Disability and the Good Human Life (Cambridge Disability Law and Policy Series)

Consequently disability has been either ignored by moral and political philosophers or simply equated with a bad human life, a life not worth living. This collection takes up the challenge that disability poses to basic questions of political philosophy and bioethics, among others, by focusing on fundamental issues and practical implications of the relationship between disability and the good human life. The Best Books of Check out the top books of the year on our page Best Books of Looking for beautiful books?

Visit our Beautiful Books page and find lovely books for kids, photography lovers and more. Other books in this series. From Rhetoric to Action: Disability and the Good Human Life Dr. Family Policy and Disability Arie Rimmerman. Restoring Voice to People with Cognitive Disabilities: Social Inclusion of People with Disabilities: National and International Perspectives Arie Rimmerman. Active Citizenship and Disability Andrew Power. When is Separate Unequal?: A Disability Perspective Ruth Colker. Discrimination, Copyright and Equality: Table of contents 1. Moral worth and severe intellectual disability - a hybrid view Simo Vehmas and Ben Curtis; 2.

Disability not as a harmful condition: Nasty, brutish and short? And yet philosophical interest in these conditions was piecemeal and occasional until the past hundred or so years. But the treatment of disability as a subject of philosophical interest is relatively new. The resurgent political philosophy of the second half of the last century, preoccupied with eliminating or reducing unearned disadvantages, tended to treat disability as a primary source of those disadvantages, to be addressed with medical correction or government compensation. Somewhat later, social philosophers began to see disability as a source both of discrimination and oppression, and of group identity, akin to race or sex in these respects.

In some ways, disability looks much like sex or race as a philosophical topic. It concerns the classification of people on the basis of observed or inferred characteristics. It raises difficult threshold questions about the extent to which the classification is based on biology or is socially constructed. And yet the strong philosophical interest in some of the characteristics on which the disability classification is based appears to accord them a significance that many would deny to the distinguishing characteristics of sex or race.

Consider, for example, the question of how well-being is affected by the characteristics on which the disability classification is based. There is little interest now in the question of whether, in a world without discrimination, blacks or women would do better or worse on various metrics of well-being than whites or men.

In contrast, there is considerable interest in this question when the subject is people with disabilities. In contrast, other philosophers claim that disability is fundamentally different from race and gender in that it necessarily reduces well-being: This is but one example of the many ways that disability generates philosophical debate about some of our most familiar ethical, political, and epistemological concepts.

This introductory entry will outline the prevailing definitions and models of disability, and discuss the epistemic and moral authority of the experiences and self-reports of people classified as disabled. The definition of disability is highly contentious for several reasons. Indeed, as late as , the Oxford English Dictionary recognized only these two senses of the term Boorse, Second, many different characteristics are considered disabilities. Indeed, some have questioned, in part because of this variation, whether the concept of disability can do much philosophical work Beaudry, Two common features stand out in most official definitions of disability, such as those in the World Health Organization ; , the U.

The classification of a physical or mental variation as an impairment may be statistical, based on the average in some reference groups; biological, based on a theory of human functioning; or normative, based on a view of human flourishing. However classified, impairments are generally seen as traits of the individual that he or she cannot readily alter. Just what makes a condition a trait or attribute of an individual is obscure and debatable, but there seems to be agreement on clear cases Kahane and Savulescu, Thus, poverty is not seen as an impairment, however disabling it may be, nor is tasteless clothing, even if it is a manifestation of impaired fashion-sense rather than scarce income.

On the other hand, diseases are generally classified as impairments, even though they are rarely permanent or static conditions. Diseases that are not long-lasting, however, such as the flu and the measles, do not count as impairments. The characterization of both features is disputed. Several scholars have challenged the prevailing view of impairment as objective and biologically grounded Shakespeare, ; Davis, ; Tremain, ; Amundson But the most controversial issue in defining disability is the relationship between the two.

At one extreme are definitions that imply, or are read to imply, that biological impairments are the sole causes of limitation. They have been criticized for ignoring disadvantages that cannot be attributed to social attitudes and practices Terzi, , ; Shakespeare, But in characterizing disability in terms of exclusion, these definitions need not deny that impairments have undesirable aspects, such as pain or discomfort—merely that those aspects are not within the scope, or part of the meaning, of disability.

In-between are definitions which assert that individual impairment and the social environment are jointly sufficient causes of limitation. The ADA is generally seen as adopting an interactive approach to disability, although it contains an amalgam of definitional features. These different understandings of the relationship of impairment to limitation inform two contrasting approaches to disability, often described as opposing models: The medical model understands a disability as a physical or mental impairment of the individual and its personal and social consequences.

It regards the limitations faced by people with disabilities as resulting primarily, or solely, from their impairments. In contrast, the social model understands disability as a relation between an individual and her social environment: Their exclusion is manifested not only in deliberate segregation, but in a built environment and organized social activity that preclude or restrict the participation of people seen or labelled as having disabilities.

