This is uncomplicated, but some contend that they would not arrange the procedure for any young deaf children they had, which is more complicated. — Jeremy Murray

A counterpoint to consider. I met a gentleman who was deaf from birth, now in his middle years. His parent refused to provide any remediation, including contact with other deaf people, in the belief that this would build his ability to adapt to "normal" hearing society and so position him well for a good life. However the result was that although he could not fit in well with the hearing, he also could not fit in with the deaf community, and so found himself isolated.

The attempt by his parents to maximise his opportunity had the exact opposite result.

There are situations that do not have an unambiguously clear response, situations in which we cannot know hat it is best to do and must muddle through. Seems to me that the best answer in such situations might be to maximise the available alternatives. Hence neither refusing a cochlear implant nor refusing participation in deaf culture would be appropriate.

This sits well with Nussbaum’s capabilities approach, providing the capacities that enable multiple forms of human flourishing.

The sociology professor appears to have privileged the supposed internal coherence of a schizophrenics self-talk over the social function of language. Internal coherence is not sufficient for social or communicative normality in the practical sense that matters for care, welfare, and interpersonal life. Again, your brother's capabilities are limited by his illness.

Mental illness and invisible disabilities do fit in to the social model, and can be dealt with using the capabilities approach. As for cost, I'll point again to the study that showed a multiplier effect of 2.25 for the NDIS scheme. Having folk with disabilities, indeed all folk, participate as fully as there capabilities will permit has a benefit to us all, even in dry economic terms.

A counterpoint to consider. I met a gentleman who was deaf from birth, now in his middle years. His parent refused to provide any remediation, including contact with other deaf people, in the belief that this would build his ability to adapt to "normal" hearing society and so position him well for a good life. However the result was that although he could not fit in well with the hearing, he also could not fit in with the deaf community, and so found himself isolated.

The attempt by his parents to maximise his opportunity had the exact opposite result. — Banno

I know of a person exactly like this, and it was and remains tragic just due to his social isolation. He did go on to get a cochlear implant, but he still has significant limitations understanding, likely from the limited language skills he obtained prior to receiving it.

The question of the cochlear implant raises is another one as well, which is whether one ought provide a cochlear implant if available. To do so requires a belief that normalization is better than allowing the person remain within the close knit and proud sub-culture the deaf have created. That is, it touches upon your question about whether being normal is the goal. It seems intuitive though to increase one's ability to interact with the world by providing hearing where it was previously lacking. The final rule therefore likely being that one ought do what increases the overall happiness of the individual even if it means tacitly admitting their former state was wanting from the state you are moving them to.

In any event, I draw a rigid distinction between ability and worth, with infinite worth taken as a given, undiminishable and not measurable by ability. That is, to suggest the worth of the deaf person has increased when he has been given the ability to hear is offensive. His worth is not to be measured in terms of the things he can do.

The final rule therefore likely being that one ought do what increases the overall happiness of the individual even if it means tacitly admitting their former state was wanting from the state you are moving them to. — Hanover

Ok. Good reasoning.

Perhaps look again at the capabilities of the individual - how are they to be maximised? Seems to be by participating as much as possible in both hearing and deaf communities. SO implant the device, and maintain contact with the deaf community.

Notice the absence here of "tacitly admitting their former state was wanting" ? instead we look towards maximising benefit - but not in terms of happiness so much as of capability. It's not worth that has increased, but capacity - they can do more things.

Really, it is an Aristotelian ethic. I find that quite curious.

Notice the absence here of "tacitly admitting their former state was wanting" ? instead we look towards maximising benefit - but not in terms of happiness so much as of capability. It's not worth that has increased, but capacity - they can do more things — Banno

But how would you justify a cochlear implant in someone feeling full fulfillment within the deaf community, having no desire to leave its comfort? Would you feel justified in insisting upon it even should the person feel overall greater unhappiness for having been pulled into the general world of the hearing?

Measuring "doing more" isn't just in counting new abilities, but in the value the person receives from them. If the person enjoyed that special comraderie of the deaf community, that thing will be lost, and it might have received great weight from him in terms of personal value not gained from hearing.

Consider SRS, for example.

But how would you justify a cochlear implant in someone feeling full fulfillment within the deaf community, having no desire to leave its comfort? — Hanover

Why would I need to?

Here's another phrase, prominent in the disability community, and promoted, if perhaps not coined by a very dear friend:

Nothing about me without me.

If they don't want an implant, I won't make 'em have one.





"Supported Residential Services"?

