This chapter compares three different general accounts of personhood (Byzantine, Boethian, and Modern) and argues that if personhood is the basis on which one has equal moral status in the moral community and the disability-positive position is correct, then the Byzantine and Boethian accounts are preferable over the Modern accounts that are surveyed here. It further argues that the Byzantine account is even friendlier to a disability-positive position compared to the Boethian account.

Ideas found in the early Daoist texts can inform current debates about disability, since the latter often involve assumptions about personhood and agency that Daoist texts do not share. The two canonical texts of classical Daoism, the Daodejing and the Zhuangzi, do not explicitly discuss disability as an object of theory or offer a model of it. They do, however, provide conceptual resources that can enrich contemporary discussions of disability. Two particular ideas are discussed here. Classical (...) Daoist thinking about the body undermines normative assumptions about it that attributions of ‘disabled’ often depend upon; and Daoism vividly problematises the common inferential leap from perceived and pronounced incapacity to a more general judgment of “useless”. In conclusion, I suggest that Daoism’s skepticism and particularistic approach to experience suggest caution about the value of appealing to theoretical models of disability. (shrink)

This chapter focuses on moral personhood understood in terms of the notion of moral status. An entity is said to have moral status only if it or its interest matters morally for its own sake. Nonutilitarians tend to think of moral status in terms of entitlements and protections that can conflict with, and sometimes override, doing what would maximize the good and minimize the bad. If moral status comes in degrees, and if there is a status of the highest (...) degree (i.e., full moral status), then moral persons are those with full moral status. After giving a more precise account of it, we assess different views of what it takes to qualify for full moral status (some of which appeal to metaphysical notions of person). We also briefly discuss how metaphysical notions of personhood are put to moral use in utilitarian moral theorizing that eschews the notion of moral personhood. (shrink)

2. I’ve never put forward a “definition of the individual as a discrete, self-reliant, self-conscious person with at least an equal store of goods as others.” Again, that would be an absurd position to hold. Being unable to walk, see, or hear does not mean that one is not an individual. 3. Nor do I hold that “protected personhood”— not my ex- pression, by the way—is a conditional category based on attri- butes “that are at least equal to those (...) of the mundane norm.”. (shrink)

This chapter is about personhood in relation to ethics and to conciliar Christian theology, and how concepts of personhood may discriminate against profoundly cognitively disabled human beings. (By ‘conciliar Christian theology’ I mean the Christian theology that is articulated in, or endorsed by, the first seven ecumenical councils.) -/- I believe we can learn several things about personhood by looking at these two topics together. By examining ancient and medieval concepts of personhood and some modern conceptions (...) of personhood we gain a better grasp of the variety of concepts and what substantive work they were intended to do. By becoming familiar with (part of) the history of concepts of personhood we are better situated to appreciate and judge the theoretical work that these concepts were intended to do and what consequences they have in ethical and theological theorizing. -/- In the first section I tell a select history of moral philosophers theorizing about personhood and discuss these in relation to human beings with profound cognitive disability. I focus on John Locke, Immanuel Kant, and Mary Anne Warren. In the “When Personhood Is Discriminatory” section I argue that concepts of personhood, especially modern concepts of personhood, are typically used in a manner that discriminates against human beings with profound cognitive disabilities. I give two arguments against discriminatory uses of personhood, the Moral Shift Argument and the Argument against Exclusive Personhood. Although the Moral Shift Argument is deductively valid, it probably has little persuasive power over those who do not share the moral belief that profoundly cognitively disabled human beings are equal members of the moral community. However, the Argument against Exclusive Personhood has more argumentative force because it denies the claims that personhood is “self-evident” and that it is “obvious” to everyone. In the following section I survey a select history of concepts of personhood in order to establish the claims that concepts of personhood are not self-evident and are not obvious to everyone. This history of personhood goes back to ancient and medieval Christian theorizing and debating about personhood. It shows that concepts of personhood are not “self-evident” but rather are theoretical posits that are posited in theory construction in order to explain certain putative theological facts. Given that personhood is a theoretical posit and is not “self-evident,” moral philosophers who aim to determine the extent of the moral community on the basis of a supposedly “self-evident” concept of personhood are not justified in doing so. Moreover, given the Argument against Exclusive Personhood, philosophical theologians who wish to articulate models of the Trinity or Incarnation that are consistent with the seven ecumenical councils will find that they, like moral philosophers, are not justified to assume, or to insist on, modern personhood for their models of the Trinity or Incarnation. My overall conclusion, then, is that modern personhood is bad for ethics and unnecessary for conciliar ecumenical Christian theology. (shrink)

This book articulates an African conception of dignity in light of the salient axiological category of personhood in African cultures. The idea of personhood embodies a moral system for evaluating human lives exuding with virtue or ones that are morally excellent. This book argues that this idea of personhood embodies an under-explored conception of dignity, which accounts for it in terms of our capacity for the virtue of sympathy. It then proceeds to apply this personhood-based conception (...) of dignity to bioethical questions, specifically, those of abortion and euthanasia. Regarding abortion, it concludes that it is impermissible since foetuses possess partial moral status. Regarding euthanasia, it argues that it is permissible for reasons revolving around avoiding the reversing of personhood. It also, though, minimally, touches on the questions regarding the mentally disabled and animals, to which it assigns lower moral status. (shrink)

