The formal justice model proposed by Anita Silvers in Disability, Discrimination, and Difference emphasizes the social model of disability and the need for full equality of opportunity, and it suggests that a distributive model of justice that gives special benefits to individuals with disabilities is self-defeating. Yet in that work, Silvers allows an exception for the "profoundly impaired." In this paper, I show how the formal justice theory falls short when it comes to defining and (...) dealing with "profoundly impaired" individuals and explore the ways in which making the exception raises serious theoretical concerns for the grounding of the formal justice model. (shrink)

In this paper, I defend a version of the medical model of disability, which defines disability as an enduring biological dysfunction that causes its bearer a significant degree of impairment. We should accept the medical model, I argue, because it succeeds in capturing our judgments about what conditions do and do not qualify as disabilities, because it offers a compelling explanation for what makes a condition count as a disability, and because it justifies (...) why the federal government should spend hundreds of billions of dollars, annually, on aid and accommodations for disabled people. After responding to a pair of objections Elizabeth Barnes has raised against the medical model, I contrast it with Guy Kahane and Julian Savulescu's welfarist account of disability, and with Barnes's own mere-difference view. Both of these accounts face serious challenges, although elements of Barnes's view can—and, in my opinion, should—be adopted by proponents of the medical model. (shrink)

Disability studies can be of great value to medical education first, by placing the medical paradigm in the broad context of a sequence of ways of understanding and responding to disability that have emerged in the last two thousand years or so; second, by reminding medical professionals that people with disabilities have suffered as well as profited from medical treatment in the last two hundred years; finally, by providing access to a distinctive point of (...) view from which the experience of disability looks very different than it may from the outside. (shrink)

Scholarship in neuroethics and related disciplines has long reflected on the value of different conceptual models of disability and impairment. While this theoretical work is valuable, centering the voices of people with mental health conditions in neuroethics research can help us better understand how such models apply in everyday people’s lives. Drawing on qualitative data from a study on mental health peer providers’ lived experiences of recovery, this paper will demonstrate that peers borrow from both a neurodiversity framework and (...) the medical model of disability, though their feelings toward the two models were often complex and ambivalent. These findings advance neuroethics by indicating that future research and clinical practice should take a nuanced approach to responding to the needs of people with mental health conditions and turn to peers as experts, honoring their values and recognizing both the promise and pitfalls of living with a mental health condition. (shrink)

Many models of cognitive ability and disability rely on the idea of cognition as abstract reasoning processes implemented in the brain. Research in cognitive science, however, emphasizes the way that our cognitive skills are embodied in our more basic capacities for sensing and moving, and the way that tools in the external environment can extend the cognitive abilities of our brains. This chapter addresses the implications of research in embodied cognition and extended cognition for how we think about cognitive (...) impairment and rehabilitation, how cognitive reserve mitigates neural impairment, and the distinction between medical and social models of disability. (shrink)

ABSTRACT: In his A Conceptual Investigation of Justice, Kyle Johannsen suggests a theory of disability that holds that to have a disability just is to be worse off, sometimes referred to as the ‘medical’ or ‘individual’ model of disability. I argue that Johannsen’s understanding of disability might force some of his key claims into an uncomfortable position. In particular, for his theory to avoid the thrust of Elizabeth Anderson’s criticisms of luck egalitarianism, the assumption (...) of the medical model of disability must be dropped, but this comes at the cost of his criticism of John Rawls’ difference principle. -/- RÉSUMÉ : Dans son livre, A Conceptual Investigation of Justice, Kyle Johannsen semble invoquer une théorie du handicap selon laquelle le fait d’avoir un handicap, c’est être pire qu’une autre personne, un modèle parfois appelé le modèle de handicap «médical» ou «individuel». Je soutiens que la compréhension de Johannsen en matière d’invalidité peut mettre sa theorie dans une position difficile. En particulier, pour que sa théorie évite les critiques d’Elizabeth Anderson sur l’égalitarisme de la chance, l’hypothèse du modèle médical du handicap doit être abandonnée. Cependant, cela se fait au détriment de la critique du principe de différence de John Rawls formulée par Johannsen. (shrink)

