The Journal of Philosophy of Disability
ONLINE FIRST ARTICLES
Articles forthcoming in in this journal are available Online First prior to publication. More details about Online First and how to use and cite these articles can be found HERE
March 16, 2023
Disability, Teleology, and Human Development in German Idealism
Exploring Disability in the History of Philosophy
first published on March 16, 2023
German idealist philosophers Kant and Hegel, who have had a significant influence on contemporary social and political theory, both insist on universal human freedom and dignity. However, they maintain teleological frameworks of human development which depend on distancing free and rational human agency from nature, leaving animality and “savageness” behind for a rational and spiritually developed future. This has implications for their implicit and explicit accounts of disability, which risk being reiterated today: insofar as disability is associated with being a static product of nature, these frameworks situate it at best as that which must be overcome, and at worst as something that bars someone from full humanity. Recognizing and understanding the place of disability within their work is vital if we want to avoid their exclusions in our inherited ideas.
October 26, 2022
Ally Peabody Smith
How Should (and Shouldn’t) We Think About Profound Intellectual Disability?
first published on October 26, 2022
Many accounts of the grounds for human moral standing rely on the possession of higher-order capacities of mind that serve as status-conferring attributes, to the exclusion of those with significant intellectual impairments. Interconnectedly, our relationships with those with profound intellectual disability (PID) remain beneath their potential. Taking as a starting point Peter Singer’s graduated account of moral status, its assumptions about PID, and its implications for what we owe those with PID, I argue that rather than conceptualizing PIDs as severe cognitive deficit, we should characterize them as disabilities marked by the impossibility of successful, mutual linguistic communication. Considering existing relationships between non-PID and PID pairs, I center the potential for atypical forms of communication. I close with the beginnings of a more extensionally adequate grounds for moral status, where moral standing is a product of one’s being able to participate in the shared activity of developing and deepening relationships.
June 10, 2022
Epistemic Arrogance, Moral Harm, and Dementia
first published on June 10, 2022
When it comes to supporting the well-being of a person living with dementia, remaining sensitive to that person’s interests can be challenging, given the impairments that typically define the condition particularly in its later stages. Epistemic arrogance, an attitude regularly adopted by people not living with dementia towards those who are, further impedes this task. In this case, epistemic arrogance amounts to the assumption that one sufficiently knows or can imagine what it is like to live with dementia to make decisions in matters concerning the care and well-being of someone with dementia, without appropriately consulting their views and preferences. Drawing on three fictional scenarios, I describe common pathways for epistemic arrogance in dementia-support contexts and the ways in which these cause moral harm, linking them to central issues in dementia studies and medical ethics, including person-centered care, the “best interests” principle and the prescriptive reach of advance directives.
June 8, 2022
Profound Disability, Equality and the Boundaries of Inclusion
first published on June 8, 2022
The sub-title of a recent book on “belonging” for people with profound intellectual and multiple disabilities (PIMD) is “Pushing the boundaries of inclusion.” One aim of this paper is to establish where at least one of these boundaries lies. Enabling profoundly disabled people to be together with others is often inspired by the ideal that anybody and everybody can be fully included in their relationships with others. This inclusive ideal can take the form of relational equality—including people with PIMD as equals in our relationships with them. I explore the scope and limits of relational equality, and where, as with some profoundly disabled people, equality is out of reach, I look at two relational alternatives.
Cognitive Disabilities, Forms of Exclusion, and the Ethics of Social Interactions
first published on June 8, 2022
Cognitively disabled individuals have been marginalized by our larger culture; they’ve also been marginalized in philosophical discussions. This paper seeks to begin correcting this situation by examining how assumptions which shape our social interactions and expectations disadvantage individuals with a range of cognitive disabilities. After considering Rubella syndrome and autism in detail, I argue that we have a moral obligation to change how we approach social interactions with cognitively disabled individuals.
June 7, 2022
Quill R Kukla
What Counts as a Disease, and Why Does It Matter?
first published on June 7, 2022
I argue that the concept of disease serves such radically different strategic purposes for different kinds of stakeholders that coming up with a unified philosophical definition of disease is hopeless. Instead, I defend a radically pluralist, pragmatist account of when it is appropriate to mobilize the concept of disease. I argue that it is appropriate to categorize a condition as a disease when it serves legitimate strategic goals to at least partially medicalize that condition, and when the condition is pathological from inside the epistemology and metaphysics of medicine. While some conditions, like pancreatic cancer, are legitimate diseases from all stakeholders’ points of view and in any context, and while other conditions, like homosexuality, are not diseases from any legitimate point of view, there is a range of interesting, messy cases—including Deafness, autism, pre-hypertension, infertility, and ADHD, for example—whose disease status is irreducibly context-dependent and under contest.
