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Radical Cognitive Limitation
Abstract
This chapter deals with the issues of moral status, inviolability, and distributive justice concerning the radically cognitively impaired. It notes these people should not be called disabled because they - the radically cognitively limited human beings - differ only slightly from most other humans. This is with respect to their psychological capacities and potential to realize the higher goods of wellbeing. In fact, any of their claims to equality of welfare is questionable. The inability of a radically cognitively limited human being to achieve higher levels of wellbeing is a feature of his or her individual nature, unlike the case of physically impaired persons whose conditions are more factual. Instead, the radically cognitively impaired should form the standard by which to assess how well their lives are going because they are relatively highly well off on the scale that has been assigned to measure them. In their case the equality principle should be applied. According to this principle, the cognitively limited human does well in his or her fortune from moment to moment, thus the priority of equalizing wellbeing should be afforded tothe worst off.
... Now take a different analogy. Suppose a therapy is invented that makes it possible to cognitively enhance the psychological capacities of people with mental limitations so that they acquire species typical abilities (McMahan, 2009). If David's IQ increased from 50 (moderate disability) to 100 (average intelligence), would he go out of existence? ...
This is Part 2 of a two-part article. The elimination view affirms that the disabled will be healed in heaven. While its theological credentials are strong, the elimination view faces philosophical difficulties—epistemic problems (it is said to misjudge the badness of life with disability), moral problems (it is said to express discriminatory attitudes to people with disabilities), and metaphysical problems (it is said to disrupt the personal identity of people with disabilities). In this article, the author defends the elimination view from these charges.
... Suffice to say that proponents of the CRPD (and the normative intent of the CRPD) seek to challenge claims that those with significant impairments lack the status of personhood. But for more of this debate, see [8][9][10][11][12]. ...
Human rights have recently impacted on current conceptualisations of the rights and obligations owed to individuals with impairments, culminating in the UN Convention for the Rights of Persons with Disabilities. Particularly significant is Article 12, where interpretations have heralded a “will and preferences” paradigm which rejects substituted decision-making mechanisms, even in situations where an individual should make personally harmful or unwise decisions about their treatment, care, or relationships. This paper explores problems with “strict” and “flexible” interpretations of Article 12, focusing specifically on safeguarding issues in cases of relational abuse, exploitation, and coercion. Drawing analogies with feminist arguments opposing violence against women in the domestic sphere, I challenge the private/public and individualistic account of autonomy which is implicit in interpretations of the “will and preferences” paradigm, and suggest that proponents of Article 12 should consider the possible justifiability of expanded protectionist measures in cases of abuse involving individuals with impairments.
This chapter is devoted to reflecting on the role of empathy in interactions with people with profound intellectual disabilities. We have a duty to respect people with intellectual disabilities. Respect involves identification with a point of view. We owe them an effort at identification with their perspective. However, if intellectually disabled people’s communicative abilities are impaired, our apprehension of their point of view might be limited, reducing our ability to identify with them and respect them. To answer this challenge, I appeal to empathy. Through imaginative empathy, we can learn to identify with their perspectives. I argue that empathy is a good moral guide and can be helpful in developing respectful attitudes toward people with profound intellectual disabilities.
This paper argues that there are reasons to believe that there is no single concept or category which demarcates all individuals who have a disability from those individuals who do not. The paper begins by describing that I call ‘a Unified Concept View of Disability’ and the role that such a view plays in debates about the nature of disability. After considering reasons to think that our concept of disability is not unified in the way that the Unified Concept View assumes, I outline what a non-unified approach to disability might look like. The paper concludes by considering implications of rejecting the Unified Concept View of disability.