Drawing on insights from the medieval theologians Duns Scotus and Hervaeus Natalis, I argue that medieval views of the incarnation require that there is a sense in which the divine person depends on his human nature for his human personhood, and thus that the paradigmatic pattern of human personhood is in some way dependent existence. I relate this to a modern distinction between impairment and disability to show that impairment—understood as dependence—is normative for human personhood. I (...) try to show how medieval theories of the resurrection of the body can provide, within this context, plausible accounts of what it might be for human persons to be redeemed. (shrink)

Three of the articles included in this issue of the Journal of Medicine and Philosophy - Ron Amundson and Shari Tresky's "On a Bioethical Challenge to Disability Rights"; Rachel Cooper's "Can It Be a Good Thing to Be Deaf?"; and Mark T. Brown's "The Potential of the Human Embryo" - interact (in various ways) with the concepts of disability, humanity, and personhood and their normative dimensions. As one peruses these articles, it becomes apparent that terms like " (...) class='Hi'>disability," "human being," and "person" carry with them great normative significance. There is, however, much disagreement concerning both the definition and the extension of such terms. This is significant because different terms and definitions are associated with different sets of normative requirements. In what follows we reconstruct the argument of each of the articles, and then offer some brief critical analysis intended to stimulate further thought about and discussion of the issues that each raises. (shrink)

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

By considering the death of the disability activist Engracia Figueroa as the consequence of her wheelchair being damaged by an airline, this article asks whether law could accommodate a definition of legal personhood that encompasses the possibility of bodies augmented by prosthetics, technology, and mobility aids. The use of mobility aids by disabled people and the role of prosthetic penises in so-called ‘gender fraud’ cases offer two useful provocations to consider the ways in which legal personhood, if (...) defined as largely mapping on to an ideal, normative body, is becoming an increasingly inadequate legal concept in the modern age. Drawing on the work of Donna Haraway and the figure of the cyborg, this article argues that a more protean, flexible, and fluctuating understanding of legal personhood would offer both a more accurate and utopian conception of the body in law than the current essentialist approach found in a number of legal areas and particularly in English criminal law. (shrink)

In this essay, I argue that Menkiti’s normative personhood is exclusionary, and logically inadequate, especially regarding mentally disabled persons. My argument is that Menkiti’s account of personhood as a moral-political theory does not possess the resources to accommodate and account for mentally disabled persons because of its rigid process of transformation, which requires moral excellence. An inclusive moral theory, I argue, should be able to accommodate all members of the moral community irrespective of their ability, but rather, their (...) capacity for relationships. Tapping into the intellectual resources of conversational thinking, I propose another conception of personhood predicated on moral status as the basis for personhood. With this method, I query the inclusiveness of Menkiti’s conception and demonstrate that a relational alternative option that bases moral status on the human capacity for relationships might be more inclusive. Here, personhood is anchored on the capacity for relationships, not the ability to exude moral excellence. I then contend that this moral status conception of personhood possesses the needed resources to account for all because it is inclusive and egalitarian, riding on the crest of Ezumezu logic, which is also both egalitarian and inclusive. (shrink)

This paper begins by saying enough about eugenics to explain why disability is central to eugenics (section 2), then elaborates on why cognitive disability has played and continues to play a special role in eugenics and in thinking about moral status (section 3) before identifying three reasons why eugenics remains a live issue in contemporary bioethics (section 4). After a reminder of the connections between Nazi eugenics, medicine, and bioethics (section 5), it returns to take up two more (...) specific clusters of issues at the intersection of eugenics, disability, and bioethics. These concern questions of life, death, and reproductive value (section 6) and the value of standpoint theory and epistemology for understanding some of the tensions between bioethics and disability in light of a shared eugenic past (section 7). (shrink)

Scientists, engineers, and healthcare professionals are currently developing a variety of new devices under the category of brain-computer interfaces (BCIs). Current and future applications are both medical/assistive (e.g., for communication) and non-medical (e.g., for gaming). This array of possibilities comes with ethical challenges for all stakeholders. As a result, BCIs have been an object of both hope and concern in various media. We argue that these conflicting sentiments can be productively understood in terms of personhood, specifically the impact of (...) BCIs on what it means to be a person and to be recognized as such by others. To understand the dynamics of personhood in the context of BCI use and investigate whether ethical guidance is required, a meeting entitled "BCIs and Personhood: A Deliberative Workshop" was held in May 2018. In this article, we describe how BCIs raise important questions about personhood and propose recommendations for BCI development and governance. (shrink)

Walter Sinnott-Armstrong and Franklin G Miller recently argued that the wrongness of killing is best explained by the harm that comes to the victim, and that ‘total disability’ best explains the nature of this harm. Hence, killing patients who are already totally disabled is not wrong. I maintain that their notion of total disability is ambiguous and that they beg the question with respect to whether there are abilities left over that remain relevant for the goods of (...) class='Hi'>personhood and human worth. If these goods remain, then something more is lost in death than in ‘total disability,’ and their explanation of what makes killing wrong comes up short. But if total disability is equivalent with death, then their argument is an interesting one. (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)

Charles Taylor argues that recognition begins with the politics of "self-image," as groups represented in the past by others in ways harmful to their own identity replace negative historical self-images with positive ones of their own making. Given the centrality of "self image" to his politics of recognition, it is striking that Taylor, himself, represents disabled people in language that is both limiting and depreciating. The author argues such negative self-images are not unique to Taylor but endemic to modern political (...) thought from John Locke to John Rawls, as the disabled are constituted in direct opposition to the rational person and/or citizen. Using contemporary social theories of disability, as articulated by disabled scholars and advocates, the author concludes that such negative self-images must be purged from political theory and replaced with an alternative theory of personhood/citizenship rooted in the image of interdependency. (shrink)