April 7, 2022
Gaming the System?: Justice, Fairness, and Disability Accommodations
first published on April 7, 2022
I am legally entitled to certain accommodations for my visual impairment that I do not always need. Affording me these rights is required by justice even on those rare occasions in which they are not necessary to give me an equal opportunity to fully participate in all aspects of society. I sometimes wonder whether I am nonetheless “gaming the system,” “exploiting a loophole,” or otherwise acting unjustly or unfairly by using disability accommodations in such circumstances. The essay aims to explore this apparent paradox by considering whether it is sometimes wrong, as a matter of justice, for disabled people to use accommodations we are justly owed. My conclusion is that, although it is not unjust for disabled people to use accommodations we are entitled to as a matter of justice, an ideally just person would sometimes forgo them for the sake of her commitment to justice itself.
April 5, 2022
Understanding “Disability” as a Cluster of Disability Models
first published on April 5, 2022
This article puts forth a novel framework for understanding conceptions of disability using six models of disability: the “Social,” “Medical,” “Tragedy,” “Affirmative,” “Minority” and “Universal” models. It analyzes these models as three opposed pairs, each pertaining to a distinct aspect of the multifaceted experience of disability: (1) the cause of disabled people’s social disadvantage and exclusion; (2) the effect of impairment on individuals’ quality of life and well-being; (3) the dichotomy or lack thereof between disabled and nondisabled people. The article argues that although each model is incompatible with its opposed pair, it is compatible with the remaining four models, in the sense that there is no contradiction in holding the views associated with these models at the same time. It therefore concludes that conceptions of disability are best understood as clusters of views on disability that are associated with compatible models.
March 2, 2022
Chronic Pain, Mere-Differences, and Disability Variantism
first published on March 2, 2022
While some philosophers believe disabilities constitute a “bad-difference,” others think they constitute a “mere-difference” (Barnes 2016). On this latter view, while disabilities may create certain hardships, having a disability is not bad in itself. I argue that chronic pain problematizes this disability-neutral view. In doing so, I first survey the literature on chronic pain (§1). Then, I argue that Barnes’s mere-difference view cannot adequately accommodate the lived experiences of many people who suffer from chronic pain (§2). Next, I consider two ways Barnes might respond and I explain why these responses are not workable (§3). Finally, I conclude with a brief discussion of disability variantism, the view that just as some disabilities can be neutral or even positive for some individuals, other disabilities like chronic pain can understandably make some people’s lives miserable not because society has failed them but simply because some conditions can openly conflict with well-being (§4).
November 10, 2021
Eva Feder Kittay
Why Human Difference is Critical to a Conception of Moral Standing
An Argument for the Sufficiency of Being Human for Full Moral Status
first published on November 10, 2021
I argue that the claim that merely being born of two human beings in a condition that supports life is sufficient for full moral status. Not only ought we not to exclude any human being from full moral status because they lack the possession of what some have deemed to be morally relevant properties, we don’t have a full grasp of what is morally relevant unless we include the many different possible lives humans live in their diverse bodies and minds. Our understanding of how we ought to treat nonhuman beings is not of lesser importance, but it necessarily depends on how we understand what is morally significant in human lives.
Supported Decision-making: the CRPD, Non-Discrimination, and Strategies for Recognizing Persons’ Choices About their Good
first published on November 10, 2021
People with cognitive impairments often have difficulties formulating, understanding, or articulating decisions that others judge reasonable. The frequent response shifts decision-making authority to substitutes through advance directives of the person or guardianship orders from a court. The Convention on the Rights of People with Disabilities defends supported decision-making as an alternative to such forms of supplanted decision-making. But supported decision-making raises both metaphysical questions—what is required for a decision to be the person’s own?—and epistemological questions: how do we know what persons judge to be their good, when they have difficulty conceptualizing and articulating? It raises practical questions, too, such as protection against risks of exploitation. This article uses a non-discrimination account of legal personhood drawn from the CRPD to explore how common features of decisions employed by people without cognitive disabilities are important in supported decision-making too. These features include prostheses, guardrails, relationships, and social contexts.
October 28, 2021
James B. Gould
Living in Nowheresville: David Hume’s Equal Power Requirement, Political Entitlements and People with Intellectual Disabilities
first published on October 28, 2021
Political theory contains two views of social care for people with intellectual disabilities. The favor view treats disability services as an undeserved gratuity, while the entitlement view sees them as a deserved right. This paper argues that David Hume is one philosophical source of the favor view; he bases political membership on a threshold level of mental capacity and shuts out anyone who falls below. Hume’s account, which excludes people with intellectual disabilities from justice owing to their lack of power, but includes them in charity, is morally deficient. The shortcomings of Hume’s theory underscore the necessity of having a view of justice which ensures that people with intellectual disabilities are not marginalized. In defending the entitlement view, I integrate philosophical analysis and concrete examples of policy issues.
