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)

In provocative readings of major figures in the continental tradition, Alcoff shows that the work of Hans-Georg Gadamer and Michel Foucault can help rectify key ...

Philosophers and bioethicists are typically sceptical about invocations of dignity in ethical debates. Many believe that dignity is essentially devoid of meaning: either a mere rhetorical gesture used in the absence of good argument or a faddish term for existing values like autonomy and respect. On the other hand, the patient experience of dignity is a substantial area of research in healthcare fields like nursing and palliative care. In this paper, it is argued that philosophers have much to learn from (...) the concrete patient experiences described in healthcare literature. Dignity is conferred on people when they are treated as having equal status, something the sick and frail are often denied in healthcare settings. The importance of equal status as a unique value has been forcefully argued and widely recognised in political philosophy in the last 15 years. This paper brings medical ethics up to date with philosophical discussion about the value of equal status by developing an equal status conception of dignity. (shrink)

Feminist approaches within the social sciences have expanded enormously since the 1960s. In addition, in recent years, geographic perspectives have become increasingly significant as feminist recognition of the differences between women, their diverse experiences in different parts of the world and the importance of location in the social construction of knowledge has placed varied geographies at the centre of contemporary feminist and postmodern debates. Gender, Identity and Place is an accessible and clearly written introduction to the wide field of issues (...) that have been addressed by geographers and feminist scholars. It combines the careful definition and discussion of key concepts and theoretical approaches with a wealth of empirical detail from a wide-ranging selection of case studies and other empirical research. It is organized on the basis of spatial scale, examining the relationships between gender and place from the body to the nation, although the links between different spatial scales are also emphasized. The conceptual division and spatial separation between the public and private spheres and their association with men and women respectively has been a crucial part of the social construction of gendered differences and its establishment, maintenance and reshaping from industrial urbanization to the end of the millennium is a central linking theme in the eight substantive chapters. The book concludes with an assessment of the possibilities of doing feminist research. It will be essential reading for students in geography, feminist theory, women's studies, anthropology and sociology. (shrink)

Individuals with ‘severe’ cognitive disabilities are primarily discussed in philosophy and bioethics to determine their moral status. In this paper it is argued that theories of moral status have limited relevance to the unjust ways in which people with cognitive disabilities are routinely treated in the actual world, which largely concerns their relegation to an inferior social status. I discuss three possible relationships between moral and social status, demonstrating that determinate answers about the moral status of individuals with ‘severe’ cognitive (...) disabilities are neither necessary nor sufficient for defending the imperative that they be treated as our social equals. (shrink)

Hojjat Soofi develops a modified version of Martha Nussbaum’s capability approach, which he offers as a conception of dignity for people living with dementia.1 He argues that this modified version can address what he identifies as four main criticisms of the concept of dignity. The first and most substantial criticism was developed by Macklin: that appeals to ‘dignity’ add little to moral debates or to the rich field of existing moral values.1 Soofi’s account of dignity does not evade this criticism: (...) to the contrary, it represents another clear example of what Macklin complained about, namely, a moral proposal in which the concept of ‘dignity’ plays no substantive role. We have much to learn from Soofi’s rich account of how to ensure the flourishing or well-being of people living with dementia, but it has little to do with dignity as such. According to Soofi, Macklin’s argument is that ‘dignity’ is just another word for respect for persons or their autonomy. This is a rather truncated representation of Macklin’s argument, which is in fact broader. Her argument is that the concept of ‘dignity’ adds nothing to the vast array of rich moral values that already populate the field of ethics, mainly because it is a less precise restatement of these existing values.2 She explicitly …. (shrink)

Particular conceptions of reconciliation vary across a number of dimensions. As section 1 explains, the kind of relationship at issue in a specific context affects the type of improvement in relations that might be necessary in order to qualify as reconciliation. Reconciliation is widely taken to be a scalar concept. Section 2 discusses the spectrum of intensity along which kinds of improvement in relationships fall, and indicates why, in particular contexts, theorists often disagree about the point along this spectrum that (...) is morally or politically most significant. Section 3 provides an overview of the processes commonly cited as contributing to reconciliation. These processes are often controversial; those praised by some commentators as appropriate and constructive responses to past conflict are dismissed by others as undermining the moral or political conditions for just and peaceful relations. Section 4 concentrates on the relationship between reconciliation and justice. While some see these values as compatible and mutually supporting, others argue that, especially in the immediate wake of conflict, parties must often choose between reconciliation and justice. (shrink)

