Philosophical Reflections on Disability (eBook)

Preface 5
Acknowledgements 7
Contents 8
Contributors 10
Author Biographies 12
1 Introduction: Philosophical Reflections on Disability 15
1.1 The Concept of Disability 18
1.2 Disability, Quality of Life, and Bioethics 21
1.3 Disability and Justice 24
1.4 Personal Voices 28
1.5 Conclusion 29
1.6 Notes 30
References 30
Part I Concepts and Theories of Disability 31
2 An Essay on Modeling: The Social Model of Disability 32
2.1 Introduction 32
2.2 Models of Disability 34
2.3 The Concept of Disability: Classification 36
2.4 The Concept of Disability: Limitation 37
2.5 Limitation and Political Action 39
2.6 Limitation and Disability Identity 43
2.7 Can the Social and Medical Models Meet? Shake Hands? Connect? 46
References 48
3 Ability, Competence and Qualification: Fundamental Concepts in the Philosophy of Disability 50
3.1 Introduction 50
3.2 Conditions for Action 51
3.3 The Idea of a Standard Basic Competence 53
3.4 Occupational Competence and Skill 54
3.5 The Conditions for Pursuing Training Programs 54
3.6 On Working Ability and its Conditions 55
3.6.1 Introduction 55
3.6.2 The Competencies 57
3.6.2.1 Technical Competence 57
3.6.2.2 General Competence 57
3.6.2.3 Personal Competence 58
3.6.2.4 Abilities Belonging to the Toleration Category 58
3.6.2.5 Abilities Belonging to the Courage Category 59
3.6.2.6 Other Virtues 60
3.7 The Notion of Qualification 60
3.7.1 The Notion of Authority 61
3.8 Health and Executive Ability 61
3.9 A Summary of a Persons Internal Conditions for Work 62
3.10 From Non-ability to Disability 63
3.10.1 Disability as Related to Ill Health 63
3.10.2 Disability as Related to Congenital Defects 64
3.10.3 Disability as Related to the Realization of Vital Goals 64
3.10.4 On the Notion of a Social Disability 66
Note 66
References 66
4 Disability and Medical Theory 68
4.1 Introduction 68
4.2 What Kind of Concept is Disability? 68
4.2.1 Common Sense 69
4.2.2 Usage By Specialists 70
4.2.3 The Medical Aspect of Disability: Impairment 73
4.2.4 Nonmedical Aspects of Disability: Ethics and Law 80
4.3 American Law on Disability Discrimination 82
4.3.1 Can an Antidiscrimination Goal Define Disability? 82
4.3.2 Disability and Impairment in the ADA 84
4.4 Two Approaches to Disability Advocacy 89
Notes 90
References 98
Part II Disability, Quality of Life, and Bioethics 102
5 Utilitarianism, Disability, and Society 103
5.1 Introduction 103
5.2 The Meaning of the Word Disability 103
5.3 Utilitarianism 104
5.4 Different Forms of Disabilities 105
5.5 A Caution About the Meaning of Life 108
5.6 How Should Society Respond to Disabilities? 110
5.7 Disabilities and the Allocation of Scarce Medical Resources 110
5.8 EgalitarianismAn Aside 112
5.9 Back to Utilitarianism 113
5.10 Tragic Disabilities 114
5.11 A Special Consideration 114
5.12 The Problem of Selection 115
5.13 Conclusion 117
5.14 Notes 118
References 119
6 Too Late to Matter? Preventing the Birth of Infants at Risk for Adult-Onset Disease or Disability 121
6.1 What is Conception and Does It Matter? 122
6.2 Objections to Selecting Against Individuals at Risk for Adult-Onset Disease: BC and HD 123
6.2.1 BC 123
6.2.2 HD 126
6.3 Phantom Children and the Confusions They Sow 128
Notes 131
References 133
7 To Fail to Enhance is to Disable 135
7.1 Introduction 135
7.2 What is Disability? 135
7.3 What Are Enhancements? 137
7.4 The Treatment/Enhancement Distinction 138
7.5 To Fail to Enhance is to Disable 141
7.6 Conclusion 142
Notes 143
References 143
8 Rehabilitating Aristotle: A Virtue Ethics Approach to Disability and Human Flourishing 144
8.1 Introduction 144
8.2 Rehabilitating Aristotle 144
8.2.1 Aristotle and Species Essentialism 145
