Disability, Misc

Willpower is a metaphor that is widespread in both common usage and expert literature across disciplines. This paper looks into willpower as a ‘metaphor we live by’, analyzing and exploring the consequences of the tacit information content of the willpower metaphor for agentive self-understanding and efficacy. In addition to contributing to stigma associated with self-control failures, the metaphor causally contributes to self-control failures by obscuring available self-control strategies and instructing agents to superfluous self-control efforts.

Nelson et al.(2023) argue that the inclusion of personal experience in bioethical debates has significant benefits and liabilities, illustrating their claim with two examples: unproven medical treatments and disability bioethics. We believe that the benefits of including personal experience in disability bioethics far exceed its liabilities. The absence of participants with relevant experience impoverishes and biases bioethical debates, while the biases risked by their inclusion are hardly unique to personal experiences and are readily mitigated.

Will Daddario’s article, “What Acceptance Is,” brilliantly moves through aspects of grief, despair, and Acceptance; it allows grievers to meaningfully hold together aspects of loss that are otherwise fragmented and dispersed in our subjective experience of it. Daddario traces contradictions that permeate our experiences not only of grief and loss, but also of how we live in light of them. This includes the paradoxical relationships between accepting and giving, cure and poison, being open and closed off, centered and decentered, and, (...) as I will later add, of willingness and willfulness. His confrontation with acceptance resists the typical rectilinear picture (e.g., the “stages of grief”), ultimately providing us with a picture of the process out of despair that manages to retain its life and dynamic movement despite the fixity of language. ... (see more) -/- . (shrink)

The leading models of disability struggle to fully encompass all aspects of “disability.” This difficulty arises, the author argues, because the models fundamentally misunderstand the nature of disability. Current theoretical approaches to disability can be understood as “nounal,” in that they understand disability as a thing that is caused or embodied. In contrast, this paper presents an adverbial perspective on disability, which shows that disability is experienced as a personally irremediable impediment to daily-living tasks or goals-like-ours. The picture theory of (...) disability technically constitutes a species of relational approach because its analysis references the interplay between an individual and their environment; it differs from other relational accounts, however, by interpreting disability as a certain kind of negative experience—rather than a function of that relationship. This purely descriptive theory makes no normative claims about disability and operates as both a mechanism for the evaluation of the experience of disability and a heuristic device for the proper interpretation of disability. When disability is reframed in this way, the theory offers a particularist perspective which shows if, when, where, and how disability is experienced. (shrink)

This paper assesses how views of disability and enhancement can combine. It is hard to maintain that disabilities and enhancements are both undesirable. Disability-positive views can combine with support for or opposition to enhancement, but not with the view that enhanced traits reliably increase well-being. It is consistent to hold that disability is bad and enhancement good; the plausibility of this combination depends on whether it is better to have more options and fewer limitations. Understanding these combined positions makes it (...) easier to check for consistency by evaluating positions on disability and enhancement against each other. (shrink)

Paperwork plays a key role in a how institutions accommodate, refuse, or manage disabled people. This article develops modes for reading paperwork that build on each other, beginning with (a) recognizing the institutional pressures at work in shaping bureaucratic practices, then (b) considering how a person's relationship to disability influences how they might encounter these practices, and ultimately (c) noticing how the encounter between disabled/mad people and an institution might create something new, what the author calls archival excess. These methods (...) for reading are in conversation with disability studies, medical humanities, and document studies, and ultimately work toward a goal adapted from the principles of Disability Justice: recognizing the wholeness of disabled subjects in institutional archives. (shrink)

Research on mental health and illness presents a variety of unique ethical challenges. This article argues that institutional review boards (IRBs) can improve their reviews of such research by including the perspectives of individuals with the condition under study either as members of the IRB or as consultants thereto. Several reasons for including the perspectives of these individuals are advanced, with the discussion organized around a hypothetical case study involving the assessment of a novel talk-therapy modality. Having made this case, (...) the article goes on to explain how to implement the idea by building on a recent proposal by Rebecca Dresser, who argues in a number of publications for the inclusion of former research participants in the IRB review process. Finally, concerns about protecting reviewer and consultant confidentiality are addressed. (shrink)