Disability is a consistent topic of concern within philosophical ethics (including medical and applied ethics, and bioethics). In many cases, however, it is viewed as a misfortune, and an impediment to well-being. This is because matters of the good human life turn on some criterion—rational autonomy, say, or personhood—that distinguishes good from bad lives. These are based in the possession of certain properties or capacities that are purported to be essential to humans.[@HughesSocialModel1997; @PatersonDisabilityStudies1999] Disability here figures not only as an impediment to the capacity to realise the goods that attend a fully human life, but as a lack of some capacity that is fundamentally human. There is no shortage of arguments by influential thinkers concerning the moral permissibility of eliminating disabled people, based on the idea that the latter are not fully human in some meaningful respect.[@ShildrickVisceralPhenomenology2015; @ShildrickWhyShould2014]
I aim to develop some aspects of a critical orientation that does not rely upon definitively human capacities, and that, as such, does not exclude atypical bodies and minds from the outset. To explore such ideas, I consider feminist theories that understand vulnerability to be a ubiquitous or even universal aspect of life, and as such, a more appropriate basis for ethics. I suggest that instead of understanding vulnerability in either universalistic or particularistic terms, these two aspects can fruitfully be integrated. Vulnerability is an ineluctable dimension of embodied existence; however, it is always and everywhere realised and experienced in concrete conditions. Significantly, vulnerability is uniquely distributed: the vulnerability of some lives is safeguarded while that of others is exposed. I suggest that this provides a fruitful way to understand disability, without appealing to essentialist notions of the human: the potential vulnerabilities of some bodies are neglected in social and material situations, such that disability is actualised as a result. I finally suggest an approach for identifying and responding to vulnerability that is not grounded on any specific criterion of the human, and that involves a collective commitment to continually compose better relations.
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.
This chapter applies African theories of human dignity to select themes in applied ethics. Specifically, it applies the four theories of human dignity to the cases of euthanasia, animal ethics and to people living with disabilities (severely mentally disabled individuals). In terms of euthanasia, it considers whether these four theories would permit voluntary euthanasia. On animal ethics, it considers whether these theories are anthropocentric or non-anthropocentric. In relation to disability ethics, it investigates whether the severely mentally disabled have a place in the moral community.KeywordsAnthropocentrismAnimal ethicsApplied ethicsEuthanasiaSeverely mentally disabled individuals
See more recent paper for an updated iteration of these ideas.
This chapter aims to provide reasons for a comprehensive vision of human rights, that includes people with severe cognitive and multiple disabilities, not only rhetorically and affirmatively, but substantially. Relying on the empirical work of the developmental psychologist and primatologist Michael Tomasello, I argue that new insights into human capabilities offer solutions for the problems human rights approaches frequently are confronted with, such as the one addressed by the utilitarian philosopher Peter Singer. The suggested “we” capability as the truly distinctive human capability includes not only rational and autonomous individuals, but all human beings. In offering reasons for an all-embracing understanding of human rights, it also suggests that we should think of human rights as socially embedded rights that addresses both carers and cared-for as subjects of rights.
Some bioethical approaches consider rationality as central to the notion of person. Jeff McMahan subordinates the personal condition to cognitive abilities; consequently, an individual having an intellectual disability is not considered a person. The notion of person is key to general bioethics and to upholding treaties and conventions. The model considered influences clinical bioethics because biomedical practice deduces rules from theoretical reflections. The article examines the cognitive abilities criterion to determine the personal status in intellectual disability using criticism to the ideal theory, based on which we identified problems in the idealization of abilities. Subsequently, we describe intellectual disability and how it is confirmed by Jeff McMahan's conceptualizations and analyze four main limitations of the cognitive abilities criterion to establish personal condition. Finally, it is argued that corporeality complements the models that describe the human person in bioethics. The cognitive abilities criterion should not be considered normative since corporeality determines the loss of our abilities and exposes us to disability itself.
People with disabilities suffer from pervasive inequalities in employment, education, transportation, housing, and health care compared to those who are not disabled. Moreover, people with disabilities are often subject to unjustified stigma and pity. In this paper, I will explain why these disadvantages violate relational egalitarian principles of justice. As I will show, my argument can account for both kinds of inequality that disabled people face.
