Disability

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.

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)

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)

[Forthcoming May 2022]. 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. The tentative table of contents is available for download below. (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)

Chapter 3 looks at the work of Charles Mills, taking in a range of his scholarship including his most famous work – The Racial Contract – and his latest work, Black Rights, White Wrongs. Zara Bain applies Mills to consider how social justice applies in the UK. She looks at the interactions and co-constitutions of racism, classism, and ableism, and the role they play in the production of poverty. The chapter argues that Mills offers us a non-ideal contractarian analysis that (...) may really offer ‘x-ray vision’ into parts of society many would readily, if not always credibly, deny precisely because it pushes us to look at the world as it really is, to learn our history and to be always on the lookout for the many ways that ignorance about matters of significant import to questions of social justice can be actively, resiliently produced. (shrink)

Rare neuromuscular diseases are a group of pathologies characterized by a progressive loss of muscular strength, atrophy, fatigue, and other muscle-related symptoms, which affect quality of life levels. The low prevalence, high geographical dispersion and disability of these individuals involve difficulties in accessing health and social care services. Teleassistance is presented as a useful tool to perform psychosocial interventions in these situations. The main aim of this research is to assess the effects of a teleassistance psychosocial program on the QoL (...) levels of people with RNMDs who have different levels of disability. A sample of 73 participants was divided into an experimental group, which participated in the intervention, and a control wait list group. QoL was evaluated through the SIP and the SF-36, and disability through the WHO-DAS II. The participants with a moderate to severe level of disability were those who most benefited from the intervention. The results also revealed that the psychosocial teleassistance program was suitable to improve physical and psychosocial aspects of people suffering from a rare neuromuscular disease with a moderate level of disability, but just psychosocial aspects in those with a severe level of disability. (shrink)

The Middles Ages are often portrayed as a time in which people with physical disabilities in the Latin West were ostracized, on the grounds that such conditions demonstrated personal sin and/or God’s judgment. This was undoubtedly the dominant response to disability in various times and places during the fifth through fifteenth centuries, but the total range of medieval responses is much broader and more interesting. In particular, the 13th-15th century treatment of three groups (martyrs, mothers, and mystics - whose physical (...) ‘defects’ were often understood as signs of special connection to God in this life, and who were often represented as retaining these signs in the life to come) challenge standard notions of beauty, disfigurement, and bodily perfection, particularly as the notion is applied to eternal life and our ultimate end. (shrink)

The morality of abortion is a longstanding controversy. One may wonder whether it’s even possible to make significant progress on an issue over which so much ink has already been split and there is such polarizing disagreement (Boyle 1994). The papers in this issue show that this progress is possible—there is more to be said about abortion and other crucial beginning-of-life issues. They do so largely by applying contemporary philosophical tools to moral questions involving life’s beginning. The first two papers (...) defend the pro-life view from recent objections involving miscarriage and abortion doctors. The third shows how the social model of disability and the concept of transformative experience applies to classic debates like abortion and euthanasia. The final two papers address how rights and harms apply to children and to beings that do not yet exist. All five papers make a noteworthy contribution to the moral issues that arise at the beginning of life. (shrink)

This chapter canvases a number of ways that issues surrounding disability intersect with social epistemology, particularly how dominate norms concerning communication and ability can epistemically disadvantage some disabled individuals. We begin with a discussion of how social epistemology as a field and debates concerning epistemic injustice in particular fail to take the problem of ableism seriously. In section two, we analyze the concept of an individual’s “knowledge capacity,” arguing that it can easily misconstrue the extended, social nature of both knowledge (...) and capacity/ability. In section three, we turn to issues of testimony and their relation to debates concerning disability and well-being. We address how the regular lack of uptake of disabled people’s testimony can lead to a number of structural rather than merely individual epistemic injustices, and we also consider how the very nature of some disabilities make testimonial issues more complicated. In our fourth and final section, we discuss various norms of social interaction and how they can systematically disadvantage Autistic people in particular. (shrink)

