Abstract
In The Minority Body, Elizabeth Barnes rejects prevailing social constructionist accounts of disability for two reasons. First, because they understand disability in terms of oppressive social responses to bodily impairment, they cannot make sense of disability pride. Second, they maintain a problematic distinction between impairment and disability. In response to these challenges, this paper defends a version of the social model of disability, which we call the Social Exclusion Model. On our account, to be disabled is to be in a bodily or psychological state that is represented as an impairment in the prevailing ideology of one’s society, and to be excluded from valuable activities on the basis of this representation. While this model refers to a distinction between disability and impairment, it makes no presuppositions about which bodies function ‘normally’ and which do not. It is the ideology of impairment rather than impairment itself that does any work to determine whether a person is disabled. We argue that this model answers some of the important objections that Barnes raises against prevailing social constructionist accounts of disability, and that it’s focus on the oppressive social positioning of disabled people gives it explanatory power that Barnes’s own account lacks.
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Notes
Barnes’s conception of disability is reminiscent of feminist and anti-racist proposals that social identities such as ‘woman’ and ‘people of color’ are neither natural nor socially given but rather are fluid constructs that come about through coalition politics. For examples see Diana Fuss, Essentially Speaking (New York: Routledge, 1989), p. 721; Nancie Caraway, Segregated Sisterhood: Racism and the Politics of American Feminism (Knoxville: University of Tennessee Press, 1991), p. Dorpp. 171–204. For a critical analysis of such models see, Iris Marion Young, “Gender as Seriality: Thinking about Women as a Social Coll/ective”, Signs (1994).
Leslie Francis examines with great clarity and detail how the definitions of disability and impairment have been contested and have shifted in the legal context (“Understanding Disability Civil Rights Non-Categorically: The Minority Body and the Americans with Disabilities Act”, in this issue, doi:10.1007/s11098-018-1067-x).
Sally Haslanger, “What Are We Talking About? The Semantics and Politics of Social Kinds” in Resisting Reality (Oxford: Oxford University Press, 2012), pp. 365–380.
Charles Mills, Blackness Invisible, (Ithaca and London: Cornell University Press, 1998), p. 51.
Sally Haslanger (2012, p. 366).
Ibid.
For a critical analysis of this view, see Stephen M. Campbell, Joseph A. Stramondo, “The Complicated Relationship of Disability and Well-Being” Kennedy Institute of Ethics Journal, Volume 27, Number 2, June 2017, pp. 151–184. For the view that disability is presumptively a misfortune, see David Degrazia, Creation Ethics: Reproduction, Genetics, and Quality of Life (Oxford: Oxford University Press, 2012) pp. 109–116; For the view that disability is inherently a misfortune, see Guy Kahane and Julian Savulescu, “The Welfarist Account of Disability” in Kimberely Brownlee and Adam Cureton, eds. Disability and Disadvantage, (Oxford: Oxford University Press, 2009).
Julian Savulescu and Guy Kahane. "The moral obligation to create children with the best chance of the best life." Bioethics 23, no. 5 (2009): 274–290. McMahan, Jeff. "Causing disabled people to exist and causing people to be disabled." Ethics 116, no. 1 (2005): 77–99.
Jessica Begon, “What are Adaptive Preferences? Exclusion and Disability in the Capability Approach” Journal of Applied Philosophy 32, no. 3 (2015): 241–257.
Derek Parfit, Reasons and Persons (Oxford: Oxford University Press, 1984) pp: 351–374.
As Iris Marion Young puts it: “The naming of women as a specific and distinct social collective…is a difficult achievement and one that gives feminism its specificity as a political movement. The possibility of conceptualizing ethnic, religious, cultural or national groups, for example, rarely comes into question because their social existence itself usually involves some common traditions—language, or rituals, or songs and stories, or dwelling place. Women, however, are dispersed among all these groups. The operations of most marriage and kinship forms bring women under the identity of men in each and all of these groups, in the privacy of household and bed. The exclusions, oppressions, and disadvantages that women often suffer can hardly be thought of at all without a structural conception of women as a collective social position” (Gender as Seriality, 719).
