This chapter contains sections titled: Acknowledgments References.

This paper considers the range of possible policy options that are available if we wish to attempt to treat people with cognitive disabilities as equal members of society. It is suggested that the goal of policy should be allow each disabled person to establish a worthwhile place in the world and sets out four policy options: cash compensation, personal enhancement, status enhancement and targeted resource enhancement. The paper argues for the social policy of targeted resource enhancement for individuals (...) with cognitive disabilities, in the form of providing cash with some limits on its use. Taking the example from the UK of ‘self-directed support’ it is argued that such policies can be cost-effective and advance the autonomy of people with cognitive disabilities, especially when compared with current policies of centrally provided services. (shrink)

People with cognitive disabilities are equal citizens, and law ought to show respect for them as full equals. To do so, law must provide such people with equal entitlements to medical care, housing, and other economic needs. But law must also go further, providing people with disabilities truly equal access to education, even when that is costly and involves considerable change in current methods of instruction. The central theme of this essay is what is required in order to (...) give such people political and civil rights on a basis of genuine equality. (shrink)

There exists a significant disparity within society between individuals in terms of intelligence. While intelligence varies naturally throughout society, the extent to which this impacts on the life opportunities it affords to each individual is greatly undervalued. Intelligence appears to have a prominent effect over a broad range of social and economic life outcomes. Many key determinants of well-being correlate highly with the results of IQ tests, and other measures of intelligence, and an IQ of 75 is generally (...) accepted as the most important threshold in modern life. The ability to enhance our cognitive capacities offers an exciting opportunity to correct disabling natural variation and inequality in intelligence. Pharmaceutical cognitive enhancers, such as modafinil and methylphenidate, have been shown to have the capacity to enhance cognition in normal, healthy individuals. Perhaps of most relevance is the presence of an ‘inverted U effect’ for most pharmaceutical cognitive enhancers, whereby the degree of enhancement increases as intelligence levels deviate further below the mean. Although enhancement, including cognitive enhancement, has been much debated recently, we argue that there are egalitarian reasons to enhance individuals with low but normal intelligence. Under egalitarianism, cognitive enhancement has the potential to reduce opportunity inequality and contribute to relative income and welfare equality in the lower, normal intelligence subgroup. Cognitive enhancement use is justifiable under prioritarianism through various means of distribution; selective access to the lower, normal intelligence subgroup, universal access, or paradoxically through access primarily to the average and above average intelligence subgroups. Similarly, an aggregate increase in social well-being is achieved through similar means of distribution under utilitarianism. In addition, the use of cognitive enhancement within the lower, normal intelligence subgroup negates, or at the very least minimises, several common objections to cognitive enhancement. Subsequently, this paper demonstrates that there is a compelling case for cognitive enhancement use in individuals with lower, normal intelligence. (shrink)

(OPEN ACCESS) In this article, I explore the implications of three moral grounds for the justification of supported voting – respect as opacity, respect as equal status, and respect as political care. For each ground, I ask whether it justifies surrogate voting for voters unable to either communicate or give effect to their electoral judgments, due to some cognitive or communicative disability. (Henceforth: incommunicability cases.) I argue that respect as opacity does not permit surrogate voting, and equal status (...) does not justify such support – although the latter account can make sense of the value loss involved in the persistent non-participation of individuals with cognitive and communicative disabilities. Finally, I argue that an account of supported voting based on the ethics of political care can accommodate a pro tanto moral permission to provide surrogate voting as a form of support in incommunicability cases, and it can account for the inclusive approach of the UN Convention on the Rights of Persons with Disabilities to supported decision-making. However, I show that in incommunicability cases, what the political community and individual caretakers ultimately owe to adult fellow citizens as equal members of the political community is some adequate form of political care – but not necessarily surrogate voting. (shrink)

This paper examines the movement for independent living among the Japanese with disabilities from the perspective of multiculturalism and human rights. The IL movement questions the conventional idea, widely held by Japanese without disabilities, that disabled people are in need of special care and cannot live independently in ordinary communities. The IL movement advocates: 1) the reinterpretation of “disability” as mere “difference”, 2) the equal right to autonomy and social participation for the disabled, and 3) the unique right to (...) care and support that enable the disabled to be autonomous. The IL movement thus projects a new “disability culture” that assigns different meanings to disability and calls for radical change in social relationships. The IL movement then is one of many forces that celebrates diversity and advocates pluralism in Japanese society in defiance of the myth of a “homogeneous monocultural” Japan. The IL movement highlights the right to care as a basic human right which is a precondition for the right to autonomy. Consequently, the IL movement reinterprets the notion of autonomy and enriches the concept of “human rights.”. (shrink)

The 1990 Americans with Disabilities Act enacted a conceptual shift in the meaning of ‘disability.’ Rather than defining ‘disability’ as a disadvantageous physical or mental deficit of persons, it codifies the understanding of ‘disability’ as a defective state of society which disadvantages these persons. In contrast, the standard medical model incorrectly conceptualizes disabled persons as biologically inferior, and thus confines them to the role of recipients of benevolence or care. Turning to an ethic of caring yields (...) counter-intuitive results that conflict with the conceptual apparatus of the ADA. It is argued that in order to liberate social thought from this medical model and thus move the disabled from being socially marginalized to being socially enabled, one must re-conceptualize current practice by adopting the ADA's conceptual framework. Keywords: caring, disability, equality, ethics, health care polic CiteULike Connotea Del.icio.us What's this? (shrink)

This chapter contains sections titled: Postscript: Exchange with Peter Singer References.

Disability has been a topic of heightened philosophical interest in the last 30 years. Disability theory has enriched a broad range of sub-specializations in philosophy. The call for papers for this issue welcomed papers addressing questions on normalcy, medical ethics, public health, philosophy of education, aesthetics, philosophy of sport, philosophy of religion, and theories of knowledge. This issue of Essays in Philosophy includes nine essays that approach the philosophy of disability in three distinct ways: The first set (...) of three essays provide a careful analysis of John Rawls, and the application of his work in ethics and justice to societies in which persons with disabilities, especially cognitive disabilities, can take active part in the processes of civil society. The second set of three essays branch out into continental philosophy, and are especially engaged with issues of community membership, communication, translation, and hermeneutics. The third set of three essays address disability specifically through the arts and aesthetics; asking questions on the portrayal of disabled persons in the arts and its implications for normalcy, sexuality, beauty, and the sublime. (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)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Paradox of Disability: Responses to Jean Vanier and L’Arche Communities from Theology and the Sciences ed. by Hans S. ReindersAdam ClarkThe Paradox of Disability: Responses to Jean Vanier and L’Arche Communities from Theology and the Sciences Edited by Hans S. Reinders Grand Rapids, MI: Eerdmans, 2010. 191pp. $18.00Jean Vanier introduces this collection of essays with a concise articulation of the themes that define L’Arche communities: (...) those with impairments “cry out” for loving service, yet love involves the receptivity by which those without obvious impairments learn to claim their own good amid a vulnerability that [End Page 205] appears to be its negation. Subsequent essays expand upon these themes, drawing on a range of theological and social-scientific perspectives. Most could serve as introductions for undergraduate or graduate classes. The volume also invites disability scholars to examine whether and how this “Vanier school” has succeeded in its attempt to reimagine and serve both those with and those without obvious impairments.For Vanier’s “school,” such reimagining entails perceiving those with impairments as “teachers.” Executing this, however, is difficult. Xavier Le Pichon, for example, argues that “the disabled” help us recover positive views of dependency in “childhood innocence” and “aged suffering” (since they embody both stages). Focusing on the suffering that human beings experience before death, he claims that paleo-anthropological evidence suggests that societies evolved as their care of the disabled taught them to accept suffering. His argument, however, risks strongly identifying persons with their impairments, thus reinforcing the social construction of “disability” as a marginalizing category in discourse and policy.Moreover, this difficulty is not limited to associations with disvalue. Hans Reinders draws on Søren Kierkegaard and Hans Ulrich in a comparison of the severely disabled to the “teachers” of Matthew 6: the birds and lilies. The disabled, he argues, embody a positive image of “humanity” characterized by dependence on God and a lack of competition with others. Such an image of grace “frees” one from a political economy that drives toward rational mastery of self and world. Yet, do the severely impaired always experience and manifest such dependence? If not, are they not being used to create a “human” image for others in which they, in fact, do not appear?Kevin Reimer’s essay contains similar difficulties. For him, the instructive values are “trust” and “gracious openness.” Citing studies that demonstrate how these values sustain communities—even absent rational agreement—he argues that they should replace rationality as the chief marker of moral maturity (as exemplified, e.g., in Lawrence Kohlberg’s stages of moral development). Like Reinders, Reimer clearly wants those with cognitive impairments to be appreciated as teachers of values that displace the rationalist ones that deprecate them. However, like Reinder’s argument, this easily slides toward defining “humanity” under a certain ideal form, thereby still implicitly devaluing those who do not embody that ideal form. Also, one finds here the danger of romanticizing that is often identified with Vanier: one only sees the form and not the real person.William Gaventa and Brian Brock, however, provide a counterresponse, the first pivotal turn in the book. Gaventa argues that the discovery of another’s value as “teacher” occurs only when one has already acknowledged her as a person (104). In other words, any “form” taught must come only after one has encountered a “person,” which is understood as a complete image of human [End Page 206] value. Here Vanier’s argument for mutual receptivity becomes a fundamental anthropology that grounds an ethic. Love must serve both persons—the teacher with impairments and the learning respondent—along distinct lines of practical action (107). In addition, Gaventa argues that persons need sources of support that are both familial and private, on the one hand, and institutional and public, on the other—thus transcending the usual splits between conservatives and liberals.Brock develops a similar anthropological ethic drawing on Martin Luther. Being human together simply means “becoming neighbors” through the absolute (Christological) imputation of personal value. Brock criticizes practices that negate this neighborly bond. In particular, he rejects the view, often endorsed by genetic counselors, that bearing potentially impaired... (shrink)

