In this article, I will propose a theoretical argument for the prohibition of unequal treatment of disabled and non-disabled individuals in health care resource allocation. I will first consider an argument for unequal treatment, which was put forward by Singer et al, and elucidate its far-reaching scope. I will then use the same argument in order to derive an argument that would prohibit unequal treatment of disabled and non-disabled individuals in almost all cases of health care allocation.Resumen:En este artículo propongo (...) un argumento teórico para prohibir el trato desigual entre personas discapacitadas y no discapacitadas en la distribución de recursos médicos. En primer lugar analizaré un argumento que apoya un trato desigual, el cual fue presentado por Singer y otros, y trataré de establecer sus alcances. Después utilizaré ese mismo argumento para derivar otro que nos llevaría a prohibir el trato desigual entre discapacitados y no discapacitados en casi todos los casos de distribución de recursos médicos. (shrink)

The Americans With Disabilities Act (ADA) promotes social justice by protecting disabled persons from discrimination and prejudice. It seeks equality of opportunity for them and protects their well being by giving them fair access to goods, services and benefits. These rights are circumscribed in the ADA, however, by constraints of cost, efficiency, utility, and certain social mores. The ADA offers little direction about how to set priorities when these values come into conflict, or about whether equality of (...) opportunity favors equivalent or preferential treatment for disadvantaged people. Until these ambiguities and potential value conflicts are resolved, a central moral and social problem remains unresolved: How can we demonstrate commitment to the rights and welfare of those with severe disabilities while placing fair limits upon their claims? Five special concerns are discussed: (1) eligibility and the allocation of health care; (2) the meaning of ‘qualified but disabled’ in employing people with mental disabilities; (3) equal opportunity and problems of envy and malingering; (4) ADA accommodation and public protection through testing and licensure; and (5) ADA protection and problems of backlash. Rather than simply wait to see what courts and administrative agencies decide, we should evaluate the moral conflicts, articulate criteria, and help make some difficult choices on morally defensible grounds. Keywords: disabled, health benefit plans, health care rationing, health care reform, health priorities, health services accessibility, Oregon, Rawls, selection bias, social justice CiteULike Connotea Del.icio.us What's this? (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 Article examines the influence of the Americans with Disabilities Act (ADA) on affective attitudes toward children with disabilities and on the incidence of disability-selective abortion. Applying regression analysis to U.S. natality data, we find that the birthrate of children with Down syndrome declined significantly in the years following the ADA's passage. Controlling for technological, demographic, and cultural variables suggests that the ADA may have encouraged prospective parents to prevent the existence of the very (...) class of people the Act was designed to protect. We explain this paradox by showing how specific ADA provisions could have given rise to demeaning media depictions and social conditions that reinforced negative understandings and expectations among prospective parents about what it means to have a child with a disability. We discuss implications for reproduction law and antidiscrimination policy. (shrink)

The writer responds to the commentary “Physician Burnout Calls for Legal Intervention,” by Sharona Hoffman, in the November‐December 2019 issue of the Hastings Center Report.

The Department of Health and Human Services, Office for Civil Rights enforces Section 504 of the 1973 Rehabilitation Act and Title II of the Americans with Disabilities Act. OCR works through complaint investigations and compliance reviews, as well as outreach, technical assistance, and public education to promote voluntary compliance. In the Olmstead decision of June 1999, the Supreme Court held that the ADA’s “integration regulation” requires state and local government to administer services, programs, and activities in the (...) most integrated setting appropriate to the needs of qualified individuals with disabilities. The decision changed the focus from whether a right to more integrated services exists, to under what circumstances and how services will be provided. The New Freedom Initiative announced by President Bush in February 2001 is a broadbased initiative to remove barriers to community living for people with disabilities and promote swift implementation of the Olmstead decision. (shrink)

A persistent paradox apparently infects disability civil rights claims. On the one hand, these rights claims are often understood to apply only to those who are sufficiently impaired in body or in mind to qualify for them because of the disadvantage they endure. On the other hand, asserting significant impairments threatens to undermine the plausibility of these claims as civil rights rather than as welfare for those who are dependent and in need of extra help. Behind this paradox lies a (...) type of categorical understanding of disability civil rights: that disability civil rights are only for those who fall into a category of disability and that this category should be defined in a particular way, in terms of disadvantaging disablement. In this article, I dispel this paradox by deploying a critical analysis of Elizabeth Barnes’s account of physical disability in her recent book, The Minority Body. In her book, Barnes makes the important critical point that disability is not “bad” difference. Instead, she argues that physical disability is a physical condition that the disability rights community is working to promote justice for. I argue that this account fails as a project of ameliorative social metaphysics because it fails to understand the role of impairment in the construction of disability antidiscrimination law. I also argue that her account risks privileging physical disability and is thus problematic as a starting place for examining disability justice. (shrink)

People with disabilities are often denied equal access to organ transplantation despite long‐standing federal nondiscrimination mandates. Under the Americans with Disabilities Act and the Rehabilitation Act, people cannot be excluded from consideration for organ transplantation because of disability itself, or because of stereotypes or assumptions about the value or quality of life with a disability. Instead, decisions concerning whether an individual is a candidate for organ transplantation should be based on an individualized assessment of (...) the patient and on objective medical evidence. Recent legal developments underscore these basic guarantees and signal a new focus on the policies, practices, and attitudes that continue to compromise equal access to life‐saving organ transplants for people with disabilities. (shrink)

