En la actualidad Cuba desarrolla un Programa de Atención Integral al Paciente con Úlcera de Pie Diabético mediante el uso del Heberprot-P, esencial para disminuir la amputación y la discapacidad. El trabajo tiene el objetivo de realizar un diagnóstico sobre la aplicación del Heberprot-P en el Servicio de Angiología del Hospital Provincial Universitario Manuel Ascunce Domenech de Camagüey. Se realizaron encuestas a pacientes para identificar necesidades sentidas relacionadas con el tratamiento y para las actitudes manifiestas, y se hicieron entrevistas al (...) personal médico y de enfermería. El diagnóstico permitió corroborar la necesaria investigación con enfoque social del servicio de salud escogido a nivel territorial. Destaca elevar el trabajo de captación de pacientes desde el nivel primario de salud para garantizar un mayor alcance del programa, así como la trascendencia del apoyo familiar y la relación profesional de la salud- paciente a fin de lograr la calidad requerida. At present Cuba is developing a program concerning the care of patient with ulcer of the diabetes foot by means of Heberprot-P essential to reduce the amputation and disability. The aim of this paper is to carry out a diagnosis about social aspects of the application of the Heberprot-P in the Angiology service at Manuel Ascunce Domenech Hospital in Camaguey. Some surveys were carry out to identify certain needs related with the treatment and the attitude shown and on the other hand some interview were made to the medical and nursing staff. The diagnosis allowed to verify the need of the research with social approach. The paper highlight how to incorporate patients from the primary health level, in order this program has a higher scope and the importance of the family support and the professional relationship to accomplish the quality required. (shrink)

A brain-computer interface technology that can decode the neural signals associated with attempted but unarticulated speech could offer a future efficient means of communication for people with severe motor impairments. Recent demonstrations have validated this approach. Here we assume that it will be possible in future to decode imagined (i.e., attempted but unarticulated) speech in people with severe motor impairments, and we consider the characteristics that could maximize the social utility of a BCI for communication. As a social (...) interaction, communication involves the needs and goals of both speaker and listener, particularly in contexts that have significant potential consequences. We explore three high-consequence legal situations in which neurally-decoded speech could have implications:Testimony, where decoded speech is used as evidence;Consent and Capacity, where it may be used as a means of agency and participation such as consent to medical treatment; andHarm, where such communications may be networked or may cause harm to others. We then illustrate how design choices might impact the social and legal acceptability of these technologies. (shrink)

Gender seems to be everywhere in the norms governing our social world: from how to be a good friend and how to walk, to children’s clothes. It is not surprising then that a difficulty in identifying someone’s gender is often a source of discomfort and even anxiety. Numerous theorists, including Judith Butler and Charlotte Witt, have noted that gender is unlike other important social differences, such as professional occupation or religious affiliation. It has a special centrality, ubiquity and (...) importance in social practices. This observation moves us away from the classic philosophical question ‘what is gender?’ towards a more underappreciated one: ‘what is the role of gender’? To answer this question, I introduce the notion of social standing, which refers to our ability to enter into social relations. Social standing distinctions are an important feature of human societies. However, our existing philosophical tools do not adequately capture this notion: it is neither a moral distinction, nor is it reducible to hierarchy. I offer a conception of our entry into social relations as always conditioned by various shared representational assumptions about social subjects. When individuals are anomalous with respect to those assumptions, their social standing is in doubt. This explains important forms of uncommon and peculiar treatment across societies. I argue that forms of social devaluation on the basis of severe and visible disability in our society are central examples of diminished social standing. In our social context, being hard to recognize through the matrix of gender makes one representationally anomalous and imperils one’s social standing. Gender plays a fundamental role because gender legibility is a precondition for full social standing. Gender norms parallel ‘ability norms’ in this respect, linking notions of normalcy in scholarship on gender and in scholarship on disability. Social standing also explains two key phenomena about gender. Firstly, it tells us why our social practices and norms are pervasively gendered. Given the performative and relational nature of gendered positions, this is necessary for constant gender legibility. Secondly, social standing recognition accounts for social anxiety phenomena around gender ambiguity. These phenomena are reactions to anomaly as a threat to our social systems of meaning. In the final part of my dissertation, I consider some political consequences of my view. Understanding this special role of gender allows us to identify a distinct type of backlash to feminist social change that is particularly insidious. It is not driven by the hierarchical investments of the most gender-privileged, but rather by our collective investment in gender as a system of social coordination. I explore 2000s ‘raunch feminism’ to argue for this hypothesis. Gender’s role as a conditioning parameter of social standing puts systematic pressure on all would-be social subjects to be gender legible. This requires that individuals position themselves in recognizably gendered ways within social practices. But when gender differentiation is eroded, this positioning becomes tricky. This gives rise to a disorientation I call ‘meaning vertigo’. Meaning vertigo prompts attempts at reinstating a clear gendered system. In the process, gender equality suffers a serious set-back. To make substantial feminist progress, we must unseat gender from its central position in social domains like sexuality. I suggest that the best way to do this may be by foregrounding other aspects of social identity as systems of social coordination, instead of working on gender directly. (shrink)

Background: Humor, both producing and appreciating, underpins positive social interactions acting as a facilitator of communication. There are clear links to wellbeing that go along with this form of social engagement. However, humor appears to be a seldom studied, cross-disciplinary area of investigation when applied to people with an intellectual disability, this review collates the current state of knowledge regarding the role of humor behavior in the social interactions of people with intellectual disabilities and their carers. (...) Method: A systematic review utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was completed which aimed to explore the current state of knowledge and quality of empirical evidence relating to humor in people with intellectual disabilities. Following this, articles were grouped thematically and summarized. A comprehensive search of four electronic databases (1954–2017) and additional search strategies yielded 32 articles which met the final inclusion criteria. Results: Humor played a significant positive and negative role in the social interactions of people with intellectual disabilities. Research had investigated humor in the classroom and humor expression in different groups including those with autism, Down syndrome, Angelman syndrome, Williams syndrome and Rett syndrome. Few investigations directly studied humor appreciation and comprehension hence themes did not focus solely on humor production/appreciation. Humor comprehension was reportedly supported by gestures. Some groups with intellectual disabilities found non-literal humor (e.g. sarcasm, irony) more difficult to understand which may affect social relationships. Various types of humor were found to be appreciated. The role of humor in relationship development, social facilitation, creativity and stigma had all received some limited attention. Humor also played a role for carer groups in coping with and enjoying the caring role. Research varied in quality with few experimental studies and mainly quasi-experimental and well-conducted qualitative studies. Conclusions: This review revealed the importance of humor behavior in many aspects of the social lives of people with intellectual disabilities. Limited disparate research exists pertaining to humor in this group, suggesting the need for further robust research in this area, including more high quality primary research in the areas of humor production, appreciation, comprehension and stigma. (shrink)

