection on accessibility and the sudden advent of working-from-home. Finally, I reflect on confinement and interdependence as key concepts to draft a politics of transformation that moves from disability and chronic illness to include all experiences of intersectional oppression. As other markers of oppression, illness and disability can determine the possibilities of survival through the crisis, not only because they are linked to bodily fragility but also because of the systemic violence they are immersed in. The knowledge produced from a place of vulnerability can hence show interesting elements to better understand the challenges of this pandemic through an intersectional perspective. (shrink)