Given basic commitments to philosophize from lived experience and a shared underlying meliorist impulse, American philosophical traditions seem well-suited to develop nascent philosophical engagement with disability studies. To date, however, there have been few efforts to facilitate research at the intersections of American philosophy and disability studies. This volume of essays seeks to offer some directions for propelling this inquiry. Scholars working in pragmatist and other American traditions consider intersections between American philosophy and work in disability studies. Consisting of three (...) broader sections, one set of essays considers how American philosophies from contemporary Mexican philosophy to classical American pragmatism inform descriptions of disability and efforts at liberation. The next offer accounts of how American philosophies disclose alternative conceptions of epistemic and ethical issues surrounding disability. Finally, a section considers "living issues" of disability, including essays on parenting, immigration policy, and art education. Throughout, these works provide direction and orientation for further investigation at the intersection of American philosophies and disability studies. (shrink)

Transhumanists and other proponents of enhancement have been criticized for their attitude to disability. Melinda Hall argues that transhumanists denigrate disabled people by devaluing interdependence and vulnerability, and implying that disabled people are dangerous. It might also be thought that further development of enhancement technologies would have bad consequences within current, ableist and otherwise oppressive social contexts. This paper responds to these objections, arguing that enhancement needn't be in conflict with disability justice. While enhancements can be used and promoted in (...) ways that reinforce ableism and other oppression, ways of mitigating these problems might be found by drawing on ideas from the disability rights movement, and social justice movements more broadly. The development of more accessible environments, and a general openness to surprises about which traits promote well-being, can help to create conditions under which people have genuine choice over which enhancement technologies, if any, to use. (shrink)

The development of new methods in the field of prenatal testing leads to an expansion of information that needs to be provided to expectant mothers. The aim of this research is to explore opinions and attitudes of gynecologists in Germany, Poland and Russia towards access to prenatal testing and diagnostics in these countries. Semi-structured interviews were conducted with n = 18 gynecologists in Germany, Poland and Russia. The interviews were analyzed using the methods of content analysis and thematic analysis. Visible (...) in all three countries is a connection of prenatal medicine with the politically and socially contentious issue of pregnancy termination. Respondents in Poland and Russia concentrated on the topic of inadequate resources. Quality of information for expectant mothers is an important point in all three countries. Only in Germany was the issue of language barriers in communication raised. With regard to non-invasive prenatal testing (NIPT) respondents in Germany focused on the ethical issues of routinization of testing; in Poland and Russia they concentrated on fair access to NIPT. Challenges in all three countries arise from structural factors such as imprecise and prohibitive regulations, lack of resources or organization of healthcare services. These should be addressed on a political and medico-ethical level. (shrink)

Nancy Jecker is right when she says that older persons ought not to be ashamed if they wish to remain sexually active in advanced old age. She offers a useful account of the role that sexuality plays in supporting key human capabilities. However, Jecker assumes an exaggerated account of what sex robots are likely to be able to offer for the foreseeable future when she suggests that we are obligated to make them available to older persons with disabilities. Moreover, whether (...) older persons should be ashamed to desire sex robots—or, more importantly, whether we should be ashamed at the thought that we should respond to the sexual needs of older persons by providing them with sex robots—turns on a range of arguments that Jecker fails to adequately consider. (shrink)