This essay examines the ethics of boycotting as a social response to injustice or wrongdoing. The boycotts in question are collective actions in which private citizens withdraw from or avoid consumer or cultural interaction with parties perceived to be responsible for some transgression. Whether a particular boycott is justified depends, not only on the reasonableness of the underlying moral critique, but also on what the boycotters are doing in boycotting. The essay considers four possible interpretations of the kind of act (...) in which boycotting consists: the avoidance of complicity, protest speech, social punishment, or social coercion. Each interpretation provides a plausible account of at least some cases of boycotting, yet each raises distinct challenges to justifying boycotting activities. (shrink)

Most democratic countries either limit or deny altogether voting rights for people with cognitive impairments or mental health conditions. Against this weight of legal and practical exclusion, disability advocacy and developments in international human rights law increasingly push in the direction of full voting rights for people with cognitive impairments. Particularly influential has been the adoption by the UN of the Convention on the Rights of Persons with Disabilities in 2007. Article 29 declares that states must ‘ensure that persons with (...) disabilities can effectively and fully participate in political and public life on an equal basis with others, directly or through freely chosen representatives, including the right and opportunity for persons with disabilities to vote and be elected’. This article also argues for the right of all people to vote, including people with cognitive impairments, by adopting a uniquely strategic approach. Firstly, some of the strategic limitations of existing arguments in favour of extending the franchise are highlighted. Most such arguments are flawed because they run the risk of inviting disparaging philosophical commentary which compares disabled people to animals, or because they are based on implausible empirical claims, or because they inadvertently tie the case for voting rights for the disabled to other cases unlikely to ever enjoy widespread acceptance. This article, instead, justifies extending voting rights to all people with cognitive impairments based on a simple cost-benefit analysis that avoids all of these problems. (shrink)

The meaning of dignity in health care has been primarily explored using interviews and surveys with various patient groups, as well as with health care practitioners. Philosophical analysis of dignity is largely avoided, as the existing philosophical literature is complex, multifaceted and of unclear relevance to health care settings. The aim of this paper is to develop a straightforward philosophical concept of dignity which is then applied to existing qualitative research. In health care settings, a patient has dignity when he (...) or she is able to live in accordance with his or her standards and values. Accordingly, health care practitioners respect a patient's dignity when they refrain from transgressing the patient's standards and values, or refrain from forcing the patient to transgress his or her standards and values. This concept is shown to explain and illuminate most of the key qualitative findings. It therefore provides a more coherent and synthesised concept of dignity in health care. (shrink)

This article explores the nature of "the phenomenological attitude," which is understood as the process of retaining a wonder and openness to the world while reflexively restraining pre-understandings, as it applies to psychological research. A brief history identifies key philosphical ideas outlining Husserl's formulation of the reductions and subsequent existential-hermeneutic elaborations, and how these have been applied in empirical psychological research. Then three concrete descriptions of engaging the phenomenological attitude are offered, highlighting the way the epoché of the natural sciences, (...) the psychological phenomenological reduction and the eidetic reduction can be applied during research interviews. Reflections on the impact and value of the researcher's stance show that these reductions can be intertwined with reflexivity and that, in this process, something of a dance occurs—a tango in which the researcher twists and glides through a series of improvised steps. In a context of tension and contradictory motions, the researcher slides between striving for reductive focus and reflexive self-awareness; between bracketing pre-understandings and exploiting them as a source of insight. Caught up in the dance, researchers must wage a continuous, iterative struggle to become aware of, and then manage, pre-understandings and habitualities that inevitably linger. Persistance will reward the researcher with special, if fleeting, moments of disclosure in which the phenomenon reveals something of itself in a fresh way. (shrink)

Recent discussions of genetic enhancement have argued that unregulated access to genetic enhancement technology will have a mainly negative impact on equality, a development that an egalitarian approach to distributive justice should be concerned with and seek to address. I argue that the extent to which egalitarians should be concerned about unequal access to genetic enhancement therapies has been overplayed. Many of the genetic differences that exist between people, including those that arise from differential access to genetic enhancement technology, are (...) simply irrelevant to egalitarian concerns. I also argue that most commentators have failed to appreciate that an egalitarian-inspired program of equal access to genetic enhancement technology may not be altogether favourable for the genetically disadvantaged in any case. The true implications of egalitarian justice in the genetic future have not been adequately explored. (shrink)

abstract In this paper I argue that the genetic manipulation of sexual orientation at the embryo stage could have a detrimental effect on the subsequent person's later capacity for autonomous agency. By focussing on an example of sexist oppression I show that the norms and expectations expressed with this type of genetic manipulation can threaten the development of autonomous agency and the kind of social environment that makes its exercise likely.