If they don't want an implant, I won't make 'em have one. — Banno

That is what I was agreeing with and suggesting your comments implied otherwise. You argued the maximization of happiness wasn't a proper objective but instead said maximizing benefit was the objective. While I suppose we could have talked past each other, I read "maximizing benefit" as something that could be measured by some observable criteria, whereas happiness is determined just by asking the person what makes him happy.

So, if you're saying maximizing benefit simply meaning maximizing personal preferences, then the distinction with that and happiness collapses for all practical purposes.

Forcing someone to have an operation looks to me to be very far from maximising their potential.

Here's a sample list of capabilities, from Nussbaum:

Life, Bodily Health, Bodily Integrity, Senses/Imagination/Thought, Emotions, Practical Reason, Affiliation, Other Species, Play, and Control over the Environment, ensuring basic freedoms like adequate nutrition, movement, education, love, political participation, and respect for nature and oneself.

A bit more than personal preferences.

And includes "bodily integrity".

So there is something a bit more sophisticated here than "happiness".

A bit more than personal preferences. — Banno

I'm not trying to over-simplify and can't disagree with Nussbaum's wish list of available capabilities, but I still abstract out the fundamental principle sounds something along the lines of advancing Enlightenment rights for the "pursuit of happiness."

So there is something a bit more sophisticated here than "happiness". — Banno

Happiness principles aren't unsophisticated. Given the centrality of the concept to Utilitarianism and the role it plays, 1000s of pages have been written trying to explain what happiness is.

But the quibble seems to be the way we wish to portray the same thing, less so the substance.

The driving force was disabled activists insisting that disability is not a deviation from the normal human body, but the consequence of social design. — Banno

I'm still having a hard time putting it this way. It's the same as saying that the infrastructure in place now is discriminatory towards and/or dismissive of people with disability. Or, the design itself makes them disabled.

But, to borrow a word used for workers, ergonomics is exactly the way we design things for the purpose of reducing or eliminating risk of injury based on the natural functioning of the human body.

Engineering and construction focus towards the functionality and usage by the average population. Which means the majority of the population should be able to use bridges, stairs, doors, roads, buildings, and vehicles with ease.

Engineering and construction focus towards the functionality and usage by the average population. — L'éléphant

Why? No one is ever average...

Why not accomodate the wide variety of human lives?

Too much trouble? The engineers aren't up to the challenge? :wink:

the fundamental principle sounds something along the lines of advancing Enlightenment rights for the "pursuit of happiness." — Hanover

Is this such a bad thing?

Hmm interesting thoughts. I think I stick by my initial take there, but I do see the truck in what Banno is getting at. I take it as tongue-in-cheek even if its not properly so.

I don't think it's that it's too much trouble, it's that running at the pace of the slowest drags everyone else down. Do the disabled have that right, in pursuit of their own? I don't have a position because they are in too high-a-tension to me. I am empathetic to the nth for those for whom better design would be advantageous, but I am also empathetic to the fact that those of us who do wish to 'race forward' in historical terms probably shouldn't be beholden to that framework.

This said, I actually agree with Banno on the restriction on enforced surgery. I think consent is fundamental. But this also commits one to antinatalism *shrug*. I don't, prima facie, have any discomfort with eugenics either, if pursuing 'a better life' in some Nussbaumian kind of way. The assumption on the capabilities take tends to be that "life is good". I don't really believe that, so its hard.

No one is ever average... — Banno

There is a pattern here in this thread. Rules are made up as we go.

Is this such a bad thing? — Banno

No, but I wasn't arguing it was a bad thing as much as I was saying we were agreeing with the happiness principle.

This said, I actually agree with Banno on the restriction on enforced surgery. I think consent is fundamental. — AmadeusD

All of this implies the disabilities we are referencing don't affect one's ability to give consent. Intellectual and psychiatric disabilities raise entirely different questions.

Why? No one is ever average... — Banno

If we are to consider disability a spectrum, with no one fully disabled and no one fully abled, but all of us at some point on the spectrum, then it would logically hold that we capture as many people along the line to allow them as full a life as possible, limited by our resources. That is, there is a bell curve of abilities, with most of us grouped in the middle (with me being an outliar of brilliance, a sage of the ages), and so we build a world that attempts to accomodate as much of that bell as we can, moving out to the extremes as much as we can. Those societal accomodations would flatten the curve, offering everyone closer to equal opportunity, leaving as few outside as possible.