This Dissertation argues for a care-centrically grounded account of relational personhood and widely realized diachronic personal identity. The moral distinction between persons and non-persons is arguably one of the most salient ethical lines we can draw since many of our most fundamental rights are delineated via the bounds of personhood. The problem with drawing such morally salient lines is that the orthodox, rationalistic definition of personhood, which is widespread within philosophical, medical, and colloquial spheres, excludes, and thereby (...) de-personifies, a large number and a great variety of human beings such as neonates, young children, the elderly who suffer from dementia, individuals with severe cognitive disabilities, and patients in vegetative states. The reconceptualization of personhood necessary for a more inclusive definition ought to originate with an appropriate moral grounding. To this end, this Dissertation grounds the notion of personhood in the care ethical sphere, thereby emphasizing the role of care relations in the maintenance of the moral consideration of vulnerable individuals. This Dissertation argues that grounding the concept of a person in care relations entails a relational account of personhood, which, along with the insights of the Extended Mind and Social Manifestation Theses, leads to an extended and externalized understanding of diachronic identity, which allows fragile people to be held in their personal identities even if they themselves lack the capacities usually associated with moral personhood. As we trace a person’s identity through time, we track the various relational properties, which constitute personal narratives and thus act as a glue that binds such dynamic and often unique properties into stable, trackable narratives. Since care relations are morally relevant on a care-centric account of personhood, what is lost in cases where such care relating ceases is not merely of sentimental value, but of great moral importance as well. Morally meaningful care relations are not replaceable, and, by extension, neither are the narratives that are constituted by such unique and irreplaceable instances of relating. This Dissertation argues that the constitutive care relational nature of personal narratives makes such narratives irreplaceable and is precisely what makes persons so morally precious. (shrink)

Through a series of essays contributed by clinicians, medical historians, and prominent moral philosophers, Cognitive Disability and Its Challenge to Moral ...

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Disability in the Christian Tradition: A Reader Edited by Brian Brock and John SwintonKevin McCabeDisability in the Christian Tradition: A Reader EDITED BY BRIAN BROCK AND JOHN SWINTON Grand Rapids, MI: Eerdmans, 2012. 576 pp. $45.00Disability in the Christian Tradition makes an important contribution to the growing area of theological inquiry known as “theology of disability.” While questions of physical and intellectual difference are getting much-deserved (...) attention from religious ethicists and constructive theologians today, relatively little attention has been given to the treatment of what we now call “disability” throughout the history of Christian thought and especially in the premodern era. This volume seeks to remedy this situation by highlighting the theological consideration of disability in Christian thinkers from the patristic era to the present. Against tendencies to treat disability as a “special case” for thinking about humanity, this volume seeks to show the often overlooked presence of reflection on disability throughout the tradition.The volume pairs introductory and interpretive essays from contemporary scholars with primary source selections from each historical thinker. Essays on Augustine, Aquinas, and Luther help to correct the historical record, which often remembers these theologians as advocating rationalist or exclusionary anthropologies that marginalize or significantly compromise the humanity of persons with disabilities. These thinkers prove to be more nuanced and insightful than is often thought. However, as Brian Brock points out with respect to Augustine, and as Stefan Heuser points out with respect to Luther, [End Page 238] these figures are often ambivalent or at odds with themselves on the practical and theological significance of disability. Following the work started here, further interpretation and analysis will be needed in order to assess the legacies of these figures and to discern their usefulness for thinking about disability today. In this respect the reader serves as a helpful invitation for further historical and constructive work.Some of the finest essays in the volume focus on disability in order to illuminate the theologians under consideration in surprising ways. Christopher Craig Brittain’s essay on Kierkegaard appeals to his letters and manuscripts in order to show how questions of suffering, marginalization, and self-acceptance are crucial aspects of Kierkegaard’s understanding of being human and being Christian—and how his work might contribute to current debates in disability theory and theology. Bernd Wannenwetsch shows how Dietrich Bonhoeffer’s visit to a community for persons with disabilities in 1933 was a pivotal experience in the formation of his anthropology. Wannenwetsch compellingly argues that Bonhoeffer’s advocacy on behalf of the weak and disabled is integrally connected to his opposition to the destructive rival anthropology advocated under Nazi rule. These essays make important contributions both to our reflection on disability as well as to our understanding of Kierkegaard and Bonhoeffer’s wider thought.A variety of perspectives on the meaning of disability are on display in this volume. One comes away with the impression that the “dialogue with the communion of saints” (3) called for in the introduction might be more of a debate than a harmonious discourse. The historical thinkers featured here do not offer one Christian account of disability that might be set against modern and secular perspectives on disability, but they do offer much that is productive for ethicists and theologians today.This volume is important for anyone concerned with theological reflection on disability, but it would be a shame if the book’s readership were limited to such a group. Historical theologians and readers interested in the theological and ethical issues pertaining to Christian anthropology and questions of embodiment, suffering, and vulnerability will find much that is of value. Indeed, it is one of the lessons of the volume that disability is not just a marginal or trendy topic in the contemporary theological scene but a central aspect of human personhood that has played an important if complex role in the understanding of what it means to be human throughout the Christian tradition. [End Page 239]Kevin McCabeUniversity of Notre DameCopyright © 2014 Society of Christian Ethics... (shrink)