Are people with flawed faces regarded as having flawed moral characters? An “anomalous-is-bad” stereotype is hypothesized to facilitate negative biases against people with facial anomalies (e.g., scars), but whether and how these biases affect behavior and brain functioning remain open questions. We examined responses to anomalous faces in the brain (using a visual oddball paradigm), behavior (in economic games), and attitudes. At the level of the brain, the amygdala demonstrated a specific neural response to anomalous faces—sensitive to disgust and a (...) lack of beauty but independent of responses to salience or arousal. At the level of behavior, people with anomalous faces were subjected to less prosociality from participants highest in socioeconomic status. At the level of attitudes, we replicated previously reported negative character evaluations made about individuals with facial anomalies, and further identified explicit biases directed against them as a group. Across these levels of organization, the specific amygdala response to facial anomalies correlated with stronger just-world beliefs (i.e., people get what they deserve), less dispositional empathic concern, and less prosociality toward people with facial anomalies. Characterizing the “anomalous-is-bad” stereotype at multiple levels of organization can reveal underappreciated psychological burdens shouldered by people who look different. (shrink)

Many models of cognitive ability and disability rely on the idea of cognition as abstract reasoning processes implemented in the brain. Research in cognitive science, however, emphasizes the way that our cognitive skills are embodied in our more basic capacities for sensing and moving, and the way that tools in the external environment can extend the cognitive abilities of our brains. This chapter addresses the implications of research in embodied cognition and extended cognition for how we think about cognitive impairment (...) and rehabilitation, how cognitive reserve mitigates neural impairment, and the distinction between medical and social models of disability. (shrink)

In this essay I ask what educational justice might require for children with autism in educational settings where “inclusion” entails not only meaningful access, but also where the educational setting is able to facilitate a sense of belonging and further is conducive to well-being. I argue when we attempt to answer the question “do inclusion policies deliver educational justice?” that we pay close attention to the specific dimensions of well-being for children with autism. Whatever the specifics of individual cases, both (...) an attitude and policy of inclusion must permit parents to choose pragmatic alternatives, i.e., different learning environments, if educational justice is to remain the overriding goal. (shrink)

A basic criticism of Perry Hendrick's "Even if the fetus is not a person, abortion is immoral: The Impairment Argument," is offered, namely that the reasons why intentionally causing fetal alcohol syndrome is wrong simply do not apply to fetuses and so the "Impairment Argument" against abortion fails.

It may seem obvious that causing disability in another person is morally problematic in a way that removing or preventing a disability is not. This suggests that there is a moral asymmetry between causing disability and causing non-disability. This chapter investigates whether there are any differences between these two types of actions that might explain the existence of a general moral asymmetry. After setting aside the possibility that having a disability is almost always bad or harmful for a person (a (...) view that we have critiqued at length elsewhere), seven putative differences are considered. Ultimately, it is concluded that none of these seven factors can ground a general moral asymmetry between causing disability and causing non-disability, though each factor can provide some moral reason to avoid causing disability in certain particular cases. (shrink)

The use of Quality-Adjusted Life Years (QALYs) in healthcare allocation has been criticized as discriminatory against people with disabilities. This article considers a response to this criticism from Nick Beckstead and Toby Ord. They say that even if QALYs are discriminatory, attempting to avoid discrimination – when coupled with other central principles that an allocation system should favour – sometimes leads to irrationality in the form of cyclic preferences. I suggest that while Beckstead and Ord have identified a problem, it (...) is a misdiagnosis to lay it at the feet of an anti-discrimination principle. The problem in fact comes from a basic tension between respecting reasonable patient preferences and other ways of ranking treatment options. As such, adopting a QALY system does not solve the problem they identify. (shrink)

even a brief review of disability narratives shows that many people with disabilities, encompassing a diverse range of impairments, encounter disruptions in their everyday interactions. Individuals with disabilities report that strangers and neighbors alike fail to communicate with them.1 Instead, people defer to friends, partners, and caretakers to offer some command over the interaction. These experiences might be understood as mere annoyances, part of the experience of impairment insofar as it undermines non-disabled individuals’ modes of interaction, leaving them fumbling, seeking (...) assurance that they are handling the situation correctly. But, read less cautiously, these frustrations are emblematic of a... (shrink)