In their extreme forms, the medical and social models serve to chart the space of possible relationships between impairment and limitation more than to reflect the actual views of individuals or institutions. A variety of more formal models, described in Altman, , graphically represent the causal complexity of disability.

The medical model is rarely defended but often adopted unreflectively by health care professionals, bioethicists, and philosophers who ignore or underestimate the contribution of social and other environmental factors to the limitations faced by people with disabilities. A variety of social models are embraced by disability scholars and activists in and outside of philosophy. More moderate versions of the social model maintain the emphasis on social causes while insisting on the interactive character of disability e.

Taking the poor fit between atypical embodiment and standard environments as their starting point, they treat disability as an interaction between biological and social causes, denying causal priority to either. Implicit in the UPIAS definition of disability are two ways that society imposes limitations on disabled people, corresponding to two distinct strands of the social model. On this view, the main reason people with disabilities encounter hardship is because they suffer discrimination along the same lines as racial or ethnic minorities.

Accordingly, civil rights protections and anti-discrimination laws are the proper responses to disability e. This suggests the human variation model, according to which many of the challenges faced by disabled people do not result from their deliberate exclusion, but from a mismatch between their characteristics and the physical and social environment.

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This view of disabilities as human variations is closely related to the view that disability is a universal human condition Zola, or shared human identity Davis, , Ch. The claim that disability is universal can be taken as nothing more than a prediction that we will all acquire familiar disabilities at some time in our lives. But that claim is better construed as one about the nature of disability; as maintaining that all human beings have physical or mental variations that can become a source of vulnerability or disadvantage in some settings.

These two versions of the social model are not incompatible, differing mainly in emphasis. The discrimination stressed by the minority group model generally leads to, and is expressed in, the societal failure to accommodate people with various differences.

In some contexts, it is appropriate to analogize people with disabilities to racial minorities; in others, it is important to reject a dichotomy between disability and normality and treat impairments as continuous variations. If one goal of social policy is to remove discrimination and its enduring disadvantages, another is to encompass the full range of human variation in the design of the physical environment and social practices.

Although the social model, in one version or another, is now the dominant legislative, social-science, and humanities paradigm for understanding disability, stronger versions, particularly the British Social Model, have been subject to extensive criticism.

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Some argue that an adequate conceptualization of disability requires a recognition of impairments as an objective basis for classification, to distinguish disability discrimination from other types of discrimination Bickenbach, Several critics argue that extreme versions of the model implausibly deny or understate the role of impairment itself as a source of disadvantage Anastasiou and Kauffman, ; Terzi, , ; Shakespeare, Others, however, contend that this criticism is misplaced, because the British Social Model does not deny the importance of impairments but rather seeks to restrict the notion of "disability" to social exclusion and oppression Beaudry, Another objection is that the social as well as the medical model both rest on a false dichotomy between biological impairments and social limitations.

There are two versions of this objection. One maintains that disability is a complex phenomenon, in which biological impairment and social exclusion are deeply interwoven and difficult to tease apart Martiny ; Anastasiou and Kauffman, The other version of this objection rejects the treatment of impairment as a strictly biological phenomenon.

Cambridge Disability Law and Policy: Disability and the Good Human Life (2013, Hardcover)

Moreover, the social environment appears to play a significant role in identifying and, arguably, in creating some impairments dyslexia Cole, ; Shakespeare, ; Davis, , Ch 1; Tremain, ; Amundson, What counts as an impairment may depend on which variations appear to be disadvantageous in familiar or salient environments, or on which variations are subject to social prejudice: Less-than-average height may be more readily classified as an impairment than greater-than-average height because the former is more often disadvantageous in environments designed for people of average height, or because it is generally seen as less desirable.

For such reasons, it is difficult to establish the objectivity of the impairment classification by appeal to a clear and undisputed biomedical norm. Amundson goes so far as to deny that there is any biological basis for a concept of functional normality—a claim emphatically rejected by Boorse Rather, she argues that being classified as having an impairment is an integral part of the social process of disablement.

Such criticism parallels the debate among gender theorists about whether we can distinguish sex from gender on the ground that gender is socially constructed whereas sex is not. Thus, some critics conclude that it is at best oversimplified and at worst futile to distinguish biological impairments from social limitations, or to attempt to separate and compare the biological and social contributions to the disadvantages of people with disabilities But even those who believe that the impairment classification can be defended in biomedical terms recognize that impairments are not merely biologically-defined atypicalities but also markers for discrimination—discrimination that may be reinforced by the conviction that it is a response to objective biological attributes.

Anita Silvers has argued that a it is both possible and desirable to construct a neutral, value-free model of disability, using strictly descriptive criteria to identify atypical forms and functions, thereby allowing scholars with conflicting views to debate their normative and policy significance. The medical and social models suggest although they do not imply different views about the impact of disability on well-being, and different views about how disability is relevant to reproductive decisions, medical interventions, and social policy.

