EQUALITY, FREEDOM, AND/OR JUSTICE FOR ALL: A RESPONSE TO MARTHA NUSSBAUM

Abstract: This essay is a reply to Martha Nussbaum's "Capabilities and Disabilities." It endorses Nussbaum's critique of the social-contract tradition and proposes that it might be productively contrasted with Michael Walzer's critique of John Rawls in Spheres of Justice . It notes that Nussbaum's emphasis on surrogacy and guardianship with regard to people with severe and profound cognitive disabilities poses a challenge to disability studies, insofar as the field tends to emphasize the self-representation of people with disabilities and to concentrate primarily on the aesthetic and political representation of physical disability. The essay concludes with an account of a recent exchange with Peter Singer on the question of our social expectations of people with Down syndrome.     

Disabilities and impairments: strategies for workplace integration

This article argues that disabilities are, within many of the U.S. debates, best understood as certain kinds of impairment affecting a person's capabilities to perform socially defined roles and functions within specific environments. We also argue that it is not the impairments per se that lead to claims about what we ought to do or ought not do for people with disabilities. Rather, it is only within the context of capabilities being linked to the concept of freedom--almost universally valued in the current U.S. socio-political environment--that disability issues take on an ethical tenor. Additionally, we link the notion of disability to that of social capital. In particular, we argue that any social organization that discriminates against people with disabilities by attenuating their opportunities within that environment also decreases the social cohesion that exists within that organization. Such corporate climates promote organizational structures and processes that fail to optimize facilitation of the mutual benefits of the members. Finally, we discuss three different kinds of accommodation strategy: assistive technologies, systemic personal change, and universal design. We suggest a case-based (casuistic) approach to problems caused by disabilities. Using methods from both philosophy and public policy, we then build policies for accommodations incrementally, based on an application of those methods to the cases, and resulting in a more nuanced process enabling the creation of policies that take account of the experiences of both disabled and non-disabled people.     

THE CAPABILITIES OF PEOPLE WITH COGNITIVE DISABILITIES

Abstract: People with cognitive disabilities are equal citizens, and law ought to show respect for them as full equals. To do so, law must provide such people with equal entitlements to medical care, housing, and other economic needs. But law must also go further, providing people with disabilities truly equal access to education, even when that is costly and involves considerable change in current methods of instruction. The central theme of this essay is what is required in order to give such people political and civil rights on a basis of genuine equality.     

A focus group study on the potential of autonomous vehicles as a viable transportation option: Perspectives from people with disabilities and public transit agencies

Autonomous vehicle (AV) technology is becoming one of the most promising alternatives to improve mobility for people with disabilities. Nevertheless, how people with disabilities perceive AV as transportation services has not been explored. Also, limited information exists about how public transit agencies comprehend and perceive autonomous vehicle transportation (AVT) services. This study discusses mobility issues for people with disabilities and explores the potential of AVT to serve that population, particularly those with visual impairments or physical disabilities. Researchers conducted six focus groups comprising people with disabilities (N = 23) and public transit service experts (N = 10) in Austin, Texas and Houston, Texas. Each session was audio-recorded and analyzed using conventional content analysis. This study identified people with disabilities’ mobility issues related to: (1) current transit services (including fixed-route and paratransit services) and (2) the quality of neighborhood built environments. Both people with disabilities and transit experts expected that AVT could mitigate current mobility issues, especially in improved built environments. However, participants with disabilities also expressed concerns and anxieties regarding AVT. Transit experts agreed that more targeted strategies would be needed to overcome possible barriers to AVT for people with disabilities. This study provides insights on shaping AVT strategies and policies relevant to improving mobility for people with disabilities.     

Poverty Among Adults with Disabilities: Barriers to Promoting Asset Accumulation in Individual Development Accounts

Adults with disabilities disproportionally experience poverty. We examine one novel strategy to promote economic well-being among adults with disabilities living in or near poverty, namely Individual Development Accounts (IDAs). IDAs are designed to help individuals save money and subsequently accumulate assets. Although adults with disabilities account for the majority of IDA participants, scant attention has been paid to their IDA saving performance. We describe the significance of accumulating assets, particularly as it relates to adults with disabilities. We then map the nature of IDA programs and analyze barriers to participation in IDAs and asset accumulation related to conflicting federal policies and a lack of sensitivity to disability-specific needs. We conclude by offering policy recommendations from our analysis, including the need to eliminate the means-tests used in welfare policies, de-linking participation in IDAs from employment status, and involving people with disabilities in designing and evaluating asset accumulation policies and programs.     

Cognitive Impairment and the Right to Vote: A Strategic Approach

Most democratic countries either limit or deny altogether voting rights for people with cognitive impairments or mental health conditions. Against this weight of legal and practical exclusion, disability advocacy and developments in international human rights law increasingly push in the direction of full voting rights for people with cognitive impairments. Particularly influential has been the adoption by the UN of the Convention on the Rights of Persons with Disabilities in 2007. Article 29 declares that states must ‘ensure that persons with disabilities can effectively and fully participate in political and public life on an equal basis with others, directly or through freely chosen representatives, including the right and opportunity for persons with disabilities to vote and be elected’. This article also argues for the right of all people to vote, including people with cognitive impairments, by adopting a uniquely strategic approach. Firstly, some of the strategic limitations of existing arguments in favour of extending the franchise are highlighted. Most such arguments are flawed because they run the risk of inviting disparaging philosophical commentary which compares disabled people to animals, or because they are based on implausible empirical claims, or because they inadvertently tie the case for voting rights for the disabled to other cases unlikely to ever enjoy widespread acceptance. This article, instead, justifies extending voting rights to all people with cognitive impairments based on a simple cost‐benefit analysis that avoids all of these problems.     