Since the 1960s, scientists, engineers, and healthcare professionals have developed brain–computer interface (BCI) technologies, connecting the user’s brain activity to communication or motor devices. This new technology has also captured the imagination of publics, industry, and ethicists. Academic ethics has highlighted the ethical challenges of BCIs, although these conclusions often rely on speculative or conceptual methods rather than empirical evidence or public engagement. From a social science or empirical ethics perspective, this tendency could be considered problematic and even technocratic because (...) of its disconnect from publics. In response, our trinational survey (Germany, Canada, and Spain) reports public attitudes toward BCIs (N = 1,403) on ethical issues that were carefully derived from academic ethics literature. The results show moderately high levels of concern toward agent-related issues (e.g., changing the user’s self) and consequence-related issues (e.g., new forms of hacking). Both facets of concern were higher among respondents who reported as female or as religious, while education, age, own and peer disability, and country of residence were associated with either agent-related or consequence-related concerns. These findings provide a first look at BCI attitudes across three national contexts, suggesting that the language and content of academic BCI ethics may resonate with some publics and their values. (shrink)

Der vorliegende Beitrag zielt auf eine Untersuchung der ethischen Implikationen von Assistenzsystemen am Arbeitsplatz – einer technischen Lösung für die Förderung der beruflichen Qualifikation von Menschen mit geistigen Behinderungen. Mein Ausgangspunkt ist die Feststellung, dass es durch den technologischen Fortschritt im Bereich der Mensch-Maschine-Interaktion heute möglich ist, solche technischen Assistenzsysteme am Arbeitsplatz einzusetzen. In diesem Beitrag entwickle ich eine These hinsichtlich des moralischen Werts solcher Systeme. Das Ergebnis meiner Untersuchung ist, dass Assistenzsysteme am Arbeitsplatz einzusetzen nicht nur moralisch erlaubt ist, (...) sondern dass sich ihr Einsatz darüber hinaus sogar ethisch befürworten lässt. Meine Kernthese lautet, dass ihr ethisch ausschlaggebender Wert in dem Beitrag liegt, den sie zur beruflichen Inklusion von Menschen mit geistigen Behinderungen leisten können. Ich argumentiere dafür, dass Assistenzsysteme am Arbeitsplatz dabei helfen können, dass Menschen mit kognitiven Beeinträchtigungen ihren Platz im Arbeitsleben finden. Das heißt, sie eröffnen ihnen einen Zugang zur Arbeitswelt, die ihnen ohne sie verschlossen bliebe oder von der sie zumindest eklatant von Ausschluss bedroht wären. Folgt man meiner Argumentation, so sind Assistenzsysteme am Arbeitsplatz also deshalb ethisch gut, weil sie dazu beitragen, das Ideal einer inklusiven Arbeitswelt zu verwirklichen. (shrink)

This paper describes how bodily positions and gestures were used to teach argument diagramming to a student who cannot see. After listening to short argumentative passages with a screen reader, the student had to state the conclusion while touching his belly button. When stating a premise, he had to touch one of his shoulders. Premises lending independent support to a conclusion were thus diagrammed by a V-shaped gesture, each shoulder proposition going straight to the conclusion. Premises lending dependent support were (...) diagrammed by a T-shaped gesture, the shoulder premises meeting at the collar bone before moving down to the belly button. Arguments involving two pairs of entailments were diagrammed by an I-shaped gesture, going from the collar bone to a mid-way conclusion above the abdomen before travelling to the final conclusion at the belly button. The student’s strong performance suggests that placing propositions at different locations on the body and uniting them with gestures can help one discern correct argumentative structures. (shrink)

This book provides rigorous but accessible scholarship, ideal for students in philosophy and public policy. It includes twelve original essays by world-renowned scholars, each examining a key topic in philosophy and public policy and demonstrating how policy debates can be advanced by employing the tools and concepts of philosophy.

Everyone is disabled in some respect, at least in the sense that others can do things that we cannot. But significant limitations on pursuing major life activities due to severely limited eyesight, hearing, mobility, cognitive functioning and so on pose special problems that fortunately have been recognized (to some extent) in our public policies.