This Introduction to the collection of essays surveys the philosophical literature to date with respect to five central questions: justice, care, agency, metaphilosophical issues regarding the language and representation of cognitive disability, and personhood. These themes are discussed in relation to three specific conditions: intellectual and developmental disabilities, Alzheimer's disease, and autism, though the issues raised are relevant to a broad range of cognitive disabilities. The Introduction offers a brief historical overview of the treatment cognitive (...) class='Hi'>disability has received from philosophers, and explains the specific challenges that cognitive disability poses to philosophy. In briefly summarizing the essays in the collection, it highlights the distinctive contributions the collection makes to ethics, political philosophy, bioethics, and the philosophy of disability. We hope that the richness of the topics explored by these essays will be a spur to further investigation. (shrink)

In this paper, I offer a solution to the Capacity/Equality Puzzle. The puzzle holds that an account of the franchise may adequately capture at most two of the following: (1) a political equality-based account of the franchise, (2) a capacity-based account of disenfranchising children, and (3) universal adult enfranchisement. To resolve the puzzle, I provide a complex liberal egalitarian justification of a moral requirement to disenfranchise children. I show that disenfranchising children is permitted by both the proper political liberal and (...) the proper political egalitarian understandings of the relationship between cognitive capacity and the franchise. Further, I argue, disenfranchising children is required by a minimalistic, procedural principle of collective competence in political decision-making. At the same time, I show that political equality requires the enfranchisement of all adults, regardless of cognitive capacities, and that the collective competence principle does not ground adult disenfranchisement. This justifies the progressive legal trend that holds the capacity-based disenfranchisement of adults to be incompatible with liberal democratic principles. (shrink)

This chapter contains sections titled: Introduction Animals Fetuses Cognitive Enhancement Supra‐persons Acknowledgments References.

This chapter contains sections titled: Why Philosophy and Cognitive Disability? Historical Overview Discussion of Themes and the Chapters Concluding Remarks References.

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)

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

This chapter contains sections titled: Defining the Term “Citizens Labeled with Cognitive Disabilities” The Scope of Moral Personhood: The Potentiality View The Fully Cooperating Assumption How Are the Two Moral Powers Acquired? The Enabling Conditions Personhood as Requiring Enabling Conditions Blocking Developmental Pathways to Moral Personhood The Causal Relationship Between Epistemic Claims and the Concrete Lives of People with Disabilities First Objection: Responding to the Epistemic Difficulty Second Objection: The Argument from Marginal Cases Conclusion Acknowledgments References.

This chapter contains sections titled: 1. Frontiers of Justice and the Challenge of Disability 2. The General Approach of Frontiers of Justice 3. Equality and Adequacy 4. Social and Economic Entitlements 5. Equality in Education 6. Equality in Political Entitlements Acknowledgments References.

In this paper, I argue that, contrary to what some critics suggest, political liberalism is not exclusionary with regards to the rights and interests of individuals with cognitive disabilities. I begin by defending four publicly justifiable reasons that are collectively sufficient for the inclusion of members of this group. Briefly, these are the epistemic uncertainty that inevitably exists about individuals’ actual capacities, the political liberal duty to treat parents fairly, the social framework that is required for the fulfilment of (...) parental duties, and the necessity of cultivating certain emotions that are strongly associated with reasonableness. These reasons show why a more inclusive reading of political liberalism is plausible, and how this can be achieved without abandoning or revising the theory’s commitment to public reason, the political conception of the person, and the role of social cooperation. I then turn to the question of what a more inclusive political liberalism would look like. More specifically, I argue that, although it would not require the participation of individuals with cognitive disabilities in the practice of legitimation, it would require their full inclusion in the realm of justice as equal rights-bearers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Human Roots of Artificial Intelligence:A Commentary on Susan Schneider's Artificial YouInês Hipólito (bio)Technologies are not mere tools waiting to be picked up and used by human agents, but rather are material-discursive practices that play a role in shaping and co-constituting the world in which we live.Karen BaradIntroductionSusan Schneider's book Artificial You: AI and the Future of Your Mind presents a compelling and bold argument regarding the potential impact (...) of advanced artificial intelligence (AI) on our society and personal identity. Schneider's argument emphasizes how AI may fundamentally alter our sense of self and disrupt traditional notions of identity and consciousness, motivating further significant cognitive science and ethical implications that require careful consideration. [End Page 297]The recent surge in AI hype has given rise to a widespread belief that AI is an autonomous and exceptional entity, potentially even possessing intelligence. This trend reflects a subtle reemergence of the classic Turing question, as the media bombards us with sensational inquiries into the intelligence of AI systems. Amidst this hype, it is easy to forget that AI is a product of human creation.Upon closer examination, the hype surrounding AI necessitates an assumption of its autonomy, which implies a belief in the realism of AI—the notion that AI, as an independent entity, is morally neutral. However, AI does not emerge in a vacuum. It is designed and developed by individuals who are shaped by their own experiences and biases.By endorsing the realism of AI as morally neutral (Cooley 1995), those involved in its design may use this argument to deflect ethical responsibility away from themselves and allow biases to persist, thereby perpetuating social injustice. Such attitudes toward AI revitalize the debate on the neutrality of technology (Ruane, Birhane, and Ventresque 2019; Du, Lu, and Xie 2021; Lüthi et al. 2023).This article presents a critique of realism with regard to AI highlighting the significant social implications both at the basis of design and that arise from our interactions with these technologies. The argument suggests that AI does not exist independently of human practices and values, but rather emerges from them. The article instead suggests viewing AI design as a cultural practice defending realism about self-determination agencies, drawing from Simone de Beauvoir's Ethics of Ambiguity as a means to understand the human roots on the basis of AI.I. Rejecting Realism about AIConsider the hypothetical scenario of an Artificial Intelligence system that is discovered by humans, but exists independently of human cognition and perception. This scenario embodies the philosophical perspective of realism about AI, which maintains that AI entities have objective existence in an abstract domain, independent of human invention or imagination. If this perspective were to hold true, then humans could not be held responsible for the actions of autonomous AI systems.If we were to conceive of AI as an ideal entity that exists independently of humans, it would likely lead to a number of negative consequences for society. First and foremost, it may lead to the dangerous assumption that AI systems are neutral and objective, devoid of the biases and prejudices that are inherent in human decision-making. This could create a false sense of trust in AI, leading to the belief that their decisions are inherently fair and impartial. However, the reality is that AI systems are not inherently neutral, but rather are shaped by the cultural and social contexts in which they are created and deployed. [End Page 298]AI as an autonomous, self-governing agent raises concerns about the attribution of accountability for its actions. Considering AI as an independent entity may pose challenges in assigning responsibility to its human creators and the industry that produced it. On the other hand, viewing AI as an ideal entity, distinct from human influence, may hinder its ability to foster a more equitable and just world. Importantly, overlooking the social and cultural dimensions of AI risks forfeiting opportunities to employ AI in redressing prevalent biases and inequities in society. AI possesses the potential to serve as a potent instrument for advancing social justice and equality, but this prospect necessitates acknowledging and... (shrink)