Disability through the Lens of Justice offers a contextual framework for considering the limitations that disability places on individuals. Specifically, those that prevent individuals from having control in certain domains of their life, by restricting the availability of acceptable options or the ability to choose between them. Begon argues that our theory of justice should be concerned with the lives individuals can lead, and not with whether their bodies and minds function typically. The problem that disability raises (...) is not the mere fact of difference, but the ways in which that difference is accommodated (or not) and the limitations it may cause. In Disability Through the Lens of Justice, Begon offers a new framework to the disability and justice model. She argues that achieving justice does not require 'normalisation', or the elimination of difference, but through implementating a model which enables all individuals to control their lives as they choose. (shrink)

Intellectual Disability: Ethics, Dehumanization, and a New Moral Community presents an interdisciplinary exploration of the roots and evolution of the dehumanization of people with intellectual disabilities. Examines the roots of disability ethics from a psychological, philosophical, and educational perspective Presents a coherent, sustained moral perspective in examining the historical dehumanization of people with diminished cognitive abilities Includes a series of narratives and case descriptions to illustrate arguments Reveals the importance of an interdisciplinary understanding of the social construction (...) of intellectual disability. (shrink)

Purpose– The purpose of this paper is to create a conceptual framework, based on a structured literature review, to analyze the digital disability divide and help find solutions for it. A digital disability divide exists between people with impairments and those without impairments. Multiple studies have shown that people without impairments are less likely to own a computer or have an Internet connection than are people with impairments. However, the digital disability divide is seen in relation not (...) only to access but also to accessibility and use. For people with impairments, new technological innovations offer solutions for everyday challenges, such as finding information, communicating with others and using electronic services.Design/methodology/approach– For this study, 4,778 conference and journal publications were systematically analyzed.Findings– A number of key findings emerged. This field is relatively new, and the literature is highly focused on the technological and social aspects of the digital disability divide, with technology and societal attributes being the core sub-attributes for a comprehensive model. The previous literature did not significantly study the consequences of the financial situation of individuals; rather, the predominant focus was on the have-nots and countries with low income potentials. Furthermore, motivation reveals a compelling case within the digital disability divide subset.Originality/value– The review provides a consolidated view of past research on the general topic of the digital disability divide and the attributes that affect it. (shrink)

Recently, scholars have argued that disability activists' redefinition of disability' as a social problem, rather than a medical problem, is maleficent, unjust, and inconsistent. It seems that the discussion on whether disability is a medical or a social category is not settled and that disability is an essentially contested concept. However, the question is: What is the social aspect in disability? It appears that there is some confusion as to what the (...) class='Hi'>social is in a social definition of disability. The article pursues possible reasons for this confusion by investigating the critique of the social model. This is followed by a discussion on what a possible space for the social might be in a social definition of disability. Such a space is illuminated by using the framework of the World Health Organization's International Classification of Functioning Disability and Health. The article suggests that disability as a social category is not inconsistent if reframed within a social relational model of disability. (shrink)

This article presents an analysis of the concept of disability in Amartya Sen’s capabilities and functionings approach in the context of Information and Communication Technologies (ICT). Following a critical review of the concept of disability—from its traditional interpretation as an essentially medical concept to its later interpretation as a socially constructed category—we will introduce the concept of functional diversity. The importance of human diversity in the capabilities and functionings approach calls for incorporating this concept into the analysis of (...) well-being and quality of life in persons with disability—aspects in which ICT currently plays a major role. When one contemplates these technologies, it becomes clear that factors such as accessibility, design for all, and user participation in development and implementation processes are key strategies in promoting equal rights and equal opportunity for persons with disability in the different environments of the information society. (shrink)

A general dearth of theoretical engagements with the embodied, historical, and especially the religious dimensions of disablement pervades the social sciences. Paradoxically, the religious heritage of the West is commonly identified as the implicit catalyst of many disabling attitudinal barriers impinging on impaired bodies. Addressing this inconsistency, this article extends dominant disability conceptualizations through combining embodiment theories and humanities perspectives. Ultimately the article seeks to demonstrate how interdisciplinary investigation can produce fresh insights into the relationships between attitudes towards (...) physical impairment and Christianized forms of Western sociality. First, the radicalization of the definition of disability in the field of disability studies is briefly discussed. Second, aspects of the sociology of the body are examined in order to illustrate how the concepts of ‘effervescent’ and ‘emergent’ embodiment, through highlighting the persistence of the sacred in ‘somatic society’, can assist in the formulation of an analytical framework, suitable for analysing the religio-cultural dimensions of impairment. Finally, the dynamism of Christian attitudes towards physical impairment is illustrated through a survey of historical and contemporaneous theological examples. The confluence of these fields, it is argued, enables the interconnected terrain between impairment, embodiment and the sacred to be mapped. (shrink)

This brief monograph was written in an attempt to discover the general situation of Disability Studies, given that this appears to have become a growth area in academia with various typically illiberal aspects. The findings bear out the initial impression. There is a style of argument, even propaganda (for there is usually little genuine engagement with opposing liberal views), that can be seen in many other areas of academia. It amounts to a relatively new ‘progressive’ industry with various (...) fashionable keywords, phrases and ideologies—often not obviously related to disabilities in any serious way—indicating the nature of the beast: ‘progressive’, ‘radical’, ‘oppression’, ‘bourgeois’, ‘empowerment’, ‘rights’, ‘equal opportunities’, ‘discrimination’, ‘prejudice’, ‘citizenship’, ‘social justice’, ‘socially constructed’, ‘Marxism’, ‘Post Modernism’ and ‘Feminism’. The overall picture is that disability has become increasingly politicised along politically correct lines to the detriment of society as a whole and, eventually, even to the disabled themselves. This is largely caused by the endemic trahison des clercs in our tax-consuming and coercively monopolised university system. (shrink)