This Essay explains why model policies proposed or adopted in response to the COVID-19 pandemic that allocate scarce medical resources by using medical evidence to pursue two core goals—saving more lives and saving more years of life—are compatible and consonant with disability law. Disability law, properly understood, permits considering medical evidence about patients’ probability of surviving treatment and the quantity of scarce treatments they will likely use. It also permits prioritizing health workers, and considering (...) patients’ post-treatment life expectancy. These factors, when based on medical evidence and not inaccurate stereotypes, are legal to consider even if they disadvantage some patients with specific disabilities. It then discusses the ethical advantages of triage policies that use medical evidence to save more lives and years of life, which I call “evidence-based triage,” focusing on the benefits of these policies for patients with disabilities. In doing so, I explain why recent critiques err by treating people with disabilities as a monolith, overlooking the political disadvantages of less-visible victims, and treating the social origins of scarcity as a justification for saving fewer lives. Evidence-based triage parallels other policy responses to the COVID-19 pandemic, like physical distancing and postponement of medical procedures, which may burden patients with specific disabilities or medical conditions but are nevertheless justified because they save more patients. (shrink)

This article challenges the view of disability presented by Harris in his article, “Is gene therapy a form of eugenics?”1 It is argued that his definition of disability rests on an individual model of disability, where disability is regarded as a product of biological determinism or “personal tragedy” in the individual. Within disability theory this view is often called “the medical model” and it has been criticised for not being able to deal (...) with the term “disability”, but only with impairment. The individual model of disability presupposes a necessary causal link between a certain condition in the individual and disablement. The shortcomings of such a view of disability are stated and it is argued that in order to have an adequate ethical discourse on gene therapy perspectives from disability research need to be taken into consideration. (shrink)

Knopes (2025) argues that the neuroethical discourse on medical models of disability has largely overlooked the lived experiences of those who have or suffer from mental health conditions. She indi...

In this paper, we offer a new account of disability. According to our account, some state of a person's biology or psychology is a disability if that state makes it more likely that a person's life will get worse, in terms of his or her own wellbeing, in a given set of social and environmental circumstances. Unlike the medical model of disability, our welfarist approach does not tie disability to deviation from normal species’ functioning, (...) nor does it understand disability in essentialist terms. Like the social model of disability, the welfarist approach sees disability as a harmful state that results from the interaction between a person's biology and psychology and his or her surrounding environment. However, unlike the social model, it denies that the harm associated with disability is entirely due to social prejudice or injustice. In this paper, we outline and clarify the welfarist approach, answer common objections and illustrate its usefulness in addressing a range of difficult ethical questions involving disability. (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)

Drawing from contemporary blog data, this article examines an emerging project termed “neuroqueer.” Neuroqueer is a collaboration of activists, academics, and bloggers engaging in online community building. Neuroqueer requires those who engage in it to disidentify from both oppressive dominant and counterculture identities that perpetuate destructive medical model discourses of cure. It is a queer/crip response to discussions about gender, sexuality, and disability as pathology that works to deconstruct normative identity categories. Blog members employ neuroqueer practices to (...) subversively combat exclusion through rejection of able-hetero assimilation and counteridentification in favor of disidentification. Of particular interest for this special issue are the ways in which neuroqueer perspectives build more fluid conceptualizations of both gender and intersectionality through conscious disidentification from neurotypical norms and medical notions of cure on which they are often unconsciously based. (shrink)