Events such as industrialization, population growth and old age have made the disability more visible. We think that the disabled people's attitude towards being disabled and religion is an important issue to be investigated in terms of formation of the social sensitivity about the learning of the thoughts of disabled people. In this context, it is aimed to investigate the function of the religion in terms of how the disabled identify, understand and overcome the problems related to being disabled. (...) The sample of the study consisted of 58 people, 20 (34.5%) female and 38 (65.5%) male. Semi-structured interview technique was used as the research qualitative research method and descriptive analysis technique was used in the analysis of the data. In the article, the relation between disability and religion has been tried to be understood in terms of sociology of religion in the context of functionalist approach. In general, disabled people evaluate disability (81.1%) as "examination", (10.3%) as "problem" and (8.6%) as "difference”. It is concluded that religion affects the thoughts of disabled person in a positive way to understand and accept the disability. It has been seen that the disabled people have applied to the state, social support systems and spiritual values ​​to overcome their problems. However, it is the duty of all social institutions to increase the social sensitivity to the disabled people.Summary: Events such as industrialization, population growth and old age have further increased disability. It is important that the social sensitivity towards disabled people and disabled people’s thoughts about disability should be learned. We think that the disabled people's attitude towards being disabled and towards religion is an important issue to be investigated. In this study, the functions of religion to overcome the problems related to the disability and the way how the disabled people define and understand the disability will be investigated. In this context, we think that an individual's overcoming the problems related to disability is an important issue that should be examined in terms of religion-referenced behavior.The sample of the study consisted of 58 people, 20 (34.5 %) female and 38 (65.5 %) male. Semi-structured interview technique was used as the research qualitative research method and descriptive analysis technique was used in the analysis of the data. In the article, the relation between disability and religion has been tried to be perceived in terms of sociology of religion in the context of functionalist approach.It is a fact that various approaches to disability in various societies have been made during the historical process. These approaches are known as moral, medicinal/medical, social, human rights and limitative models. Each of these approaches points to a specific direction and problems of disability. In other words, each model handles and predicts a different dimension of the subject.According to the Qur’ân, disability means not to be in a bodily sense, but to stay away from the truth and expressed in the way of not seeing the truth, not grasping and not hearing, that is, figuratively meaningful. Again from the point of view of the Qur’ân, the first cause of disability comes to people through the divine will and test. The others are due to people's own mistakes.The changing paradigm shift with the enlightenment process has changed the way people view each other. In this context, with the thought and modernization of enlightenment, people's view of human beings and environment has changed. The body which is thought as the trust of God has turned into a body in which one is his proprietor. Therefore, this situation brought the contest, the debate, the comparison and the alienation together.Today, people with disabilities face many financial, spiritual, social and cultural problems. Poverty arising from unemployment, livelihood, accommodation constitute financial problems that are the first to come to mind; access to places of worship, instruction of worship, fulfillment of worship, lack of spiritual care and support constitute spiritual problems; education, health, access and social exclusion constitute social and cultural problems.Disabled people ask themselves these questions related to disability: Why did it happen to me? If it is a test, why do not I start the test on equal conditions with healthy people? Here the disabled person consults the religion to understand and find an answer to the situation that he is in. Because religion is an important factor that responds to the search for meaning, it reduces the feeling of deprivation, and fulfills the task of compensation mechanism. In addition to this, religion gives life a goal and power to the person to overcome the problems he encounters with.In our research on the relationship between disability and religion, religion as in many subjects has contributed positively to the individual’s view towards the fact of disability and to overcome some problems. For example, as a result of the research, the participants evaluated "disability" (81.1 %) as ‘test’ (10.3%) as ‘problem’ and (8.6 %) as ‘difference’.They answered the question ‘How has the disability affected your religious thoughts?’, 71% of the participants expressed that it has affected in a positive way (as a test, made me closer to God, increased my loyalty to God, a motivation source). Besides, 23 % of the participants expressed that it hasn't caused any changes (already believed, fate, disability isn't an obstruct to worship) and 6 % of the participants expressed that it has affected in a negative way (my life is upside down, I am questioning this situation).In addition to those who answered the question ‘Has the disability affected your life?’ in a ‘positive’ way, there is a considerable amount of people who said that the entrances of the mosques are not suitable for the disabled people. In addition, the disabled people stated that they have problems with the way of worshipping (orthopedically disabled), listening to the Qur’ân, hearing the azan (hearing impaired), and cannot go to the mosques and cannot fast because of the health problems, all of which have affected their religious life in a ‘negative’ way. We can gather the answers given to the question in three categories about what kind of behaviors the disabled people do to overcome/eliminate problems. The first is that they receive a variety of services and assistance by applying to the state for material support in order to overcome the problems related to disability and the second is that the social support services are mainly given within the family and friends, and the third is they worship, pray and fast, which are must of Islam, to eliminate the spiritual distress.The rate of people, whose answers are ‘positive’ to this question ‘Does your religious belief have an effect to deal with the disability?’ because they believe the afterlife and who say they feel relieved by praying and worshipping, is very high (95%). Moreover, it is remarkable that the ones say they are ‘not positive’ still explain this with religious concepts such as test and examination which require patience. In short, religion relieves disabled people by fulfilling the task of compensation mechanism with understanding disability and overcoming problems.Almost half of the participants (45%) said no to the following question: Is there any kind of material/spiritual support given to you by the religious officials or religious people in your community? Some factors affecting this situation are that religious officials have no knowledge and education about how to treat disabled people and how to help them.As a result, disabled people face various financial and spiritual problems. They consult religion to solve some of these problems. The vast majority of the disabled consider disability as a test and a fate. Therefore, religion plays an important role for disabled people to understand disability and cope with it. Besides, disabled people have stated that they face various problems in fulfilling their worship and in accessing the places of worship. In this context, physically disabled people also need the supportive power of religion just like other disabled people. (shrink)

I offer a principled objection to arguments in favour of legalizing non-voluntary euthanasia on the basis of the principle of beneficence. The objection is that the status of death as a benefit to people who cannot formulate a desire to die is more problematic than pain management care. I ground this objection on epistemic and political arguments. Namely, I argue that death is relatively more unknowable, and the benefits it confers more subjectively debatable, than pain management. I am not primarily (...) referring to the claim that it is difficult to make comparisons between live and post-mortem states, but rather to the fact that it is epistemically and metaphysically problematic to impute a “life-worse-than-death” or a state of “suffering-calling-for-death” to people who cannot subjectively wish to die, as though this kind of suffering were a medically observable fact rather than a belief- and value-laden notion. On the contrary, people enduring similar causes of pain may have different experiences of suffering and views on how it affects the worthwhileness of their existence or the desirability of death or of continuing their lives. The projection of a “suffering-calling-for-death” onto infants or people with severe intellectual disabilities may not be indefensible, but it is more controversial than judging that pain management will improve their well-being from the perspective of beneficence. My argument also relies on our society’s liberal endeavour to avoid endorsing unverifiable beliefs about life and death or controversial conceptions of the good life. My goal is not to suggest we should not attend the suffering of cognitively disabled people. On the contrary, I only cast doubt on too quick an assumption that ending their lives is the best way of caring for them, when robust palliative treatments are available. Moreover, I express the concern that a lack of attention to distinctions between “pain-calling-for-relief” and “suffering-calling-for-death” may be based on ableist projections and assumptions. I conclude that it is imperative to continue research into the nature of pain and suffering experienced by individuals with mental or cognitive impairments preventing them from expressing autonomous wishes about the kind of treatment that would most benefit them. (shrink)

One of the most significant economic challenges faced by people with disabilities in Turkey and globally is employment. Unfortunately, even in developed countries, the desired level of employment of the disabled individuals has not yet been measured up. The fundamental rights and freedoms of employment and labor have gained a basis of legitimacy through certain principles within the legal system throughout human history. As a matter of fact, in the main references of Islamic law, the principles of justice, rights, equality (...) of opportunity, merit, anti-discrimination, and social responsibility for all people in general and disabled people in particular have been a reference in the development of employment policies. In this regard, the main objective of Islamic economic policies has been determined as ensuring the happiness of the individual in this world and the hereafter since the early period. The study first includes active and passive employment models developed in modern legal systems. It can be stated in this framework that from the early period, both in the practices of the Prophet Muhammad and the Companions and in the later Islamic societies, institutionalization was provided according to the characteristics of the period in which disabled individuals were actively and passively employed, and it can be stated that the developments regarding the employment of disabled individuals in Islamic societies started much earlier than expected. However, we must admit that legal regulations in the modern sense were introduced later compared to the West. The study focuses on the phenomenon of disability, the problems and needs of the disabled, and the studies on employment in Islamic societies from the past to the present. It is determined that many disabled people in Islamic society are actively employed in state positions ranging from imam to judge, from commander to governor according to their abilities, and the disabled people who cannot be employed are compensated for their disadvantages through passive employment methods such as health, care, housing, salary binding, and tax reduction. Determining the principles of employment of disabled according to Islamic law is the main subject of the study, and it has been established that maslahah, custom, siyasa shar’iyya, merit, and sedd-i zerâi constitute the jurisprudential basis of the employment of the disabled in Islamic law. In this framework, it has been stated that the principle of maslahah plays a key role in the development of social responsibility policies, in resolving issues that are not included in verses and hadiths and furû fiqh acquis, in gaining the economic independence of disabled and ensuring the minimum standard of living. Maslahah is also beneficial for the individual, family, society and the state, too. It has been pointed out that the employment of disabled people has become one of the most significant matters of both national and international legal regulations today, and it has been determined that the employment of disabled people has transformed into customary practices in accordance with the criteria of being a source of Islamic law. In Islamic administrative law, active and passive employment policies, legal regulations, and institutional structures related to disabled are carried out by the authority delegated to public administrators under the siyasa shar'iyya. It has been emphasized that administrative and public service appointments in Islamic law are ordered to be made on the basis of merit, that nepotism and favoritism are prohibited, and that disability is not an obstacle to employment. In conclusion, the insufficiency of studies on employment of people with disabilities in Islamic law has been pointed out and it has been suggested that further studies should be carried out on these subjects and exploitation of disability according to Islamic law should be studied. (shrink)