The question of how to treat people with cognitive disabilities (PCDs) poses an important problem for Rawlsian theories of justice because it is unclear whether PCDs are included within the scope of moral personhood. Rawls’s Standard Solution focuses on nondisabled adults as the fundamental case, while later addressing PCDs as marginal cases. I claim that the Standard Solution has two weaknesses. First, it relies on a dichotomy between nondisabled and disabled that is tenuous and difficult to defend. Second, it (...) makes the theory circular in a vicious way.I argue that Rawls’s theory can be revised so that it solves the problem of how to treat PCDs while avoiding the two weaknesses of the Standard Solution. There are three constraints on any successfully revised Rawlsian theory: 1) it must be resourcist rather than welfarist; 2) it must provide some principled basis for limiting our obligations to PCDs; and 3) it must address the whole range of PCDs, including the most severely disabled individuals. (shrink)

In 21st century America, personhood is under daily assault, sometimes with dire consequences. Scientist, ethicist, and ordained minister Craig C. Malbon encourages the reader to consider such assaults on personhood endured by victims of abortion, ageism, Alzheimer's disease, drug addiction, mental and physical disabilities, gender, gender orientation, racism, sexual preference, identity politics, and our will-to-power over the "other." In exploring personhood status, Malbon poses difficult questions for us. Is personhood assigned as all-or-nothing, or is it a (...) sliding scale based upon criteria arbitrarily aimed at our vulnerabilities? Does the voiceless embryo and fetus have advocates who can speak to the moral question of abortion? Is the personhood of an economically insecure pregnant woman degraded to the point where lack of access to early termination of pregnancy results in "coercive childbearing?" Does being a member of the LGBTQI+ community target one for assaults on personhood, to the extreme of being killed? In delving into the biology and psychology of assaults of "self" upon the "other," Malbon sees powerful linkages of everyday assaults on personhood to darker, profound "original sins" that are foundational to the rise of the American empire, i.e., assaults on the indigenous Native Americans and assaults derivative to the institution of slavery upon Africans, African Americans, and their descendants. (shrink)

This book uses the tools of analytic philosophy of disability (and Disability Studies more generally) and close readings of medieval Christian philosophical and theological texts in order to survey what these thinkers said about what today we call “disability.” The chapters also compare what these medieval authors say with modern and contemporary philosophers and theologians of disability. This dual approach enriches our understanding of the history of disability in medieval Christian philosophy and theology and opens (...) up new avenues of research for contemporary scholars working on disability. The volume is divided into three parts. Part I addresses theoretical frameworks regarding disability, particularly on questions about the definition(s) of “disability” and how disability relates to well-being. The chapters are then divided into two further parts in order to reflect ways that medieval philosophers and theologians theorized about disability. Part II is on disability in this life, and Part III is on disability in the afterlife. Taken as a whole, these chapters support two general observations. First, these philosophical theologians sometimes resist Greco-Roman ableist views by means of theological and philosophical anti-ableist arguments and counterexamples. Here we find some surprising disability-positive perspectives that are built into different accounts of a happy human life. We also find equal dignity of all human beings no matter ability or disability. Second, some of the seeds for modern and contemporary ableist views were developed in medieval Christian philosophy and theology, especially with regard to personhood and rationality, an intellectualist interpretation of the imago Dei, and the identification of human dignity with the use of reason. This volume surveys disability across a wide range of medieval Christian writers from the time of Augustine up to Francisco Suarez. It will be of interest to scholars and graduate students working in medieval philosophy and theology or disability studies. (shrink)

This article addresses the precarious place of transgender and gender non-cis persons in relation to their discrimination-protections in recent legal, medical, and ethical policies in the United States. At present, there exists a contradiction such that trans persons are considered "pathological" enough that they are included in the latest iteration of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-V) as "gender dysphoric," but they are not included in the category of "disabled" under the Americans with Disabilities Act (ADA). As (...) such, trans persons in America are subject to the stigma of pathology (albeit with medical treatment) without the full protections of the ADA. By contrast, transgender and non-cis-gender Americans find their queer cohorts who are HIV-positive to be fully protected by the ADA. We ask whether transgender and non-cis-gender persons should embrace their (already pathologized) personhood as a disability. Sometimes "choosing disability" affords more rights than it deploys stigma. (shrink)

This article suggests that those individuals typically acknowledged as vulnerable during public health crises, such as pandemics, are often-times doubly so. I suggest that individuals can be vulnerable in a person-affecting way as well as in a personhood-affecting way. I suggest that the former notion of vulnerability coincides with many existing accounts of vulnerability and that subsequently, many of the more standard arguments for moral and justice-based obligations to minimize such vulnerability, hold. I also suggest that the latter notion (...) of vulnerability adds another layer of vulnerability to those that we typically view to be at risk. I argue that personhood-vulnerability constitutes a novel interpretation of vulnerability than expands our ideas of the kinds of harm that emerge during public health crises. (shrink)

