Sara Purinton

This paper raises a set of dilemmas centered on the role that vagueness should play in an adequate theory of disability. These dilemmas arise because we expect the concept of disability to serve many different, often conflicting normative roles. Some of these roles would be better served with a more precise conception of this category, but other roles are better served with less precision. This gives rise to the first dilemma, which is that we should strive to reduce vagueness and not reduce vagueness in our theories of disability. The second dilemma stems from the fact that some normative roles are better served with a more expansive conception of disability, while other roles speak in favor of adopting a narrower understanding of the category. This gives rise to the second dilemma, which is that we should expand and narrow the boundaries of this category. I ultimately argue that we can resolve certain instances of both dilemmas by adopting a contextual understanding of disability. The paper concludes by drawing out an upshot of my argument for our understanding of disability. In particular, I suggest that the arguments made in this paper lend support to the idea that we should think of disability as a normative concept.

Healthcare providers often rely on the following sort of concerning reasoning when encountering patients with difficult-to-explain symptoms: in the absence of evidence for a physical cause, the symptoms are presumed to be psychological in origin. In this paper, we take up this concern in the context of chronic pain, with particular attention to how such reasoning disproportionately affects women and how it interacts with the many levels of gender bias in medicine. We first examine the unwarranted inference from diagnostic uncertainty to psychogenic diagnosis and explore how identity prejudice and diagnostic uncertainty interact in clinical practice. We then consider additional contributors to diagnostic uncertainty concerning women’s pain: gendered research gaps and male-centered diagnostic paradigms. After outlining the harms associated with psychogenic diagnoses, we consider the objection that such diagnoses might be pragmatically justified. We end by calling for a more nuanced approach to diagnosing and treating chronic pain.

Living with chronic illness can involve fluctuating between radically different bodily states depending on whether you are experiencing flareups of illness symptoms. What you can do in these bodily states can differ drastically from one another. Sometimes, these fluctuations in abilities lead to fluctuations in your values. That is, your evaluative perspective can shift when you are experiencing flareups of the illness. This can give rise to a puzzle for planning, since it is unclear what you should plan on doing when you do not have a stable set of preferences guiding your plans. This paper argues that one way to navigate this puzzle is for the agent to adopt an overarching plan that mediates the conflict between her differing perspectives.