I appreciate the generosity principle you identify in characterizing disability in terms of society's ability to accomodate as opposed to referencing the limitations inherent in the individual when compared to others, but I'd leave it at that, which is that the chararacterization is presented in order to provide respect and acceptance. If pressed though, I wouldn't be willing to then start suggesting there really aren't important physical differences that can be chararacterized as being less advantageous just because that position loses credibility in not recognizing certain truth.

Where we do agree is that human worth is not diminished by ability, and so I am in favor of doing whatever is required to keep that clarified, which includes creating a language that preserves that dignity and in modifying the landscape so that it is more universally navigable.

I am empathetic to the nth for those for whom better design would be advantageous, but I am also empathetic to the fact that those of us who do wish to 'race forward' in historical terms probably shouldn't be beholden to that framework. — AmadeusD

So survival of the fittest?

No, but I wasn't arguing it was a bad thing as much as I was saying we were agreeing with the happiness principle. — Hanover

Well, I'll say "almost" and point out that Nussbaum, perhaps the foremost ethicist here, is a classicist authority on Aristotle, so let's call it "flourishing"?

But cheers to the sentiment.

If pressed though, I wouldn't be willing to then start suggesting there really aren't important physical differences that can be chararacterized as being less advantageous just because that position loses credibility in not recognizing certain truth. — Hanover

I don't think anyone is denying that wheelchair users need a wheelchair...

In any event, I draw a rigid distinction between ability and worth, with infinite worth taken as a given, undiminishable and not measurable by ability. That is, to suggest the worth of the deaf person has increased when he has been given the ability to hear is offensive. His worth is not to be measured in terms of the things he can do. — Hanover

To be clear: You promote the adversarial approach to human interaction. How do you reconcile this with your idea of a person having "infinite worth"?

The adversarial approach to human interaction implies that other people are expendable and can be destroyed; so, obviously, it's not a reflection of the belief that they have "infinite worth".

All of this implies the disabilities we are referencing don't affect one's ability to give consent. Intellectual and psychiatric disabilities raise entirely different questions. — Hanover

That's true, but I'm unsure to what degree - which hinges on my having brought up antinatalism in some large way. If we take it back, you shouldn't have kids. Plain and simple. But once they're alive, if they have (and I do think this is the case) interest in continuing to live, then consent is desirable if it will lead to more (quality) life. Whcih then hinges on my bringing up eugenics.

So, in principle yeah there are some tricky cases that will come up - but if one is alive but unable to consent (for instance, to a lung transplant as is in a coma or some such) that's different to one not existing.

So survival of the fittest? — frank

Bit of a black-white fallacy I think. I'm pressing against survival of the least fit as a mode - not suggesting we do the Nazi thing. But I think it patently odd (and probably a bad thing, overall) that we train our best and brightest to put themselves in harm's way (well, 60 years ago this would hit a lot harder) and do our absolute best to pour resources into retaining the worst(you really need to read this word in context and not ascribe some mora position to me because of an emotional reaction here of us, in terms of species-level survival and progress. There is almost no way that doesn't leave a bad taste in mouths - but it seems obvious.

I took your concern to be disability ought be considered an interplay of person upon environment, focusing more upon the deficiencies in the environment than the person. Under this model, we view the environment needing modification and correcting, leaving challenges to dignity of the person undisturbed. This requires we recalibrate the conceptual, pointing to the deficient environment, not the person. — Hanover

I'll move my response here, since it fits in better with the discussion of disability than of "normal".

That's a good first approximation. And disability is an excellent test for our conception of "normal"

Have a look at 4. Misuses and temptations

Austin would highlight several philosophical temptations:

Reification — Treating “the normal” as a property things have, rather than a judgement relative to a practice.
Illicit normativity — Smuggling ought into is under cover of medical or statistical language.
False objectivity — Speaking as though “normal” names a natural kind rather than a shifting standard.
Category drift — Moving from “statistically normal” to “functionally proper” to “morally acceptable” without noticing the slide. — Banno

All of these misuses occur in the medical model of disability.

The social model helps us to recognise this. It's not the wheelchair that is the problem but the absence of a ramp. However the focus remains on what is negative, on the absence of a ramp. The capabilities approach refocuses on what is positive, on what we can do to maximise what we can do.

The medical model asks "What's wrong with you?", invoking the Misuses of "normal". The social model asks "what's wrong with how things are?" shifting the focus from the individual to their environment. The capabilities model asks "How do we support the opportunities you have to lead the kind of life you value?" The language of deficiency is bypassed.

And then we might add in @Jamal's work on Adorno, the suffering of particular beings that are crushed by universalising systems, which one presume continues in the capabilities approach, or the dialectic approach of Crip Theory with the thesis of the medical model and the antithesis of the social model.

