Christopher A. Riddle

I examine both the morality of prenatal testing, as well as selective abortion on the basis of the results of that testing. As our ability to test for a variety of genetic conditions grows, the necessity of a nuanced assessment of this practice increases. First, I explore the permissibility of prenatal testing. I assess arguments that suggest that the fallibility or unreliability of the tests renders them moot for making decisions pertaining to life and death. I then examine arguments that suggest that the very nature of prenatal testing is such that it provides impermissible or immoral directive counseling. If we test to ensure something is not wrong with the fetus, or that everything is normal, it implies that a positive test, or a departure what from is perceived to be normal, is necessarily negative. I suggest that while these arguments are worth taking seriously, ultimately, they do not render the practice of prenatal testing immoral. Second, I examine the practice of selectively aborting a fetus as a result of a potentially disabling condition. While I acknowledge the ever-present ablest assumptions prevalent in society surrounding what constitutes a life worth living, I suggest that the three dominant kinds of arguments opposing selective abortion, fail. First, selective abortion does not constitute a form of eugenics. Second, disability-bias is an insufficient justification for denying selective abortion rights. Third, and finally, prospective parents do not assent to raise any child, irrespective of the outcomes of a prenatal test.

I argue that despite criticism from some disability rights organizations, aid in dying is morally permissible. First, I suggest that disability-related concerns can be classified as emerging from one of two kinds of harm: person affecting, and personhood affecting. Second, I examine whether person affecting harm has occurred within those jurisdictions that have legalized aid in dying. I conclude that despite suggestions to the contrary, there is no evidence to demonstrate that people with disabilities have been adversely impacted by legalized medical aid in dying. Third, I entertain these same arguments as a matter of principle and conclude the principled objections should not give us reason for concern. Fourth, I explore whether we have evidence to suggest the presence of increased personhood affecting harm where aid in dying is permissible. I suggest, through a focus on disability support services, that no evidence of social attitudes that diminish the moral worth of disabled people is present. Fifth, I examine whether we ought to have a principled concern with personhood affecting harm emerging from medical aid in dying. I conclude that to the contrary, to deny people with disabilities access to aid in dying constitutes a morally egregious form of personhood affecting harm.

In _Discrimination Against the Dying_, Philip Reed argues, among other things, that ‘right to die laws (euthanasia and assisted suicide) also exhibit terminalism when they restrict eligibility to the terminally ill’. 1 Additionally, he suggests ‘the availability of the option of assisted death only for the terminally ill negatively influences the terminally ill who wish to live by causing them to doubt their choice’. 1 I argue that on scrutiny, neither of these two points hold. First, we routinely limit a course of treatment to only those for whom we believe the treatment might provide a benefit. Typically, we do not think hastening death provides benefit when an individual is not experiencing a terminal illness. Thus, I conclude, either all treatments are discriminatory, or medical aid in dying is not. Second, I argue that permitting individuals to refuse or remove life sustaining care may very well cause...

Smajdor’s Reification and Assent in Research Involving Those Who lack Capacity claims, among other things, that ‘adults who cannot give informed consent may nevertheless have the ability to assent and dissent, and that these capacities are morally important in the context of research’.1 More pointedly, she suggests we can rely upon Gillick competence, or that ‘it is worth thinking about why the same trajectory [as children] has not been evident in the context of [adults with impairments of capacity to give informed consent (AWIC)]’.1 I argue that her likening assent in AWIC to assent in children is problematic for at least two related reasons. First, direct comparisons between AWIC and children run the risk of perpetuating or reinforcing infantilising stereotypes against people with disabilities. Second, I argue that people with disabilities are vulnerable in ways that most children are not, and thus, are dissimilar in a morally relevant manner. The infantilising of people with disabilities is quite widely documented and thought to be deeply problematic.2 Not only are people with disabilities often thought to be infantile in regard to particular …

I argue that despite criticism from some disability rights organizations, aid in dying is morally permissible. First, I suggest that disability-related concerns can be classified as emerging from one of two kinds of harm: person affecting, and personhood affecting. Second, I examine whether person affecting harm has occurred within those jurisdictions that have legalized aid in dying. I conclude that despite suggestions to the contrary, there is no evidence to demonstrate that people with disabilities have been adversely impacted by legalized medical aid in dying. Third, I entertain these same arguments as a matter of principle and conclude the principled objections should not give us reason for concern. Fourth, I explore whether we have evidence to suggest the presence of increased personhood affecting harm where aid in dying is permissible. I suggest, through a focus on disability support services, that no evidence of social attitudes that diminish the moral worth of disabled people is present. Fifth, I examine whether we ought to have a principled concern with personhood affecting harm emerging from medical aid in dying. I conclude that to the contrary, to deny people with disabilities access to aid in dying constitutes a morally egregious form of personhood affecting harm.

This book presents the argument that health has special moral importance because of the disadvantage one suffers when subjected to impairment or disabling barriers. Christopher A. Riddle asserts that ill health and the presence of disabling barriers are human rights issues and that we require a foundational conception of justice in order to promote the rights of people with disabilities. The claim that disability is a human rights issue is defended on the grounds that people with disabilities experience violations to their dignity, equality, and autonomy. Because human rights exist as a subset of other justice-based rights, Riddle contends that we must support a foundation of justice compatible with endorsing these three principles. This volume argues that the “capabilities approach” is the best currency of justice for removing the disabling barriers that consistently violate approximately one billion people’s human rights.