for The Deweyan Task Before Us: The New Global Paradigm for Philosophy, Education, and Democracy Emerging from the Pandemic (2021 edited volume under review) John Dewey proposed soon after the atomic bombings of Hiroshima and Nagasaki that citizens of techno-industrial nations suffer from "cultural lag" (LW 15:199-200; cf. LW 4:203-28). He had in mind a sort of moral jet lag, a condition in which most of the basic alternatives we have on hand to think and talk about moral and political (...) life, from customary moralizing to sophisticated theorizing, were developed, canned, and pickled on a shelf so long ago that they now lag far behind the multi-faceted problems that our values must speak to. The failure of many countries, most visibly the United States, to effectively navigate climate change and the Covid-19 global pandemic exemplifies our moral jet lag. Our collective responses to the new normal of global disruptions are, in William James’s words in Pragmatism, “out of plumb and out of key and out of ‘whack’” (1907, 37). The American philosophical tradition that includes James and Dewey has long sought to compensate for the excesses of America’s hyper-individualism and its anti-naturalistic distrust of experimental intelligence. In this brief analysis of our morally jet lagged response to the Covid-19 pandemic, we draw heavily on two highly articulated intellectual resources for America’s moral, political, and educational recovery: Jane Addams’s social ethics and Dewey’s deeply democratic theory of moral and political deliberation. (shrink)

This essay argues that the systemic turn in deliberative democracy has opened up avenues to think about disabled citizenship within discursive processes. I highlight the systemic turn’s recognition of the interdependence of individuals and institutions upon each other in a system as key to this project. This recognition has led to three transformations: a more generous account of deliberative speech acts and behaviors; recognition of the role of enclaves; and incorporating the role of discursive representatives. These changes normalize the participation (...) of cognitively disabled individuals and suggest institutional opportunities for more effective participation. (shrink)

In this paper, I will argue that efforts to legalize aid-in-dying or physician-assisted suicide are attempts to rebrand this sort of death as a good choice. It is common to justify physician-assisted suicide through arguments for a) relieving suffering or b) allowing individual autonomy, but I will show that the problem with these justifications is that once this type of death is judged as acceptable, it is difficult to justify limiting it to a narrow group such as the mentally competent, (...) communicatively able, terminally ill adults designated by these legalization bills. Ultimately, we must either label many more deaths as good deaths, destigmatizing suicide, or we must reject the notion that death at the time we choose is acceptable. I will argue for the latter. (shrink)

Patients living with chronic pain require appropriate access to opioid therapy along with improved access to pain care and additional therapeutic options. It's both medically reasonable and ethical to consider opioid therapy as a treatment option in the management of chronic, non-cancer pain for a subset of patients with severe pain that is unresponsive to other therapies, negatively impacts function or quality of life, and will likely outweigh the potential harms. This paper will examine opioid therapy in the setting of (...) the opioid epidemic, why critics feel that the CDC guideline has resulted in harsh consequences for patients and their physicians, and the rationale for opioid therapy as a means of providing ethical and compassionate pain care. (shrink)

My aim in this essay is to partially characterize an ideal kind of respectful attitude that we should aspire to have towards all people and to explain why some of the ways we often regard and treat those with disabilities may be incompatible with realizing this ideal. My proposal is roughly that that one kind of respect, which I call ‘identity respect’, is directed at the identity or self-conception of persons; that this kind of respect involves regarding the identity of (...) others as worthy of our understanding, appreciating the value to others of their identities and not being judgmental in our assessments of them within certain limits; and that respecting the identities of all people is a moral ideal because of its connection to our nature as rational persons. Having a respectful attitude of this sort would lead to improvements in how we regard and treat disabled people and others, but reflecting on its nature and value can also advance our understanding of parts of morality that go beyond our moral rights and duties and concern the kinds of attitudes, character traits and relationships that we should strive to develop and maintain. (shrink)