Recently, scholars have argued that disability activists' redefinition of disability' as a social problem, rather than a medical problem, is maleficent, unjust, and inconsistent. It seems that the discussion on whether disability is a medical or a social category is not settled and that disability is an essentially contested concept. However, the question is: What is the social aspect in disability? It appears that there is some confusion as to what the social is (...) in a social definition of disability. The article pursues possible reasons for this confusion by investigating the critique of the social model. This is followed by a discussion on what a possible space for the social might be in a social definition of disability. Such a space is illuminated by using the framework of the World Health Organization's International Classification of Functioning Disability and Health. The article suggests that disability as a social category is not inconsistent if reframed within a social relational model of disability. (shrink)

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

In its institutionalized form, disability studies has historically drawn from political activism in the United States and the United Kingdom, particularly struggles that sought rights and recognition through the development of a social understanding of disability in opposition to the mainstream medical model.1 Recent work that expands the geographic scope of disability studies beyond these contexts has spurred debate about the challenges such a move poses to the foundations of the field. This essay responds to (...) the field’s transnational turn by interrogating recent work by Nirmala Erevelles, Jasbir Puar, and Robert McRuer that displaces the white, wealthy, and Western contexts that have grounded the landmark achievements of disability studies. At issue here are the category struggles that emerge when a concept confronts the conditions and limits of its own migration. (shrink)

This paper challenges the view that there is one medical model of disability monolithically and oppressively imposed on disabled people. Because the presence of disability may be ambiguous in any given case, multiple actors, lay and professional, may invoke particular medical models of disability and advance competing claims about an individual’s disabilities and related needs. The literature for parents of disabled children is seen as a resource on which parents can draw in making claims (...) about their children’s disabilities and disability-related needs. Particular attention is given to the assumptions that this literature makes about the identity, resources and dispositions of the audience. Ultimately, these assumptions favor disability claims made by white, highly educated, upper-income parents. (shrink)

Here, Ann Cvetkovich, interviewed by Abby Wilkerson, brings Cvetkovich’s influential cultural studies analysis of depression explicitly into conversation with disability studies. Cvetkovich understands “feeling bad” as a defining affective state under neoliberalism. Drawing on a distinctive historical/cultural archive, she challenges the atomism of the neoliberal medical model that frames depression and affective distress more generally as the result of faulty brain chemistry—individual organisms gone awry. Instead, she traces these common experiences to sociopolitical phenomena ranging from current neoliberal (...) demands for productivity as exemplified in university life, to histories of colonization, slavery, and displacement. The conversation considers the value of disability frameworks for understanding mental health diagnoses and the intersections of social institutions, bodily practices, and everyday affective life. (shrink)

The question “what is disability” and its implications are addressed in a new book Arguing about disability: philosophical perspectives, which aims to fill the gap between disability studies and philosophy. The structure of the book has been organised roughly on the basis of three branches of philosophy: metaphysics, political philosophy and ethics. One of the main themes of the book is the characterisation of a third way of thinking about disability, a way between two extremes, the (...) medical and social models of disability. (shrink)

Several studies have shown that nondisabled people—especially healthcare professionals—tend to judge the quality of life of disabled people to be much lower than disabled people themselves report. In part, this is due to dominant narratives about disability. Teachers of biomedical ethics courses have the opportunity to help students to think critically about disability. This may involve interrogating our own assumptions, given the pervasiveness of ableism. This article is intended to facilitate reflection on narratives about disability. After discussing (...) two readings that illustrate the medical and social models of disability, I share my own approach to teaching on disability in my biomedical ethics course. I include student responses to the readings and ways that they report their thinking about disability changed through engagement with the medical and social models. (shrink)

Previous discussions of addiction have often focused on the question of whether addiction is a disease. This discussion distinguishes that question – the disease question – from the question of whether addiction is a disability. I argue that, however one answers the disease question, and indeed on almost any credible account of addiction, addiction is a disability. I then consider the implications of this view, or why it matters that addiction is a disability. The disease model (...) of addiction has led many to see addiction as primarily a medical problem, and to make medical treatment of the addicted person the first priority in addressing addiction. Once addiction is viewed as a disability, different concerns are foregrounded. The problem of addiction resides not only in the addicted person, but also in the social environment in which the addicted person finds herself. The fundamental ethical question about addiction is not how addicted persons can be treated or otherwise changed, but how a just society can make reasonable accommodations for addicted persons. (shrink)