Or as Sally Haslanger states it, “Race is the social meaning of the geographically marked body,” which is some complicated (and possibly indeterminate) combination of one’s genetic ancestry and one’s physiological features such as skin tone, hair and facial features (2012, 236).
See e.g., Jerome Bickenbach. “Disability, ‘Being Unhealthy,’ and Rights to Health.” Journal of Law, Medicine & Ethics, 2013, 821–28. Christopher Boorse. “Health as a Theoretical Concept.” Philosophy of Science 44, no. 4 (1977): 542–73.
Though, as we discuss below when it comes to being gay, one may presently face many other forms of exclusion and stigmatization, and may in some times or places face ‘pathologizing’ stigma similar or identical to that faced by paradigm disabled people.
Kingma, E. (2007). What is it to be healthy? Analysis, 67(294), 128–133.
Given this difficulty, the most justifiable view may turn out to be that infertility is itself not a health problem – that fertility treatment is not therapy but an enhancement.
42 U.S. Code §12102. The ADA definitions of impairment and disability are philosophically infelicitous in some ways; circularly defining ‘disability’ partly in terms of ‘being regarded as’ or ‘having a history of’ disability itself. The usage in the text may reflect better conceptual hygiene: being disabled can be a matter of being, or being regarded as, or having a history of, impairment; where impairment is defined non-circularly as pathology that limits life function. For an extended discussion of the important role that impairment plays in the legal definition of disability, see Leslie Francis (“Understanding Disability Civil Rights Non-Categorically: The Minority Body and the Americans with Disabilities Act”, in this issue, doi:10.1007/s11098-018-1067-x).
It should be noted however that on Barnes’s own account of disability, it is unclear whether this sort of person would count as non-disabled. If infertility is the sort of bodily state that the disability rights movement ought to promote justice for, then an infertile person seems to be disabled on Barnes’s account regardless of whether or not that person wishes to have biological children or whether or not that person knows about their condition. It may be that infertility is not the sort of physical condition that the disability rights movement ought to promote justice for—if this is the case it is not because such a person lacks awareness of her condition, but because of the norms of solidarity that guide what sorts of conditions properly fit under the umbrella of disability.
It is easy to imagine scenarios in which others become aware of person, S’s, infertility and this information about S’s bodily state leads these others to discount S’s testimony that S never wanted to have children in the first place. Were this to happen, S would be marginalized on the basis of S’s presumed impairment and so could potentially be understood as disabled, on a social model.
See here Shelley Tremain, “On the Subject of Impairment,” ed. Marion Corker and Tom Shakespeare (New York: Lexington, 2002), 32–47.
Or for that matter such disabilities needn’t be understood as bad, all-things-considered, in our unjust society.
We will not in the end endorse precisely this view, even though we think it is defensible.
As Leslie Francis usefully articulates many pressing questions remain about how we can “improve justice in contexts of injustice” (“Understanding Disability Civil Rights Non-Categorically: The Minority Body and the Americans with Disabilities Act”, in this issue, doi:10.1007/s11098-018-1067-x). This, she argues, will require keeping the categories of disability and impairment distinct.
That is not to say, however, that any adequate definition of disability must entail that all disabled people have actual impairments. Indeed, the account we defend below will follow the ADA in allowing that some people are disabled because they have a bodily state which is mistakenly construed as an impairment. Still, some bodily difference is required. This is part of what distinguishes disability from other identity categories, especially purely social categories like caste or class. Thus our view may depart from ADA in denying that people whose bodies are perfectly ‘normal’, biomedically, can be disabled—even if such people are erroneously believed by others to possess impairments. This need not constitute a critique of ADA as policy; it may make sense to extend the protection of anti-discrimination law to these cases, (in part) so as to relieve actually disabled people of the burden of demonstrating actual (as opposed to perceived) bodily difference. Our definition may also be used as a way to clarify the ADA’s commitments to remedying discrimination for those who have bodily differences that have been erroneously understood as being more impairing than they actually are. Insofar as having a disability involves some bodily difference, the best avenue for remedying discrimination is often through accommodation of that difference, even if it is not as impairing as employers think or not impairing at all. As Leslie Francis discusses in detail, this remedy has been problematically removed from ADA protections [see section II, this volume].