I draw on my experiences of passing as non-disabled to explain how a disabled person can hide his disability, why he might do so, and what costs and risks he and others might face along the way. Passing as non-disabled can bring greater social acceptance and inclusion in joint-projects, an enhanced sense of belonging, pride and of self-worth, and an easier time forming and maintaining personal relationships. Yet hiding one’s disability can also undermine some of these same values when doing (...) so, for example, prevents someone from living up to normal social expectations or from sharing important aspects of himself with others. Hiding a disability can also interfere with a person’s self-respect, self-acceptance, integrity, and self-development. Although the chapter does not take a stand on whether hiding a disability is, overall, prudent, wise or morally justified, it draws out some lessons about disability from why someone might want to hide it. (shrink)

This essay considers Denis Diderot’s Letter on the Blind for the Use of Those Who Can See as a work that can contribute to a disability political theory. By recounting the experiences of visually impaired persons in their own words, Diderot opens up possibilities for a disability politics of self-representation, maintaining that sighted persons should listen to blind persons’ accounts of their own experience rather than relying on their own imaginings and assumptions. By using blind experiences to challenge a philosophical (...) problem that intrigued philosophers of the seventeenth and eighteenth centuries amid often-unsuccessful efforts to “cure” blindness through cataract surgeries, Diderot develops a powerful critique of the empiricist stress on vision as the primary source of perception and provides a remarkably forward-looking critique of disablist attitudes toward the blind. Through this philosophical discourse, he engages a political argument about the way knowledge is gathered, evaluated, and interpreted through relationships of power. (shrink)

This paper explores the relationship between eugenics, disability, and dehumanization, with a focus on forms of eugenics beyond Nazi eugenics.

This article presents an archaeological inquiry into the early histories of Quality of Life measures, and takes this as an occasion to rethink the concept of the ‘medical model of disability’. Focusing on three instruments that set the ground for the emergence of QoL measures, namely, the Karnofsky Performance Scale, and the classification of functional capacity as a diagnostic criterion for heart diseases and as a supplementary aid to therapeutic criteria in rheumatoid arthritis – I discuss how medicine, throughout the (...) emergence of QoL, began to expand its gaze beyond the confines of the body to what that body does in daily life. Building upon Armstrong et al.’s notion of ‘distal symptoms’ and Wahlberg’s idea of ‘knowledge of living’, I propose the notion of disabilitization to encapsulate this expansion of the clinical gaze, through which medicine has come to articulate diseases and their treatments in new ways, and in so doing, has inadvertently created disability as a new kind of knowledge category in itself – a category that is defined not through its reduction to mere pathology, but through its dispersal into everyday life. I present this concept not as a periodization, but as a provocative discontinuity with the totalizing history assumed within the medical model of disability, and in so doing, ask what, in fact, holds ‘the medical model’ together, and whether there might be other ways of understanding medicine’s complex relationship to disability than what the concept of the medical model allows us to envisage. (shrink)

This paper argues that epistemic errors rooted in group- or identity- based biases, especially those pertaining to disability, are undertheorized in the literature on medical error. After sketching dominant taxonomies of medical error, we turn to the field of social epistemology to understand the role that epistemic schemas play in contributing to medical errors that disproportionately affect patients from marginalized social groups. We examine the effects of this unequal distribution through a detailed case study of ableism. There are four primary (...) mechanisms through which the epistemic schema of ableism distorts communication between nondisabled physicians and disabled patients: testimonial injustice, epistemic overconfidence, epistemic erasure, and epistemic derailing. Measures against epistemic injustices in general and against schema-based medical errors in particular are ultimately issues of justice that must be better addressed at all levels of health care practice. (shrink)

On 26 July 2016, Satoshi Uematsu murdered 19 and injured 26 at a caregiving facility in Sagamihara, Japan, making it the country’s worst mass killing since WWII. In this article, I offer an analysis of the Sagamihara 19 massacre. I draw on the work of Julia Kristeva and Emmanuel Levinas to argue that claims about disability experience are insufficient to justify normative projects. In short, disability is normatively ambiguous.