Does life have meaning? What is flourishing? How do we attain the good life? Philosophers, and many others of us, have explored these questions for centuries. As Eva Feder Kittay points out, however, there is a flaw in the essential premise of these questions: they seem oblivious to the very nature of the ways in which humans live, omitting a world of co-dependency, and of the fact that we live in and through our bodies, whether they are fully abled or (...) disabled. Our dependent, vulnerable, messy, changeable, and embodied experience colors everything about our lives both on the surface and when it comes to deeper concepts, but we tend to leave aside the body for the mind when it comes to philosophical matters. Disability offers a powerful challenge to long-held philosophical views about the nature of the good life, what provides meaning in our lives, and the centrality of reason, as well as questions of justice, dignity, and personhood. These concepts need not be distant and idealized; the answers are right before us, in the way humans interact with one another, care for one another, and need one another--whether they possess full mental capacities or have cognitive limitations. We need to revise our concepts of things like dignity and personhood in light of this important correction, Kittay argues. This is the first of two books in which Kittay will grapple with just how we need to revisit core philosophical ideas in light of disabled people's experience and way of being in the world. Kittay, an award-winning philosopher who is also the mother to a multiply-disabled daughter, interweaves the personal voice with the philosophical as a critical method of philosophical investigation. Here, she addresses why cognitive disability can reorient us to what truly matters, and questions the centrality of normalcy as part of a good life. With profound sensitivity and insight, Kittay examines other difficult topics: How can we look at the ethical questions regarding prenatal testing in light of a new appreciation of the personhood of disabled people? What do new possibilities in genetic testing imply for understanding disability, the family, and bioethics? How can we reconsider the importance of care, and how does it work best? In the process of pursuing these questions, Kittay articulates an ethic of care, which is the ethical theory most useful for claiming full rights for disabled people and providing the opportunities for everyone to live joyful and fulfilling lives. She applies the lessons of care to the controversial alteration of severely cognitively disabled children known as the Ashley Treatment, whereby a child's growth is halted with extensive estrogen treatment and related bodily interventions are justified. This book both imparts lessons that advocate on behalf of those with significant disabilities, and constructs a moral theory grounded on our ability to give, receive, and share care and love. Above all, it aims to adjust social attitudes and misconceptions about life with disability. (shrink)

Drawing on the built environment concept of “inclusive design” and its emphasis on creating accessible environments for all persons regardless of ability, I suggest that a central task for feminist disability theory is to redesign foundational philosophical concepts to present opportunities rather than barriers to inclusion for people with disability. Accounts of autonomy within liberal philosophy stress self-determination and the dignity of all individual persons, but have excluded people with intellectual disability from moral and political theories by (...) denying their capacity for individual autonomy, seen as a chief marker of moral personhood. This paper modifies and extends feminist theories of relational autonomy by arguing for the need to view autonomy as a feature of persons that is manifested only through relations of support, advocacy, and enablement. An “inclusively designed,” relational account negotiates the tensions encountered in attempts to apply autonomy to people with high support needs, and politicizes the concept as an advocacy tool for people with intellectual disability and their allies. (shrink)

The concept of personhood has been central to bioethics debates about abortion, the treatment of patients in a vegetative or minimally conscious states, as well as patients with advanced dementia. More recently, the concept has been employed to think about new questions related to human-brain organoids, artificial intelligence, uploaded minds, human-animal chimeras, and human embryos, to name a few. A common move has been to ask what these entities have in common with persons (in the normative sense), and then (...) draw conclusions about what we do (or do not) owe them. This paper argues that at best the concept of “personhood” is unhelpful to much of bioethics today and at worst it is harmful and pernicious. I suggest that we (bioethicists) stop using the concept of personhood and instead ask normative questions more directly (e.g., how ought we to treat this being and why?) and use other philosophical concepts (e.g., interests, sentience, recognition respect) to help us answer them. It is time for bioethics to end talk about personhood. (shrink)

The concept of personhood has been central to bioethics debates about abortion, the treatment of patients in a vegetative or minimally conscious states, as well as patients with advanced dementia. More recently, the concept has been employed to think about new questions related to human-brain organoids, artificial intelligence, uploaded minds, human-animal chimeras, and human embryos, to name a few. A common move has been to ask what these entities have in common with persons (in the normative sense), and then (...) draw conclusions about what we do (or do not) owe them. This paper argues that at best the concept of “personhood” is unhelpful to much of bioethics today and at worst it is harmful and pernicious. I suggest that we (bioethicists) stop using the concept of personhood and instead ask normative questions more directly (e.g., how ought we to treat this being and why?) and use other philosophical concepts (e.g., interests, sentience, recognition respect) to help us answer them. It is time for bioethics to end talk about personhood. (shrink)