The republican ideal of non-domination identifies the capacity for arbitrary interference as a fundamental threat to liberty that can generate fearful uncertainty and servility in those dominated. I argue that republican accounts of domination can provide a powerful analysis of the nature of legal and institutional power that is encountered by people with mental disorders or cognitive disabilities. In doing so, I demonstrate that non-domination is an ideal which is pertinent, distinctive, and desirable in thinking through psychological disability. Finally, I (...) evaluate republican strategies for contesting domination, focusing on the limits of contestatory democracy, and proposing a participatory alternative which better addresses problems of political agency in the mentally disordered and cognitively disabled. (shrink)

This article discusses what is involved in having full moral status, as opposed to a lesser degree of moral status and surveys different views of the grounds of moral status as well as the arguments for attributing a particular degree of moral status on the basis of those grounds.

It is widely agreed that first-person testimony is a good source of evidence, including testimony about the contents of mental states unobservable to others. Thus we generally think that an individual’s testimony is a good source of evidence about her wellbeing—after all, she experiences her quality of life and we don’t. However, some have argued that the first-person testimony of disabled individuals regarding their wellbeing is defeated: regardless of someone’s claim about how disability affects her overall wellbeing, other evidence about (...) disability undermines the force of her testimony with respect to our justified beliefs. In this paper, I argue that at least some cases of first-person testimony about disability is not defeated. Particularly, neither the existence of conflicting testimony nor evidence about disabilities’ associated harms or challenges successfully undermine either the content of the testimony or the reliability of the testifiers. While I do not claim that first-person testimony is the only evidence relevant to characterizing disability, I argue that it is not always blocked by other evidence about disability. At least some first-person testimony from disabled individuals is, therefore, undefeated evidence relevant to evaluating disability and overall wellbeing. (shrink)

Independence was a core value of the movement for disability rights. People with disabilities did not have to be dependent, advocates claimed; they were robbed of autonomy by poverty, social prejudice, and architectural barriers. Recently, critics have noted that the emphasis on independence equates personhood with autonomy, reason, and self-awareness, thereby excluding those who are incapable of self-determination. The stigma of dependency is communicated to caregivers whose work is devalued and undercompensated. These values are echoed in the life writing of (...) people with disabilities, which tends to present a singular narrative voice, even when the author requires assistance in the physical or intellectual work of composition. The 1979 Mexican memoir-testimonio Gaby Brimmer, collaboratively authored by the acclaimed journalist Elena Poniatowska, Brimmer, her mother, and her paid caregiver is a notable exception. Consisting of interwoven dialogue among its three informants, Gaby Brimmer enacts dependency at the level of form, while exploring the challenges and opportunities of interdependence in societies that devalue the giving and receiving of care. (shrink)

This article explores how visual images of dependency and care reflect and reinforce perceptions of people who are ill, disabled, or otherwise dependent, those who sustain them, and the meaning of the work they do. Scenes of care are a valuable index for understanding cultural assumptions about who is deserving of care, how and where care should be given, and who is obligated to serve as a giver of care. It positions these images in the context of the emphasis, within (...) the disability rights movement, on independence. I argue that the insistence on independence entails a form of what Lauren Berlant calls "cruel optimism"—desire for the very things that undermine happiness and well-being—because they rely on a willful disregard of the inevitable interdependency that is a fact of all human existence, as well as the particular forms of dependency that pertain to many disabled bodies. The end of the article considers works of visual art that challenge dominant modes for representing how care is given and received. If the invisibility of caregiving is one aspect of our willful forgetting that all bodies are dependent, I'll argue that visual images of care are an essential resource for recognizing and reimagining its status in our society. One desired outcome of such reconsideration would be to complicate the meaning of autonomy—as it relates to choosing disability—as well as how the work of caregiving is acknowledged and valued. (shrink)

Annotated bibliography on eugenics and philosophy.