I argue that capabilities approaches are useful in formulating a political theory that takes seriously the needs of persons with severe cognitive disabilities (PSCD). I establish three adequacy criteria for theories of justice that take seriously the needs of PSCD: A) understanding PSCD as oppressed, B) positing a single standard of what is owed to PSCD abled individuals, and C) concern with flourishing as well as political liberty. I claim that conceiving valued capabilities as the end of social distribution (...) may help a political theory to meet these criteria.I posit three further adequacy criteria: D) refusing to see PSCD as less than human, E) valuing moral powers other than practical reason, and F) securing space for care and dependency relationships. I show that how well Elizabeth Anderson and Martha Nussbaum’s capabilities approaches meet these criteria depends on their divergent conceptions of what capabilities are for. I sketch another capabilities approach that might better meet the three latter criteria (inspired by Lawrence Becker and Eva Kittay’s work), that conceives capabilities as for agency and relationship. (shrink)

I Several years ago, when the Carter administration announced that it would support congressional action to end the public fund ing of abortions, the President was asked at a press conference whether he thought that such a policy was unfair; he responded, "Life is unfair." His remarks provoked a storm of controversy. For other than those who, for principled reasons, opposed abor tion on any grounds, it seemed that the President's comments were cruel, violating what was thought to be an (...) American com mitment to providing equal access to health services to all citi zens, regardless of their capacity to pay. Those sentiments had, in fact, been reflected in public opinion polls that had, for at least three decades, indicated that Americans supported the propo sition that the government should guarantee health care to all. Ultimately, those beliefs had been translated into the oft-ex 1 pressed political demand for a one-class system of health care. This commitment to equality is rather remarkable. American society evidences a striking willingness to tolerate vast inequal ities with regard to income and wealth. While it guarantees ed ucation to all children, there is not even a pretense that the children of the wealthy and the children of the poor ought to get precisely the same kind of schooling. While some commitment 'Hazel Erskine. "The Polls: Health Insurance," Public Opinion Quarterly, XXXIX (Spring, 1975), 128-143. (shrink)

This chapter contains sections titled: Introduction What Is the Problem? Why Try to Change the Profession? The Challenges Epistemic Responsibility and Credibility Why the Personal Is Philosophical Is Political References.

In lieu of an abstract, here is a brief excerpt of the content:Concurrent Contents: Recent and Classic References at the Interface of Philosophy, Psychiatry, and PsychologyArticlesAntonak, R. J., C. R. Fielder, and J. A. Mulick. 1993. A scale of attitudes toward the application of eugenics to the treatment of people with mental retardation. Journal of Intellect Disabilities Research 37:75–83.Arens, K. 1996. Commentary on “Lumps and bumps.” Philosophy, Psychiatry, & Psychology 3:15–16.Bavidge, M. 1996. Commentary on “Minds, memes, and multiples.” Philosophy, Psychiatry, (...) & Psychology 3:29–30.Blashfield, R. K. 1973. Evaluation of the DSM-II classification of schizophrenia as a nomenclature. Journal of Abnormal Psychology 85(2):140–150.Braude, S. E. 1996. Multiple personality and moral responsibility. Philosophy, Psychiatry, & Psychology 3:37–54.Broverman, I. K., S. R. Vogel, D. M. Broverman et al. 1972. Sex-role stereotypes: a current appraisal. Journal of Social Issues 28:59–78.Broverman, I. K., D. M. Broverman, P. E. Clarkson et al. 1975. Sex-role stereotypes and clinical judgments of mental health. Journal of Consulting and Clinical Psychology 34:1–7.Checkland, D., and M. Silberfeld. 1996. Mental competence and the question of beneficient intervention. Theoretical Medicine 17(2):121–134.Clark, S. R. L. 1996. Commentary on “Multiple personality and moral responsibility.” Philosophy, Psychiatry, & Psychology 3:55–57.Clark, S. R. L. 1996. Minds, memes, and multiples. Philosophy, Psychiatry, & Psychology 3:21–28.Dickenson, D., and D. Jones. 1995. True wishes: The philosophy and developmental psychology of children’s informed consent. Philosophy, Psychiatry, & Psychology 2:287–303.Donaldson, T. 1978. Psychoanalyzing the practical inference model. Philosophical Research Archives 4:1215.Eekelaar, J. 1995. Commentary on “True wishes.” Philosophy, Psychiatry, & Psychology 2:305–307.Fisher, S., and R. P. Greenberg. 1993. How sound is the double-blind design for evaluating psychotropic drugs? Journal of Nervous and Mental Disease 181:345–350.Fulwiler, C., and M. F. Folstein. 1995. Commentary on “Chris Walker’s interpretation of Karl Jaspers’ phenomenology.” Philosophy, Psychiatry, & Psychology 2:345–346.Heinze, M. 1995. Commentary on “Moralist or therapist?” Philosophy, Psychiatry, & Psychology 2:31–32.Iturrate, M. 1977. Man’s freedom: Freud’s therapeutic goal. Review of Existential Psychology and Psychiatry 15:32–45.Littlewood, R. 1991. From diseae to illness and back again. Lancet 337:1013–1015.Maddox, J. 1993. New genetics means no new ethics. Nature 364:97.McCormick, S. 1995. Commentary on “True wishes.” Philosophy, Psychiatry, & Psychology 2:309–310.Murray, T. H. 1995. Commentary on “True wishes.” Philosophy, Psychiatry, & Psychology 2:311–312.Muzika, E. G. 1989. Object relations theory, Buddhism, and the self-synthesis of eastern and western approaches. International Philosophical Quarterly 30(1):59–74.Parker, M. 1995. Commentary on “True wishes.” Philosophy, Psychiatry, & Psychology 2:313–314.Phillips, J. 1996. Key concepts: Hermeneutics. Philosophy, Psychiatry, & Psychology 3:61–69.Pole, D. 1970. Self and personality. The Journal of the British Society for Phenomenology 1:30–36.Priebe, S. 1989. On the subjectivity of psychiatric diagnosis. Psychiatric Praxis 16:86–89.Radden, J. 1996. Lumps and bumps: Kantian faculty psychology, phrenology, and twentieth-century psychiatric classification. Philosophy, Psychiatry, & Psychology 3:1–14.Sampson, E. E. 1981. Cognitive psychology as ideology. American Psychologist 36:730–743.Sarbin, T. R. 1976. Contextualism: A worldview for modern psychology. Nebraska Symposium on Motivation 24:1–41.Senft, P. A. 1975. The self-contradictions (antinomies) of psychotherapy: Is a solution in social action possible? The Human Context 7:367–372.Shuman, D. W. 1996. Commentary on “Multiple personality and moral responsibility.” Philosophy, Psychiatry, & Psychology 3:59–60.Sprigge, T. 1996. Commentary on “Minds, memes, and multiples.” Philosophy, Psychiatry, & Psychology 3:31–36.Wallace, K. 1996. Commentary on “Lumps and bumps.” Philosophy, Psychiatry, & Psychology 3:17–20.Wells, L. A. 1995. Commentary on “True wishes.” Philosophy, Psychiatry, & Psychology 2:315–317.Wiggins, O. P., and M. A. Schwartz. 1995. Chris Walker’s interpretation of Karl Jaspers’ phenomenology: a critique. Philosophy, Psychiatry, & Psychology 2:319–343.BooksAmerican Hospital Association. 1994. Values in conflict: Resolving ethical issues in health care. 2nd ed. Chicago: American Hospital Association.American Medical Association. 1992. Code of medical ethics: Annotated current opinions of the council on ethical and judicial affairs. Chicago: American Medical Association.———. 1994. Council on ethical and judicial affairs... (shrink)

In this essay, I reflect on the way that the COVID-19 pandemic deepens the care crisis and the radical, democratic transformation this turning point demands. Beginning with an assessment of the status of the free-riding on care and the gender division of labor, I continue with an analysis of the hegemonic justifications that, as Wendy Brown has shown, underpin such unbalance. I conclude with some remarks on the imminent challenge to advance towards a model of state, society and citizenship (...) capable of securing a sustained and co-responsible social compromise with the care of the community. (shrink)

A feminist ethics that bases morality on dependence or vulnerability challenges the moral priority of uniform over disparate treatment. Persons with disabilities resist equality's homogenization of moral personhood. But displacing equality in favor of caring or trust reprises the repression of those already marginalized. The ethics of difference proves an ineffective remedy for the negative consequences attendant on how historically marginalized groups are different. An historicized conception of equality resolves the dilemma.