This paper discusses three cultural narratives that threaten the health of people with intellectual/developmental disabilities (IDD) and which have become more evident during the COVID-19 pandemic. These meta-narratives are the medical model of health/disability; the population health approach to health inequalities; and policies premised on the assumption of the importance of national economic growth as an incentive for reducing health inequalities. Evidence exists that health research is more likely to become policy if it fits within a (...) class='Hi'>medical model and addresses national economic growth. These two criteria are particularly problematic for people who have IDD. The paper also proposes a research model to facilitate the inclusion of IDD related issues in future policy regarding health inequalities. (shrink)

This article develops an analysis of disability according to which disabling conditions are properties of organisms embedded in sets of environments. We begin by presenting the three mainstream accounts of disability—the medical, social, and interactionist models—and rehearsing some known limitations. We argue that, because of their primary focus on etiology, all three models share, more or less implicitly, a problematic assumption. This is the tenet that disabilities are individual properties. The second part of the essay presents an (...) “ecological” interpretation of disability, inspired by classic and contemporary research on biological niches. Our proposal preserves many insights underlying extant approaches, while allowing a more accurate characterization of the nature and experience of disability. We conclude by drawing some general implications of our analysis. (shrink)

Is Tom Shakespeare disabled, or simply distinct in stature? And if the latter, what makes that distinction important?For more than a decade, the British sociologist has been a critical voice in the sociology of difference. The son of a physician with achondroplasia “widely admired as a doctor and as a disabled role model” ,1 Shakespeare fils also has achondroplasia, is the father of children with the condition and, like his father, is professionally successful. As his book’s back cover announces, (...) Shakespeare has “taught and researched sociology at the Universities of Cambridge, Sunderland, Leeds, and Newcastle. He has written and broadcast extensively about disability and genetics, and his co-authored books include The Sexual Politics of Disability, Exploring Disability, and Genetic Politics.”This volume brings together a decade of papers that, Shakespeare says, “draws on my experience of being a disabled person, and the son, father, husband and friend of disabled people”1 to argue the following thesis: “Disability results from the interplay of individual and contextual factors. In other words, people are disabled by society and by their bodies.”1 That argument, he suggests, has resulted in the “breakdown of my relationship with the mainstream of the UK disabled people’s movement”, whose members advance a model of disability based wholly on social construction. Shakespeare sees that as simplistic and no longer viable despite of the extraordinary gains made by those seeking parity through advancement of the social construction thesis.1According to Shakespeare, his former confrères in the British disability movement see as a betrayal his rejection of their argument, one he formerly endorsed, and thus perhaps a repudiation of a generation of admittedly successful activism. To them, in other words, Shakespeare is no longer disabled but disabling, and that judgment must …. (shrink)

This essay examines constructions of deafness in medieval culture, exploring how deaf experience disrupts authoritative discourses in three textual genres: medical treatise, literary fiction, and autobiographical writing. Medical manuals often present deafness as a physical defect, yet they also suggest how social conditions for deaf people can be transformed in lieu of treatment protocols. Fictional narratives tend to associate deafness with sin or social stigma, but they can also imagine deaf experience with a remarkable degree of sympathy and (...) nuance. Autobiographical writing by deaf authors most vividly challenges diagnostic models of disability, exploring generative forms of perception that deafness can foster. In tracing the disruptive force that deaf experience exerts on perceived notions of textual authority, this essay reveals how medieval culture critiqued the diagnostic power of medical practitioners. Deafness does not simply function as a symptom of an individual problem or a metaphor for a spiritual or social condition; rather, deafness is a transformative capacity affording new modes of knowing self and other. (shrink)