The common ground in the criticisms of what folk call "the enlightenment" is of the all-embracing rational model that solves all our problems. The response from Hegelians is the ongoing dialectic. But all this amounts to is our acknowledging that our responses are never compete, that the task and the discussion are ongoing.

All of these misuses occur in the medical model of disability. — Banno

I deal with the medical 'industry' regarding disability almost constantly. I do not see most of these occurring. Parochial, to be sure, but relevant to any comments I might make on it. Specifically, reification odes not occur. The concept of disability, medically, is specifically a relative term, to the statistical norm with no moral comment (again, that's my experience). That seems correct regardless of which terms we're using to describe that practice.

As someone else mentioned "tall" is very similar term.

Wouldn't that make people with ginger hair disabled, if it's only about statistics?

So survival of the fittest?
— frank

Bit of a black-white fallacy I think. I'm pressing against survival of the least fit as a mode - not suggesting we do the Nazi thing. But I think it patently odd (and probably a bad thing, overall) that we train our best and brightest to put themselves in harm's way (well, 60 years ago this would hit a lot harder) and do our absolute best to pour resources into retaining the worst(you really need to read this word in context and not ascribe some mora position to me because of an emotional reaction here of us, in terms of species-level survival and progress. There is almost no way that doesn't leave a bad taste in mouths - but it seems obvious. — AmadeusD

So maybe you'd favor a plan that splits resources between improving access and doing medical research, recognizing that research is expensive up front, but keeps giving downstream.

Btw, there's a disable actress in the recent Wicked movies. She lost the ability to walk when she was 11 due to an automobile accident. So by research, we could also mean focusing on safety issues.

A counterpoint to consider. I met a gentleman who was deaf from birth, now in his middle years. His parent refused to provide any remediation, including contact with other deaf people, in the belief that this would build his ability to adapt to "normal" hearing society and so position him well for a good life. However the result was that although he could not fit in well with the hearing, he also could not fit in with the deaf community, and so found himself isolated. — Banno

Hello Banno, sorry for the delayed response. The black dog barks loudest this time of the year.

I feel your counterpoint tragic, but I can't tell from this response what your stance is on deaf parents denying an infant cochlear implants? Implants from a young age would avoid some of the concerns with your gentleman. I don't want to overstate things, but it feels, in some ways, different from the idea that even infants can express a gender ideology which trumps parental desires, or on the conservative side, that parents have the right to deny an infant vaccinations, which the child might have wanted?

I recognize that deaf culture is a more substantial form of culture than trans conservatism or 'anti-vax' culture. But it is hard to dispute that this action denies the child opportunities later in life, for the gains of a more substantial connection to the deaf culture of their parents.

Internal coherence is not sufficient for social or communicative normality in the practical sense that matters for care, welfare, and interpersonal life. — Banno

An entirely reasonable stance. But it is precisely this grey area where I feel the 'capabilities' approach runs into challenges? You note:

There are situations that do not have an unambiguously clear response, situations in which we cannot know hat it is best to do and must muddle through. — Banno

but elsewhere in the thread seem to discount Aristotelean ethics, which strike me as superior to deontological or utilitarian ethics in the ability to grapple with said situations? Or did I misread that?

I'll point again to the study that showed a multiplier effect of 2.25 for the NDIS scheme. Having folk with disabilities, indeed all folk, participate as fully as there capabilities will permit has a benefit to us all, even in dry economic terms. — Banno

I take all think tanks with a grain of salt, but I have seen similar work and agree in principle. My problem with such a simple conclusion is that it ignores complexity of blanket accessibility laws. Requiring new corporate businesses, government buildings, transit hubs, etc to be designed and built with ability in mind is different from insisting that all business be retroactively made accessible - a cost that some small businesses simply can't bear. Here in Canada, the deadline for universal accessibility standards came and went without success.

Some accommodations are vastly more expensive than others. A friend of mine who works with DD students talked about the 'million dollar kid' in her class, non-verbal, wheelchair-bound, hugely limited, but the parents and the team wanted the child in 'mainstream' education. My friend could not ascertain what the child wanted. That million dollar cost is not in a vacuum - it reduces the ability to address other social goods.

Last point - 'invisible' disability requires a degree of trust not present in modern society. For example, an individual with PTSD could be triggered by an unfriendly / hostile employee. In such circumstances, it feels unlikely that the sufferer would be able to raise their need for accommodation successfully. You can insist on the 'believe victims' principle, but the disability's invisibility makes this a completely different category from a wheelchair user who has been inconvenienced.