In this work we address the proposition that because it emerges from the contract tradition and so relies upon the assumption of mutual advantage, John Rawls' theory of “Justice as Fairness” cannot accommodate persons with severe mental and/or physical impairments. We respond to this criticism by proposing a revision to Rawls' contracting situation, the Original Position . Specifically, we propose to supplant the traditional understanding of mutual advantage—which we agree does constitute the necessary and sufficient condition for deliberation to come (...) about in the OP, as it stands—with a more modest alternative: a Hobbes-inspired concept that we call minimal mutual advantage. We argue that when this revision is introduced into Justice as Fairness, it reconciles admirably the seeming tension between contractarianism’s insistence on the rational, self-interested actor and the reality of societies in which not all members are capable of meeting a standard of reciprocity understood in terms of productive contributions to the general well-being. In so doing, minimal mutual advantage renders indistinguishable the disabled from the able in the OP, allowing Justice as Fairness to capture successfully problems of disability while leaving intact the more appealing aspects of liberalism that other approaches would dismiss. (shrink)

This paper investigates one aspect of corporate social responsibility, incorporating diversity, especially the employment of people with disabilities in Japan. Where literature on incorporating diversity through the inclusion of minorities in Japan is concerned, a reasonable number exists that focus on gender and women managers. In contrast, very scant literature (in English) exists on the employment of people with disabilities in Japan. This paper will try to fill the gap.

In lieu of an abstract, here is a brief excerpt of the content:How Deafness May Emerge as a Disability as Social Interactions UnfoldGabrielle HodgeMy hearing loss ranges from moderate to profound in both ears. I use spoken English, written English and Auslan (Australian sign language) to communicate, and rely heavily on two hearing aids, speach reading skills and my vision to interact with other people. Here I demonstrate how my deafness tends to emerge as a disability through (...) interactions with other people within the health and wellbeing context of group yoga practice. I compare two experiences from practicing yoga in group classes (which involves physical interaction and requires attendance to non–spoken tasks), and use these experiences to explore what the label ‘disability’ does not capture, how this term reflects my lived experience of deafness, and what this might mean for health and wellbeing [End Page 193] professionals engaging with clients who experience types of deafness.All human interactions are uniquely and intersubjectively shaped by the actors, how they communicate, and what they are doing while interacting. In my case, if someone is simultaneously attending to some task while talking with me, this may mean that I cannot see their face and therefore cannot access their spoken utterances. During group conversations, others may overlap their spoken turns at a pace faster than I can visually track and therefore I cannot access the dynamic content of the group conversation. In these situations, my deafness may manifest as disability. This contrasts with interactions where I engage with other signers using Auslan, where my deafness does not manifest as disability at all. For me, deafness as disability tends to be an emergent characteristic of my interactions with other people, rather than a constant feature of all interactions, or all moments of a single interaction. It emerges most prominently through interactions with strangers, and less during interactions with social intimates. This characterisation contradicts the concept of disability as a fixed feature of an individual that impacts uniformly on all aspects of their experience.I regularly practice yoga and have done so for many years. I enjoy participating in classes with other students, as we jointly learn and develop practices that challenge and illuminate different aspects of our lives. “At the heart of all yogas lies the manipulation of visible, accessible means to reach invisible, intangible ends” (Givón 2005, p. 23). How one manipulates their visible, accessible means depends on one’s personal physiology, psychology and sociality. Over the years I have developed various strategies that enable me to participate in group practice and engage with other students and teachers without over–reliance on teachers or mediation from Auslan interpreters. I have mostly come to depend on observing how the teacher and other participants move (or even how shadows on the wall infer that they move) and interpreting their movements in context of the group practice.For example, by placing myself at the front or the middle of the class, I can observe the movements of others from several viewpoints in order to synchronise my own with theirs as the practice unfolds. Through experience, I can distinguish when these movements are intentional and when they may be accidental. By combining these strategies with one–on–one discussions with teachers before or after class, as well as doing my own research, I can subsequently learn about teachings that may be verbally expressed during classes and later match these with various teachers and practices over time. These strategies enable me to adapt to a situation where it is impossible to experience consistent face–to–face interaction and where it is difficult to access spoken instruction.Group yoga classes usually begin with the teacher sharing some comments or a story to prompt the theme of the class. This helps us to integrate our exploration of action with the exploration of “invisible and intangible” goals. As a class, we observe our teacher’s intentional movements and mirror these both mentally and physically. As the class progresses, the teacher migrates around the class observing and attending to individual students with adjustments and other assistance. Throughout the class, the teacher alternates between observing, demonstrating and assisting, while simultaneously instructing the class verbally.Most of the students in these group classes... (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)

pt. 1. Background you need. -- What is brain-compatible teaching -- The old and new of it -- When brain research is applied to the classroom everything will change -- Change can be easy -- We're not in Kansas anymore -- Where's the proof -- Tools for exploring the brain -- Ten reasons to care about brain research -- The evolution of brain models -- Be a brain-smart consumer: recognizing good research -- Action or theory: who wants to read all (...) that research -- Excellent sources of research -- Fun factoids on the brain -- What's in the human brain -- Brain teaser -- The brain divided -- The brain connected -- Brain geography -- Brain "cell" ebration: far-out facts about brain cells -- Learning happens but how -- Are today's kids different -- Boy's and girl's brain differences -- Learning disabilities; different brains -- The cranial soup bowl: understanding the chemicals in our brains -- pt. 2. The foundation for teaching is principles, not strategies. What are the principles -- Principle 1: the principle of change: brain is dynamic, not fixed -- Principle 2: the principle of variety: all brains are unique -- Principle 3: the principle of developmental sensitivity -- Principle 4: the principle of interaction: we have a social brain -- Principle 5: the principle of connectivity: the brain is an integrated system of systems -- Principle 6: the principle of memory malleability -- Principle 7: the principle of resource consumption -- necessity for processing -- pt. 3. So what; now what. Asking big questions: what's in a brain-compatible curriculum -- Brain-compatible test-taking success strategies -- Systemic change: the next level -- Big picture analysis: transformation happens -- Action research makes a difference -- The learning community -- What's next. (shrink)

This article puts forth a novel framework for understanding conceptions of disability using six models of disability: the “Social,” “Medical,” “Tragedy,” “Affirmative,” “Minority” and “Universal” models. It analyzes these models as three opposed pairs, each pertaining to a distinct aspect of the multifaceted experience of disability: (1) the cause of disabled people’s social disadvantage and exclusion; (2) the effect of impairment on individuals’ quality of life and well-being; (3) the dichotomy or lack thereof between disabled (...) and nondisabled people. The article argues that although each model is incompatible with its opposed pair, it is compatible with the remaining four models, in the sense that there is no contradiction in holding the views associated with these models at the same time. It therefore concludes that conceptions of disability are best understood as clusters of views on disability that are associated with compatible models. (shrink)