This monograph consists of five parts: (1) introductory material including a conference overview; (2) papers presented at an international symposium on the topic of ethical issues in disability and rehabilitation as a section of the Annual Conference of the Society for Disability Studies; (3) responses to the symposium, prepared by four of the participants; (4) selected additional papers which offer views from perspectives or cultures not represented at the Denver conference; and (5) an annotated international bibliography. Representatives from (...) 10 countries discussed ethical issues and decision making in disability and rehabilitation. Conference papers include: "Genetic Engineering--The New Eugenics? Evolving Medical Attitudes towards the Quality of Life" (Hugh Gallagher);"Description of the Decision-Making Project" (Daryl Evans); "Treatment and Nontreatment Decisions with Respect to Extremely Premature, Very Low Birthweight Infants (500-750g)" (Ernle Young); "Allocation of Resources and Distributive Justice" (John Mather); "Quality Assurance as an Aid to Ethical Decision Making in Disability Management: Lessons from Recent Ethical Issues Involving Disadvantaged Groups in New Zealand" (Peter Gow); "Disability and Ethical Issues: A Point of View from the Netherlands" (Yolan Koster-Dreese); "Who Shall Live or How Shall They Live? Consumer and Professional Perspectives on Treatment/Non-Treatment Decisions" (Joseph Kaufert and Patricia Kaufert); and "Debates across Social Movements on Reproductive Technologies, Genetic Engineering, and Eugenics" (Theresia Degener). Conference commentaries include: "The Meeting of Disability and Bioethics: A Beginning Rapprochement" (Adrienne Asch); "A Plea for More Dialogue: Commentary on Ethics Conference" (Robert Slater); "Healing Our Wounds" (Martha Lentz Walker); "Theories and Values: Ethics and Contrasting Perspectives on Disability" (Harlan Hahn); and "Current Example of Ethical Dilemma" (Susan Lacetti). Selected additional papers include: "High-tech Medicine Is Basic Care" (Frederick Abrams); "Prevention of Disabilities as a Medical Question" (G. Schioler); "The Ethics of Disability Prevention: A Parent's Point of View" (Mrs. J. Baker); "A Reference Matrix for Issues of Life and Personhood" (Mike Miles); "Nazi Scientists and Ethics of Today" (Isabel Wilkerson); "Ethical and Policy Issues in Rehabilitation Medicine (Hastings Center Report)" (Arthur Caplan et al.); and "Differing Approaches to Prevention of Disability and Treatment of Impaired Infants Creates Controversies Worldwide" (Barbara Duncan). (JDD). (shrink)

In this article I examine the proposition that severe cognitive disability is an impediment to moral personhood. Moral personhood, as I understand it here, is articulated in the work of Jeff McMahan as that which confers a special moral status on a person. I rehearse the metaphysical arguments about the nature of personhood that ground McMahan’s claims regarding the moral status of the “congenitally severely mentally retarded” (CSMR for short). These claims, I argue, rest on the (...) view that only intrinsic psychological capacities are relevant to moral personhood: that is, that relational properties are generally not relevant. In addition, McMahan depends on an argument that species membership is irrelevant for moral consideration and a contention that privileging species membership is equivalent to a virulent nationalism (these will be discussed below). In consequence, the CSMR are excluded from moral personhood and their deaths are less significant as their killing is less wrong than that of persons. To throw doubt on McMahan’s conclusions about the moral status and wrongness of killing the CSMR I question the exclusive use of intrinsic properties in the metaphysics of personhood, the dismissal of the moral importance of species membership, and the example of virulent nationalism as an apt analogy. I also have a lot to say about McMahan’s empirical assumptions about the CSMR. (shrink)

Having encountered landmines in offering a critique of philosophy based on my experience as the mother of a cognitively disabled daughter, I ask, “Should I continue?” I defend the idea that pursuing this project is of a piece with the invisible care labor that is done by people with disabilities and their families. The value of attempting to influence philosophical conceptions of cognitive disability by virtue of this experience is justified by an inextricable relationship between the personal, the political, (...) and the philosophical. If one grants that the “special relationship” between mother and child requires moral recognition, then I need first to make vivid the case that this relationship in the case of a child who lacks some “normal capacities” is indistinguishable from any mother‐child relationship. If this is so, then I believe I can make a case that has as its conclusion that the moral personhood of even the severely cognitively disabled must be granted. Moreover, such recognition, I argue, necessitates the recognition of others who bear no special relationships to the child. (shrink)

Political philosophy is obviously concerned with people. If there were no people we would have no subject. But the contemporary significance of the concept of personhood is largely due to its central role in liberal political philosophy. Puzzles about personhood typically arise as objections to liberalism.

The promotion of rights, autonomy and choice reacts against paternalism, an early twentieth-century response to intellectual disability that suppressed individual personhood through a combination of resource limitations and poor administration. These liberal individualist concepts reflect the contemporary zeitgeist of Anglophone nations, although the strength and certainty with which these concepts are expressed in ID policy when compared with policy for other vulnerable groups suggests that they also serve a secondary function. It has been argued that excessive certainty in (...) ID evidences a feared drop... (shrink)

This chapter contains sections titled: Introduction Definition of Disability Causes of Intellectual Impairment Evolving Terminology for Intellectual Impairment The Bell Curve and IQ: Levels of Intellectual Disability Cognitive Developmental Thresholds Intellectual Disability and the Brain: Fluid and Crystallized Intelligence Neuroplasticity in Brain Development Developmental Perspective on Intellectual Disability: Cognitive Developmental Thresholds Moral Development Implications of Recognizing Personhood and Autonomy Participation in Research Summary References.

For caregivers of minimally communicative individuals, providing support in the absence of clearly meaningful responses is ethically fraught. We conducted a secondary analysis of qualitative data from caregivers of individuals who are minimally communicative, including persons with advanced dementia and individuals in disorders of consciousness. Our analysis led to two central claims: (1) Personhood is a threshold concept that is situated, relational, and dynamic and (2) in circumstances in which personhood is difficult to judge, caregivers can “fill the (...) gap” to reach the threshold through a repertoire of strategies. Because personhood is in part an attribution from others, a situational loss of personhood does not preclude restoration, nor does it eliminate moral status. (shrink)