Work injury compensation and pensions are often determined according to medical disability rating scales attributing a percentage to each impaired body part or function. Incorporated into central medical–administrative networks of committees and examinations, these produce disability as a calculable space. This article examines the specific case of the Israeli National Insurance regulations regarding work injuries of 1956 and analyzes the shifted order they set. Looking at this system in the specific historical context of transition from the (...) British Mandate workmen’s compensation system to the “disability percentages” system, provides insight into the process of structuring and stabilizing durable numerical forms and the production of centralized government. Drawing on conceptualizations regarding the sociotechnical role of classification systems, I contend that through encoding and calculating classifications of disability, heterogeneity is eliminated and an ordering based on physiology is “black boxed,” illustrating the importance of technoscientific formations in structuring the “medical model of disability.”. (shrink)

What is a disability? What sorts of limitations do persons with disabilities or impairments experience? What is there about having a disability or impairment that makes it disadvantageous for the individuals with it? Are persons with severe cognitive impairments capable of making autonomous decisions? What role should disability play in the construction of theories of justice? Is it ever ethical for parents to seek to create a child with an impairment? This anthology addresses these and other questions (...) and is a valuable addition to a growing interdisciplinary literature exploring issues at the intersection of disability studies, philosophy, and bioethics. Most of the authors are well-known from their previous work in the disability field and have already made significant philosophical contributions to it. (shrink)

The biomedicalist conceptualization of disablement as a personal medical tragedy has been criticized by disability studies scholars for discounting the difference between disability and impairment and the ways disability is produced by socio-environmental factors. This paper discusses prospects for partnerships between disability studies teaching/research and medical education; addresses some of the themes around the necessity of critical disability studies training for medical students; and examines a selection of issues and themes that have (...) arisen from disability education courses within medical schools globally. The paper concludes that providing there is a commitment from senior management, universities are well positioned to apply both vertical and horizontal approaches to teaching disability studies to medical students. (shrink)

Some authors in disability studies have identified limits of both the medical and social models of disability. They have developed an alternative model, which I call the ‘composite model of disability’, to theorise societies’ ableist norms and structures along with the subjective/phenomenological experience of disability. This model maintains that ableist oppression is not the only source of suffering for disabled people: impairment can be as well. From a feminist, queer, trans activist, anti-ableist (...) perspective and using an intersectional, autoethnographic methodology, I apply this composite model of disability to trans identities to consider the potentially ‘debilitating’ aspects of transness. I argue that transness, like disability, has too often been perceived from two perspectives, medical or social, without the benefit of a third option. From a medical perspective, transness is reduced to an individual pathology curable with hormonal/surgical treatments, a conceptualisation that erases structural oppression. From a social point of view, transness is conceptualised as a neutral condition and variation in sex/gender identity. In this model, structural oppression (transphobia/cisgenderism) is seen as the only cause of ‘trans suffering’. I argue that, just as the medical and social models of disability provide limited opportunities for reflection on the complex experience of disability, medical and social understandings of transness, respectively, are insufficient to describe the complexity of trans experience. I explore the possibilities presented by the application of a composite model of disability in trans studies. By both problematising cisgenderist oppression and acknowledging trans people's subjective experiences of suffering through some of the debilitating aspects of transness, this composite model avoids the pitfalls of the medical and social models. The application of tools from disability studies to trans issues uncovers cisnormativity in disability movements and denounces ableism in trans movements. This will, I hope, solidify alliances between these communities and fields of study. (shrink)

The drawbacks of using the concepts of models in discussing the problems of disabled people are discussed. It is suggested that the terms “impairment”, “disability”, and “handicap” can unify the different models and enhance the position of people with disabilities in society.