Those who accept a social model of disability regard the association between disability and well-being as highly contingent, mediated by a variety of environmental and social factors. They question conceptions of well-being that give a central role to the possession or exercise of the standard array of physical and mental functions, as those conceptions imply, or are often taken to imply, that well-being is precluded or diminished merely by the absence or limitation of those functions.

These differences are reflected in the conflicting assessments of life with disabilities found in the bioethics and public policy literature on the one hand, and disability scholarship on the other contrast Brock, with Goering, The different models of disability also seem to favor different responses to disability.

The medical model appears to support the correction of the biological condition or some form of compensation when that is impractical; the minority group model appears to favor measures to eliminate or compensate for exclusionary practices and recognize their injustice; the human variation model appears to favor reconstruction of the physical and social environment to take into account a wider range of differences in human structure and function.

Importantly, such reconstruction may also be supported by the minority group model as an antidiscrimination measure, since that model views exclusionary environments and practices as the characteristic form of discrimination against people with disabilities. The human variation model may just make explicit the appropriate social response to disability in a society without exclusion or discrimination. But claims about the causes of disadvantage do not always yield straightforward prescriptions for their remediation Wasserman, ; Samaha, The proper response to the disadvantages associated with disability depends not only on causal attributions but also on moral judgments about responsibility, respect, justice.

The debates over cleft lip surgery and breast reconstruction after mastectomy are not only about the comparative importance of biological and social factors in making the treated conditions disadvantageous. They also concern whether those interventions are justifiable uses of scarce medical resources, and whether they are complicit with suspect norms Little, , as in the case of skin-lighteners for people of color Asch, Although it is subject to dispute and qualification, the distinction between biological impairment and social limitation is relevant to many normative and policy issues, especially those concerning the choice between measures that modify the disabled individual or alter his environment.

In this section, we consider the role of that distinction in addressing the critical question of how the experiences of people with disabilities are relevant to those issues. The disability rights movement has long complained that the perspectives of people with disabilities are too often ignored or discounted. The slogan that served as the title for James Charlton's book, Nothing About Us Without Us Charlton, ; Stone, has often been invoked to demand the inclusion of people with disabilities in policy making and research concerning disability.

The slogan suggests that they have both a unique perspective to bring to those activities and a right to take part in them. Such questions are best approached in terms of the two aspects of impairments recognized by most disability theorists: These two aspects of impairment roughly correspond with two distinct types of disability experience:. There may be more commonalities in one kind of experience than the other, and greater relevance to specific research or policy issues.

Further, the epistemic and moral authority of statements made by people with disabilities about their experiences may vary with the kind of experience they describe. The first type of experience involves the particularities of living with atypical embodiment or functioning. Questions about this kind of experience are often framed as what-is-it like questions: The experience of atypical functioning or sensing may be far more salient for someone getting to know a person with a disability than it is to the person herself.

It may also be highly salient to a person who is recently impaired, trying to function without limbs or senses that she used to have. But the experience of loss and frustration becomes less salient with time, peer and professional support, as she gets more immersed in going about day-to-day life. A person who can see but not hear has very different sensory experiences from a person who can hear but not see, who in turn has very different experiences from a person who can see and hear but cannot move his legs.

Further, their experience of life with an impairment may vary with the kinds of activity they engage in, and how they regard their impairments as affecting their opportunities for self-fulfillment. Opportunities in turn may be influenced by all the factors, unrelated to impairment, that affect everyone: Moreover, people's experience of living with an atypical function sometimes may be difficult to distinguish from their experience of stigma and discrimination.

Despite these differences, the experiences of living with diverse impairments have one thing in common—they are likely to be ignored, or given insufficient weight, in the design of the physical and social environment. In constructing buildings, transit systems, and work schedules, they often fail to listen carefully to what people with various impairments say about their experiences of daily living. Those experiences cannot be adequately simulated by spending a day in a wheelchair or walking around with a blindfold—indeed, the confusion and disorientation that nondisabled people experience in simulating impairments is a very misleading guide to the way people with disabilities experience and negotiate the activities of daily living.

Moreover, in learning about the experiences of living with atypical functions, planners and policy makers cannot take any single impairment as representative. The experiences of people with different impairments differ as much from each other as they do from the experiences of nondisabled people. As the human variation model emphasizes, the very diversity of impairments poses an important challenge for an inclusive society. They will experience something of the stigma and discrimination that cut across impairments.

The second type of disability experience, then, is of attitudinal barriers to ordinary activity that are facts of life for people with disabilities. These negative responses involve several elements. The most discussed is overt stigmatization and discrimination: But there are also less overt ways that society makes living with a disability difficult.

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Simply being different from the majority of the population, in a way that the majority makes salient, can make people with disabilities feel isolated or alienated. This experience is similar to those not only of other stigmatized minorities, such as African-Americans or LGBTs, but of people with atypical characteristics who may not form a distinct political or cultural minority but are nonetheless constantly reminded of their difference. It is in the social construction of disability that we move from the particularity of any one disability toward the common social experiences of people with disabilities.