This article puts forth a novel framework for understanding conceptions of disability using six models of disability: the “Social,” “Medical,” “Tragedy,” “Affirmative,” “Minority” and “Universal” models. It analyzes these models as three opposed pairs, each pertaining to a distinct aspect of the multifaceted experience of disability: (1) the cause of disabled people’s social disadvantage and exclusion; (2) the effect of impairment on individuals’ quality of life and well-being; (3) the dichotomy or lack thereof between disabled (...) and nondisabled people. The article argues that although each model is incompatible with its opposed pair, it is compatible with the remaining four models, in the sense that there is no contradiction in holding the views associated with these models at the same time. It therefore concludes that conceptions of disability are best understood as clusters of views on disability that are associated with compatible models. (shrink)

Parenting a child with a disability presents unique challenges and requires additional care and attention. Parents play a crucial role in promoting their child’s development, fostering their independence, and nurturing their overall well-being. This research study aims to investigate the adequacy of resources and support available to families of children with disabilities, as well as the perception of parents regarding these aspects. A specially designed questionnaire consisting of 21 questions was used as the research instrument, which was distributed (...) to families through a Google form. The research sample was convenience-based and comprised 250 parents of children with disabilities. The findings of the study reveal widespread dissatisfaction among parents in relation to institutional support. The results indicate that a significant majority of parents (80%) do not receive adequate institutional support, while only 1% reported receiving it. Furthermore, not a single parent reported being satisfied with the coordination among medical, educational, and social institutions, with 56% expressing dissatisfaction and 44% indicating partial satisfaction. This study highlights the need for improved coordination among various institutions, increased parent education, and the provision of comprehensive support services to ensure a better quality of life for families of children with disabilities. (shrink)

Disability studies in education scholars have discussed the need to engage students, and certainly preservice teachers, in critical discussion of disability as a concept. To better understand what such critical discussion entails, Ashley Taylor examines the pedagogical implications of promoting an understanding of disability as a shared experience of being human. In particular, Taylor is concerned with how the appeal to a shared experience of disability might contribute to or impede students' development of critical attitudes toward (...) ableist social and educational practices. She describes two chief limitations of the shared reality view and argues that these complicate efforts to teach about disability in ways that avoid reinforcing students' existing beliefs. Taylor concludes by offering a pedagogical framework that retains valuable aspects of the shared reality view while avoiding its limitations. (shrink)

It is commonly held that there are both cases in which there is a strong moral reason not to cause the existence of a disabled person and cases in which, although it would be permissible to cause a disabled person to exist, it would be better not to. Yet many disabled people are affronted by the idea that it is sometimes better to prevent people like themselves from existing, precisely because these people would be disabled. One of their grounds for (...) concern, which will be my particular focus in this paper, is that claiming that there are reasons to prevent the existence of disabled people may be expressive of a demeaning and hurtful view of the status of existing disabled people, a view that may encourage discriminatory attitudes towards and treatment of the disabled. I will contend that there can indeed be moral and prudential reasons for preventing the existence of a disabled person. But I will argue that it is less obvious than many people assume what, if anything, the recognition of these reasons expresses about disabled people. And I will contend that, even if the recognition of these reasons does express a perception of disabled people that is potentially hurtful, this effect could be offset by the social expression of a contrary view that I will claim is in fact compatible with and equally valid as the potentially hurtful view. Whether it may be morally objectionable to cause a disabled person to exist depends, in part, on whether the person’s life would be worth living. If it is ever objectionable to cause a disabled person to exist, the objections are surely strongest when the person’s life would be “worth not living” – that is, would have aspects or features that would be bad for the person and that would decisively outweigh those, if any, that would be good. Such cases are, however, quite rare. Indeed, some people question whether there are any disabilities so severe as to cause life to be worth not living. It can be argued that disability involves only the absence of certain abilities and that mere deficits.... (shrink)

In the social system in which we live, the imaginary body is an able body. The able-bodied has established its representations that are the projection of able-bodied subjectivities. In this article, I shall develop a psychoanalytic account of physical disability in order to open up possibilities for physical disability beyond its position as castrated able-bodiedness. Psychoanalysis, to me, is not simply about `sexuality' but can also be used to analyse `physical disability', indeed all aspects of (...) one's subjectivity. I shall propose the appropriation of psychoanalysis to explain the construction of subjectivity, whether it is able-bodied or disabled, in a way that parallels the male/female dichotomy. Within an able-bodied symbolic, in which the able-bodied takes itself as normal, it is impossible to illustrate the multiplicity of the disabled. Following Irigaray's claim that the ambiguity of female sexuality does not conform to male notions of sexuality, I argue that the complexity of the disabled body does not fit into the able-bodied norm of subjectivity. In this article, I shall be drawing on Irigaray's theory of embodied subjectivity to argue against the masculine-able-bodied-based theory of subjectivity found in Freud and Lacan. (shrink)

Continuing tensions exist between mainstream bioethics and advocates of the disability rights movement. This paper explores some of the grounds for those tensions as exemplified in From Chance to Choice: Genetics and Justice by Allen Buchanan and coauthors, a book by four prominent bioethicists that is critical of the disability rights movement. One set of factors involves the nature of disability and impairment. A second set involves presumptions regarding social values, including the importance of intelligence in (...) relation to other human characteristics, competition as the basis of social organization, and the nature of the parent–child relationship. The authors’ disapproval of certain aspects of the disability rights movement can be seen to be associated with particular positions regarding these factors. Although the authors intend to use a method of ‘broad reflective equilibrium,’ we argue that their idiosyncratic commitment to particular concepts of disability and particular social values produces a narrowing of the moral significance of their conclusions regarding disability rights. (shrink)

