We’ll now be commencing our discussion of Elizabeth Barnes’ recent Ethics article, “Valuing Disability, Causing Disability,” with a critical précis by Tom Dougherty. Tom’s précis is below the fold. Thanks to all of the participants, and we’re very much looking forward to a fun and productive conversation.
Critical Précis of Elizabeth Barnes’s “Valuing Disability, Causing Disability.”
Is a disability a misfortune? A cause for condolences? Not according to many activists in the disability pride movement, and not according to Elizabeth Barnes in “Valuing Disability, Causing Disability.” Rather than seeing disability as an inherently bad state, Barnes defends the idea that disability is merely a different way for humans to be.
It’s easy to get the gist of this “mere-difference view,” but formulating it more precisely faces a couple of hurdles. First, there’s a theoretical controversy about what disability is. For the purposes of her article, Barnes stays neutral on this controversy by defining disability ostensibly with reference to paradigms like mobility impairments and deafness. (In The Minority Body, forthcoming from Oxford University Press, Barnes breaks from this neutrality and defends a social constructivist account of disability based on group solidarity; for more info, see the helpful chapter summaries at http://elizabethbarnesphilosophy.weebly.com/book.html .) The second hurdle is that the mere-difference view is held by advocates who form a broad church, and these advocates will differ regarding how they prefer to define the view. Barnes obviates this difficulty by grouping together related claims that are sufficient, but not necessary, for holding a version of the mere-difference view—the claim that disability is analogous to features like sexuality, gender, and race, the claim that disability is not a defect or departure from “normal functioning,” the claim that disability is a valuable part of human diversity, and the claim that many of the most significant bad effects of having disabilities result from society’s treatment of disabled people rather than the disabilities themselves. These claims concern the state of being disabled, leaving room for the thought that the process of becoming disabled is often difficult. But the end result of this transition isn’t a bad way to be. Just a different one.
While the mere-difference view is popular among members of the disability pride movement, several prominent philosophical discussions of disability instead adopt the “bad-difference view.” Barnes also frames this in terms of a family of claims, including the claim that disability is an automatic cost, the claim that an arbitrary disabled person is worse-off than an arbitrary non-disabled person, and the claim that a disabled person would be better off without her disability.
Barnes’s reason for adopting the mere-difference view is that her epistemic guide to the quality of disabled people’s lives is their own testimony. This is testimony that adherents of the bad-difference view are either unaware of, ignore or give relatively little credence to. What epistemic guide do they use instead? We can speculate that frequently they are guided by non-disabled people’s intuitions concerning the desirability of being disabled. But Barnes is unimpressed with these intuitions, noting that they are vulnerable to being clouded by implicit ableism and by a limited understanding of the lives of disabled people. In short, it is bad methodological practice to rely on the intuitions of a privileged majority when thinking about what it is like to be a member of a minority group, particularly when this minority is stigmatised.
This background debate provides the context for Barnes’s central line of argument. Barnes criticises arguments that aim to offer independent traction on the debate by appealing to our intuitions concerning the permissibility of causing disability in a variety of cases. Barnes’s response is that these arguments fail either because the mere-difference view can account for the relevant moral facts or because these arguments simply beg the question by relying on an independent intuition that the mere-difference view is false. As such, Barnes’s central argument in her article is negative in tenor: the debate will not be fruitfully advanced by considering these cases of causing disability.
That’s the general shape of Barnes’s argument. To get into its specifics, lets turn to the three arguments that she responds to. The first argument rejects the mere-difference view on the grounds that it is wrong to non-consensually cause an adult to become disabled. Not a great argument, as Barnes points out, since we also think it’s wrong to non-consensually change someone’s gender or sexuality. Moreover, the mere-difference view can and should allow that there are frequently transition costs to becoming disabled, and that it is wrong to make someone suffer these costs against her will.