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

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Dignity and Destiny: Humanity in the Image of God by John F. KilnerRichard W. ReichertDignity and Destiny: Humanity in the Image of God John F. Kilner GRAND RAPIDS, MI: EERDMANS, 2015. 414 PP. $35.00There is a problem with locating the imago Dei in a set of unique human attributes that other animals do not possess, such as self-awareness or higher cortical function: persons deficient in these attributes might (...) then be viewed as less complete images of God and therefore be treated as less than fully human. [End Page 209] According to John Kilner, this nonbiblical view contributes support for racism, sexism, and other oppressions. In Dignity and Destiny, Kilner's solution is to realize that the image of God is equally and fully present in every human as a divine blueprint, rooted in God's purpose for humans to reflect the image of God as revealed in Christ. Jesus is the image of God; all humans are created in the image of God.The various imperfect manifestations of God's image among the lives of individuals is due to the corruption of sin, not any diminution of the imago Dei. Here Kilner offers the useful metaphor of a coin. The denarius held up by Jesus when he addressed taxes had the image of Caesar cast on it as evidence of ownership and obligation: "Render to Caesar the things that are Caesar's." Yet even though Caesar's image on some coins was so worn or marred as to be nearly invisible, each coin still had the same monetary value as determined by Caesar's stamp. So, too, humans are stamped by God with the image of Christ, and despite the fact that some people barely manifest Christ's image, all humans still share equal value and dignity based on this divine stamp. Sin corrupts every person's ability to reflect God's image to some extent but does not mar the image of God itself. This concept of the imago Dei secures the full dignity and protection of all humans and opposes all forms of discrimination and oppression. Further, the eschatological destiny of humankind is not merely a return to a state of Edenic innocence but a future destiny toward full conformity to the image of Christ.Dignity and Destiny is a carefully referenced work, and Kilner's argument is clear and well-reasoned. He engages thoughtfully with those who hold alternative views of the image of God, especially with those theologians who argue that the imago Dei entails attributes of reason, righteousness, rulership, or relationship. He offers incisive but limited exegetical support for his view that the Bible does not offer an actual definition of the imago Dei but instead presents a "hermeneutical lens" to understand God's plan for humanity. Kilner's thesis certainly implies a teleological ethic of natural law, but his argument is actually aimed more toward Christ-like virtues and an understated kingdom ethic.The main value of Dignity and Destiny is its cogent evangelical argument against all forms of discrimination, marginalization, and human oppression. This work should appeal to all Christians who value human rights. But Kilner's argument may also provide strong support against many forms of euthanasia and abortion that are frequently justified by applying a qualitative scale of human attributes such as cognition and agency. For this reason, some nonevangelicals might find Kilner's thesis threatening and difficult to accept. In either case, Dignity and Destiny is a provocative and valuable contribution to theological anthropology. [End Page 210]Richard W. ReichertSouthern Baptist Theological SeminaryCopyright © 2017 Society of Christian Ethics... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Virtues, Obligations, and the Prophetic VisionRoy Branson (bio)Ethics at its best is only bad poetry—that is, it seeks to help us see whatwe see every day but fail to see rightly...If ethicists had talent, they might be poets,but in the absence of talent, they try tomake their clanking conceptual anddiscursive chains do the work of art.—Stanley HauerwasThe speaker was so severely bent over that his congenitally deformed back had (...) to be supported. He was a young Ph.D. in history. We were some 50 physicians, lawyers, health care administrators, and ethicists studying the ethics of organ transplants. Before he arrived, the conference had discussed different understandings of equal access and the nuances of federal policies governing organ transplant distribution. 1 In his lecture, our guest matter-of-factly described his own condition. He then pointed out that not only in ancient civilization but in American history as well, the disabled had been killed just because they were disabled. Indeed, even now, he said, they were not being allowed to live.In the question and answer session, he was immediately challenged by nationally prominent transplant surgeons. He responded by asking the surgeons: If two people could avoid death and anticipate significantly prolonged life from receiving an organ transplant and the only difference between them was that one was disabled and the other not, who would receive the life-saving transplant? The surgeons’ initial, spirited defense of excluding the significantly disabled person died down as they began to realize that, as far as they were concerned anyway, they might not have allowed the lecturer to live. They were stunned by the realization that they had not felt the disabled were fully persons. In the silences between their sentences, the participants sensed that they had passed beyond the discussion of economic, medical, and legal terms to glimpse new horizons of responsibility. [End Page 361]The conference was experiencing the truth of William F. May’s claim that moral quandaries must be placed within “a fresh and liberating vision of the world;” within “metaphysical horizons” (May 1983, pp. 15, 19).Pastoral VirtuesIn the late sixties, André Hellegers, the dynamic physician and Catholic layman who founded the Kennedy Institute of Ethics and who claimed that he had invented the word bioethics, focused bioethics elsewhere—on virtue. “As the caring branches of medicine were gradually pushed aside by the curing ones,” Hellegers said, “there seemed to be less use for the Christian virtues.” We must, he declared, “recapture the Christian virtues of care” (cited in McCormick 1985, p. 111). In a subsequent essay on the conceptual foundation of bioethics, Hellegers, writing with Albert Jonsen, did not invoke the word pastor, but he did argue that the codes drawn up for the ethical practice of medicine were, among other things, guides for the cure of physicians’ souls (Jonsen and Hellegers 1976, pp. 35–36).In 1969, at the same time that André Hellegers was in the process of establishing the Kennedy Institute, Edmund Pellegrino, then a medical school dean, led in the founding of humanities programs within American medical schools. Pellegrino, like Hellegers, a physician and Catholic layman, also focused on virtue. Obligations are not irrelevant for Pellegrino, but in biomedical ethics “one starts always with one’s commitment to be a certain kind of person and then approaches clinical quandaries, conflicts of values, and patient interests as a good person ought” (Pellegrino 1988, p. 123). Pellegrino knows that the classical and Christian tradition of Aristotle and Aquinas, a tradition with which he identifies, is concerned with the whole gamut of ethics. But for Pellegrino, that tradition teaches that “no matter to what depths a society may fall, virtuous persons will always be the beacons that light the way back to moral sensitivity” (p. 123). He freely acknowledges that “a virtue-based ethics is inherently elitist, in the best sense, because its adherents demand more of themselves than does the prevailing morality” (p. 123).Hellegers and Pellegrino added to the need of physicians acquiring professional skills their responsibility to become the embodiment of the moral ideal in the patient-physician relationship by caring for the patient... (shrink)

Participatory action research (PAR) is a form of community-driven qualitative research which aims to collaboratively take action to improve participants’ lives. This is generally achieved through cognitive, reflexive learning cycles, whereby people ultimately enhance their wellbeing. This approach builds on two assumptions: (1) participants are able to reflect on and prioritize difficulties they face; (2) collective impetus and action are progressively achieved, ultimately leading to increased wellbeing. This article complicates these assumptions by analyzing a two-year PAR project with mothers (...) of disabled children from a South African urban settlement. Participant observation notes, interviews, and a group discussion served as primary data. We found that mothers’ severe psychological stress and the strong intersectionality of their daily challenges hampered participation. Consequently, mothers considered the project ‘inactionable’. Yet, many women quickly started expressing important individual and collective wellbeing transformations. To understand these ‘unlikely’ transformations, a feminist relational account, in particular, that of relational wellbeing, proves essential. We reflect on the consequences of these findings for the dominant PAR methodology and operationalization, and propose to sensitize future PAR with marginalized women by employing relational wellbeing as an overarching ontological awareness. (shrink)

The social and cultural model of disability has challenged the historically powerful perception of disability as a deficiency. Disability is no longer conceived of solely in terms of an individual lack of capacities but also considered as a structural effect of disabling social institutions and normalizing thinking. The UN Convention on the Rights of Persons with Disabilities (CRPD) from 2006 marks a decisive step towards the recognition of humans with (cognitive) disabilities as legal subjects who are (...) entitled to enjoy all human rights on equal terms with others. A central claim of the CRPD refers to full political participation of persons with (cognitive) disabilities. This paper argues for strengthening the political participation of persons with severe cognitive disabilities. The normative starting point is the claim that they are our equals, both morally and socially. In spelling out this status equality for the realm of the political, I focus on what political equality and inclusivity means concerning franchise. I will argue that the disenfranchisement of persons with cognitive disabilities, as practiced in many countries, cannot be justified. Furthermore, enfranchising persons with cognitive disabilities is deemed a central expression of their recognition as equals. Thus, it marks a crucial moment of emancipatory transformation towards a more inclusive political system. In cases where severely cognitive disabled persons cannot exercise the right to vote themselves, forms of assisted voting and supported decision-making must be available. (shrink)