In 1990 the landmark Americans with Disabilities Act (ADA) became federal law with the express purpose to “establish a clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities."l The act includes separate titles prohibiting discrimination on the basis of disability in employment, public services, transportation and public accommodations. Since it prohibits discrimination on the basis of disability in both public and private services and programs, in health care “it applies (...) to programs provided by the government, benefits provided by employers, and services pro- ”2 vided by physicians.Moreover, the ADA defines disability broadly to include “any.. (shrink)

This paper chronicles the author’s experience, as an instructor and as an administrator, taking up the Americans with Disabilities Act (ADA) and implementing changes in the curriculum to accommodate a logic student with dyslexia. The author discusses his misconceptions about dyslexia and his attempts to determine more precisely how it affected his student’s reading abilities. While his student struggled with abstract symbol systems (e.g. standard logical notation), the student had no difficulty with sequences of (...) letters. The author elected to teach the introductory logic course with a logical notation composed entirely of letters, namely Lukasiewicz’ notation. The author details the work that went into learning this notation and teaching an introductory logic course in it, including overviews of lessons on semantics, syntax, and introduction/elimination rules for proofs. The student learned the material very quickly and with great success, progressing to moderately sophisticated proofs. The author reflects on how this reformulated version of an introductory logic course squares with the ADA’s language of “reasonable accommodations” and implores professional philosophers to take seriously what the ADA means for their pedagogy. (shrink)

This article studies the response of the US disability community to the prevalent assumption that disabled people do not have a future, in the form of the disability rights movement. It provides an exploratory discussion of the key role played by utopianism in the response. In doing so, the article adds to critical theorizing on the importance of utopia to the oppression of non-dominant groups and to transcending that oppression. I use utopian studies scholarship to interpret the activities leading up (...) to the passing of the Americans with Disabilities Act in 1990 as a minor utopia, characterized by an ambiguous, grounded, and provisional effort to imagine alternative ways of being. I articulate the central role played by a positive vision of disability and disabled people for this inversion of the historically negative relationship between utopia and disability. The article turns to disability activists to show that the movement countered exclusionary utopian approaches by acting as if it had a right to envision and enact a different, better future for all from the perspective of disability and disabled people. (shrink)

Because of New York City's proximity to water, edifices were built with one step as a barrier to potential flooding. The increase in the disability population made it evident that this step formed a barrier to people who could not negotiate level changes, especially those in wheelchairs and motorized scooters. The Americans with Disabilities Act (ADA) requires that new construction be accessible to people with disabilities and that older buildings be altered when such accessibility (...) is “readily achievable.” The problem is that except for people with disabilities filing legal complaints when the ADA is violated, there is no other enforcement mechanism. Also, New York City's narrow streets allow too little space for compliant ramps. This article describes how disability activists and government representatives created a model for accessibility that allowed for informal agreements and solutions that, although not always strictly compliant with the law, served the actual needs of the disability population. (shrink)

This paper asks whether statutory social insurance programs, which provide contributory tax-based income support to people with disabilities, are compatible with the disability rights movement's ideas. Central to the movement that led to the Americans with Disabilities Act is the insight that physical or mental conditions do not disable; barriers created by the environment or by social attitudes keep persons with physical or mental differences from participating in society as equals.The conflict between the (...) civil rights approach and insurance seems apparent. A person takes out insurance to deal with tragedy, such as premature death, or damage, such as accidental harm to an automobile or home. Social insurance, for example, the United States Social Security old-age and disability programs, consists of government-run insurance to cover risks of advanced age and disability for which the private market has not provided affordable coverage. But the civil rights approach to disability posits that disability is not a risk, not tragedy, and not a damage or defect. Instead it is a maladaptation of society to human variation. This paper argues that a justification remains for social insurance under the civil rights approach to disability, and further suggests that expansion of social insurance for disability is both compatible with disability rights principles and supported by wise public policy. (shrink)

More than two decades after the passage of the Americans with Disabilities Act , people with disabilities continue to live at the margins of American democracy and capitalist society. This persistent exclusion poses a conundrum to political theorists committed to disability rights, multiculturalism, and social justice. Drawing from feminist insights, specifically the work of Nancy Fraser, among others, I examine the necessary conditions for meaningful inclusion to be realized within a deliberative democracy. Using Fraser's concept (...) of “participatory parity” as a proxy for inclusion, I strategize how to overcome informal barriers—economic inequality and misrecognition—that persist even after disabled people are granted the legal right to participate. The analysis concludes that a truly inclusionary and multicultural democracy requires the redistribution of wealth and a more expansive model of political deliberation, one that can recognize unconventional modes of communication through practices of translation. (shrink)