The second argument against the mere-difference view is more interesting. This argument is centered around the claim that it’s impermissible to cause a non-disabled new-born child to become disabled, but it’s permissible to cause a disabled new-born child to become non-disabled. Barnes notes that the mere-difference view has the option of claiming that there is a moral distinction between these actions on the grounds that the former is more risky, particularly in light of social prejudice against disability. But she instead recommends simply rejecting the claim that there is a moral distinction between these actions. Barnes counters that the thought that there is such a moral distinction between the actions depends on an independent intuition that disability is a bad-difference. Therefore, invoking this moral distinction between the actions cannot provide independent reasons for embracing the bad-difference review.
Barnes offers a similar response to the third argument agains the mere-difference view. The third argument objects that the view cannot explain why it is wrong for a prospective parent to choose to conceive a disabled child when she has the option of conceiving a non-disabled child. Barnes responds that it would not be wrong to conceive the disabled child. Any intuition to the contrary is again dependent on an intuition in favour of the bad-difference view. So this line of argument fails to provide independent support for this intuition.
Having rebutted these arguments, Barnes ends by noting that a consequence of the mere-difference view is that attempts to find “cures” for disability are misguided, given that we live in an ableist world. (By loose analogy, consider a homophobic society in which attempts are made to find ways of changing people’s sexuality, particularly when these are framed as “cures” for homosexuality.)
Is Barnes’s argument successful? To answer this question, we need to bear in mind both the background dialectical context and what the target of her criticism is. We saw that there is a debate in which the testimony of disabled people is pitted against other people’s intuitions that disability is inherently bad. Barnes’s criticisms are focused on attempts to move forward this debate by adding arguments that appeal to intuitions about cases of causing disability. Whether these attempts advance the debate depends on whether these arguments provide us with any independent traction above and beyond a brute appeal to intuitions against the mere-difference view. Assessing Barnes’s criticism by this standard, I’m fully persuaded by her that we find no independent traction here.
So given that I agree with Barnes’s central line of criticism, I’ll start the discussion by posing three questions that explore extensions of her position:
(1) The discussion focuses primarily on quality of life issues. (At least, those are the issues that I assume the testimony of disabled people concerns.) But what about quantity of life issues? Barnes notes that people with Duchenne Muscular Dystrophy would like research into how to extend the life span of people with muscular dystrophy. If two states involve the same quality of life, and yet people in one state have a significantly shorter life span than people in the other state, does that mean that people in the former state enjoy lives with less overall welfare than people in the latter? (Note that this question is independent of other questions concerning our attitudes towards this state. Biological females tend to live longer than males. But even if someone thereby concluded that this means that females enjoy more welfare over the course of their lives than males, she could still see maleness as a valuable part of human diversity.)
(2) Restricting ourselves to quality of life issues, are there any ways that someone’s physical body could be that in themselves lead to an overall net reduction in this person’s quality of life? If so, are there any disabilities among these? If not, then how does this bear on the viability of a distinction between health and illness—a distinction that might seem useful for designing healthcare institutions and policy?
(3) As these two questions suggest, I’m unsure about the breadth of the scope of the mere-difference view—does it concern all disabilities, most disabilities or some disabilities? My guess is that since the view is shared by many different people, there may be room for reasonable variation here. So I’ll just ask directly: with respect to welfare, is Barnes’s view that all disabilities are mere differences?
These questions aim to press Barnes to say more about what view we should take of the relationship between disabilities and welfare. But in starting the discussion with these questions, I don’t want to distract from what I see as Barnes’s important accomplishment in her article. This is to mount a powerful case for the claim that the bad-difference view is one that we should not take. And this view is no strawman: a significant number of people inside and outside of philosophy take the view that all or most disabilities are bad ways for humans to be since these disabilities diminish people’s quality of life. To my mind, Barnes’s article convincingly shows that intuitions in favour of this view cannot get independent support from arguments concerning the permissibility of causing disabilities. This is significant because it means the debate will have to be settled on other grounds. In this regard, if the choice we have to make is between relying on non-disabled people’s intuitions about disabilities or relying on disabled people’s testimony, then things are looking good for the mere-difference view.