Some doctors and nurses played a key role in Nazism. They were responsible for the sterilization and murder of people with disabilities. Nazi doctors used concentration camp inmates as guinea pigs in medical experiments that had military or racial objectives. What we have learnt about the behaviour of doctors and nurses during the Nazi period enables us to reflect on several issues in present-day medicine. In some authors' opinions, the teaching of the medical aspects of the Holocaust could (...) be a new model for education relating to professionalism, Human Rights, Bioethics and the respect of diversity. Teaching Medicine and the Holocaust could be a way of informing doctors and nurses of violations of Ethics in the past. Moreover, a Study Trip to Holocaust and Medicine related sites has a strong pedagogical value. Visiting Holocaust related sites, T4 centres and the places where medical experiments were carried out, has a special meaning for medical students. Additionally, tolerance, anti-discrimination, and the value of human life can be both taught and learned through this curriculum. The following article recounts our experiences of organizing and supervising a study trip with a group of medical students to some Holocaust and medicine-related sites in Berlin and Hadamar. The study tour included lectures at universities in Düsseldorf and Berlin. (shrink)

Because many involuntarily childless people have equal interests in benefitting from assisted reproductive technologies like in vitro fertilization as a mode of treatment, we have normative reasons to ensure inclusive access to such interventions for as many of these people as is reasonable and possible. However, the prevailing eligibility criterion for access to assisted reproductive technologies—'infertility'—is inadequate to serve the goal of inclusive access. This is because the prevailing frameworks of infertility, which include medical and social infertility, fail to (...) precisely capture and unify the relevance of certain involuntarily childless experiences as warranting assisted reproductive technology (ART) treatment. I argue that the least we can do for those who have an interest in accessing ARTs is to conceptualize involuntarily childless experiences in dialogue with interactionist and ecological models of disability, to outline a unified and more inclusive eligibility criterion. (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)

A crucial question in relation to support designed to enable the legal capacity of people with mental disabilities concerns when support constitutes undue influence. This article addresses this question in order to facilitate the development of law and policy in England and Wales, by providing a normative analysis of the different approaches to undue influence across decisions about property, contracts, health, finances, and accommodation. These are all potential contexts for supporting legal capacity, and, in doing so, the article compares approaches (...) to undue influence that are rarely considered together. -/- Drawing on the UN Convention on the Rights of Persons with Disabilities, third sector and public body documents, and law in England and Wales, the analysis identifies six models that conceptualise undue influence in terms of: modes of influence; an overborne will; an inference from the situation; an overborne will understood as a mental incapacity; an overborne will in connection with vulnerability; and impaired discursive control. This final approach is a novel proposal for understanding undue influence. The analysis highlights key policy-relevant issues that distinguish the models, and generates a deliberative framework for navigating them, with the ‘overborne will’, ‘inference-based’, and ‘discursive control’ models identified as potentially fitting for the support context. (shrink)

This paper critically engages with Tom Shakespeare’s book Disability rights and wrongs. It concentrates on his attempt to demolish the social model of disability, as well as his sketch of an “alternative” approach to understanding “disability”. Shakespeare’s critique, it is argued, does British disability studies a “wrong” by presenting it as a meagre discipline that has not been able to engage with disability and impairment effects in an analytically sophisticated fashion. What was required was (...) a measured presentation and evaluation of the rich mix of theoretical and empirically based ideas to be found in the discipline, as the groundwork for forward thinking located within a social oppression paradigm. Shakespeare’s undermining of the discipline’s credibility in the eyes of outsiders and newcomers represents a diversionary missed opportunity by an influential writer and activist.Shakespeare’s book1 has certainly stirred up debate, and invited a flurry of angry reviews, in disability studies in the UK—the social science discipline that has been developing radical ideas about disability and disablism since the 1980s. Peopled by both disabled academics and like-minded non-disabled researchers and writers, the DS community recognises that Shakespeare’s book seeks to deliver a fatal wound to what he sees as its sacred cow: the British social model of disability.Shakespeare explains that what he calls the “strong” version of the social model of disability was formulated by Michael Oliver, a leading DS writer and disability activist, on the basis of the social and political ideas advanced in the 1970s by a group of disabled individuals fighting to free themselves from what they experienced as an oppressive care system that relegated and segregated people with serious impairments to residential institutions and to the category of the unemployable.2 3 In short, the social model asserts that “disability” is not caused …. (shrink)