Journal of Social Philosophy, EarlyView.

A recent report in the UK, Being Disabled in Britain: A Journey Less Equal, highlights the many inequalities, threats to dignity and discriminatory attitudes faced by disabled people. No doubt these are replicated in other countries. Using the evidenced-based findings from this report and the report’s invitation for those concerned to join the conversation on disability, this paper explores both the way in which the experiences of people with disabilities can sharpen up an understanding of Catholic social teaching and the (...) way in which that teaching contributes to a deeper theology of disability. Moreover, insights from this teaching demonstrate that people with disabilities contribute significantly and positively to society and to interpersonal relationships. (shrink)

Cancer research is experiencing ‘paradigm instability’, since there are two rival theories of carcinogenesis which confront themselves, namely the somatic mutation theory and the tissue organization field theory. Despite this theoretical uncertainty, a huge quantity of data is available thanks to the improvement of genome sequencing techniques. Some authors think that the development of new statistical tools will be able to overcome the lack of a shared theoretical perspective on cancer by amalgamating as many data as possible. We think instead (...) that a deeper understanding of cancer can be achieved by means of more theoretical work, rather than by merely accumulating more data. To support our thesis, we introduce the analytic view of theory development, which rests on the concept of plausibility, and make clear in what sense plausibility and probability are distinct concepts. Then, the concept of plausibility is used to point out the ineliminable role played by the epistemic subject in the development of statistical tools and in the process of theory assessment. We then move to address a central issue in cancer research, namely the relevance of computational tools developed by bioinformaticists to detect driver mutations in the debate between the two main rival theories of carcinogenesis. Finally, we briefly extend our considerations on the role that plausibility plays in evidence amalgamation from cancer research to the more general issue of the divergences between frequentists and Bayesians in the philosophy of medicine and statistics. We argue that taking into account plausibility-based considerations can lead to clarify some epistemological shortcomings that afflict both these perspectives. (shrink)

The concept of rights is now so dominant in the language of politics that it is becoming difficult to identify its use with any particular approach to the solution of social problems or to gain a clear picture of its significance, its advantages and its disadvantages as a way of conceptualizing and resolving contentious political issues. None the less there is a perceptible shift towards an emphasis on rights in contemporary politics which many welcome and encourage and others question and (...) even reject, a shift which is matched in jurisprudence by the renewed stress which many theorists place on rights as a basic legal concept despite recurrent problems associated with the concept as a tool for legal analysis and moral justification. Conflicting theories of legal rights are canvassed and this in turn feeds into the debate concerning the reality or significance of non-legal rights, for the process of law reform is often presented as a matter of giving legal embodiment to the rights which various interested categories of people are asserted to possess already. (shrink)

John Fischer challenges me to defend my arguments regarding the badness of death; I sharpen my position, but make some concessions, discussing the possibility of postmortem harm. In response to John Deigh, I defend the account of disgust given in Hiding from Humanity, together with the research of Paul Rozin that I follow there, I discuss Patrick Devlin's conservative position, agree that we need to object to its emphasis on solidarity, not only to its emphasis on disgust, and argue that (...) Deigh's statement of Devlin's position is too kind to Devlin. In response to Henry Richardson, I summarize my reasons for thinking that the classical social contract tradition cannot handle well the problems posed by the issue of justice for people with disabilities, and that even Rawls's position requires major modification if it is to do so. I explore differences between Richardson's position and my own on the issues of self-respect, liberty, and primary goods. (shrink)