This article suggests that those individuals typically acknowledged as vulnerable during public health crises, such as pandemics, are often-times doubly so. I suggest that individuals can be vulnerable in a person-affecting way as well as in a personhood-affecting way. I suggest that the former notion of vulnerability coincides with many existing accounts of vulnerability and that subsequently, many of the more standard arguments for moral and justice-based obligations to minimize such vulnerability, hold. I also suggest that the latter notion of vulnerability adds another layer of vulnerability to those that we typically view to be at risk. I argue that personhood-vulnerability constitutes a novel interpretation of vulnerability than expands our ideas of the kinds of harm that emerge during public health crises.

In this brief paper, a case is made for the moral permissibility of assisted dying. The paper proceeds by highlighting a common critique from within disability rights scholarship and advocacy that emphasizes the vulnerability of people with disabilities and the risks associated with permitting assisted dying. The paper suggests that because medicine necessarily involves risk, primarily through the high likelihood of medical error, that the risk and harm being utilized as a justification to prohibit assisted dying by disability rights scholars is in fact, not conceptually or morally unique. Finally, it is argued that because all medicine involves a risk of harm, and assisted dying is not unique in this respect, that one cannot effectively launch a critique of assisted dying on this basis.

This article explores at least two dominant critiques of assisted dying from a disability rights perspective. In spite of these critiques, I conclude that assisted dying ought to be permissible. I arrive at the conclusion that if we respect and value people with disabilities, we ought to permit assisted dying. I do so in the following manner. First, I examine recent changes in legislation that have occurred since the Royal Society of Canada Expert Panel on End-of-Life Decision-Making report, published in this journal. I suggest that these changes are likely to only strengthen opposition to assisted dying from disability rights activists and people with disabilities. Second, I focus on respect for people with disabilities and in particular, respect for their autonomy and decision-making abilities. Third, I explore the opposition to assisted dying that focuses on risk and the vulnerability of people with disabilities. Here I suggest that this risk ought not to be of special concern. Ultimately, I conclude that upholding respect for the disabled requires the legalization of assisted dying, rather than the denial of access in a misguided effort to protect people with disabilities.

From Disability Theory to Practice pays tribute to Professor Jerome Bickenbach’s highly influential and immensely important work. Professor Bickenbach is a scholar, policy-maker, and activist, of international stature. This volume brings together ten friends, mentors, and mentees, who have penned eight chapters engaging in topics that range, as the title suggests and as Professor Bickenbach’s work has spanned, from theory to practice. This volume begins, much as Professor Bickenbach’s career has, by grappling with philosophical and sociological issues related to the definition of disability, its relation to health, and conceptions of justice for people with disabilities. Subsequently, these conceptions are utilized to advance policy suggestions that range from assisted dying legislation, mental health policy, and the implementation of the International Classification of Functioning, Disability and Health.

Recent discussions surrounding the conceptualising of disability has resulted in a stalemate between British sociologists and philosophers. The stagnation of theorizing that has occurred threatens not only academic pursuits and the advancement of theoretical interpretations within the Disability Studies community, but also how we educate and advocate politically, legally, and socially. More pointedly, many activists and theorists in the UK appear to believe the British social model is the only effective means of understanding and advocating on behalf of people with disabilities. This model, largely reliant upon materialist research traditions, contends that disability is a form of social oppression and hence, is a phenomenon that should be conceptualised in social terms. Individual properties such as impairments are disregarded as they are viewed to be unimportant in the analysis of the social causes of disability. Concurrently, many bioethicists and philosophers have embraced what Tom Shakespeare has classified as an ‘Interactional Approach’ to disability—that “the experience of a disabled person results from the relationship between factors intrinsic to the individual, and the extrinsic factors arising from the wider context in which she finds herself”. I intend to demonstrate that the benefits of the British social model are now outweighed by its burdens. I suggest, as Jerome Bickenbach has, that while it may be somewhat churlish to critique the social model in light of its political success, taken literally, it implies that people with disabilities require no additional health resources by virtue of their impairments. Despite the eloquent arguments that have preceded me by interactional theorists, none have been accepted as evidence of fallacious reasoning by British social model theorists. This article is an attempt to clarify why it is that the types of arguments British social model theorists have been offering are misguided. I suggest that the British social model, unlike an interactional approach, is unable to provide a realistic account of the experience of disability, and subsequently, unable to be properly utilized to ensure justice for people with disabilities

This article explores gun control and the ethics of hunting and suggests that hunting ought not to be permitted, and not because of its impact on those animals that are hunted, but because of the risk other humans are subjected to as a result of some being permitted to own guns for mere preference satisfaction. This article examines the nature of freedom, its value, and how responsibility for the exercising of that freedom ought to be regarded when it involves subjecting others to a risk of grave bodily harm. A distinction between two kinds of freedom is put forth and it is argued that it would be wrong to sacrifice freedoms of intrinsic worth for freedoms of instrumental worth.