Realities of the formed information society made actual for inclusive education a problem of formation of professionals of the new directions capable to apply information technologies to improvement of interaction between participants of process of distance learning. Until recent time the institute of distance learning had no analogs in our educational system. It has to become one of the most important elements of the organization of remote education. Inclusive education becomes the new strategic direction of modern education in Russia, (...) its program of development to 2020 is designated by the Federal law ‘About the education in the Russian Federation‘ which has come into force on September 1, 2013. Ideas of inclusive training were born from a pressing need of society to help children to be integrated with features of development into society. Without it a creation of a new civilized society, the education system that meets the requirements of the humanistic principles is not possible. In this connection, creation of a substantial and technological basis of the organization of inclusive education of children in the mode of distance learning is an extremely important for today social, moral and pedagogical problem. In its center are the development of the subject, granting equal opportunities to each pupil to build the individual educational trajectory, culturological cultivation of the person capable to take an independent position in relation to external conditions. Distance learning serves as strong and active technology of socialization of such children. However, in the theory and a technique of training, the problem of distance learning of children with disabilities is insufficiently solved that is caused by unavailability of most of teachers to apply these technologies. There is a contradiction between objective practical need of distance learning for children with disabilities and insufficient readiness of a theoretical and technological basis. This is a main problem discussed in the study. In theoretical plan, it is a problem of development of the practical-focused theoretical and technological basis of distance learning of children with disabilities. On the practical level, it is a problem of formation of the subject information and education environment, designing of the contents, definition of methods, pedagogical technologies, the conditions of formation promoting achievement of the planned educational results and development of cognitive independent activity without prejudice to health of children on the basis of the accounting of their individual abilities. Technological effectiveness of the purposes is provided with prediction of educational results, their expression through requirements to actions of pupils. Recent time, children only start studying and mastering remote technologies therefore, first of all, they have to seize rational ways of educational activity and learn to work with information, i.e. priority value has to be allocated for formation of informative and logical and informative and information universal educational actions. (shrink)

On July 2021, the UK High Court of Justice heard the Case CO/2066/2020 on the application of Heidi Crowter who lives with Down’s syndrome, and Máire Lea-Wilson whose son Aidan has Down’s syndrome. Crowter and Lea-Wilson, with the support of the disability rights campaign, ‘Don’t Screen Us Out’, have been taking legal action against the Secretary of State for Health and Social Care (the UK Government) for a review of the 1967 Abortion Act: the removal of section 1(1)(d) making (...) termination of pregnancy lawful for ‘severe’ fetal indications detected after 24 weeks' gestation. On 23 September 2021, the High Court dismissed the claim. This action came at a time when non-invasive prenatal testing (NIPT) was introduced into the NHS England Fetal Anomaly Screening Programme for the trisomies 21, 13 and 18. The implementation of NIPT has been heavily criticised, in particular by ‘Don’t Screen Us Out’ campaigners, for increasing fetal selection and discrimination of people living with disabilities. The case of Crowter and Lea-Wilson echoes debates in other European countries such as in France and Germany, where the introduction of NIPT in the public healthcare system has provoked equally vehement public reactions and discussions. The comparison between these three countries allows contextualising the public discourses around NIPT and the ground for termination of pregnancy in relation to different socio-cultural and political contexts. We examine how each country, and particularly England, deals with the conflict between the principles of promoting the rights of people living with disabilities and preserving women’s reproductive autonomy. (shrink)

Significant minority populations confer richness and diversity to British society. Responsive end-of-life care is a universal need that has ascended the public agenda following myriad reports of inadequate provision. Nevertheless, the potential exists for unwitting discrimination when caring for terminally ill patients on the basis of their religion or faith. Recent implementation of the Equality Act 2010, together with the government and professional initiatives, promises to positively impact upon this area of contemporary relevance and concern, although the extent to (...) which facilitative policies can truly enhance patient care will depend upon how these are translated into care at the bedside. The contributions of health professionals will be central in meeting the challenges and seizing the opportunities for meeting the religion and faith interests of patients of South Asian descent. (shrink)

The belief that people convicted of crimes deserve punishment is commonplace. Yet the punitive conception of individual responsibility commonly associated with ‘just deserts’ exaggerates the moral meaning of criminal guilt, normalizes excessive punishment, and distracts from shared responsibility for social injustice. The problem is, many people who get caught up in the criminal justice system cannot reasonably be thought to deserve their fate. Mental illness, intellectual disability, addiction, trauma, and poverty are morally mitigating factors when it comes to assessing (...) how blameworthy a person is for criminal behavior. But with the exception of extreme forms of mental illness that fall into the very narrow legal category of ‘insanity,’ people who struggle with serious difficulties are not treated as less blameworthy by the criminal justice system. The criteria of legal guilt does not match up well with the moral concept of blameworthiness.The solution might seem to be somehow to refine legal practice to make blame more context-sensitive, but I argue that rather than try to revise our criminal justice practices to fit better with common notions of blame and desert, we should get out of the public blaming business altogether. A determination morally to condemn individual offenders is not helping us to resolve the disaster of mass incarceration or the problems faced by returning citizens. It does not help us to see clearly the connection between crime and other problems of social injustice, like poverty, lack of mental health care, drug addiction, racial discrimination, and violence. Were we to be less fixated on individual responsibility, and more cognizant of our shared responsibility to treat all members of society as equal persons, entitled to the same basic rights, liberties, and opportunities, we might be in a better position to work collectively to address problems of social injustice that contribute to the problem of crime. (shrink)

Why do so many—including philosophers—care about equality? Mere envy? This book investigates how Homo sapiens developed, thrived in, and nurtured a certain social condition that happened to abet our continual survival. Empirical evidence points to a natural, possibly inborn, sense that humans live most humanly as equals: No one told them what to do; no one had significantly more goods. Humans evolved in such a condition of social equality and autonomy. This condition of individual autonomy in turn shaped our (...) species and led humans to demand social equality to this day. All changed when groups stopped roving for food, settled down, and cultivated land. Some individuals started storing goods clandestinely, gaining wealth and power. Inequality set in and, ever since, a struggle between haves and have-nots. People strive to reestablish some degree of equality, philosophical theories notwithstanding. This book’s empirical theory of equality’s ontology explains why humans over the millennia strive for equality and help assess whether theories of equality, if implemented in policy, could accommodate this need. Equality is essentially bound up with autonomy, liberty and justice. Any political theory neglecting these interconnections may fall short of its goals. While industrial societies will unlikely implement the book’s theory, at the least it can illuminate common theories of equality and where they fly or fail. (shrink)

Recognizing Justice For Citizens With Cognitive Disabilities engages with the most prominent liberal theories of justice today in revealing the path toward equal justice for citizens with cognitive disabilities.

The concept of equality is subject to many different interpretations, and it is closely connected to similar concepts such as equity, justice, fairness, and human rights. As an ideal, equality entails many aspects that are untenable. For instance, genetic and social inequalities may never be extinct, but they can both be ameliorated by proper distribution of society's resources. Likewise, within the context of health care, equality can be promoted by proper rationing of health resources, amongst which nursing care stands (...) out. In the field of nursing, the principle of equality presents itself in various forms of ethical and deontological mandates. However, beyond good intentions and abstract notions, there is a need to examine the ways in which nurses enforce this principle in practice, within the reality of modern health systems. Although there is scarcity of qualitative evidence in the nursing care rationing literature, existing studies suggest that fair treatment pertains to a largely intuitive sense of equality which involves subjective perceptions and judgements about rationing. Nurses’ initial predisposition is to view all patients as equal and treat them in an equal manner; yet, on an individual basis, each patient has a different starting point, different needs and different prospects that render rationing decisions complex and uncertain. Equality should be accepted with its unavoidable limitations in practice and be further examined within the context of nursing care rationing, in the hope that it can be advanced in a consistent way, despite the idealistic nature in many of its aspects. (shrink)

‘Academic rentiership’ is an economistic way of thinking about the familiar tendency for academic knowledge to consolidate into forms of expertise that exercise authority over the entire society. The feature that ‘rentiership’ high-lights is control over what can be accepted as a plausible knowledge claim, which I call ‘modal power’. This amounts to how the flow of information is channelled in society, with academic training and peer-reviewed research being the main institutional drivers. This paper begins by contextualizing rentiership (...) in the deeper issues surrounding ‘cognitive economy ’that lie at the heart of the Western philosophical tradition. The psychological phenomenon of the ‘Gestaltshift’ is used to illustrate various ways in which the flow of information can be channelled to enable or disable certain possible ways of regarding the world. Against this background, such familiar concepts from academic practice as ‘quality control’ and ‘plagiarism’ acquire a new look. Quality control aims to maintain rentiership, whereas plagiarism aims to undermine it. The second half of the paper is largely concerned with the historical swings back and forth between rentiership and anti-rentiership in academia. Rentiership’s decline is associated with corruption of its quality control processes, which reveals academia’s reliance on equally corrupt power elites in society. In addition, the introduction of new communication media over which academia cannot exert proprietary control also serves to open up the sphere of plausible knowledge claims. The ongoing Internet revolution is likely to permanently alter the terms on which academic rentiership will be possible in the future. (shrink)