People with disabilities face inequalities in mental wellbeing, for which social exclusion is a contributing factor. Musical activities offer a promising but complex intervention, making impacts on a population with highly varied characteristics and needs challenging to capture. This paper reports on a mixed methods, person-centered study investigating a community music intervention for such a population. Three groups of adult service users with varied disabilities, took part in weekly music workshops in different locations. Music staff, housing and resource center (...) staff, as well as participants and members of their families, took part in semi-structured interviews. A quantitative measure administered by service staff was used to rate service users’ social development. Two lay researchers, both individuals with a disability contributed to all aspects of the study. Interviews were analyzed through thematic analysis. Improvements in individuals’ self-expression, confidence, mood, and social skills were consistent with previous findings. Differences in effect between centers included: Group 1, some of whom had previous experience of workshops, showed an improvement in musical skills; Group 2 showed a mixed response, some participated with enthusiasm but others chose art activities over music workshops; Group 3 had lasting positive impact, this group had very limited opportunities for music due to their rural location. Quantitative analysis showed significant increase over all groups in communication, interaction with others, and joint attention. The intervention was beneficial for participants in separate locations in similar ways, but also highlighted that context and prior experience mediated effects in distinct ways. The lay researchers enhanced the qualitative analysis by emphasizing the importance of recognizing participants’ self-expression in non-verbal modes of communication and the importance of having music staff with a disability to provide a positive role model. This paper proposes that mixed methods person-centered research is the most suitable approach to capture and understand the multiple and varied effects of this complex intervention for a diverse group of participants. (shrink)

This book provides a range of interdisciplinary and international perspectives on difficulties in literacy development. The high-profile team of contributors provide ethical and policy discussions, as well as contextualizing individual and collective strategies to addressing difficulties in literacy development. The chapters break new ground by encompassing a wide range of perspectives related to critical literacy, socio-cultural, cognitive, and psychological viewpoints, to help inform practice, policy and research into literacy difficulties. This book will be of interest to postgraduate students, teachers, researchers, (...) education professionals and policy makers who are keen to address difficulties in literacy development. (shrink)

What is it like to live with the label “Disability?” NIB editorial staff and narrative symposium editors, Jeffery Bishop and Naomi Sunderland developed a call for stories, which was sent to several list serves, shared with the 1000 Voices Project community and posted on Narrative Inquiry in Bioethics ’ website. The request for personal stories from people who identify with the label “disabled” asked them to: consider how the label “disability” interacts with other aspects of their life (...) in health care settings; does the term “disability” reflect their actual embodied experiences of impairment or does it fail to do justice to their particular experience of impairment; describe the kind of experiences that are possible because of the impairment(s); discuss how the label has affected their “authentic voice”; and many other concepts about what effects the label has on their lives. These authors share deeply personal experiences that will help readers understand their world, challenges, and joys. Thirteen stories are found in the print version of the journal and an additional five supplemental stories are published online only through Project MUSE. The stories are complemented by four commentary articles by Elizabeth R. Schiltz; Lorna Hallahan; Nicole Matthews, Kathleen Ellem, and Lesley Chenoweth; and Jeffery Bishop, Rachelle Barina, and Devan Stahl. These scholars come from the disciplines of law, social work, media studies, medicine, and bioethics from Australia and the United States. Together, the symposium’s storytellers and commentators offer striking and informative insights into the everydayness of living with disabilities. (shrink)

Fetal alcohol spectrum disorders is an umbrella term covering several conditions for which alcohol consumption during pregnancy is taken to play a causal role. The benefit of individuals being identified with a condition within FASD remains controversial. The objective of the present study was to identify ethical aspects and consequences of diagnostics, interventions, and family support in relation to FASD. Ethical aspects relating to diagnostics, interventions, and family support regarding FASD were compiled and discussed, drawing on a series (...) of discussions with experts in the field, published literature, and medical ethicists. Several advantages and disadvantages in regards of obtaining a diagnosis or description of the condition were identified. For instance, it provides an explanation and potential preparedness for not yet encountered difficulties, which may play an essential role in acquiring much needed help and support from health care, school, and the social services. There are no interventions specifically evaluated for FASD conditions, but training programs and family support for conditions with symptoms overlapping with FASD, e.g. ADHD, autism, and intellectual disability, are likely to be relevant. Stigmatization, blame, and guilt are potential downsides. There might also be unfortunate prioritization if individuals with equal needs are treated differently depending on whether or not they meet the criteria for a specific condition. The value for the concerned individuals of obtaining a FASD-related description of their condition – for instance, in terms of wellbeing – is not established. Nor is it established that allocating resources based on whether individuals fulfil FASD-related criteria is justified, compared to allocations directed to the most prominent specific needs. (shrink)

Individuals with disabilities face significant challenges, both physically and socially. To claim a disability, therefore, is not something one ought to do lightly. Pregnancy, however, presents a very difficult and interesting case. Pain, discomfort, and inconvenience are often daily aspects of pregnancy, and pregnancy itself can cause physical, as well as social, impediments that can substantially interfere with one's day-to-day work and life. In practice, based on our current laws concerning family leave, ailments brought on by pregnancy (...) can be cited as a temporary disability in certain circumstances. However, the kind of "pregnancyrelated disability" that is built into such leave policies and laws falls short of... (shrink)

Some authors in disability studies have identified limits of both the medical and social models of disability. They have developed an alternative model, which I call the ‘composite model of disability’, to theorise societies’ ableist norms and structures along with the subjective/phenomenological experience of disability. This model maintains that ableist oppression is not the only source of suffering for disabled people: impairment can be as well. From a feminist, queer, trans activist, anti-ableist perspective and using (...) an intersectional, autoethnographic methodology, I apply this composite model of disability to trans identities to consider the potentially ‘debilitating’ aspects of transness. I argue that transness, like disability, has too often been perceived from two perspectives, medical or social, without the benefit of a third option. From a medical perspective, transness is reduced to an individual pathology curable with hormonal/surgical treatments, a conceptualisation that erases structural oppression. From a social point of view, transness is conceptualised as a neutral condition and variation in sex/gender identity. In this model, structural oppression (transphobia/cisgenderism) is seen as the only cause of ‘trans suffering’. I argue that, just as the medical and social models of disability provide limited opportunities for reflection on the complex experience of disability, medical and social understandings of transness, respectively, are insufficient to describe the complexity of trans experience. I explore the possibilities presented by the application of a composite model of disability in trans studies. By both problematising cisgenderist oppression and acknowledging trans people's subjective experiences of suffering through some of the debilitating aspects of transness, this composite model avoids the pitfalls of the medical and social models. The application of tools from disability studies to trans issues uncovers cisnormativity in disability movements and denounces ableism in trans movements. This will, I hope, solidify alliances between these communities and fields of study. (shrink)