Resumen Estudio de naturaleza teórica donde se evidencia la discapacidad como dispositivo heurístico para indagar la condición humana. La relación entre discapacidad y condición humana ha sido poco explorada. En la primera sección se analiza cómo vulnerabilidad y dependencia pertenecen a la condición humana e inciden en la discapacidad condicionando la pérdida de cualidades. Posteriormente se analiza la modalidad peculiar de posesión de las mismas. En la tercera parte se argumenta cómo a pesar de que con la discapacidad intelectual puede no manifestarse la racionalidad esto no supone una exclusión de la condición personal. Por último, se explica cómo no obstante con la discapacidad se puedan perder cualidades, no es posible perder la corporeidad y la pertenencia a la familia humana. Se empleó el enfoque heurístico con la formulación de preguntas apoyándose en tres casos hipotéticos. La discapacidad es un modo de manifestarse de la condición humana con valor heurístico porque ayuda a examinar aspectos constitutivos de nuestra existencia.
Explaining Right and Wrong aims to shake the foundations of contemporary ethics by showing that moral philosophers have been deploying a mistaken methodology in their efforts to figure out the truth about what we morally ought to do. Benjamin Sachs argues that moral theorizing makes sense only if it is conceived of as an explanatory project and carried out accordingly. The book goes on to show that the most prominent forms of moral monism-consequentialism, Kantianism, and contractarianism/contractualism-as well as Rossian pluralism, each face devastating explanatory objections. It offers in place of these flawed options a brand-new family of normative ethical theories, non-Rossian pluralism. It then argues that the best kind of non-Rossian pluralism will be spare; in particular, it will deny that an action can be wrong in virtue of constituting a failure to distribute welfare in a particular way or that an action can be wrong in virtue of constituting a failure to rescue. Furthermore, it also aims to show that a great deal of contemporary writing on the distribution of health care resources in cases of scarcity is targeted at questions that either have no answers at all or none that ordinary moral theorizing can uncover.
This article engages with debates concerning the moral worth of human beings with profound intellectual and multiple disabilities (PIMDs). Some argue that those with such disabilities are morally less valuable than so-called normal human beings, whereas others argue that all human beings have equal moral value and that, therefore, each group of humans ought to be treated with equal concern. We will argue in favor of a view that takes points from opposing camps in the debates about the moral worth of humans with such disabilities. Our position, roughly, is this: most humans with PIMDs are persons in the morally significant sense and, therefore, deserve moral consideration equal to that granted to so-called “normal” human beings. Some humans with PIMD may not be persons, but nevertheless deserve moral consideration equal to that of persons because they stand in a special relation to persons.
It seems that we should want to avoid becoming intellectually disabled. It is common for philosophers to infer from this that those of us without intellectual disabilities are intrinsically better off than individuals with intellectual disabilities, and that there are consequently stronger moral reasons for others to preserve our lives than to preserve the lives of intellectually disabled individuals. In this article, I argue against this inference from what states we should prefer for ourselves to how much moral reason others have to maintain these states on our behalves. I argue that there is an important sense in which an outcome contributes to our well-being to a certain degree, namely the extent to which others should want it out of care for us, which plays a central role in determining the moral priority of ensuring the outcome for us over ensuring distinct outcomes for others. But an outcome's contribution to our well-being in this sense can come apart from the extent to which we should prefer it for ourselves.
Recent research suggests that a minority of patients diagnosed as vegetative using traditional behavioral assessments may be covertly aware. One of the most pressing concerns with respect to these patients is their welfare. This article examines foundational issues concerning the application of a theory of welfare to these patients, and develops a research agenda with patient welfare as a central focus. We argue that patients diagnosed as vegetative with covert awareness likely have sentient interests, and because sentient interests are sufficient for moral status, others have an obligation to take the welfare interests of these patients seriously. However, we do not view sentient interests as necessary for moral status, and thus it is possible that vegetative patients who lack such interests have moral status for other reasons. We propose four areas in which future research is needed to guide the ethical treatment of these patients: the assessment and management of pain; the development of quality of life assessments; end-of-life decision making; and enriching the day-to-day lives of these patients.
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