I wasn't really familiar with Nussbaum till reading this thread, but this and some preliminary reading piqued my interest. Any recommendations as to key works appreciated.

All of these misuses occur in the medical model of disability. — Banno

Words like "abnormal", "strange," and "deviant" contain negative connotations, but for our purposes we need a word that avoids that so that we can discuss those that simply diverge from the way most are. The term "neuro-divergent" is a word that has become euphamistic for autistic, and so despite it being a euphamism, it has picked up a connotation of someone who thinks differently in a way that challenges them socially. However, I heard someone insist that gifted children be considered neuro-divergent, which is not a typical use of that word, but it makes sense, given those children do think differently than their classmates. This just points out the difficulty in creating language truly intended to be neutral. We might just be inherently judgmental creatures and so purely neutral language offers us little use.

The response from Hegelians is the ongoing dialectic. But all this amounts to is our acknowledging that our responses are never compete, that the task and the discussion are ongoing. — Banno

I've found myself less and less dialectical of late. It arises out of my theological bent, where I feel the need to leave science in the lab and religion in the chapel, without any real need to figure out how they can mesh to a higher truth, but instead to give them each their time. It's like visiting divorced parents. You care for them both, you visit them both, but you don't put them in the same room.

The term "neuro-divergent" is a word that has become euphamistic for autistic, and so despite it being a euphamism, it has picked up a connotation of someone who thinks differently in a way that challenges them socially. — Hanover

I don't think it's a euphemism exactly, although maybe some use it that way. It's supposed to be a broader category than autism, to include ADHD, dyslexia, hyperlexia, savantism etc. It may eventually become a replacement for autism and ADHD, as there is some talk of there being a continuum between ADHD and autism, but it's all a bit muddy.

This just points out the difficulty in creating language truly intended to be neutral. — Hanover

But it's hard to think of medical concept of disability that is normatively neutral. If you just define 'disability' as statistical outliers without making a judgement, then gingers are disabled.

I don't think it's a euphemism exactly, although maybe some use it that way. It's supposed to be a broader category than autism, to include ADHD, dyslexia, hyperlexia, savantism etc. — bert1

But all of those conditions refer to conditions that are generally thought of disadvantageous, where you could make an argument that Einstein was neurodivergent or someone who was particularly creative would be as well. Something can be said regarding people in this forum in terms of the thought processes being significantly (in a statistical sense) deviating from the norm. It just depends upon what aspect of one's neural processing you're looking at.

But it's hard to think of medical concept of disability that is normatively neutral. If you just define 'disability' as statistical outliers without making a judgement, then gingers are disabled. — bert1

I guess the issue is that the word "normal" is not normatively neutral, but it designates someone who is appropriate in some respect.

But all of those conditions refer to conditions that are generally thought of disadvantageous — Hanover

I don't think that's true among, for example, the autistic community (insofar as there is such a homogenous thing). Autistic people often consider neurotypicals to have communication disabilities, not saying what they mean, not meaning what they say, being obsessed with the weather and what they had for breakfast and talking about it with no awareness of how boring it is. And not taking an interest in fascinating topics like steam engines. Neurodivergence was embraced as a concept as a means of unifying people with different diagnoses who nevertheless shared similar experience. It was (and still is) broadly seen as a positive.

I guess the issue is that the word "normal" is not normatively neutral, but it designates someone who is appropriate in some respect. — Hanover

Indeed. 'Typical' is normatively neutral, and is only statistical.

It depends what the context of the 'plan' is. But in principle yeah, it's got to be a balance. Both of those avenues are noble and worth pursuing.

I can't quite understand the question - having red hair is not an ability-related trait. Having a cleft lip also wouldn't be (usually). I have a couple of odd physical features which are generally not visible. They don't affect my abilities. So I think there's just a category issue going on. "most people have brown, black or blonde hair" isn't the type of statistic that gives us a normative fact. Its just a statistical one. "Most people can walk on two legs with aplomb" is normative. It creates an expectation of ability.

I am slightly misusing 'normative'. I just can't think of a better word right now - sorry for that.

I can't quite understand the question - having red hair is not an ability-related trait. — AmadeusD

Might they be in a society of gingerphobes? The ginger people wouldn't be able to speak perhaps, because everyone knows gingers are incapable of learning, so it would be a waste to try to teach them.

I don't want to go overboard defending the social model - I do think the medical model has its place. For example, a deficit model is appropriate when developing aids for an amputee, perhaps. A peg leg makes a lot more sense than installing foot-high platforms alongside all pavements for amputees to rest their stumps on.