Martha Nussbaum has powerfully argued in Frontiers ofJustice and elsewhere that John Rawls’s sort of social-contract theory cannot usefully be deployed to deal with issues pertaining to justice for the disabled. To counter this claim, this article deploys Rawls’s sort of social-contract theory in order to deal with issues pertaining to justice for the disabled—or, since, as Nussbaum stresses, we all have some degree of disability—for the severely disabled. In this way, rather than questioning one by one Nussbaum’s interpretive claims (...) about Rawls’s view, one can simply see how the Rawlsian framework can work in application to this issue. Following Rawls’s lead, the paper utilizes the idealized “initial choice situation” as an analytic and comparative device for examining alternative principles of justice, developing three different interpretations of the initial choice situation that each correspond to a different set of principles that apply to people of all levels of disability. One of these sets of principles is a simple extension of Rawls’s, one is very close to what Nussbaum herself recommends, and the third is a kind of hybrid. In this way, it is shown not only that Rawls’s social-contract device can usefully be applied to these issues, but also that it is helpful for exploring the deep commitments underlying each of these competing sets of principles. (shrink)

This article aims to clarify the notion of a psychiatric disability. The article uses conceptual analysis, examining and applying established definitions of (general) disability to psychiatric disabilities. This analysis reveals that disability as inability to perform according to expectations or norms is related to impairment as deviation from the (statistical) norm, while disability as inability to achieve (personal) goals is related to impairment as deviation from the (personal) ideal. These two views of impairment and disability are distinct from the self-organization (...) view of impairment as disrupted self-creation or disrupted self-repair and of disability as disrupted whole person self-compensation (in relation to an impairment). All these three views of disability pertain to psychiatric disability. Although there is nothing necessarily psychiatric about psychiatric disability other than the psychiatric impairment related to it, the life course and life circumstances typical of many people with (severe) psychiatric disorders may lead to disability and may thus confer some (psychiatric) specificity on this disability. This analysis may facilitate research on specific psychiatric disabilities and a broader scope for psychiatric rehabilitation. (shrink)

In this article I draw on two scenarios from my personal life—the diagnosis of my newborn grandnephew with CHARGE syndrome and the diagnosis of my father with depression—to reflect on whether and when diagnosis may be harmful to patients. Despite the great differences between the two scenarios, I argue that in both cases the tendency of diagnosis to generalize, categorize, and stigmatize can lead to insidious and counterproductive effects. The perspective of disability studies can help physicians to anticipate, minimize or (...) avoid these negative ramifications. I also reflect on the matter of who "owns" a particular diagnosis, whose purposes it serves, and how. (shrink)

RESUMEN La discapacidad que afecta a la población infantil constituye un problema emergente; diagnosticarla y tratarla de manera integral es parte del trabajo diario del profesional de Enfermería en la atención primaria de salud. Durante el estudio se identificaron carencias en las habilidades profesionales de los licenciados en Enfermería respecto a este saber. Se aplicó un entrenamiento encaminado al desarrollo de habilidades profesionales especializadas para la atención integral a la discapacidad infantil en este personal. Por ello el objetivo del presente (...) trabajo está dirigido a exponer los resultados del entrenamiento. Los métodos y técnicas empleados incluyeron la observación científica, encuesta, entrevista, la técnica de grupo focal y el criterio de expertos. El entrenamiento se sometió al criterio de expertos. Se corroboró su impacto positivo como una vía importante para la preparación y desarrollo de habilidades profesionales en la muestra seleccionada. ABSTRACT The disability that affects the children population constitutes an emergent problem; to diagnose it and to treat it as an integral way is a part of the daily work of the professional of Infirmary in the primary health care. During the study, lacks in the professional skills of the Bachelors of Infirmary with regard to this know ledge were identified. There was applied a training directed to the development of specialized professional skills for the integral attention to the infant disability in this personnel. That is why the objective of the present work is directed to exhibit the results of the training. The methods and techniques used included the scientific observation, polls, interviews, the technique of focal group and the experts' criteria. The training was surrendered to the experts' criteria. It was corroborated its positive impact as an important route for the preparation and development of professional skills in the chosen sample. (shrink)