Richard J. Arneson version 7/27/99 Is having a disability more like being a member of a racially stigmatized group or like lacking a talent? Both analogies might be apt. The Americans with Disabilities Act stresses the former analogy. The framing thought is that people with disabilities are objects of prejudice and prejudiced behaviors which wrongfully exclude them from participation in important social practices such as the labor market. Think for example of a blind person whose (...) job applications are always automatically rejected because she is blind and without any consideration of her aptitude for this or that specific job. Such a person suffers wrongful discrimination and is denied equality of opportunity. (shrink)

In Kimber v. Thiokol Corp., 196 F.3d 1092, the U.S. Court of Appeals for the Tenth Circuit upheld a U.S. District Court's grant of summary judgment against an employee's claim that an employeroperated disability insurance plan, which offered different levels of compensation for disabilities due to mental and physical conditions, violated Title I of the Americans with Disabilities Act. The Court of Appeals found that the Thiokol plan administrator's interpretations of the plan were not arbitrary and (...) capricious, and that the plan's different treatment of disabilities caused by physical and mental conditions did not violate the ADA. (shrink)

State prescription drug monitoring programs (PDMPs) use proprietary, predictive software platforms that deploy algorithms to determine whether a patient is at risk for drug misuse, drug diversion, doctor shopping, or substance use disorder (SUD). Clinical overreliance on PDMP algorithm‐generated information and risk scores motivates clinicians to refuse to treat—or to inappropriately treat—vulnerable people based on actual, perceived, or past SUDs, chronic pain conditions, or other disabilities. This essay provides a framework for challenging PDMP algorithmic discrimination as disability discrimination under (...) federal antidiscrimination laws, including a new proposed rule interpreting section 1557 of the Affordable Care Act. (shrink)

How should we respond to individuals with disabilities? What does it mean to be disabled? Over fifty million Americans, from neonates to the fragile elderly, are disabled. Some people say they have the right to full social participation, while others repudiate such claims as delusive or dangerous. In this compelling book, three experts in ethics, medicine, and the law address pressing disability questions in bioethics and public policy. Anita Silvers, David Wasserman, and Mary B. Mahowald test important (...) theories of justice by bringing them to bear on subjects of concern in a wide variety of disciplines dealing with disability. They do so in the light of recent advances in feminist, minority, and cultural studies, and of the groundbreaking Americans with Disabilities Act. (shrink)

Data about the accessibility of United States municipalities is infrastructure in the smart city. What is counted and how, reflects the sociotechnical imaginary of a time or place. In this paper we focus on features identified by people with disabilities as promoting or hindering safe pedestrian travel. We use a regionally stratified sample of 178 cities across the United States. The municipalities were scored on two factors: their open data practices, and the degree to which they cataloged the (...) environmental features that persons with disabilities deemed critical for safe movement through urban spaces. In contradiction to the dominating narrative of too much data and not enough analyses, we find that when it comes to data points that might be useful to persons with disabilities, data are lacking. This data gap has consequences both politically and materially—on one hand data could help enforce compliance with the Americans with Disabilities Act, on the other they would allow for safe route planning. We find that reading these data formats and collection patterns from the perspective of critical disability studies—particularly those whose work disrupts notions of “normal” —helps answer questions about potential benefits and harms of data practices. This lens has the potential to promote analysis that is as disruptive to injustices as it is practical. (shrink)

This chapter contains sections titled: Understanding Disability in Relation to Social Justice Cognitive Disabilities and Equality Considering Disability under Conditions of Injustice.