The issue of whether biological and psychological properties associated with disability can be harmful, beneficial, or neutral brings up an important philosophical question about how we evaluate disability, and disability’s impact on well-being. The debate is usually characterized as between those who argue disability is intrinsically harmful, and disability rights advocates who argue that disability is just another way of being different, in part, because disability can also provide important benefits. I argue that this debate is a false one, as (...) neither view can capture the more complicated relationship between disability and well-being. I argue that many disabilities are best understood as a kind of pro-tanto extrinsic harm that is characterized in counterfactual terms. This means that our judgments concerning disability and harm must be context-sensitive. (shrink)

Fertility specialists, adoption agents, judges and others sometimes take themselves to have a responsibility to fairly adjudicate conflicts that may arise between the procreative and parenting interests of people with disabilities and the interests that their children or potential children have to be nurtured, cared for and protected. An underlying assumption is that having a disability significantly diminishes a person's parenting abilities. My aim is to challenge the claim that having a disability tends to make someone a bad parent by (...) arguing that the interests of prospective parents with disabilities and the interests of their children or potential children are often aligned and mutually supporting. (shrink)

John Rawls’s use of the “fully cooperating assumption” has been criticized for hindering attempts to address the needs of disabled individuals, or non-cooperators. In response, philosophers sympathetic to Rawls’s project have extended his theory. I assess one such extension by Cynthia Stark, that proposes dropping Rawls’s assumption in the constitutional stage (of his four-stage sequence), and address the needs of non-cooperators via the social minimum. I defend Stark’s proposal against criticisms by Sophia Wong, Christie Hartley, and Elizabeth Edenberg and Marilyn (...) Friedman. Nevertheless, I argue that Stark’s proposal is crucially incomplete. Her formulation of the social minimum lacks accompanying criteria with which the adequacy of the provisions for non-cooperators may be assessed. Despite initial appearances, Stark’s proposal does not fully address the needs of non-cooperators. I conclude by considering two payoffs of identifying this lack of criteria. (shrink)

Cecilea discusses with Shelley Tremain her experience as a first-generation U.S. citizen and first-generation university graduate; why she was motivated to study philosophy and become a professional philosopher; the launching of the new, open access, online journal, the Journal of Philosophy of Emotions (JPE); the “mismatch” between what she seemed like “on paper” and what she is is capable of; how societal, institutional, professional, and philosophical practices and policies must be adjusted to enable others like her to flourish as professional (...) philosophers; and any resources—such as articles, books, and videos—that she would like to recommend on the topics and issues that she has addressed in this interview. (shrink)

In this peer commentary on L. Syd M. Johnson’s “Inference and Inductive Risk in Disorders of Consciousness,” I argue for the necessity of disability education as an integral component of decision-making processes concerning patients with DOC and, mutatis mutandis, all patients with disabilities. The sole qualification Johnson places on such decision-making is that stakeholders are educated about and “understand the uncertainties of diagnosis and prognosis.” Drawing upon research in philosophy of disability, social epistemology, and health psychology, I argue that this (...) educational qualification is insufficient to address systemic ableism and other forms of epistemic bias in quality of life judgments. (shrink)

This article argues against a leading cognitivist and moral interpretation of shame that is present in the philosophical literature. That standard view holds that shame is the felt-response to a loss of self-esteem, which is the result of negative self-assessment. I hold that shame is a heteronomous and primitive bodily affect that is perceptual rather than judgmental in nature. Shame results from the breakdown and thwarting of our desire for anonymous, unexceptional, and disattentive co-existence with others. I use the sociological (...) theory of Erving Goffman and the theory of shame found in philosophical anthropology to support this view. I also use the cases of shame and chronic shame that often accompany disability to show that shame is separable from negative self-assessment and, instead, emerges as an affective response to a world (of equipment, things, and people) that disallows unburdened and unreflective interpersonal equilibrium. (shrink)