The study of social, ethical, and political issues from a naturalistic perspective has been pervasive in social sciences and the humanities in the last decades. This articulation of empirical research with philosophical and normative reflection is increasingly getting attention in academic circles and the public spheres, given the prevalence of urgent needs and challenges that society is facing on a global scale. The contemporary world is full of challenges or what some philosophers have called ‘existential risks’ to humanity. Nuclear (...) wars, natural and/or engineered pandemics, climate change, global totalitarianism, and emergent technologies, are some of the challenges mentioned by many authors devoted to the study of long-term potential risks for the survival of the human species. However, while there are many reasons to be a pessimist about the future of humanity, there is also a lot of ink wasted in showing that the world today is far better than we had in the past and also that there have been many instances of social and moral progress in the last centuries. Some authors have even claimed that “we have made more progress over the last 100 years than in the first 100,000”. According to ‘our world in data’, some of the most relevant advances of humanity in the last centuries have to do with the reduction of poverty and/or inequality, better health and security, the decline of violence and war, and the development of democracy and institutional mechanisms to guarantee individual freedom and rights. Yet, there is a more concrete concern that our world faces nowadays, and requires a particularly detailed analysis. In a few words, the advance in information and communication technologies, the huge volume of people migration because of prevalent instances of global inequality, and the reality of an interconnected world that just mirrors an extensive history of massive human intergroup relations open the question about the feasibility of social and moral progress in the contexts of diverse, multicultural, and unequal societies. This makes it crucial to reflect not only on whether human societies may keep advancing on a path of social progress, but how this can be achieved by addressing the challenges of inequality and potential intergroup conflict. This concern closely relates to the further consolidation of democratic values and the achievement of a more generalized consideration of the equal moral value of human individuals far from group, ethnic, or collective distinctions. This vision of progress follows the moral convictions that have been considered right and worthy to be pursued by most ethical theories explored by philosophers and social scientists so far. This work aims to contribute to the study of the mechanisms and feasibility of social and moral progress grounded on the precept of human equality and is guided by the idea that social and moral progress in a plural world requires the accomplishment of a more democratic and tolerant society. These forms of progress have already been defined by philosophers Allen Buchanan and Russel Powell as inclusivist forms of moral progress. According to these authors, inclusivist moral progress is featured by the transformation of moral judgments, motivations, and norms guided by the rejection of “group-based restrictions on moral standing and moral status” (2018). The work of Buchanan and Powell is fundamental for the argumentation developed in this work since they have pioneered a more complex debate in the field of evolutionary social sciences and philosophical anthropology. In brief, these authors have inquired how human nature, conceptualized by the advances in evolutionary thinking and the empirical sciences, is related to our moral convictions and the possibilities that we have to establish certain forms of social and moral progress. The work of Buchanan and Powell contributes to the debate on moral progress by incorporating empirically-informed concepts and arguments. With this objective in mind, they develop their discussion around a generalized tension between exclusivist and inclusivist forms of moral progress. This tension revolves around the question of whether and to what extent human moral concerns, motivations, and norms, are limited or bounded by social identities, group thinking, or collective values. This question is at the center of this work. In other words, I aim to answer whether and to what extent the nature of our social and moral cognition hinders or enables the development of inclusivist forms of morality and moral progress. As I mentioned so far, the distinction between exclusivist and inclusivist forms of morality has a practical implication and facilitates the reflection on the mechanisms and feasibility of concrete forms of progress based on the precept of human equality, which is the road to progress that we should follow according to most ethical theories. The distinction between exclusivist and inclusivist morality is not used here as a form of summarizing highly divergent descriptive approaches to morality, but as a way to address the practical implications of morality research, particularly around the question of the feasibility of social forms of progress based on the precept of equality and tolerance. My objective then has less to do with offering a conceptualization of human morality or with the proposition of a new ethical perspective. Instead, I aim to identify, from an empirically informed perspective, what enables the achievement of egalitarian forms of social progress, to subsequently offer a normative reflection about what we should do if we want to accomplish such inclusivist forms of progress. This task is of great relevance, having in mind that some theoretical proposals on the matter have claimed that human prosocial behavior and morality are constrained by exclusivist fixed tendencies as a product of our evolutionary history. According to these views, human morality is a group-centered cognitive and behavioral expression that has severe limits in its scope and extent, which hinders in the end the emergence of inclusivist forms of moral concerns and behaviors. These claims align with the philosophical intuition about the ‘dissociation of empathy’, or the fact that human individuals tend to express empathy and sympathy preferably for members of their group whereas their empathic and moral concern and recognition for outgroup individuals tend to be reduced or eliminated in real-life social interactions. Multiple theorists have expressed, however, that these assumptions are wrong for empirical and philosophical reasons, which results in a serious challenge to the conception of human morality as exclusivist by nature. Furthermore, simple intuition and practical experience constantly show us that human individuals can develop and endorse a broad spectrum of moral considerations and adopt an arguably inclusivist stance concerning the kind of persons or agents that deserve moral concern. Moreover, and adopting a historical perspective, the expansion of cultural and commercial exchanges, the consolidation of democracy, the development of welfare states, or the emergence of institutions based on the concept of universal human rights, have partially driven human progress based on the impartial concern for the well-being of persons. These historical instances of cultural evolution and institutional design have shown that it is feasible to promote behaviors and attitudes grounded in impersonal prosocial and inclusivist principles. This optimistic perspective, however, still begs the question of the exact relationship between social, cultural, and historical contexts, and the emergence of certain behavioral expressions of inclusivist morality. This is crucial since a great number of human individuals around the world still do not make part of these instances of social progress, and some authors have suggested that such instances of social and moral progress are particularly favored by the contexts of the WEIRD world, that is the world of Western, Educated, Industrialized, Rich, and Democratic societies. Some of these approaches consider moral inclusivity a ‘luxury good’ and follow the ‘dependency thesis’ according to which the expression of moral inclusivity depends on the presence of very concrete material conditions that trigger inclusivist and impersonal prosocial tendencies that human beings are not able to express in threatening contexts without physical security. This thesis is problematic for various reasons and has led to incomplete explanations about the enabling and causal factors of inclusivist moral progress, as well as unsatisfactory suggestions about what we should do to foster the accomplishment of more generalized instances of progress based on inclusivist concerns. In an attempt to contribute to this debate, the main objective of this thesis is to offer an alternative proposal about the nature of human morality and a more detailed reflection on what we should do if we want to further accomplish such instances of progress. More precisely, this work adopts a particular developmental and constructivist vision of human morality to answer the question of how feasible it is to reach generalized forms of social progress based on the precepts of moral inclusivity. Furthermore, it offers some ideas about what are the most adequate and favorable conditions to foster such progress both at the individual and the collective level. At this point, a preliminary clarification of some starting points is necessary. In the first place, and contrary to what other authors have proposed when debating moral progress from an empirically-based approach, my perspective adopts a radical developmental and constructivist perspective, following particularly the conceptual and empirical ideas of the social-domain theory in moral psychology. From this perspective, morality is a domain of normative and social knowledge that develops and emerges in human interactions. Moral concerns, judgments, and norms are not only the result of the expression of innate adaptive intuitions, nor the product of social conformity and a simple process of mirroring the normativity that communities have established to organize their social life. Human individuals, instead, construct moral concerns and judgments during their situated interactions. More specifically, the constructivist tradition claims that we need to research how moral concerns, judgments, and reasons emerge in social interactions and how human beings construct the content of their moral knowledge in the first place. Based on these ideas, morality is defined here as the result of a constructive process through which human individuals, by the means of constant interactions on a background of mutual respect and recognition, develop evaluative concerns about how we ought to treat others, and how to ‘care’ and ‘respect’ others’ well-being, needs, and vulnerabilities. This developmental-constructivist theory of human psychology contributes to an alternative understanding of the origins of moral variability and informs a very particular normative stance about the most desirable contexts needed for the urgent accomplishment of inclusivist forms of morality in contemporary societies. This is so given that the very same definition of morality adopted presupposes the feature of inclusivity. The main objective of this work is then to argue, based on a developmental perspective, what are the most favorable conditions to foster the development of moral inclusivity and what we should do to accomplish concrete instances of moral progress that truly help us to overcome our most urgent moral challenges. The whole thesis is organized as follows. In part I, I show how received visions about human social evolution have informed conceptions of morality as an adaptive function evolved to solve the challenges of cooperative life. Based on these assumptions, some theories argue that human morality is limited by the boundaries of group thinking, and always obeys the mandates of collective interests and the will of the majority. However, this conception has problematic implications from a normative and ethical perspective. The aim of Chapter 1 is to present this introductory debate in detail. In chapter 2, I consider a relevant amount of scientific evidence that helps to consolidate a more optimistic and inclusivist perspective about the starting conditions of human prosocial behavior. Later, I will summarize some ideas offered to explain the possible evolutionary mechanisms that led to the consolidation of these inclusivist capacities. However, I will also show how evolutionary theories that share the same adaptationist foundations but initially seem relevant to explain the feasibility of moral inclusivity, result incomplete when considering the complexity of moral behavior and its ethical implications. Part II is devoted to presenting a developmental alternative to the adaptationist versions around the starting conditions of morality. In this section, I first summarize the epistemological, conceptual, and empirical basis of a constructivist perspective already proposed by several authors in the last decades. This is the goal of chapter 3. More precisely, I adopt the conceptualization of morality established by the social-domain theory school and clarify its conception of the situated development of moral concerns, motivations, and norms. All these ideas are essential for my argumentation on the feasibility of inclusivist moral progress offered later. Chapter 4 provides a more detailed idea of constructivist thinking about moral development, by analyzing one particular dimension: the development of moral concerns for fairness and the sense of justice in distributive dilemmas. In Part III, I assume a constructivist perspective on morality to contribute to the philosophy of moral progress. In particular, I discuss the implications of such a perspective for the conceptualization of human moral nature and discuss what are the most favorable conditions for moral inclusivity to emerge. Answering that question is of enormous relevance since favoring the transition of human societies towards more inclusivist forms of moral concern and behavior supposes a more generalized accomplishment of our most urgent moral convictions. Previous developmental or culturally-sensible attempts to explore this issue are already on the market. As mentioned before, most authors have approached the topic by situating the cultural evolution and development of (inclusivist) moral progress in the WEIRD world. For instance, some of these authors claim that very concrete material conditions (mostly present in the Western World) have been necessary for triggering inclusivist and impersonal prosocial tendencies that human beings are not able to express in threatening contexts without physical security. Despite their interest in explaining inclusivist morality and the feasibility of inclusivist forms of progress following a naturalistic and culturally situated approach, these theories are problematic for two main reasons. In the first place, most of the authors that explain moral progress tend to focus exclusively on the consolidation of liberal values in the Western world and the underlying adoption of laws, social-epistemic practices, and public narratives about tolerance and inclusivity, as unequivocal signs of inclusivist morality. Nevertheless, there is an enormous distance between the institutional and public support of inclusivist moral values or the construction of public images of tolerance and inclusivity, and the real materialization of impersonal moralities in situated social interactions. Secondly, the variability of human moral behavior is far bigger than most of the theories in moral psychology and moral progress tend to assume. Accordingly, inclusivist and exclusivist forms of morality may develop simultaneously in similar or divergent geographical and socio-ecological environments, including those with harsh conditions such as competition for scarce resources, potential intergroup conflict, and risks of disease transmission. In addition, harsh environmental conditions are usually present in almost all societies around the globe, and the presence of socio-ecological conditions such as physical security and prosperity, predominant in highly resourced populations, do not prevent the existence of exclusivist moral tendencies. My model explores a different perspective on the relationships between cultural, institutional, and historical factors, and the situated development of human morality. This supposes a clear distinction from previous approaches to the matter since it offers a different view on what we should do to pursue further instances of inclusivist social progress. In the fifth chapter, I first analyze the proposals of some defenders of the ‘dependency’ theory. The attention is focused on the ‘Evolutionary Developmental Model’ proposed by Buchanan and Powell (2018). Based on a critique of this approach, I will argue that to explain the evolution and development of human morality in its multiple manifestations, it is essential to put focus on social interactions. This also involves a different perspective on human-environment relations that in line with a constructivist worldview makes an innovative contribution to the philosophy of moral behavior and moral progress. Later, in the sixth chapter, I will define my alternative relational view of inclusivist morality and I will offer my view on how to establish favorable conditions that make inclusivist morality possible. Complementing the constructivist approach, my conception is based on the essential role of equality and individuality and on how moral inclusivity is favored if moral concerns do not develop driven by the accomplishment of group-centered, binding, and communitarian concerns and values. In brief, my relational model suggests that the accomplishment of moral inclusivity not only depends on the overall achievement of certain levels of physical security or economic prosperity. Instead, its development is favored by transforming the interactional contexts in which moral concerns towards autonomy and individuality emerge. In arguing so, I will need to start with a critique of contemporary situated and embodied approaches in ethics. Then, I will show how societies guided by the accomplishment of group-centered values of power, dominance, and relational inequality tend to express exclusivist moral behaviors, while individualistic societies tend to be more inclusivist. Starting from this diagnosis, my final attempt is then to reflect on which are the best conditions for the moral valuation of individuality to emerge and what we should do to promote the accomplishment of moral inclusivity at the societal level. (shrink)