A number of recent legal cases in the United States have considered both disability‐based exceptions to Covid‐19‐related mask mandates and disability‐based claims to stronger masking rules in states restricting the abilities of local governments to enforce mask mandates. We argue that a proper legal and ethical analysis of such cases requires understanding the distinction between disability accommodations and disability modifications. Disability accommodations are individualized adjustments that enable qualified individuals to perform jobs or achieve access on terms comparable to those experienced (...) by others. Disability modifications are programmatic changes to structures or policies that increase accessibility. We contend that in the context of mask mandates, modifications rather than accommodations are ethically desirable because modification‐oriented policies promote disability access in a way that treats all individuals fairly, avoiding the risk of promoting misinformation and uncertainty about the health benefits of masking. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Call to Wonder reimagining disabilityRosemarie Garland-ThomsonComing to WonderI came to wonder last summer on a research visit to the Ringling Brothers Museum in Sarasota, Florida. Scattered with garish posters and peculiar objects, the museum’s circus archive was a cabinet of curiosities documenting a lost world of the extraordinary. Circuses, sideshows, and early museums were entertainment venues that offered good jobs to people with disabilities at (...) a time well before disability rights or accessible workplaces integrated people with disabilities into public life. At the Circus Museum, I came to understand more fully that many of the people on the freakshow’s broadsides are my ancestors, people with rare congenital disabilities that gave them uncommon appearances and occasioned for them some creativity in carrying out the tasks of daily living.That muggy summer day in Sarasota, the archivist opened for us one by one the thin but wide drawers of the filing cabinets designed to store rare and valuable documents. As each assemblage of posters revealed its strange contents, I came to recognize a lost community of ancient ancestors. All manner of human variation in extravagant shapes, sizes, and forms peered out of the drawers, beckoning our attention and igniting our wonder. The dwarf musicians, legless cyclists, exotic albinos, fat ladies, hermaphrodites, and giants who entertained and charmed circus audiences then have today been transformed into people with disabilities. Civil rights legislation such as the Americans with Disabilities Act, an [End Page 483] accessible designed and built public environment, and broad awareness of disability inclusion offer these unusual people opportunities for education and wider employment opportunities today. Many of my friends and colleagues resemble these circus celebrities and performers. All of us now go about our lives quite differently from these lost ancestors. We have lives, work, families, communities, and environments that are much more compatible with our ways of being. Nonetheless, my shudder of sympathetic recognition witnesses our congruence, despite the decades and centuries that separate us from them. As I move along the unsettling archive they have left me, my vanished ancestors stare back at me from the scrapbooks, circus posters, tattered photos, and ancient prints tucked into the drawers and cabinets along our tour. Their steady returning gaze demands my response. They pull from me an unsettling merger of awe and tenderness, familiarity and strangeness. They have awakened in me the ancient affect of wonder.For me, the most compelling occupant of these archival coffins was the “The Little Man of Nuremberg,” the armless calligrapher, Matthias Buchinger (Figure 1). This prodigy of ornate micrography gazed frankly back at me with dignified contemplation, inviting me into his elaborate realm of the miniature (see Schjeldahl 2016). His diminutive hands peeked out of the velvet cuffs, startling me with their familiarity to my own unusual arms and hands. Famous during his lifetime (1674–1739) as “The Greatest Living German,” Buchinger was a calligrapher, artist, performer, and entrepreneur who was an early exemplar of a genre of legless and armless disabled performers who inspired wonder and awe in their audiences and communities.1 Buchinger’s 1724 engraving offers his viewers an early 18th-century resume or social media page. The illustration’s loquacious caption describes, “the wonderful Little Man of about 29. Inches high, born without Hands, Feet, or Thighs, June the 2, 1674. In Germany.” The “last of nine Children,” he goes on to verify his own reproductive robustness by detailing that he “has been married four times, and has had issue Eleven children, one by his first Wife, three by his second, six by his third, and one by his present Wife.”Amazement apparently requires detail for its realization. His self-portrait engraving continues to variously solicit our wonder. “This little Man performs such Wonders as had never been done by any; but Himself,” he assures us. These wonders include playing various instruments, including the flute, bagpipe, dulcimer, and trumpet. Moreover, he designs and makes musical instruments and draws coats of arms and pictures of life “with Pen.” His astonishing feats include playing cards and dice, performing tricks with “Cups and Balls, Corn, and Live Birds,” playing at “Skittles or Nine Pens to... (shrink)

Shavelson et al., argues that California’s End of Life Option Act (ELOA) violates the Americans with Disabilities Act (ADA), because the ELOA requires the patient to “self-administer” their prescri...

In Ogborn v. United Food & Commercial Workers Union, Local No. 881, the U.S. Court of Appeals for the Seventh Circuit held that while major depression can constitute a disability under the Americans with Disabilities Act, isolated bouts of depression do not. Furthermore, the court held that an employee's firing after taking medical leave for depression does not violate the Family and Medical Leave Act, where evidence shows that the employee would have been fired for poor performance (...) even if he had not taken the leave.Alleging that he was fired in violation of the ADA and the FMLA, Jerry Ogborn sued his former employer, Local 881 of the United Food and Commercial Workers Union, as well as the union's vice president. Beginning in 1980, Ogborn worked as a business agent for the union, which represents members employed primarily in the retail grocery industry. Ogborn's duties consisted of visiting retail grocery stores employing workers represented by the union, meeting with members about working conditions, and filing and processing members’ grievances. (shrink)

Title III of the Americans with Disabilities Act (ADA) grants people with disabilities access to public accommodations, including the offices of medical providers, equal to that enjoyed by persons without disabilities. The Department of Justice (DOJ) has unequivocally declared that the law requires effective communication between the medical provider and the Deaf patient. Because most medical providers are not fluent in sign language, the DOJ has recognized that effective communication calls for the use of (...) appropriate auxiliary aids, including sign language interpreters. The final decision on what to offer the Deaf patient is the doctor's, and under current DOJ regulations, the doctor does not have to consult with the patient or give "primary consideration" to the patient's choice of auxiliary aid as long as what the doctor offers results in effective communication. However, given the great variation in people's communication styles and skills, a standard, one-size-fits-all auxiliary aid would fail to achieve effective communication in many cases, harming not only that Deaf patient, but also the medical provider, who would be potentially liable for violating the ADA as well as hamstrung in getting accurate information for purposes of diagnosis and treatment. Moreover, most doctors are not savvy about Deafness and Deaf culture. Thus, the best way to ensure effective communication would be to require the medical provider to ask the Deaf patient for his or her choice of auxiliary aid and to give "primary consideration" to the patient's expressed choice of auxiliary aid. Such an approach is required under Title II of the ADA, which makes it mandatory for state and local governments to consult with people with disabilities and give "primary consideration" to the patient's choice of auxiliary aid. Given that there is no difference between a public doctor and a private doctor that would justify the two different approaches and that cost is not a factor, since under either title, a medical provider cannot pass on the costs to the person with a disability, the DOJ should revise its interpretation of Title III in order to bring in into line with its interpretation of Title II. To fail to do so would operate to frustrate both the letter and the spirit of the ADA. Until the DOJ brings the titles into line, the courts should decline to give controlling weight to the DOJ's interpretation of Title III. (shrink)