Despite the availability of safe vaccines against SARS-CoV-2, some people will remain vulnerable because they will not be vaccinated. Who are these non-vaccinated people? We can distinguish two groups: (i) persons who cannot be vaccinated for clinical reasons and who, despite having been vaccinated, have not achieved immunity; (ii) persons who voluntarily refuse to get vaccinated. These groups have in common an immune system that will make them vulnerable to COVID-19. The reasons for their vulnerability and the ethical judgment they (...) deserve are different; the solutions offered to them are also different. In the case of those who voluntarily avoid vaccination, States are not compromised to introduce new protective policies. In the case of people who remain involuntarily vulnerable, instead, the response should be articulated on the same rules and principles that inform the social model of disability because they will live with an organic disability. (shrink)

This chapter contains sections titled: Introduction Investing in Science: Child Health and U.S. Medicine in the Twentieth Century The Impact of Specific Medical Interventions The Changing Definition of ID The “Flynn Effect” and the Impact of Improved Public Health Conclusion References.

This book offers new direction in disability studies, by integrating the medical and social model of disability. The first aim is to provide an integral approach to thinking about impairment and disability through the integrative lens of being vulnerable. The second aim is to transcend the normative trap which impairment and disability debate finds itself locked in. Disability debate is trapped in a normative struggle to escape oppressive norms. Either, by legitimizing the desire (...) to be free from impairment, where a legitimization identity is promoted through the medical model. Or, by resisting discriminative social norms, where the desire is to be free from oppressive social barriers that exist on top of having impairment. Identifying with one’s vulnerability, or embodied uncertainty, allows for the possibility of forging meaning and building new identity. It allows freedom to express embodied difference, rather than to transform or defend it. (shrink)

Based on in-depth interviews and fieldwork, this article examines mothers raising kids with invisible, social/emotional/behavioral disabilities to refine feminist theories of mother-blame. The mother-valor/mother-blame binary holds mothers responsible for families and future citizens, maintaining this “natural” care at the center of normative femininity. The author explores how mothers raising such burdensome children understand their experiences and makes three arguments: Fewer mothers are blamed for causing their child's troubles in an era of “brain-blame,” but more are blamed as proximate causes if (...) they do not make unrelenting efforts, paralleling “concerted cultivation,” to resolve them; such mothers often exceed concerted cultivation, as they seize authority, as vigilantes, within educational and medical systems in the midst of turf wars, cost containment, and a resulting proliferation of medication treatments; and this maternal speedup holds mothers accountable for feminizing ties to sons, for policing gender boundaries while policing their own feminine care. In sum, mothers raising invisibly disabled kids may represent the model of maternal valor for an era of public stinginess and extensive medicalization. (shrink)

In disability studies, social and medical explanatory models are seen as being conflicting or mutually exclusive, and as mystifying respectively bodily impairment and the agency of social and environmental factors. This article uses critical discourse analysis to discuss the relationship between such models in policy documents produced by The Norwegian Federation of Organizations of Disabled People. Analysis of key topoi in the policy documents shows that they display elements of both social and medical discourse, and that the (...) consequences of medically defined impairments are used as justifications for policy interventions in a framework of social justice. While a strict version of the social model is adopted in general programmatic documents, arguments about specific policy fields conceptualize disability as a property of individuals — traditionally, a medical model framing. Analysis of topoi is shown to be a useful tool when CDA is applied to policy texts. (shrink)