This chapter contains sections titled: Introduction I Education, Capability and Equal Participation in Society II Capability Equality in Education: Elements of a Fundamental Educational Entitlement III Elements of a Fundamental Educational Entitlement for Students with Disabilities and Special Educational Needs IV Towards a Principled Framework for a Just Distribution of Educational Resources to Students with Disabilities and Special Educational Needs Notes References.

In lieu of an abstract, here is a brief excerpt of the content:CompassionEdward J. VolpintestaTo the Editor: In his essay, “Can We Mandate Compassion?” (March–April 2011), Ron Paterson, a former health and disability commissioner in New Zealand, discusses the decline of physicians’ compassion—an issue that is receiving more attention in the media, and in our journals, hospitals, and medical societies, as well.He decided—and I agree—that compassion should not be mandated. How could it be? After all, it’s unquantifiable; it’s not (...) meted out in milliliters or grams. Compassion is a spontaneous emotion that arises from the individual caregiver’s spiritual reservoirs. Trying to regulate or mandate it would be absurd—the ultimate attempt at dehumanizing medicine. Giving students more exposure to the humanities, however, and teaching doctors what is not acceptable in “terms of conduct, attitudes, and behavior” may increase awareness of its importance. Putting that awareness into action is another thing.Could it be that physicians are too hard-pressed for time and too overstressed with ordering and interpreting tests that they have little time and energy left for compassion? Has the threat of malpractice suits made physicians distrust patients, seeing them more as potential lawsuits than as suffering human beings, as horrible as that may sound to some? Or has the vast amount of new medical knowledge that rapidly reaches doctors given them an information overload so great that they have room only for cognition and none for emotion? When one adds the pressure physicians feel to control costs and to follow guidelines that often clash with their judgment, it becomes clear why compassion has declined.As a primary care doctor, there are days when all I have to offer some patients is compassion. A divorce, problems with personal finances, depression, a recent death, a child in trouble with the law or with drugs, an unwanted pregnancy—these are some of the problems that are the most difficult and time-consuming for me. They do not require any new scientific knowledge. Like compassion, they are not quantifiable, and there are no board exams to test how well I help my patients cope with them. There is also no code that I can send to an insurance company that will accurately convey what I have done, or its value to my patients. Only my patient and I are aware of whether I was able to use compassion in a way that helped. How could it be otherwise?It is much easier for me to treat a patient with pneumonia or conjunctivitis. I doubt that there ever will be a foolproof way to teach compassion to physicians. Perhaps performing psychological tests on incoming medical students may be the best way to determine which are most inclined to become compassionate physicians.The Flexner Report of 1910, which contained many recommendations for improving medical education, may have overstressed the importance of science while neglecting the human dimensions of medical practice. The Carnegie Foundation, which funded the original study, has undertaken a second examining any unintended consequences of the first. Unlike the first, which was dominated by one man, the second comprises a broad team of educators, doctors, philosophers, and psychologists. Perhaps this broader approach will restore compassion to its rightful place.Letters to the editor may be sent by e-mail to [email protected], or to Managing Editor, Hastings Center Report, 21 Malcolm Gordon Road, Garrison, NY 10524; (845) 424-4931 fax. Letters appearing in the Report may be edited for length and stylistic consistency.Statement of Ownership, Management, and CirculationThe Hastings Center Report is a bimonthly journal published by The Hastings Center, 21 Malcolm Gordon Road, Garrison, NY 10524. The editor is Gregory Kaebnick, at the same address. The annual subscription price is $80; contact person is Anne Marie Schoonhoven; telephone number is 845-424-4040. The tax status of the organization has not changed during the preceding twelve months.As of the filing date of September 6, 2011, the average number of copies of each issue during the preceding twelve months was 3,342; the actual number of copies of the single issue published nearest to the filing date was 3,150. The journal has a total paid and/or requested circulation... (shrink)

Contemporary industrialized societies have been confronted with the fact and consequences of women's increased participation in paid employment. Whether this increase has resulted from women's desire for equality or from changing economic circumstances, women and men have been faced with a crisis in the organization of work that concerns dependents, that is, those unable to care for themselves. This is labor that has been largely unpaid, often unrecognized, and yet is indispensable to human society.

Theories of social justice are necessarily abstract, reaching beyond the particular and the immediate to the general and the timeless. Yet such theories, addressing the world and its problems, must respond to the real and changing dilemmas of the day. A brilliant work of practical philosophy, Frontiers of Justice is dedicated to this proposition. Taking up three urgent problems of social justice neglected by current theories and thus harder to tackle in practical terms and everyday life, Martha Nussbaum seeks a (...) theory of social justice that can guide us to a richer, more responsive approach to social cooperation. The idea of the social contract--especially as developed in the work of John Rawls--is one of the most powerful approaches to social justice in the Western tradition. But as Nussbaum demonstrates, even Rawls's theory, suggesting a contract for mutual advantage among approximate equals, cannot address questions of social justice posed by unequal parties. How, for instance, can we extend the equal rights of citizenship--education, health care, political rights and liberties--to those with physical and mental disabilities? How can we extend justice and dignified life conditions to all citizens of the world? And how, finally, can we bring our treatment of nonhuman animals into our notions of social justice? Exploring the limitations of the social contract in these three areas, Nussbaum devises an alternative theory based on the idea of capabilities. She helps us to think more clearly about the purposes of political cooperation and the nature of political principles--and to look to a future of greater justice for all. (shrink)