In this open peer commentary, we concur with the three target articles’ analysis and positions on abortion in the special issue on Roe v. Wade as the exercise of reproductive liberty essential for the bioethical commitment to patient autonomy and self-determination. Our proposed OPC augments that analysis by explicating more fully the concept crucial to Roe of fetal personhood. We explain that the development and use of predictive reproductive technologies over the fifty years since Roe has changed the literal (...) image, and thereby the epistemological landscape, through which a prospective parent comes to know the fetus. The logic of Roe required a legal and ethical denial of fetal personhood to prioritize maternal autonomy over claims to fetal moral personhood. Our claim is that such a denial may be more complicated today. The fetal person genetic testing and reproductive imaging now presents to prospective parents has become an increasingly individualized, distinct medicalized picture of a developing person with which a parent can either identify or differentiate. In contrast, the fetal person of Roe was an abstract and vague figure stripped of most human particulars, a pregnancy rather than the specific individualized human entity reproductive technology now presents as a person to prospective parents. We discuss the implications of this shift and call for a more capacious analysis of reproductive ethics that works towards both reproductive and disability justice. (shrink)

Collaborative memoirs by co-writers with and without autism can enable the productive interaction of the voices of the writers in ways that can empower rather than exploit the disabled subject. Carly's Voice, co-written by Arthur Fleischmann and his autistic daughter Carly, demonstrates the capacity for such life narratives to facilitate the relational interaction between writers in the negotiation of understandings of disability. Though the text begins by focusing on the limitations of life with autism, it develops into a collaboration (...) which helps both writers move toward new ways of understanding disability and their own and one another's life stories. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Disability in the Christian Tradition: A Reader Edited by Brian Brock and John SwintonKevin McCabeDisability in the Christian Tradition: A Reader EDITED BY BRIAN BROCK AND JOHN SWINTON Grand Rapids, MI: Eerdmans, 2012. 576 pp. $45.00Disability in the Christian Tradition makes an important contribution to the growing area of theological inquiry known as “theology of disability.” While questions of physical and intellectual difference are getting much-deserved (...) attention from religious ethicists and constructive theologians today, relatively little attention has been given to the treatment of what we now call “disability” throughout the history of Christian thought and especially in the premodern era. This volume seeks to remedy this situation by highlighting the theological consideration of disability in Christian thinkers from the patristic era to the present. Against tendencies to treat disability as a “special case” for thinking about humanity, this volume seeks to show the often overlooked presence of reflection on disability throughout the tradition.The volume pairs introductory and interpretive essays from contemporary scholars with primary source selections from each historical thinker. Essays on Augustine, Aquinas, and Luther help to correct the historical record, which often remembers these theologians as advocating rationalist or exclusionary anthropologies that marginalize or significantly compromise the humanity of persons with disabilities. These thinkers prove to be more nuanced and insightful than is often thought. However, as Brian Brock points out with respect to Augustine, and as Stefan Heuser points out with respect to Luther, [End Page 238] these figures are often ambivalent or at odds with themselves on the practical and theological significance of disability. Following the work started here, further interpretation and analysis will be needed in order to assess the legacies of these figures and to discern their usefulness for thinking about disability today. In this respect the reader serves as a helpful invitation for further historical and constructive work.Some of the finest essays in the volume focus on disability in order to illuminate the theologians under consideration in surprising ways. Christopher Craig Brittain’s essay on Kierkegaard appeals to his letters and manuscripts in order to show how questions of suffering, marginalization, and self-acceptance are crucial aspects of Kierkegaard’s understanding of being human and being Christian—and how his work might contribute to current debates in disability theory and theology. Bernd Wannenwetsch shows how Dietrich Bonhoeffer’s visit to a community for persons with disabilities in 1933 was a pivotal experience in the formation of his anthropology. Wannenwetsch compellingly argues that Bonhoeffer’s advocacy on behalf of the weak and disabled is integrally connected to his opposition to the destructive rival anthropology advocated under Nazi rule. These essays make important contributions both to our reflection on disability as well as to our understanding of Kierkegaard and Bonhoeffer’s wider thought.A variety of perspectives on the meaning of disability are on display in this volume. One comes away with the impression that the “dialogue with the communion of saints” (3) called for in the introduction might be more of a debate than a harmonious discourse. The historical thinkers featured here do not offer one Christian account of disability that might be set against modern and secular perspectives on disability, but they do offer much that is productive for ethicists and theologians today.This volume is important for anyone concerned with theological reflection on disability, but it would be a shame if the book’s readership were limited to such a group. Historical theologians and readers interested in the theological and ethical issues pertaining to Christian anthropology and questions of embodiment, suffering, and vulnerability will find much that is of value. Indeed, it is one of the lessons of the volume that disability is not just a marginal or trendy topic in the contemporary theological scene but a central aspect of human personhood that has played an important if complex role in the understanding of what it means to be human throughout the Christian tradition. [End Page 239]Kevin McCabeUniversity of Notre DameCopyright © 2014 Society of Christian Ethics... (shrink)

This paper re-envisions the personhood of severely disabled children, who are often excluded from the category of human beings in the academic literature due to their perceived lack of mental faculties, based on Japanese philosopher Watsuji Tetsuro’s concept of human beings. It begins with Carl Elliott’s claim that personhood should be used as a thick ethical concept. This concept has two features. First, it represents a fusion of fact and value. Second, it is embedded in our rich and (...) culturally specific forms of life. This paper suggests that Watsuji’s concept of ningen also has these features. Watsuji criticizes how Western ethicists take individual consciousness or will as their starting point for determining personhood. Instead, he argues that neither a subject nor a community exists as an entity in itself, but that the relationality between them is essential to their identity and that our communication is embedded within rich and social contexts. Through his etymological study of Japanese word ari, Watsuji points out that in making statements, one both discloses the world and becomes aware of the attitude one should take toward other beings. Some commentators, such as Sakabe Megumi, have suggested that such self-awareness entails the transformation of our sense of relationality. This paper leverages Watsuji’s concept of ningen to re-envision the relationship between caregivers and severely disabled children as relationality-based and therefore open to complex and rich communication. (shrink)