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

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Eye of the Beholder: Deformity and Disability in the Graeco-Roman WorldThomas A. J. McGinnRobert Garland. The Eye of the Beholder: Deformity and Disability in the Graeco-Roman World. Ithaca: Cornell University Press, 1995. xviii + 222 pp. 64 pls. Cloth, $39.95.Recent years have witnessed increased attention among ancient historians in the subject of marginal types. What is new is not so much the unearthing of evidence, most of (...) which has long been available though not always easily accessible in the works of antiquarians, but the sophistication of method and the vigor of approach spurred by developments in the social history of more recent periods.An incomplete notice might include the studies devoted to gladiators (Wiedemann) and actors (Leppin, Ducos), Roman slaves (Bradley), so-called humiliores (Rilinger), leistai, mercenaries, and traders in fourth-century Greece (McKechnie), blacks in the Roman world (Thompson), and dwarfs in Egypt and Greece (Dasen).What is common to most or all of these efforts is a tight focus limited to one society, a narrowly-framed period of time, and/or a well-defined group. This narrow approach is not at all surprising, given the fact that the sources are scattered and composite, and demand a wide range of expertise in their treatment. A general study of the situation of the deformed and disabled in antiquity is then an all the more welcome addition to this trend in scholarship, though the true test of its usefulness will be its ability to confront successfully this central challenge posed by the sources.The book under review deserves praise for attempting to fill this need. There are undeniable advantages to the panoptic approach. The book calls attention to the value of evidence that is easily ignored: two prominent examples are the visual arts and physiognomy. Among its other virtues is a valuable demonstration of how ridicule is employed as a “marginalizing” device. The introduction is in some ways exemplary for its lucid emphasis on the difficulties of the enterprise. Unfortunately, such caution is fully justified by the result. This review argues two points: that a synthesis of this subject is as yet premature and that future studies should avoid wedding themselves as directly to modern concerns as this one does.A list of the chapter-headings shows that the book is organized thematically: “Survival of the Weakest,” “Half-Lives,” “The Roman Emperor in His Monstrous World,” “The Deformed and Divine,” “Deriding the Disabled,” “The Physiognomic Consciousness,” “Images of the Deformed,” “Medical Diagnosis and Treatment,” “Towards a Teratology,” and “Racial Deformity.” The chapters are bracketed by an Introduction and Conclusion, and followed by a Glossary, Notes, Bibliography, Index Locorum, and General Index. Plates with sixty-four illustrations complement the presentation of visual evidence in the text.The author sets himself a double aim (xii–xiii). One goal is to study the social [End Page 667] and economic conditions governing the existence of the deformed and disabled, and further to attempt to establish to what extent the ancients developed a teratology—the study of the causes of congenital deformity. The other purpose lies in the author’s desire to contribute a personal perspective, one avowedly shaped by the passage in 1990 of the Americans with Disabilities Act (ADA).The forthright assertion of modern—and deeply personal—concerns is a hallmark of this work. As the title suggests, this is a subjective evaluation of the ancient evidence. It will come as no surprise that, when measured by the author’s standard, that of the ADA, the Greeks and particularly the Romans fall short of the mark. Unfortunately, the successful pursuit of this second goal spoils the fruits of the first. In brief, the author displays a pronounced inclination to moralize, which reduces the power of his work.In a similar way, the breadth of approach ultimately defeats its own purpose. The challenge of the sources—confronted with honesty by Garland in his introductory chapter—is exacerbated to an unacceptable degree by his refusal to define carefully what he means by “deformed” and “disabled” (see 5–7). There are also various infelicities of treatment, especially though not exclusively on the Roman side, which might have been avoided... (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 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)

Mild and moderate mental illnesses can hinder labor force participation, lead to work interruptions, and hamper earning potential. Targeted interventions have proven effective at addressing these problems. But their potential depends on labor protections that enable people to take advantage of these interventions while keeping jobs and income.

Physical attractiveness is highly valued in our society and impacts a variety of decisions made by organizations. Generally speaking, research findings suggest that the more attractive the person, the greater the likelihood of favorable employment-related decisions. It follows then, that those considered physically unattractive will suffer adversely in some employment-related decisional contexts — decisions that may prevent them from achieving the good life. Until recently, discrimination against unattractive people has been considered nothing more than a moral or ethical issue. However, (...) with the introduction of the Americans with Disabilities Act (ADA) of 1990, attractiveness as an employment-related criteria may become a legal issue. In this essay, we propose that the history of social and legal trends, coupled with uncertainties and ambiguities within the ADA, represents a possible expansion of protection for physically unattractive people. (shrink)