Why do people hate one another? Who gets to speak for whom? Why do so many people combat prejudice based on their race, sexual orientation, or disability? What does segregation look like today? Many of us ponder and discuss urgent questions such as these at home, and see them debated in the media, the classroom, and our social media feeds, but many of us don't have access to the important new ways philosophers are thinking about these very issues. Enter UnMute, (...) the popular podcast hosted by Myisha Cherry, which hosts a diverse group of philosophers and explores their cutting-edge work through casual conversation. -/- This book collects 31 of Cherry's lively and timely interviews, offering an accessible resource through which to encounter some of philosophy's most socially and politically engaged, public-facing work. Its original illustrations, depicting the interview subjects up close, show just how broad a range of philosophers--black, white, and brown, male and female, queer and straight, abled and disabled--are at the center of crucial contemporary conversations. Cherry asks philosophers to talk about their ideas in ways that anyone can understand, explaining how they got interested in philosophy, and why the questions they investigate matter urgently. -/- Along with the interviews, the volume provides a foreword by Cornel West, a section in which all the interviewees explain how they got into philosophy, and a "Say What?" glossary defining terms that might be new to some readers. Like the podcast that inspired it, the book welcomes in those new to these philosophical questions, those captivated by questions of race, class, gender, and other issues and looking for a new lens through which to examine them, and those well-versed in public philosophy looking for a one-stop guide. (shrink)

This paper argues for Serious Distributive Egalitarianism – the view that some material inequalities are seriously objectionable as such; not merely, say, because such inequalities tend to generate inequalities in status. Social justice requires equality, I argue, because basic social institutions produce important goods and are produced in turn by the relevantly equal contributions of all those that comply with them. E.g., basic social institutions make it much easier to produce cooperatively than it would be in their absence; therefore, these (...) institutions produce, among other things, opportunities to participate in particular productive enterprises. But basic social institutions are themselves produced, in large part, by the compliance of those subject to them; these subjects, therefore, contribute to the production of the goods that basic institutions produce. This gives (at least) every compliant subject of basic social institutions a claim on these goods. And, I argue that, though some do contribute more to the maintenance of basic institutions than others, those who contribute more are too responsible for the fact that others contribute less to point to the consequences of this difference as a reason they should get greater returns. I conclude that all subjects of basic social institutions have equally forceful and forcefully equal claims on the goods these institutions produce; claims that render inequalities in the Distribution of these goods Seriously objectionable as such. (shrink)

This commentary explores Medicaid's role for children with special health care needs today and considers how changes to Medicaid's federal financing structure under a per capita cap or block grant could affect coverage for these children.

ABSTRACTModern Kantians often address the conception of Kant as ‘cold hearted rationalist’ by arguing that there is a place, in Kantian moral theory, for the emotions. This theme of reconciling Kantianism with the emotions is concurrent with a recent interest, on the part of some Kantians, in issues pertaining to character education. This paper will argue that Kantianism has much to offer character education; in particular, inclusiveness of those who might have difficulty experiencing appropriate moral emotion. Nevertheless, I will argue (...) that this inclusivity can only be maintained if Kantians refrain from over-emotionalising their accounts. (shrink)

The emerging field of the philosophy of dance, as suggested by Aili Bresnahan, increasingly recognizes the problem that (especially pre‐modern) dance has historically focused on bodily perfection, which privileges abled bodies as those that can best make and perform dance as art. One might expect that the philosophy of dance, given the critical and analytical powers of philosophy, might be helpful in illuminating and suggesting ameliorations for this tendency in dance. But this is particularly a difficult task since the analytic (...) philosophy of dance is too young to have achieved a comprehensive treatment of dance per se, let alone to update such a treatment in line with the demands of social justice. As a step in that direction, the present article (a) summarizes dance theorists on disabled dance (as opposed to the dance of the temporarily able‐bodied, or TAB) and then applies (b) the philosophy of art and dance to disability, (c) the philosophy of disability to dance, (d) interdisciplinary disability theory to dance, and (e) my own Figuration philosophy of dance to disability, as inspired in part by John Dewey. (shrink)