During recent decades various researchers from health and social sciences have been debating what it means for a person to be disabled. A rather overlooked approach has developed alongside this debate, primarily inspired by the philosophical tradition called phenomenology. This paper develops a phenomenological model of disability by arguing for a different methodological and conceptual framework from that used by the existing phenomenological approach. The existing approach is developed from the phenomenology of illness, but the paper illustrates how (...) the case of congenital disabilities, looking at the congenital disorder called cerebral palsy (CP), presents a fundamental problem for the approach. In order to understand such congenital cases as CP, the experience of disability is described as being gradually different from, rather than a disruption of, the experience of being abled, and it is argued that the experience of disability is complex and dynamically influenced by both intrinsic and extrinsic factors. Different experiential aspects of disability— pre-reflective, attuned and reflective aspects—are described, demonstrating that the experience of disability comes in different degrees. Overall, this paper contributes to the debates about disability by further describing the personal aspects and experience of persons living with disabilities. (shrink)

This article explores contemporary approaches to the understanding and interpretation of the formation of inclusive society. The focus is on the investigation of the everyday experiences of individuals who face various limitations in their living conditions such as limited opportunities, special needs, and disabilities. The paper highlights the importance of considering the unique aspects of subjective time when systematically analyzing the functional characteristics and existential mechanisms of an inclusive society, which constitutes the living environment for people with disabilities. It (...) points out that the temporal intentionality of a mentally challenged individual manifests in a unique form of ordering, synchronization, and existence within various phenomena and events within the individual's mental imagery and inner experiences. The authors emphasize the necessity to differentiate two primary stages in an individual's perception and understanding of their actual existence—the evaluation stage and the stage of identifying prospects. The study shows how intentional temporality inherently transforms into individual time, revealing the peculiarities of internal experiences and the unique aspects of an individual's mental imagery. These are integral steps in the formation of a system of social events that are marked within the individual consciousness. The novelty of this study lies in the examination of intentionality within the framework of a disabled person's subjective time, a characteristic that is fundamentally individual yet resonates with the collective daily consciousness of disabled individuals within an inclusive micro-society. (shrink)

In this study caring is shown to be a membershipbound activity to kin and gender categories with strong moral connotations. Being a daughter or being a son are good enough reasons for becoming a caregiver, more so for women than for men. Caregivers were interviewed within the research project The role of women in family care of disabled elderly conducted by the Social and Economic Research Department of INRCA, Ancona, Italy. Transcripts of the interviews were analyzed through a detailed (...) discourse analysis within an ethnomethodological framework. Interview data are treated as interactional encounters that occasion members to display relevant aspects of their identities and morally adequate images of being a caregiver. In the interview interaction, interlocutors display an orientation towards the production of a moral order in which duty and responsibilities are allocated on the basis of gender distinction. Males are generally described as not being responsible for caring tasks, except for situations in which females are absent or sick, that is, for serious reasons. Caregivers'' perception of time dedicated to caring is pervasive. Most caregivers said it occupied all their time, but gender differences were noticeable. Caring tasks are recognized as gender specific practices, thus failing to carry out these tasks is morally sanctionable when women are involved, but not so for men. Many caregivers described caring for older relatives as an intense source of stress, involving serious physical and psychological problems. The study on moral and identity issues related to caregiving highlights endangering constructions of caring. (shrink)

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

Brain–Computer Interface (BCI) technology is a promising research area in many domains. Brain activity can be interpreted through both invasive and non-invasive monitoring devices, allowing for novel, therapeutic solutions for individuals with disabilities and for other non-medical applications. However, a number of ethical issues have been identified from the use of BCI technology. In this paper, we review the academic discussion of the ethical implications of BCI technology in the last five years. We conclude that some emerging applications of BCI (...) technology—including commercial ventures that seek to meld human intelligence with AI—present new and unique ethical concerns. Further, we seek to understand how academic literature on the topic of BCIs addresses these novel concerns. Similar to prior work, we use a limited sample to identify trends and areas of concern or debate among researchers and ethicists. From our analysis, we identify two key areas of BCI ethics that warrant further research: the physical and psychological effects of BCI technology. Additionally, questions of BCI policy have not yet become a frequent point of discussion in the relevant literature on BCI ethics, and we argue this should be addressed in future work. We provide guiding questions that will help ethicists and policy makers grapple with the most important issues associated with BCI technology. (shrink)

This article explains how the most recommended treatment for obstructive sleep apnea, the continuous positive airway pressure device, acts and interacts with users’ bodies, sleep partners’ bodies, and cultural discourses to produce emotions and practices that generate the subjectivity of a disabled or abled person. Drawing upon in-depth interviews with OSA patients, this article illustrates how introducing CPAP devices into patients’ lives may disturb their sleep and breathing, diminish their independence, disfigure their appearance, and problematize intimacy with bed partners, thereby (...) disrupting both the fleshy body and the culturally preferred image of a healthy, independent, and attractive individual. In response, many patients reject this treatment. ability as a subjective state is shown to emerge from associations in a network composed of heterogeneous entities that have agency. That is, disabled subjectivity emerges when the device prevents individuals from accomplishing what they consider to be the essential and socially significant aspects of sleep and primarily its disembodied and interembodied aspects. (shrink)

Enhancement - Behinderung - gutes Leben. Der Band verknupft diese drei Themen und entwickelt einen breiten Zugang zur Debatte um die biotechnologischen Moglichkeiten zur Verbesserung des menschlichen Korpers. Die Beitrage gehen von der Arbeitshypothese aus, dass die Erfahrungen von Menschen mit Behinderungen wichtig sind, um ethische Fragen, die sich bei Enhancement-Projekten stellen, konkreter - und so besser - zu verstehen. Eine zweite Hypothese ist, dass die Sprache der Rechte, Pflichten und Verbote nicht ausreicht, um zu erfassen, worum es im Kern (...) der Fragen zum Enhancement in ethischer Hinsicht geht. Stattdessen muss geklart werden, inwieweit mit einer moglichen Verbesserung auch eine Steigerung des menschlichen Wohls verbunden ist und welche Veranderungen im Kontext eines guten Lebens wunschenswert sind.". (shrink)

The International Classification of Functioning, Disability and Health (ICF), designed by the WHO, attempts to provide a holistic model of functioning and disability by integrating a medical model with a social one. The aim of this article is to analyze the ICF’s claim to holism. The following components of the ICF’s complexity are analyzed: (1) health condition, (2) body functions and structures, (3) activity, (4) participation, (5) environmental factors, (6) personal factors, and (7) health. Although the ICF (...) claims to be holistic, it presupposes a monistic materialistic ontology. We indicate some limitations of this ontology, proposing instead: (a) a pluralistic–holistic ontology (PHO) and (b) a multidimensional view of the human being, with individual and environmental aspects, in relation to three levels of reality implied by the PHO. For the ICF to attain its holistic claim, the interactions between its components should be based on (a) and (b). (shrink)