Predictive medical information is used by underwriters to assess the future risk of a claim in medically based insurance products such as health, life, and disability insurance. Medical underwriting involves the science of evaluating medical information to determine the risk for groups of individuals with various medical conditions. In disability insurance, this involves an evaluation of medical information to predict the risk of becoming disabled.Before discussing medical underwriting, an understanding of certain terms used by disability insurance companies and the (...) products that are available is required. The first is the definition of disability. The Americans with Disabilities Act defines disability as the following:A physical or mental impairment that substantially limits one or more of the major life activities; or has a record of such an impairment; or is regarded as having such an impairment even when no impairment exists, no substantial limitation results from the impairment, or the impairment is only substantially limiting because of the attitudes of others. (shrink)

As an unfunded federal mandate, the Americans with Disabilities Act requires public and private entities to ensure disability accommodations without providing state funding to pay for these accommodations. Disability accommodations under the ADA can take many forms, including audio description of a museum exhibit, designated parking for people with disabilities, or accessible toilet stalls. For each of these examples, once it is established or installed, the accommodation is available to serve the needs of numerous disabled (...) individuals. Individualized service accommodations for disability accessibility emerge only once the individual with the disability makes the request. For example, a deaf job candidate requests communication access for a job interview. The request for the accommodation is individual-dependent, and in the case of signed language interpreting, individual-specific and not fungible. Given that the unfunded mandate of the ADA does not directly provide a mechanism to alleviate expenses related to providing service accommodations to individuals, which can serve as a deterrent to inclusive practices, the question arises as to whether the ADA discriminates against individuals who require ongoing service accommodations. (shrink)

This personal essay uses the first-person voice to describe the author’s experience as a dependent adult growing up in America after the Americans with Disabilities Act of 1990. The author’s personal story is contextualized as a reality specific to her race, gender, class, and degenerative physical disability. Descriptions of the author’s need for significant assistance serve as anchors for the essay’s more open-ended questions concerning care on a massive scale for multiple generations of people. Such questions seek (...) new social imaginaries that challenge Western social values of independence, individuated desires and activities, and an autonomous private life. (shrink)

Most forms of egalitarian theory impose on government to redress the inequalities of fortune that result from bad luck. This Article takes issue with the various forms of this large claim, and argues that decentralized forms of assistance are likely in the long run to do better by the very standards by which egalitarians justify their own program. The alleviation of poverty depends in the first instance on increases in wealth that can only come through private innovation and technological (...) advances. These have in fact produced major improvements in overall well-being, with disproportionate advances for the poor. But if one starts with Dworkin’s unsustainable distinction between option and brute luck, or Nussbaum and Sen’s capability theory, then no egalitarian theory can deliver on the promise to level differences in wealth without seriously compromising overall levels of social welfare. By expanding the scope of government regulation, these proposals open the door to selfish political forces whose political clout ensures that ill-conceived programs, such as the Americans with Disabilities Act, frustrate the very goals they hope to achieve. State intervention to redistribute resources should be understood as a last resort for dealing with problems of ill fortune. (shrink)

Texas festivals are given credit for providing benefits for both the festival's community and for the people who visit the community. As a result of these perceived benefits, communities across Texas stage a broad range of festivals and events. These events require substantial planning and skilled management to be successful. Those involved in the planning are often volunteers and have little or no background in event planning and management. Regardless of their experience level however, most event coordinators have ongoing needs (...) for information that will help them produce successful events. To produce a successful event, coordinators seek information from a variety of sources. These sources may include their personal network of friends and colleagues to professional consultants or formal workshops, conferences, and seminars. The primary purpose of this project is to provide information that will help the Texas Agricultural Extension Service Recreation, Park & Tourism Program evaluate its future role in responding to the needs of Texas festival coordinators. To accomplish this end, this study seeks to identify information needs of Texas festival coordinators and to describe how current sources of information are utilized by festival coordinators. This paper outlines the development and implementation of an information needs assessment of Texas festival coordinators and a description of current information sources being used by them. The project seeks to identify gaps in the provision of information and the access Texas festival coordinators perceive they have to information. The "importance"/"access" scale of this survey clearly identifies a range of important information topics which organizations could address. The following are the top 10 information needs of Texas festival coordinators as indicated by mail survey respondents: 1. Writing press releases 2. How to measure advertising success 3. Regulations for food, fire, safety, etc. 4. How to find regional talent 5. Insurance issues 6. Americans with Disabilities Act (ADA) 7. How to find and contract for professional entertainment 8. How to determine space requirements for event activities 9. How to create a layout for people/vehicle flow and activities 10. Estimating amount and type of security need It is indicated that most coordinators are aware of the six organizations and agencies that serve the needs of the festival industry. 1. International Festivals & Events Association (IFEA) 2. Texas Agricultural Extension Service (TAEX) - Department of Recreation, Park & Tourism at Texas A&M University 3. Texas Travel Industry Association (TTIA) 4. Texas Festivals & Events Association (TFEA) 5. Texas Department of Economic Development (TDED) 6. Texas Department of Transportation (TxDOT) Of respondents to the needs assessment mail survey, 82.8% to 72.6% of Texas festival coordinators are aware of the programs and services of these organizations and agencies. While coordinators show a high level of awareness of conferences, seminars, and workshops, only 13% to 24.7% have attended. Coordinator networks and the internet are viable sources of information. The majority (88%) of festival coordinators (n=216) indicated they have access to the internet and 81.9% of respondents (n=215) said they use the internet. Organizations can use this study and its results to focus on information needs that coordinators indicate are important and have low accessibility. January and February followed by June and July would be the best months for conferences, seminars, and workshops. Seminars may be held during the "off peak" months of January and February while brochures about how to better market an event can be distributed during the peak festival times of September and April. Coordinators' responses as to the best months they would be able to attend Certified Festival Manager (CFM) training also corresponded with event seasonality patterns. Using multiple distribution methods can improve access to festival planning information. Workshops, internet sites, brochures, and publications are just a few of the ways organizations may vary their distribution of information resources. Coordinators indicted their main source of information comes from coordinator networks (48.9%). This finding should be used to note the importance of networking at coordinator informational events. The internet is a viable source of information. Of the respondent coordinators, 98% indicted they have access to the internet. It is reasonable to suggest that more information can be provided via the internet. There are clearly overlapping functions among these organizations', however, many programs are carried out as partners in serving the festival industry. While this study did not examine these overlapping roles, it would be appropriate that areas of overlap should be examined more closely. (shrink)