September 21, 2021
Joseph A. Stramondo
Tragic Choices: Disability, Triage, and Equity Amidst a Global Pandemic
first published on September 21, 2021
In this paper, I make three arguments regarding Crisis Standards of Care developed during the COVID-19 pandemic. First, I argue against the consideration of third person quality of life judgments that deprioritize disabled or chronically ill people on a basis other than their survival, even if protocols use the language of health to justify maintaining the supposedly higher well-being of non-disabled people. Second, while it may be unavoidable that some disabled people are deprioritized by triage protocols that must consider the likelihood that someone will survive intensive treatment, Crisis Standards of Care should not consider the amount or duration of treatment someone may need to survive. Finally, I argue that, rather than parsing who should be denied treatment to maximize lives saved, professional bioethicists should have put our energy into reducing the need for such choices at all by resisting the systemic injustices that drive the need for triage.
August 28, 2021
Kim Q. Hall
Limping Along: Toward a Crip Phenomenology
first published on August 28, 2021
A queer crip embodied experience of limping is the point of departure for my reflections on the differences between a crip phenomenology and a phenomenology of disability. I argue that a crip phenomenology can further understanding of how ableism and heternormativity work together, along with other structures of violence, to shape experiences at the edges of ability and disability, and, indeed, the possibility of queer crip movement in and through worlds.
August 18, 2021
Joseph J. Fins
Disorders of Consciousness, Disability Rights and Triage During the COVID-19 Pandemic
Even the Best of Intentions Can Lead to Bias
first published on August 18, 2021
As a member of the New York State Task Force on Life and the Law and the author of Rights Come to Mind: Brain Injury, Ethics and the Struggle for Consciousness, the author draws upon his work as a clinical ethicist during the COVID-19 Spring surge in New York to analyze the impact of ventilator allocation guidelines proposed by the Task Force on people with disorders of consciousness. While a non-discriminatory methodology was intended by the Task Force, the author concludes that the guidelines would have discriminated against people with disorders of consciousness had they been promulgated. This was due to errors in exclusion criteria, the utilization of the Sequential Organ Failure Assessment (SOFA) score, and the Glasgow Coma Scale which assesses motor output and not consciousness. While allocation and triage decisions may be neccessary during a pandemic, the ethical integrity of these determinations depend upon proper metrics.
July 27, 2021
Andrew F. Smith
Surviving Sustainability: Degrowth, Environmental Justice, and Support for the Chronically Ill
first published on July 27, 2021
The quest for ecological sustainability—specifically via prioritizing degrowth—creates significant, often overlooked challenges for the chronically ill. I focus on type-1 diabetes, treatment for which depends on nonrenewables and materials implicated in the global proliferation of toxins that harm biospheric functions. Some commentators suggest obliquely that seeking to develop ecologically sustainable treatments for type-1 shouldn’t be prioritized. Other medical concerns take precedence in a post-carbon world marked by climate change and widespread ecological devastation. I challenge this view on three grounds. Its proponents (i) fail to treat type-1 as the public health issue it is, particularly within the context of what Sunaura Taylor calls disabled ecologies. They (ii) deny persons with type-1 an equal opportunity to pursue survival. And they (iii) presume without warrant that treating type-1 is an all-or-nothing affair. Indeed, research by biohackers points to suboptimal but potentially workable ways to make type-1 survivable in a post-carbon future—so long, I stress, as their findings are cripped in a manner that foregrounds the demands of environmental justice.
July 13, 2021
Technologies of Reproduction: Race, Disability, and Neoliberal Eugenics
first published on July 13, 2021
When considering the relation between race, disability, and reproduction, race and disability tend to figure as outcomes of reproduction. It is assumed that one births a child with a certain race and ability status as a function of biological and genetic processes. This paper shifts such analyses of race and disability in the context of contemporary reproduction to examine how race and disability are not only produced but are productive. Building on recent work describing race as a technology emergent in certain sociopolitical contexts and used to develop and maintain certain ways of life, intimate and collective relations, and political orders, this essay examines the possibilities for understanding disability as a technology. It argues that race and disability function as technologies in contemporary reproductive practices through the naturalization of choice, the normative production of ‘risk,’ and the making and unmaking of kinship.
July 7, 2021
Andrea J. Pitts
The Polymorphism of Necro-Being
Examining Racism and Ableism through the Writings of Leonard Harris
first published on July 7, 2021
In this paper, I examine the writings of African American philosopher Leonard Harris as an author who has been read primarily for his contributions to the study of Africana philosophy, U.S. pragmatism, and moral philosophy. Despite contributions to bioethics and reflections on systemic racism within the context of institutional medical settings, Harris’s work has yet to be read in terms of its relevance for disability critique. This paper demonstrates how Harris’s writings may be read as contributing to the field of philosophy of disability by arguing that his concept of “necro-being” helps reveal the mutually reinforcing relationships between race, disability, gender, and class. To carry this out, I consider core themes from his work such as metaphilosophy, health, and autonomy to show the relevance of his writings for philosophy of disability, and, in a parallel manner, the importance of disability critique for expanding his accounts of oppression and racism.