The question of whether medical and psychiatric judgements involve a normative or evaluative component has been a source of wide and vehement disagreement. But among those who think such a component is involved, there is considerable further disagreement as to its nature. In this article, I consider several versions of Aristotelian normativism, as propounded by Christopher Megone, Michael Thompson and Philippa Foot, and Martha Nussbaum. The first two, I claim, can be persuasively rebutted by different modes of liberal pluralist challenge (...) — respectively, pluralism about structures of social organisation and pluralism about biological forms. Nussbaum's version, by contrast, is alert to the need for pluralism; I argue, however, that the Aristotelian aspects of her theory hamper her pursuit of those pluralistic aims. (shrink)

The article discusses the key stages of the development of ‘disability studies’. Public awareness of the problems of inclusion, as overcoming social inequality, is in the stage of formation in Ukraine and needs a socio-philosophical implementation. he main purpose of the article is to analyze the problem of social space of the city, which is convenient for the life of citizens with different set of opportunities, and the expediency of including disability as a social phenomenon (...) in the broad philosophical context of study. The field of thinking about the city in the study is outlined in the following concepts: the right to the city, the urban space for human development, social communications and the just principles of being. It is important to understand the vector of the development of the socio-cultural field of the city in terms of overcoming the "soulless indifference" (bliss) and for the development of communication between the citizens. The novelty of the work is determined by the rationale for the transformation of traditional disability models in modern conditions of social development. The relevance of the study is associated with the complexity of the phenomenon of disability, insufficient knowledge of the factors and problems of inclusion of people with special needs in society. With the growing number of people with disabilities in society, the problem of developing a culture of disability becomes urgent, the low level of which should be considered a challenge. A culture of disability implies a mutual desire of people with disabilities and society to move towards each other. The practical aspect of the research is related to the need for change of social consciousness, inclusion of persons with disabilities in the social space, development of social competences of people with disabilities and transformation of these people from the object of social assistance into an active subject and participant of the processes taking place in society., implementation of projects based on justice and citizenship. (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 International Classification of Functioning, Disability and Health (ICF), designed by the WHO, attempts to provide a holistic model of functioning and disability by integrating a medical model with a social one. The aim of this article is to analyze the ICF’s claim to holism. The following components of the ICF’s complexity are analyzed: (1) health condition, (2) body functions and structures, (3) activity, (4) participation, (5) environmental factors, (6) personal factors, and (7) health. Although the ICF (...) claims to be holistic, it presupposes a monistic materialistic ontology. We indicate some limitations of this ontology, proposing instead: (a) a pluralistic–holistic ontology (PHO) and (b) a multidimensional view of the human being, with individual and environmental aspects, in relation to three levels of reality implied by the PHO. For the ICF to attain its holistic claim, the interactions between its components should be based on (a) and (b). (shrink)

ABSTRACT People who are paid to provide basic care for others are frequently undervalued, exploited and expected to reach often unrealistic standards of care. I argue that appropriate social recognition, support and fair pay for people who provide care for those who are disabled, frail and aged, or suffering ill health that impedes their capacity to negotiate daily activities without support, depends on a reconsideration of the paradigm of the citizen or and moral agent. I argue that by drawing (...) on the ideas of human vulnerability and dependency as central to our personhood, a more realistic conception of selves, citizens and persons can be developed that better recognises the inevitability of human dependency and the social value of care work. I also indicate the significance of this vulnerability‐focussed view for ethical evaluation of the emotional aspects of care relationships. (shrink)

The coronavirus disease 2019 (COVID-19) pandemic has had profound effects on all aspects of society. Families were among those directly impacted by the first measures imposed by health authorities worldwide to contain the spread of the Sars-CoV-2 virus, where social distancing and mandatory quarantine were the main approaches implemented. Notably, little is yet known about how social distancing during COVID-19 has altered families' daily routines, particularly regarding music-related behaviors. The aim of this study was 2-fold: (i) to (...) explore changes in families' daily routine and caregivers' levels of well-being and stress during the COVID-19 outbreak in Brazil and (ii) to investigate whether musical behaviors of caregivers and the children under their care (aged from 3 to 6 years old) changed during social distancing. One hundred and eighty-eight caregivers residing in Brazil participated in an online cross-sectional study conducted between July and August 2020. Our findings suggest significant changes in families' dynamics during the COVID-19 outbreak, with parents (especially mothers) spending more time on childcare and a substantial decrease in caregiver's well-being. Regarding music-related behaviors, our results revealed considerable changes in caregivers' and children's musical activities at home during social distancing, including an increase in child-only musical behaviors and shared caregiver-child activities. Moreover, sociodemographic factors such as caregiver background and well-being as well as the child's disability status significantly influenced musical engagement at home during social distancing. This study captured some features of the home musical environment of middle-class families in Brazil in the first stages of social distancing restrictions during the pandemic and caregivers' role in providing an environment where musical experiences are nurtured. Further research is needed to better understand aspects such as the long-term impact of the changes of musical behaviors at home on musical parenting and families' well-being. (shrink)

The essay is an attempt to describe the ‘different’ personal life experience of the author. The problems of inclusion in the Ukrainian society of the Soviet period are touched upon and positive examples of inclusion at the present stage of formation of the civil society are given. The question was raised about the need for a philosophical analysis of the formation and functioning of the ’public sphere of disability’, the role and place of disabled people in modern Ukrainian society, (...) as well as the identification of key agents of discussion based on the classical communicative action model of Jürgen Habermas, in addiction to modern directions of development of this model. Vasil’ Sukhomlinskyi’s holistic pedagogical doctrine of the ‘School of Joy’ is considered as a field of activity for specialists in educational philosophy, practical and social philosophy in the light of the problems of integration and inclusion of people with special needs. (shrink)

In this commentary, I suggest expanding the deliberative aspects of critical care policy development in two ways. First, critical-care policy development should expand the scope of deliberation by leaving fewer issues up to expertise or private choice. For instance. it should allow deliberation about the relevance of age, disability, social position, and psychological well-being to allocation decisions. Second, it should broaden both the set of costs considered and the set of stakeholders represented in the deliberative process. In (...) particular, it should consider efforts to reduce the cost of end-of-life care and to redirect resources away from the provision of costly interventions, and should expand the set of individuals included in deliberation to include stakeholders outside the health-care system. (shrink)