A key question in disability studies, philosophy, and bioethics concerns the relationship between disability and well-being. The mere difference view, endorsed by Elizabeth Barnes, claims that physical and sensory disabilities by themselves do not make a person worse off overall—any negative impacts on welfare are due to social injustice. This article argues that Barnes’s Value Neutral Model does not extend to intellectual disability. Intellectual disability is (1) intrinsically bad—by itself it makes a person worse off, (...) apart from a non-accommodating environment; (2) universally bad—it lowers quality of life for every intellectually disabled person; and (3) globally bad—it reduces a person’s overall well-being. While people with intellectual disabilities are functionally disadvantaged, this does not imply that they are morally inferior—lower quality of life does not mean lesser moral status. No clinical implications concerning disability-based selective abortion, denial of life-saving treatment, or rationing of scarce resources follow from the claim that intellectual disability is bad difference. (shrink)

Tom Shakespeare’s important new book includes, among other topics, a persuasive critique of the social model of disability. A key component in his case against that model consists in an argument against the impairment/disability distinction as this is understood within the social model. The present paper focuses on the case Shakespeare makes against that distinction. Three arguments mounted by Shakespeare are summarised and responded to. It is argued that the responses adequately rebut Shakespeare’s case on (...) this specific issue. Moreover, as the engagement with Shakespeare’s argument illustrates, his claim to employ a critical realist perspective appears to be in considerable tension with the case he offers against the impairment/disability distinction. (shrink)

What is it for something to be a disability? Elizabeth Barnes, focusing on physical disabilities, argues that disability is a social category. It depends on the rules undergirding the judgements of the disability rights movement. Barnes’ account may strike many as implausible. I articulate the unease, in the form of three worries about Barnes’ account. It does not fully explain why the disability rights movement is constituted in such a way that it only picks out paradigmatic (...) disability traits, nor why only the traits identified by the movement as constituting experiences of social and political constraint count as disability. It also leaves out the contribution of people other than disability activists, to the definition of disability. I develop Barnes’ account. On my account, a person is disabled if she is in some state which is constitutive of some constraint on her legitimate interests. This state must be the subject of legitimate medical interest and be picked out by the disability rights movement as among the traits for which they are seeking to promote progress and change. My account addresses the worries about Barnes’ account. It is also able to include all disabilities, rather than only physical ones. (shrink)

Shavelson and colleagues (2023) describe how medical aid-in-dying laws in the United States prohibit assistance in administering aid-in-dying medication. This prohibition distinguishes aid in dying...

This chapter contains sections titled: Introduction Investing in Science: Child Health and U.S. Medicine in the Twentieth Century The Impact of Specific Medical Interventions The Changing Definition of ID The “Flynn Effect” and the Impact of Improved Public Health Conclusion References.

The current public health crisis has exposed deep cracks in social equality and justice for marginalised and vulnerable communities around the world. The reported rise in the number of ‘do not resuscitate’ orders being imposed on people with disabilities has caused particular concerns from a human rights perspective. While the evidence of this is contested, this article will consider the human rights implications at stake and the dangers associated with using ‘quality of life’ measures as determinant of care in (...) class='Hi'>medical decision-making and triage assessments. (shrink)

One criticism of medical aid in dying (MAID) is the expressivist objection: MAID is morally wrong because it expresses judgments about disabilities or persons with disabilities, that are offensive, disrespectful, or discriminatory. The expressivist objection can be made at the level of individual patients, medical providers, or the state. The expressivist objection originated with selective abortion, and responses to it in that context typically claim either that selective abortion does not express specific judgments about disabilities, or that any (...) judgments expressed are not offensive. This response is inadequate: MAID often does express negative judgments about disabilities, which could reasonably be seen as offensive. But, does this offensiveness make MAID wrong? Drawing on Joel Feinberg’s account of offense, I argue that it is unlikely that the offensiveness of the judgments expressed by individuals who seek MAID or through the state’s legalization of MAID is enough to make it morally impermissible. (shrink)