Much academic work (in philosophy, economics, law, etc.), as well as common sense, assumes that ill health reduces well-being. It is bad for a person to become sick, injured, disabled, etc. Empirical research, however, shows that people living with health problems report surprisingly high levels of well-being - in some cases as high as the self-reported well-being of healthy people. In this chapter, I explore the relationship between health and well-being. I argue that although we have good reason to believe (...) that health problems causing pain and death typically do reduce well-being, health problems that limit capabilities probably don't reduce well-being nearly as much as most people suppose. I then briefly explore the consequences of this conclusion for political philosophy and ethics. If many health problems don't significantly reduce well-being, why should governments go to great expense to prevent or treat them? Why should parents be obliged to ensure the health of their children? (shrink)

The deeply entrenched, sometimes heated conflict between the disability movement and the profession of bioethics is well known and well documented. Critiques of prenatal diagnosis and selective abortion are probably the most salient and most sophisticated of disability studies scholars’ engagements with bioethics, but there are many other topics over which disability activists and scholars have encountered the field of bioethics in an adversarial way, including health care rationing, growth-attenuation interventions, assisted reproduction technology, and physician-assisted suicide. -/- The tension between (...) the analyses of the disabilities studies scholars and mainstream bioethics is not merely a conflict between two insular political groups, however; it is, rather, also an encounter between those who have experienced disability and those who have not. This paper explores that idea. I maintain that it is a mistake to think of this conflict as arising just from a difference in ideology or political commitments because it represents a much deeper difference—one rooted in variations in how human beings perceive and reason about moral problems. These are what I will refer to as variations of moral psychology. The lived experiences of disability produce variations in moral psychology that are at the heart of the moral conflict between the disability movement and mainstream bioethics. I will illustrate this point by exploring how the disability movement and mainstream bioethics come into conflict when perceiving and analyzing the moral problem of physician-assisted suicide via the lens of the principle of respect for autonomy. To reconcile its contemporary and historical conflict with the disability movement, the field of bioethics must engage with and fully consider the two groups’ differences in moral perception and reasoning, not just the explicit moral and political arguments of the disability movement. (shrink)

This paper examines the impact of disability on wellbeing and presents arguments against the mere-difference view of disability. According to the mere-difference view, disability does not by itself make disabled people worse off on balance. Rather, if disability has a negative impact on wellbeing overall, this is only so because society is not treating disabled people the way it ought to treat them. In objection to the mere-difference view, it has been argued, roughly, that the view licenses the permissibility of (...) causing disability and the impermissibility of causing nondisability. In her recent article, “Valuing Disability, Causing Disability”, Elizabeth Barnes attempts to show that this causation-based objection does not succeed. We disagree and argue why. We begin by explaining that in order to defeat the causation-based objection it does not suffice to show that it is not always true that the mere-difference view licenses causing disability. Rather, license in some cases, in a way that undermines the plausibility of the mere-difference view, would be sufficient for the causation-based objection to succeed. Then our discussion turns to an important challenge for proponents of the causation-based objection: Some defenders of the mere-difference view are prepared to simply accept the counterintuitive implications of their position. A dialogue with such proponents of the mere-difference view requires arguments with independent traction. We present several such arguments to the effect that the mere-difference view needs to be significantly reduced in scope – and may turn out to be false altogether. (shrink)

In the exploratory study reported here, we tested the efficacy of an intervention designed to train teenagers with Möbius syndrome (MS) to increase the use of alternative communication strategies (e.g., gestures) to compensate for their lack of facial expressivity. Specifically, we expected the intervention to increase the level of rapport experienced in social interactions by our participants. In addition, we aimed to identify the mechanisms responsible for any such increase in rapport. In the study, five teenagers with MS interacted with (...) three naïve participants without MS before the intervention, and with three different naïve participants without MS after the intervention. Rapport was assessed by self-report and by behavioral coders who rated videos of the interactions. Individual non-verbal behavior was assessed via behavioral coders, whereas verbal behavior was automatically extracted from the sound files. Alignment was assessed using cross recurrence quantification analysis and mixed-effects models. The results showed that observer-coded rapport was greater after the intervention, whereas self-reported rapport did not change significantly. Observer-coded gesture and expressivity increased in participants with and without MS, whereas overall linguistic alignment decreased. Fidgeting and repetitiveness of verbal behavior also decreased in both groups. In sum, the intervention may impact non-verbal and verbal behavior in participants with and without MS, increasing rapport as well as overall gesturing, while decreasing alignment. (shrink)