Liberalism welcomes diversity in substantive ideas of the good but not in the process whereby these ideas are formed. Ideas of the good acquire weight on the presumption that each is a person's own, formed independently. But people differ in their capacities to conceptualize. Some, appropriately characterized as cerebral, are proficient in and profoundly involved with conceptualizing. Others, labeled cognitively disabled, range from individuals with mild limitations to those so unable to express themselves that we cannot be sure whether their (...) behavior is mediated by concepts at all. Constricted cognitive capacities have been thought to prevent participation in the prescribed process for forming personalized ideas of the good. So liberal theory, when formulating principles and practices of justice, often disregards cognitively disabled peoples' perspectives. We put aside metaphysically driven notions about personhood and show how interpersonal processes of “prosthetic” thinking (different from surrogacy) can satisfy liberalism's standards, positioning cognitively disabled individuals as fully participating subjects of justice. (shrink)

In this article I examine the proposition that severe cognitive disability is an impediment to moral personhood. Moral personhood, as I understand it here, is articulated in the work of Jeff McMahan as that which confers a special moral status on a person. I rehearse the metaphysical arguments about the nature of personhood that ground McMahan’s claims regarding the moral status of the “congenitally severely mentally retarded” (CSMR for short). These claims, I argue, rest on the (...) view that only intrinsic psychological capacities are relevant to moral personhood: that is, that relational properties are generally not relevant. In addition, McMahan depends on an argument that species membership is irrelevant for moral consideration and a contention that privileging species membership is equivalent to a virulent nationalism (these will be discussed below). In consequence, the CSMR are excluded from moral personhood and their deaths are less significant as their killing is less wrong than that of persons. To throw doubt on McMahan’s conclusions about the moral status and wrongness of killing the CSMR I question the exclusive use of intrinsic properties in the metaphysics of personhood, the dismissal of the moral importance of species membership, and the example of virulent nationalism as an apt analogy. I also have a lot to say about McMahan’s empirical assumptions about the CSMR. (shrink)

This paper responds to Love's Labor, Eva Feder Kittay's seminal contribution to feminist disability theory, arguing that Kittay's “nested obligations” approach creates a two-tiered system of justice in which care relationships built around private dependence and private obligation are figured as wholly prepolitical, to the detriment of both gender justice and disability justice. I suggest that centering the civic membership of the disabled person allows us to keep what is valuable in Kittay's contribution, namely her theorization of the (...) nature of care and its political significance, and her call for collective support of care relationships, while omitting the nesting of obligations and resituating care recipients and care workers as equal and interdependent. (shrink)

The claim that corporations are not people is perhaps the most frequently voiced criticism of the United States Supreme Court decision Citizens United v. Federal Election Commission. There is something obviously correct about this claim. While the nature and extent of obligations with respect to group agents like corporations and labor unions is far from clear, it is manifest in moral understanding and deeply embedded in legal practice that there is no general requirement to treat them like natural persons. Group (...) agents may be denied rights to marry, vote, or run for public office. More generally the need to guard against discrimination, the core injustice in racism and sexism, has no direct application to the case of group agents. There is also something obviously incorrect about the claim that corporations are not people. The legal practice of treating some group agents as persons under law is ancient, found already in Roman law at the time of Justinian. In this essay I propose that reflection on this tension reveals that fundamental revision to the doctrine of legal personhood is needed. More specifically I propose that legal personhood be decomposed into at least two elements—standing and liability—and that legal systems reject the principle that an entity possesses one just in case it possesses the other. The import of this change ramifies broadly. Decomposing legal personhood not only enables a satisfactory account of the status of corporations and labor unions, who as such have liability but not standing, it also enables a satisfactory account of the status of those who as such have standing but not liability: severely mentally disabled persons, very young children, and non-human animals with phenomenal consciousness but lacking capacities to understand reasons and justifications. (shrink)

In this relatively thin volume, Pia Matthews has managed a comprehensive and fluid covering of how discourse on personhood can shape new ethical commitments to individuals with profound disabilitie...

The wrongful disability problem arises whenever a disability-causing, and therefore (presumptively) wrongful, procreative act is a necessary condition for the existence of a person whose life is otherwise worth living. It is a problem because it seems to involve no harm, and therefore no wrongful treatment, vis-à-vis that person. This essay defends the nonconsequentialist, rights-based, account of the wrong-making features of wrongful disability. It distinguishes between the person-affecting restriction, roughly the idea that wrongdoing is always the wronging (...) of some person, and the harm principle, the idea that all wrongings are harmings. It argues, first, that the harm principle should be rejected, in light of offending intuitions in salient examples. Rejection of the harm principle is not only independently plausible, but also paves the way for a nonconsequentialist diagnosis of wrongful disability. This diagnosis conceives of wrongdoing as a failure to express adequate respect for the humanity or personhood inherent in the person created. The paper defends a theory of humanity-respecting rights that accommodates plausible intuitions about satisficing and fairness, without resorting to consequentialist premises that lead to well-known impossibility results and paradoxes. (shrink)