8.2.2 Aristotle, Boorse and the Biostatistical Theory of Disease 145
8.2.3 A Better Understanding of Biology and Flourishing 146
8.2.4 Practical Wisdom, Judgment and Disability 147
8.3 Paradigm Cases 148
8.3.1 Helen Keller as a Paradigm Case of Flourishing 149
8.3.2 Anencephaly as a Paradigm Case of Inability to Flourish 150
8.4 The Deliberate Creation of Disabilities 152
8.4.1 Creating Disabled Children 152
8.4.2 The Case of Candice McCullough and Sharon Ducheneau 153
8.4.3 Deliberately Avoiding Creating Disabled Children 156
8.4.4 Clitoridectomy and the Deliberate Disabling of Women 157
8.5 Conclusion 158
Notes 159
References 162
Part III Disability, Social Justice, and Public Policy 163
9 Equal Treatment for Disabled Persons: The Case of Organ Transplantation 164
9.1 Two Kinds of Justice Problems 164
9.1.1 Baby K: The Case of Total Unconsciousness 164
9.1.1.1 The Demand for Respiratory Support in the Absence of Scarce Resource Concerns 165
9.1.1.2 The Hypothetical Concern About Scarce Resources 165
9.1.1.3 Baby K and Organ Transplant 168
9.1.2 Moderate Chronic Disability: The Case of Trisomy-21 171
9.2 Justice and What is Morally Right for the Disabled 174
References 175
10 Disability Rights: Do We Really Mean It? 177
10.1 Early Context 179
10.2 Media 180
10.3 Actual Arguments 1: Disadvantages Remain 183
10.4 Actual Arguments 2: Not Unduly Burdensome 185
10.5 Actual Arguments 3: The Meaning of Reasonable Accommodation 186
10.6 Conclusion 188
Notes 189
References 189
11 Dignity, Disability, Difference, and Rights 191
11.1 Natural Kinds 194
11.2 Diseases and Natural Kinds 196
11.2.1 Realism and Anti-Realism 197
11.3 Disability, Disease, and Natural Kinds 197
11.4 Natural Kinds and Dignity 198
11.4.1 Intrinsic Dignity and Rights 199
11.5 Differences and Natural Kinds 200
11.5.1 Variations 201
11.5.2 Differentiations 201
11.5.3 Diseases, Injuries, and Disabilities 201
11.6 Intrinsic Dignity as the Basis for Human Rights 202
11.7 Rights and the Care of the Disabled 202
11.7.1 Health Care and the Disabled 203
11.7.2 Disability, Difference, and Health Care 205
11.8 Concluding Caveats 205
11.9 Notes 205
References 206
12 Public Policy and Personal Aspects of Disability 207
12.1 Introduction 207
12.2 Current Societal Perspectives and Resulting Work Disability Programs 208
12.2.1 Legitimate Categories 208
12.2.2 Risk Assumption and its Consequences 209
12.2.3 Insurable Risk 210
12.2.4 Misuse of Disability Categories 210
12.2.5 Civil Rights and Disability 211
12.3 Changing Views of Disability 211
12.4 Disability and the Person 212
12.4.1 Who is the Person with Disability? 213
Notes 216
References 217
13 Disability and Social Justice 218
13.1 Introduction 218
13.2 The Problem of Self-Sufficiency 221
13.3 Political Authority 223
13.4 The Needs of the Disabled and the Dependency Worker 224
13.5 The Disabled and Citizenship 227
13.6 Some Concluding Thoughts 230
Notes 232
References 233
14 The Unfair and the Unfortunate: Some Brief Critical Reflections on Secular Moral Claim Rights for the Disabled 235
14.1 Facing Tragedy: Not All that is Unfortunate is Unfair 235
14.2 Justice-Based Claims to Support, Care, and Accommodations for the Disabled: Some Skeptical Reflections 236
14.3 The Challenge to Claim Rights on Behalf of the Disabled 238
14.4 Justice in the Face of Moral Pluralism: The Deflation of the Self-Evidence of Claim Rights on Behalf of the Disabled 239
14.5 From Justice to the Creation of Social Insurance 241
References 243
Part IV Personal Voices 244
15 Neither Victims Nor Heroes: Reflections from a Polio Person 245
15.1 Polios as Victims 245
15.2 Polios as Heroes 249
15.3 Neither Victims Nor Heroes 252
Notes 253
References 254
Index 255