Michelle Garcia Winner’s Social Thinking Curriculum is widely used by schools across the USA and has garnered attention internationally. The curriculum addresses social language and behavior deficits among those on the autism spectrum. Although many embrace this curriculum without reservation, the emphasis on social conformity, including avoiding behaviors that make others uncomfortable, merits scrutiny. Individuals who have difficulty understanding social cues and conventions can derive tremendous benefit from learning to fit in, for example, or learning what is likely to make (...) others uncomfortable and why. However, too much emphasis on pleasing others can reinforce undesirable tendencies. For example, autism is already linked to avoidant personality disorder. An emphasis on avoiding making others uncomfortable may also inhibit the development of principled ethical thinking and action. Reframing social thinking to treat it not (or not only) as an end in itself, but as a way to achieve a variety of social and personal goals would go a long way toward addressing the weaknesses of the Social Thinking Curriculum. (shrink)

The perceived meaning of life significantly affects the quality of human life. It is of particular significance in borderline situations. One of such situations is the birth of an intellectually disabled child. The article presents the results of the study concerning the perceived meaning of life in the case of parents who bring up a child with limited intellectual abilities. The study included 87 mothers and 65 fathers bringing up an intellectually disabled child. In the studied cases, parents perceived their (...) life as highly meaningful. The results indicated that the perceived meaning of life in the case of parents of intellectually disabled children was related with: suffering experienced by the parents as a result of a limited intellectual ability of their daughter/son, the manner of performing their parental role and the sense of parental identity. (shrink)

This paper proposes a theoretical framework for understanding fat stigma and its impact on people’s well-being. It argues that stigma should never be used as a tool to achieve public health ends. Drawing on Bruce Link and Jo Phelan’s 2001 conceptualization of stigma as well as the works of Hilde Lindemann, Paul Benson, and Margaret Urban Walker on identity, positionality, and agency, this paper clarifies the mechanisms by which stigmatizing, oppressive conceptions of overweight and obesity damage identities and diminish moral (...) agency, arguing that the use of obesity-related stigma for public health ends violates the bioethics principles of nonmaleficence, autonomy, and justice. (shrink)

Unlike his theory of justice as fairness, John Rawls’s political liberalism has generally been spared from critiques regarding what is due to the disabled. This paper demonstrates that, due to the account of the basic ideas of society and persons provided by Rawls, political liberalism requires that the interests of numerous individuals with disabilities should be put aside when the most fundamental issues of justice are settled. The aim is to accommodate within public reason the due concern for the disabled (...) while upholding political liberalism. To achieve this aim, a revision of the basic ideas of persons and society is proposed. The idea of persons should be regarded as more fundamental than that of social cooperation, and persons should be defined in terms of minimal moral powers. (shrink)

In this chapter, our focus is the role played by notions of rationality in the diagnosis of mental disorders, and in the practice of overriding patient autonomy in psychiatry. We describe and evaluate different hypotheses concerning the relationship between rationality and diagnosis, raising questions about what features underpin psychiatric categories. These questions reinforce widely held concerns about the use of diagnosis as a justification for overriding autonomy, which have motivated a shift to mental incapacity as an alternative justification. However, this (...) approach too has recently been criticized from a mental disability rights perspective. Our analysis of the relationship between mental capacity and rationality is used to illuminate these concerns, and to investigate further the relationship between rationality and psychiatric diagnosis. (shrink)