It has been argued by disability advocates that supported decision-making must replace surrogate, or substituted, decision-making for people with cognitive disabilities. From a moral perspective surrogate decision-making it is said to be an indefensible form of paternalism. At the heart of this argument against surrogate decision-making is the belief that such paternalistic action expresses something fundamentally disrespectful about those upon whom it is imposed: that they are inferior, deficient or child-like in some way. Contrary to this widespread belief, I will (...) argue that surrogate decision-making sometimes expresses more respect for people with life-long, ‘severe’ or ‘profound’ cognitive disabilities than does the adoption of supported decision-making.. Specifically, I argue that in some cases supported decision-making can arguably express that people with severe or profound cognitive disabilities lack equal moral value. I also argue that supported decision-making for people with profound cognitive disabilities can arguably express that they lack complex and rich inner lives. If our aim is to ensure our behaviour and practices express respect for people with life-long ‘severe’ or ‘profound’ cognitive disabilities, then sometimes surrogate rather than supportive decision-making will be a better option. (shrink)

This paper describes the lifeworld of one individual, Ann, in an attempt to elucidate the existential impact of early stage multiple sclerosis. Drawing on Ann's own reflections captured in a relatively unstructured interview, I construct a narrative around her first year of living with the diagnosis. Then, existential-phenomenological analysis reveals how Ann's life - lived in and through a particular body and lifeworld context - is disrupted. The unity between her body and self can no longer be taken for granted. (...) The existential possibilities inherent in her lived body are diminished and have to be renegotiated. Her sense of identity, project, relations with others and present/future plans are threatened. Ann's illness is encountered in the context of her life activities and relationships. This is the intertwining of body, self and world. To live with multiple sclerosis is to experience a global sense of disorder - a disorder which incorporates a changed relation with one's body, a transformation in the surrounding world, a threat to the self, and a change in one's relation to others. (shrink)

The last twenty-five years or so of thought about tort law have been remarkably productive and dynamic, as the dominance of the law and economics model has been challenged by theories that reintroduce the language of corrective justice. Over this same time period, theorizing about corrective justice has sprung up in response to a wide range of social, political and moral issues. I have in mind work on restorative theories in criminal justice; on postwar justice; on truth commissions, political reconciliation (...) and transitional justice in contexts of regime change; on official apologies as responses to international crises, institutionalized abuse and historical injustices; and on interpersonal apology, the making of amends, and forgiveness as responses to everyday moral transgressions. In these writings, theorists explore what people owe to one another in the aftermath of various kinds of wrongdoing, and thereby subtly challenge our ideas about what should be included under the heading of corrective justice. One new strand of thought, which appears in many of these debates, suggests that corrective justice requires a form of reconciliation or relational repair. My goal in this chapter is to introduce this idea and explore what it might offer to the philosophy of tort law. (shrink)

This volume collects many of the major essays of feminist theory of the past forty years. The essays included here are those which have made key contributions to feminist theory during this period and which have generated extensive discussion. The volume organizes these essays historically, so as to provide a sense of the major turning points in feminist theory. Beginning with those essays which have provoked widespread discussion in the early days of the second wave, the volume then presents essays (...) which have been central to major discussions since that time. The essays present the complex relationship between feminism and Marxism, the second wave's "gynocentric turn," the theoretical elaboration of differences among women, and the essentialist debate, as these have occupied the attention of feminist theorists. Through this collection, the reader is able to gain a sense of the diverse directions feminist theory has taken over the past forty years, where feminist theory stands at the moment, and the questions which are just now beginning to emerge. (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)

Although tissue plasminogen activator (tPA) is the only medication approved by the United States Food and Drug Administration (FDA) for acute ischemic stroke, there is no consensus about the need for informed consent for its use. As a result, hospitals throughout the U.S. have varying requirements regarding obtaining informed consent from patients for the use of tPA, ranging from no requirement for informed consent to a requirement for verbal or written informed consent. We conducted a study to (1) determine current (...) beliefs about obtaining patients’ informed consent for tPA among a large group of stroke clinicians and (2) identify the ethical, clinical, and organizational factors that influence tPA consent practices. Semi-structured interviews were conducted by trained and experienced investigators and research staff to identify key barriers to implementing acute stroke services. Part of the interview explored current beliefs and practices around informed consent for tPA.This was a multicenter study that included 38 Veterans Health Administration (VHA) hospital locations. Participants were 68 stroke team clinicians, serving primarily on the neurology (35 percent) or emergency medicine (41 percent) service. We conducted thematic analysis based on principles of grounded theory to identify codes about consent for tPA. We used interpretive convergence to ensure consistency among the individual investigators’ codes and to ensure that all of the investigators agreed on coding and themes.We found that 38 percent of the stroke clinicians did not believe any form of consent was necessary for tPA, 47 percent thought that some form of consent was necessary, and 15 percent were unsure. Clinicians who believed tPA required informed consent were divided on whether consent should be written (40 percent) or verbal (60 percent). We identified three factors describing clinicians’ attitudes about consent: (1) legal and policy factors, (2) ethical factors, and (3) medical factors.The lack of consensus regarding consent for tPA creates the potential for delays in treatment, uneasiness among clinicians, and legal liability. The identified factors provide a potential framework to guide discussions about developing a standard of care for acquiring the informed consent of patients for the administration of tPA. (shrink)