John Swain and Sally French, Towards an Affirmation Model of Disability, Disability & Society, 15 (4) (2000), 569–582. pp 570–572.
Of course, most disabled people will have bodily differences, on this view, but these differences are not, literally, any part of their disability properly speaking, since that is exhausted by social perceptions and their consequences.
As Leslie Francis compellingly argues, focusing on physical disabilities first as the paradigm case can make the legal battle harder for people with cognitive and psychological disabilities to win anti-discrimination cases (“Understanding Disability Civil Rights Non-Categorically: The Minority Body and the Americans with Disabilities Act”, in this issue, doi:10.1007/s11098-018-1067-x).
For criticisms regarding the inclusiveness of the disability rights activism and scholarship, see Susan Wendell, “Unhealthy Disabled: Treating Chronic Illnesses as Disabilities,” Hypatia 16, no. 4 (November 2001): 17–33, doi:10.1111/j.1527-2001.2001.tb00751.x; Tom Shakespeare, Disability Rights and Wrongs (Routledge, 2006), 74ff.
See here Sean Aas, “Disabled – Therefore, Unhealthy?,” Ethical Theory and Moral Practice 19, no. 5 (November 22, 2016): 1259–74, doi:10.1007/s10677-016-9735-4.
Simon Baron-Cohen, “Is Asperger Syndrome Necessarily Viewed as a Disability?,” Focus on Autism and Other Developmental Disabilities 17, no. 3 (August 2002): 186–91.
Ron Amundson, “Against Normal Function,” Studies in History and Philosophy of Biological and Biomedical Sciences 31, no. 1 (2000): 33–53, doi:10.1016/S1369-8486(99)00033-3.
Lance Wahlert and Sabrina Gill argue, based on a social model of disability, that trans* people may be well-advised to embrace the legal protections that go with the label of ‘disability’, even at risk of enhancing perceptions of pathology. Our account of disability can accommodate such a view. Lance Wahlert and Sabrina Gill, “Pathological, Disabled, Transgender: The Ethics, History, Laws, and Contradictions in Models That Best Serve Transgender Rights,” Kennedy Institute of Ethics Journal 27, no. 2 (2017): 249–66, doi:10.1353/ken.2017.0017.
Joseph Stramondo has argued that while there may be no outward hostility, the ideology of pity towards people with disabilities can reinforce their subjugation, see “How an Ideology of Pity Is a Social Harm to People with Disabilities” Social Philosophy Today, vol. 26 (2010). We thank Leslie Francis for pushing us to clarify our position on this matter.
Cf. e.g., UPIAS, 1976, Fundamental principles of disability, London: Union of the Physically Impaired Against Segregation; Michael Oliver, The Politics of Disablement (London: Palgrave McMillan, 1990).
Acknowledgements
Both authors contributed equally to this manuscript. We would like to thank Elizabeth Barnes, Marion Danis, Leslie Francis, Leah Pierson, S. Andrew Schroeder, Robert Steel, Dave Wendler, David Wasserman, and participants at the Pacific APA as well as a workshop at the National Institutes of Health, Clinical Center Department of Bioethics. This project was conducted while one of us (DH) was working at the National Institutes of Health. The views expressed in this paper however are our own and do not represent the position or policy of the NIH, DHHS, or US government.
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Howard, D., Aas, S. On valuing impairment. Philos Stud 175, 1113–1133 (2018). https://doi.org/10.1007/s11098-018-1074-y
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DOI: https://doi.org/10.1007/s11098-018-1074-y