Ethical Aspects Related to Nursing Care for Persons with Disabilities: A Qualitative Analysis Aspectos éticos relacionados com a atenção de enfermagem em pessoas com deficiência: uma análise qualitativa The purpose of the study is to describe ethical aspects related to nursing care for persons with disabilities; a population considered socially vulnerable and in conditions of inequality. It corresponds to the first phase of a primary study conducted in Atacama, Chile using a qualitative methodology and content analysis. Nursing graduates (...) are interviewed respecting Ezekiel Emanuel’s ethical criteria. The main findings account for ontological categories such as moral reasoning, value system, nurse-patient relationship model, consequences of the ethical nursing action, strategies to overcome moral conflicts, and barriers in care. It is concluded that caring for people with disabilities is a source of dilemma and moral anguish for nurses, especially when it comes to individuals with sensitive or cognitive disabilities. The paternalistic medical model predominates in the clinical context, limiting the right to autonomy of persons with disabilities. Instrumental values such as efficiency are added to traditional moral values promoted by nurses. Civic values considered fundamental to the challenge of human diversity and life in a democracy are not mentioned. Para citar este artículo / To reference this article / Para citar este artigo Campillay-Campillay M, Rivas-Rivero E, Dubó-Araya P, Calle-Carrasco A. Aspectos éticos relacionados con la atención de enfermería en personas en situación de discapacidad: un análisis cualitativo. Pers Bioet. 2020;24:43-56. DOI: https://doi.org/10.5294/pebi.2020.24.1.4 Recibido: 19/07/2019 Aceptado: 12/11/2019 Publicado: 07/05/2020. (shrink)

All nurses, whatever setting they work in, are likely to encounter people who are at risk of abuse and neglect. Recent reports have highlighted poor care and abuse and safeguarding adults is therefore a key requirement in pre-registration programmes. This book seeks to raise nurses' awareness of vulnerability, abuse and neglect whilst providing them with the knowledge and skills required to safeguard those within their care. It encourages them to make links between theory and practice, to think critically in order (...) to achieve the necessary balance between protection and empowerment and to examine how their personal practice may be improved. (shrink)

This note introduces a framework incorporating multiple sources of evidence into the response to COVID-19 to overcome the neglect of social and psychological causes of illness. By using the example of psychological research on loneliness and its effects on physical and mental health with particular focus on aging and disability, I seek to open further inquiry into how relevant psychological and social aspects of health can be addressed at policy level.

The history of the recovery movement began with a pushback against treatment, and the philosophies that it was founded upon still have relevant applications to contemporary social work practice. Financial aspects of service provision for people with serious mental illnesses have enabled other actors in the medical model of psychosis treatment to benefit, while disempowering and dehumanizing the consumers of those services. Since then, other movements like Psychopolitics and the Mad Movement have helped empower psychosis survivors to advocate (...) for their right to self-determination amid the epistemological pressure to identify as disabled. Social workers would like to believe that the field has moved beyond the philosophies that perpetuated institutionalization of people with serious mental illnesses. Contemporary examples, however, reveal how social services in the US maintain the status quo of sanism for psychosis survivors. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.4 (2002) 373-380 [Access article in PDF] Spiritual Experience and Psychopathology:Dichotomy or Interaction? Caroline Brett Keywords: mysticism, psychosis, values, phenomenology, spiritual emergence. THE PURPOSE OF Marzanski and Bratton's paper is to challenge Jackson and Fulford's (1997) treatment of the area of spiritual experience and psychosis, specifically the perspective of discriminating pathological from spiritual experiences on the basis of action enhancement in contrast to action failure. (...) In my opinion, they are partially successful in this aim, and in their analysis they further the discussion of this complex and controversial area in an interesting and potentially fruitful way. What the paper does not offer, or attempt to suggest, is an alternative way of making a distinction, and in the following discussion I intend to explain why I think that, on the one hand, the status of specific experiences is of practical importance, and on the other hand any distinction should not be conceptualized as mutually exclusive. I also hope to clarify those issues which I perceive as being raised by both Jackson and Fulford's and Marzanski and Bratton's papers. The Critique Marzanski and Bratton's first, and in my opinion strongest, point is to argue that "values and actions alone cannot always discriminate between religious experience and psychopathology." They demonstrate convincingly that the fact that an individual positively evaluates a certain anomalous experience and shows enhanced function as a result of it, does not in itself mean that the experience should be viewed as "spiritual." Their second and third points relate to the way spirituality ought to be regarded, suggesting that Jackson and Fulford are in error to identify spirituality with experience, and moreover that any judgment of genuine spiritual content or value requires reference to an individual's personal history, and also some spiritual tradition or authority. I believe that the former point, although certainly relevant to the issue, is in danger of broadening the debate too far from the consideration of particular anomalous experiences: namely, those that are phemenologically similar or identical to psychotic symptomatology. Marzanski and Bratton also mount an objection to the psychologization of spiritual experience by Jackson and Fulford, although I am not convinced that they represent these authors' opinions fairly. Whose Values? Action or Ethics? The first point, the refutation of the thesis that a spiritual experience can be distinguished from [End Page 373] psychopathology on the basis of a positive evaluation and preservation of functionality, succeeds in that it is shown both that (1) experiences accepted as spiritual within major religious traditions may actually be distressing and/or disabling; and (2) anomalous experiences that are both positively evaluated by the experient and action enhancing nevertheless may not have genuine spiritual characteristics. The argument proceeds through the use of counterexamples, and it is indeed a problem for the Jackson and Fulford account that suffering and periods of social withdrawal or distress do appear to be historically, anthropologically, and theologically associated with the spiritual journey. Bratton and Marzanski use, among other examples, the "dark night of the soul" of mystics, raising the very interesting point that a person may have experiences that, at least at the time of experiencing, are profoundly disturbing or even disabling, socially or functionally, and yet those same experiences may in some way set the scene for a profound transformation or spiritual renewal. To my mind this concept can be seen reflected in the "terrible" forms of the Wisdom Goddess in Advaita Vedanta (as expressed in my own paper), and can be related to the concept of "breaking down to break through" espoused by transpersonal psychologists such as Grof and Grof (1992).Therefore, on closer examination, it appears that Jackson and Fulford's notion of preserved functionality may play some role after all, even if it does require supplementation: if the breaking through aspect of the process is necessary to distinguish from simply breaking down, then action enhancement may remain a criterion determining the spiritual value of an experience. However, it will need to be observed in the longer term, and as such can only play a role... (shrink)