As medical technology becomes more sophisticate the ability to manipulate nature and manage disease forces the dilemma of when can becomes ought. Indeed, most bioethical discourse is framed in terms of balancing the values and interests and the benefits and burdens that inform principled decisions about how, when, and whether interventions should occur. Yet, despite advances in science and technology, one caregiver mandate remains as constant and compelling as it was for the earliest shaman—the relief of pain. Even when cure (...) is impossible, the physician's duty of care includes palliation. Moreover, the centrality of this obligation is both unquestioned and universal, transcending time and cultural boundaries.Although universally acknowledged, pain is a complex phenomenon for both the patient and the caregiver, influenced as much by personal values and cultural traditions as by physiological injury and disease. (shrink)

Jean Hampton argues that we can detect exploitation in personal relationships by thinking about what we would agree to were we to set aside the emotional benefits we receive from those relationships. Hampton calls her account "feminist contractarianism," but it has recently been critiqued as decidedly unfeminist, on the grounds that it is hostile to women's interests and women's values. Furthermore, Hampton's requirement that we imaginatively distance ourselves from our emotional connections to our loved ones--the key element in her contractarian (...) test--is simply ad hoc. In this essay, I will evaluate these objections and offer a new justification for Hampton's test. I conclude that feminist contractarianism is not only a useful tool for detecting exploitation in the family, it is also deserving of its feminist label. (shrink)

Do future generations of a wrongdoing group have a responsibility to preserve the memory of the past? If so, what manner of responsibility is it? In this essay, I critically examine the categories of forward-looking and backward-looking collective responsibility to see what they might offer to this discussion. I argue that these concepts of responsibility are ambiguous in ways that threaten to prevent important questions from being raised. I draw my examples from contemporary German practices of preserving the memory of (...) the Holocaust and World War II, especially the stolpersteine, which are memorial plaques for individual victims embedded in the sidewalks of German cities. (shrink)

Bi-intuitionistic logic is the union of intuitionistic and dual intuitionistic logic, and was introduced by Rauszer as a Hilbert calculus with algebraic and Kripke semantics. But her subsequent ‘cut-free’ sequent calculus has recently been shown to fail cut-elimination. We present a new cut-free sequent calculus for bi-intuitionistic logic, and prove it sound and complete with respect to its Kripke semantics. Ensuring completeness is complicated by the interaction between intuitionistic implication and dual intuitionistic exclusion, similarly to future and past modalities in (...) tense logic. Our calculus handles this interaction using derivations and refutations as first class citizens. We employ extended sequents which pass information from premises to conclusions using variables instantiated at the leaves of refutations, and rules which compose certain refutations and derivations to form derivations. Automated deduction using terminating backward search is also possible, although this is not our main purpose. (shrink)

The recent literature on criminal justice has yielded an intriguing suggestion: that someone who does wrong has a right to make amends. In this essay, I evaluate arguments for and against this claim with regard to cases of both criminal wrongdoing and private wrongs. I conclude that the balance of arguments speaks in favor of a right to make amends. This conclusion has ramifications for the just design of criminal sanctions, and these will also be addressed here.

In this paper, I present different ways in which transcendental argumentation has been used in contemporary debates in moral philosophy to justify the normative authority of morality. My aim is to defend strong “retorsive” transcendental argumentation as a way to ground a sort of critical realism in metaethics, comparing transcendental arguments proposed by Karl-Otto Apel, Christine Korsgaard and Alan Gewirth – which are sometimes referred to as “constitutivist” arguments. In particular, I endorse an argumentative strategy that considers the merits of (...) the respective positions while overcoming the limits of each. Such a strategy aims at grounding transcendentally the metaphysical fact of human value, making explicit the ontological implications of transcendental argumentation, and showing that a justification of fundamental values alone can ultimately make it possible to ground basic moral principles. (shrink)

A study of informal networks in Soviet science, this article documents the existence of a complex system of interlocking and overlapping channels ofprofessional communication that cut across the formal, hierarchical chains of command in the USSR Academy of Sciences. Through coauthorship data and career histories, one can identify science schools, research groups, social circles, and professional cliques in the Soviet scientific community during the Stalin, Khrushchev, and Brezhnev regimes. There was an expansion and integration of social circles over time and (...) a pluralism of interdependent, but distinct, scientific elites. This structure took on political significance through the persistence of a liberal democratic tradition among scientists in the Academy. (shrink)