It is obvious that technology is rapidly changing the world around us. Nowhere is that change more evident than in the revolution occurring for those with physical and mental limitations-their portrayal in the media, their use of the media to achieve group aims and their use of the new on-line media to communicate with others who have limitations and the non-disabled world. In a very real way the growing sense of community among those with disabilities has been linked to the (...) media. (shrink)

This study explored relations between willingness to disclose in 5 psychotherapy scenarios and 2 independent variables. Scenarios involved suicidal, gravely disabled, physically abusive, and sexually abusive patients, and a police officer patient who shot a suspect. For each of the 5 scenarios, participants in the privilege condition had significantly higher willingness-to-disclose scores than participants in the no-privilege condition. There were no significant differences between willingness-to-disclose scores of participants with and without therapy experience; neither was there a significant interaction between privilege (...) condition and therapy experience. Privilege condition was more predictive of willingness to disclose than personal characteristics or therapy experience. Results provide empirical support for the U.S. Supreme Court's recognition of the psychotherapist-patient privilege in Jaffee v. Redmond. (shrink)

The purpose of this paper is to contribute to the ongoing analyses that aim to confront the problem of marked variation. Negatively marked differences are those natural variations that are used to cleave human beings into different categories (e.g., of disablement, of medicalized pathology, of subnormalcy, or of deviance). The problem of marked variation is: Why are some rather than other variations marked as epistemically or culturally significant or as a diagnostic of pathology, and What is the epistemic background that (...) makes these—rather than other variations—marked as subnormal? For Wilson (2018a), critical examination of the problem of marked variation is central to understanding the epistemology of medicalized pathology that made the history of eugenics possible. My aim is to explore the role marked variation plays in eugenic and other problematic classifications and the inferences they appear to license. I pay particular attention to the normative valuations of marked variations, how these valuations affect the inferences that are made by others about those possessing the variation, and how those possessing the variation perceive themselves. In the final sections, I illustrate this by critically discussing three putative kinship conceptions of race. I rely on these to extend the scope of the puzzle of marked variation from the context of historic and current markings of an individual’s variation as disability in the eugenics movement to historic and current markings for assigning putative racial ascriptions to individuals and groups. Lastly, I suggest that the problem of marked variation is a problem that looms over any epistemic account that is dependent upon sorting or classifying. (shrink)

This comment argues for increased tolerance of privacy risks in the Internet activity of adults with intellectual disabilities. Excessive caution about such risks denies those individuals not only the great benefits of Internet use but also the difficult but valuable experiences of loss, disappointment, and hurt associated with those risks. A level of risk-aversion appropriate for small children will be disrespectful for adults with intellectual disabilities. To the extent that additional safeguards are justified, they are better achieved through individualized security (...) and privacy settings than through caregiver oversight. (shrink)

Among the various human forms alluded to in the Hebrew prayer, mental retardation appears to be one of the most difficult to celebrate. It is the disability that other disabled persons do not want attributed to them. It is the disability for which prospective parents are most likely to use selective abortion (Wertz 2000). And it is the disability that prompted one of the most illustrious United States Supreme Court Justices to endorse forced sterilization, because "three generations of imbeciles are (...) enough." The mentally retarded have at times been objects of pity, compassion, or abuse by their caretakers and society at large. But they have rarely been seen as subjects, as citizens, as persons with equal entitlement to fulfillment. (shrink)

In this paper, I argue that the concept of normality in medical research and clinical practice is inextricable from the concept of ambiguity. I make this argument in the context of Edmund Pellegrino's call for a renewed reflection on medicine’s basic concepts and by drawing on work in critical disability studies concerning Deafness and body integrity identity disorder. If medical practitioners and philosophers of medicine wish to improve their understanding of the meaning of medicine as well as its concrete practice, (...) I contend that they should take seriously the import and centrality of ambiguity for biomedicine. (shrink)