On April 3, 1995, the Fourth Circuit upheld the right of a Maryland hospital to terminate a surgeon who was HIV-positive ). A resident in the University of Maryland Neurosurgical Training Program was dismissed when hospital administrators learned of his infection with HIV. The resident, known as Dr. Doe, claimed that his termination violated federal laws protecting persons with disabilities. The court upheld the hospital's actions as lawful and affirmed the trial court's grant of summary judgment for (...) the hospital.Dr. Doe charged that his dismissal from the training program violated the Rehabilitation Act and the Americans with Disabilities Act. (shrink)

Domestic violence is a growing societal concern that often spills over into the workplace. However, employers are not recognizing the spillover of domestic violence as a workplace issue. This is problematic considering the serious financial, legal, and ethical consequences for organizations. We analyzed six cases involving domestic violence that were litigated under specific legal bases: Violence Against Women Act, discrimination laws including Title VII, Family and Medical Leave Act, Americans with Disabilities Act, Social Security Disability, Occupational Safety (...) and Health Act, and associated state and municipal ordinances. We chose cases that illustrate the problems of companies meeting the legal standards but not necessarily reaching ethical expectations. Our approach is congruent with the perspective that both legal and ethical analyses should be used in organizational decision making. We suggest for future research the analysis of additional litigated cases, other ethical perspectives, and additional sources of data. In addition, we suggest that companies who are striving for corporate social responsibility should integrate the ethical treatment of domestic violence victims. (shrink)

In Saks v. Franklin Covey Co., the Court of Appeals for the Second Circuit held that the American with Disabilities Act, Title VII of Civil Rights Act of 1964, the Pregnancy Discrimination Act, and New York state law do not proscribe an employer's self-insured employee health plan from excluding surgical impregnation procedures from its coverage. Although the court found that infertility qualifies as a disability under the ADA, it restricted required coverage of certain infedty treatments.Title I of the (...) ADA prohibits an employer from discriminating on the basis of disability “in regard to … fringe benefits available by virtue of employment, whether or not administered by the covered entity.” The ADA defines “disability” as “a physical or mental impairment that substantially limits one or more major life activities.” In Bragdon v. Abbott, the U.S. Supreme Court found that reproduction was a major life activity under the ADA. (shrink)

Definitions of health and disease are of more than theoretical interest. Understanding what it means to be healthy has implications for choices in medical treatment, for ethically sound informed consent, and for accurate assessment of policies or programs. This deeper understanding can help us create more effective public policy for health and medicine. It is notable that such contentious legal initiatives as the Americans with Disability Act and the Patients' Bill of Rights fail to define adequately the medical (...) terms on which their effectiveness depends. In Ethics and the Metaphysics of Medicine, Kenneth Richman develops an "embedded instrumentalist" theory of health and applies it to practical problems in health care and medicine, addressing topics that range from the philosophy of science to knee surgery."Embedded instrumentalist" theories hold that health is a match between one's goals and one's ability to reach those goals, and that the relevant goals may vary from individual to individual. This captures the normative implications of the term health while avoiding problematic relativism. Richman's embedded instrumentalism differs from other theories of health in drawing a distinction between the health of individuals as biological organisms and the health of individuals as moral agents. This distinction illuminates many difficulties in patient-provider communication and helps us understand conflicts between promoting health and promoting ethically permissible behavior. After exploring, expanding, and defending this theory in the first part of the book, Richman examines its ethical implications, discussing such concerns as the connection between medical beneficence and respect for autonomy, patient-provider communication, living wills, and clinical education. (shrink)

This essay comments on the articles by Loretta M. Kopelman and Anita Silvers. It extends their analyses and concludes that consistency and the total absence of conflict may be unavailable when one interprets and applies the Americans with Disabilities Act.

As a consequence of the problems caused by genetic discrimination, federal and state law makers are being pressured to pass a legislative remedy. A primary question is whether the Americans with Disabilities Act of 1990 applies to individuals with a potentially disabling genetic disorder who are pre-symptomatic or asymptomatic and may never become ill and to healthy individuals who are carriers of genetic conditions. At present, this question has relevance principally for individuals with the genotype (...) for single gene disorders, like Huntington disease and hemochromatosis, and to asymptomatic carriers of single gene disorders such as cystic fibrosis. Although many such single gene conditions exist, the total incidence of these conditions in the U.S. population is less than 0.4 percent. However, the question concerning the applicability of the ADA will become increasingly important because genetic tests will almost certainly be developed in the near future for common multifactorial diseases like diabetes, heart disease, and certain forms of cancer. (shrink)

One of the goals of The Patient Protection and Affordable Care Act is the reduction and elimination of health inequities, generally defined as population-level health differences that adversely affect disadvantaged groups. The ACA provides powerful new tools to collect, analyze, and share standardized data on these inequities. Prior to the ACA, disability was marginalized in data collection efforts, limiting our ability to understand and address significant health inequities experienced by millions of Americans. Now, for the first time, we can (...) use these tools to collect valuable new data on the nature and extent of health inequities experienced by people with disabilities across the country. Standardized health data collection is critical to health equity. (shrink)

Memory, funerals, and the communion of the saints: growing old and practices of remembering / M. Therese Lysaught -- God bends over backward to accommodate humankind...while the Civil Rights Acts and the Americans with Disabilities Act require [only] minimum effort / Mary Jo Iozzio -- Radical solidarity: migration as challenge ofr contemporary Christian ethics / Kristin E. Heyer -- Catholic lesbian feminist theology / Mary E. Hunt -- Theology of whose body? Sexual conplementarity, intersex conditions, and La (...) Virgen de Guadalupe / Katie M. Grimes -- Social conscience and politics in the United States of America: reflections / Mary Jo Bane -- Pope Francis, women, and the church for the poor / Lisa A. Fullam -- Floodwaters and the ticking clock: the systematic oppression and stigmatization of poor, single mothers in American and Christian theological responses / Julie A. Mavity Maddalena --What causes inequity? / Dean Baker -- Engaging the U.S. Bishops' pastoral on crime and criminal justice: from atomism to community justice / Robert DeFina and Lance Hannon -- Reconstructing the moral claim of racially unjust mass incarceration / Alison Benders -- The systemic erasure of the Black/dark-skinned body in Catholic ethics / Bryan Massingale -- Anti-blackness and white supremacy in the making of American Catholicism / M. Shawn Copeland -- White privilege / Charles E. Curran -- The Black Lives Matter Movement: justice and health equity / Michael P. Jaycox -- Mujerista theology: a challenge to traditional theology / Ada María Isasi-Díaz -- Faith of our mothers; Catholic womanist God-talk / Diana L. Hayes. (shrink)

The United States District Court of Kansas, in Gudenkauf v. Stauffer, Znc., granted the defendants motion for summary judgment for the plaintiff's claims of pregnancy-related discrimination under the Americans with Disabilities Act and the Family and Medical Leave Act of 1993, but the court denied a similar motion for the plaintiff's claim under the Pregnancy Discrimination Act. The court found summary judgment to be appropriate for the ADA claim based on its finding that the plaintiff's pregnancy did (...) not constitute an impairment as required by the statute; as for the FMLA claim, it determined that the defendants failure to grant the plaintiff's leave request did not violate the statute. However, the court determined that summary judgment was inappropriate for the PDA claim because of material questions of fact about whether the defendant had acted with discriminatory intent.In considering the motions for summary judgment, the court accepted the following facts as incontrovertible. Plaintiff Michaela Gudenkauf worked for the defendant Stauffer, Inc. (shrink)

If one can judge a society by how it treats its prisoners, one can surely judge a society by how it treats cognitively- and learning-impaired children. In the United States children with physical and cognitive impairments are subjected to higher rates of corporal punishment than are non-disabled children. Children with disabilities make up just over 13% of the student population in the U.S. yet make up over 18% of those children who receive corporal punishment. Autistic children are (...) among the most likely to receive corporal punishment. -/- Although they may deny or redescribe particular instances of corporal punishment or their use of restraints, educators defend such actions as legitimate punishment. In this paper, I assess the logic underlying the use of restraints and corporal punishment on autistic children by educators. The rationalizations for the corporal punishment or restraint of autistics stems from the educator’s desire to control the autistic children so as to end typical autistic behaviors such as rocking, repetitive verbalizations, or “flapping” but also the autistic child’s non-affective responses such as not appearing to feel remorse or shame or the absence of a verbal acknowledgement of remorse or shame. The educators assume that the autistic’s failure to exhibit the desired responses is evidence of the autistic’s moral incorrigibility and is, therefore, evidence of the appropriateness of corporal punishment. But this assumption of the incorrigibility of the autistic child is questionable. -/- Indeed accepting this incorrigibility assumption reveals two important problems. First, instructors using physical punishment on autistic children do not understand autism. Second, they are not working with a tenable conception of punishment. Any action undertaken to induce socially acceptable behaviors (whether it be the end of autistic acts or responses such as remorse) is to fail to understand what the legitimate punishment of children is about. (shrink)