心理贫困：概念、表现及其干预

长期物质贫困产生特殊的心理后果——心理贫困。心理贫困指的是不利于贫困阶层摆脱贫困的心理与行为模式,主要表现为 “志向失灵”与“行为失灵”,即抱负与志向缺位,理念和意识扭曲,能力与行为方式错位,还易于做出不利于脱贫的决策行为;长此以往,就陷入“贫穷—特定心理与行为模式—继续贫穷”的恶性循环。对此,研究者们先后开发了有条件现金转移项目、减少认知资源损耗项目、“转移和坚持”心理干预策略、社会阶层流动信念干预策略、公平感提升策略等干预方案。该领域研究及其相关成果对“精准”扶贫,促进社会公平、增加人类福祉具有重要意义。未来研究应在整合的干预方案和本土化的干预方案等方面予以加强。     

心理贫困：概念、表现及其干预

长期物质贫困产生特殊的心理后果——心理贫困。心理贫困指的是不利于贫困阶层摆脱贫困的心理与行为模式,主要表现为 “志向失灵”与“行为失灵”,即抱负与志向缺位,理念和意识扭曲,能力与行为方式错位,还易于做出不利于脱贫的决策行为;长此以往,就陷入“贫穷—特定心理与行为模式—继续贫穷”的恶性循环。对此,研究者们先后开发了有条件现金转移项目、减少认知资源损耗项目、“转移和坚持”心理干预策略、社会阶层流动信念干预策略、公平感提升策略等干预方案。该领域研究及其相关成果对“精准”扶贫,促进社会公平、增加人类福祉具有重要意义。未来研究应在整合的干预方案和本土化的干预方案等方面予以加强。     

What the State Owes ‘Bastards’: A Modest Critique of Modest One-Child Policies

This essay criticises ‘modest’ one-child policies, which would impose sanctions upon parents who create multiple children. Specifically, this article considers what the state owes individuals who would be born (illegally) beneath restrictive procreative policies and argues that such policies would fail to show due respect to second- or third-born individuals created beneath them. First, I argue that modest procreative restrictions (like sanctions) are likely to generate only modest compliance. I then suggest it is reasonable to think a one-child policy fails to demonstrate due respect to existing second and third children. I argue that such a policy generates an undue burden on any second or third children who would be born beneath them, before concluding by considering whether the state might be able to avoid effectively reinscribing ‘bastardy’ into its law by locating responsibility for the effects of such a policy entirely on the parents, rather than on children.     

Transforming psychological practice and society. Policies that reflect the new paradigm

As people with disabilities challenge psychology to acknowledge the sociopolitical foundations of their marginalization, they urge psychologists to help improve disability policy within and beyond the borders of the discipline. Understanding disability through a social paradigm offers opportunities to reframe the way psychologists define problems related to disability, to develop more collaborative relationships between psychologists and people with disabilities, and to adopt new professional responsibilities with respect to the disability community. The authors address the impact of the social paradigm on policies within psychology that guide consulting, advocacy, and training. The impact of national policy decisions, such as those associated with reimbursement, on practice and training is also discussed. Highlighted throughout are points of controversy prompted by new disability frameworks that remain open to illumination from the field.     

On the ethical evaluation of stem cell research: remarks on a paper by N. Knoepffler

This response to Nikolaus Knoepffler's paper in the same issue of the Journal agrees that if the arguments supporting the first two of the eight human embryonic stem cell research policy options discussed are unsound, as Knoepffler argues, then it seems natural to move to the increasingly permissive options. If the arguments are sound, however, then the more permissive options should be rejected. It is argued that three of the rejected arguments, taken together, constitute very good reasons to hold that a human embryo is endowed with dignity from fertilization onward. Thus, countries that want their public policies to match the moral imperative of respect for human beings should refrain from allowing destructive human embryo research and should devote considerable energy and public funds to research and clinical trials using non-embryonic ("adult") stem cells.     

Can I Make a Difference? Efficacy,Employment, and Disability

Political efficacy is a widely studied phenomenon and an important predictor of political participation, but little is known about the political efficacy of the millions of people with disabilities in the United States. This paper reports the results of a nationally representative telephone survey of 1,240 people—stratified to include 700 people with disabilities—following the November 1998 elections. Several measures of efficacy that help predict political activity were found to be significantly lower among people with disabilities than among otherwise similar people without disabilities. Although lower levels of internal efficacy and civic skills could largely be explained by educational and employment gaps, lower levels of other variables (external efficacy, perceived influence of people with disabilities, and perceived treatment of people with disabilities) remained after applying a wide range of controls, indicating that people with disabilities are less likely to see the political system as responsive to them. This perception is concentrated among non–employed people with disabilities. The lower efficacy levels linked to "disability gaps" in employment, income, education, and group attendance appear to account for as much as half of the disability political participation gap; hence, policies intended to increase employment and educational opportunities for people with disabilities have potentially important political effects.     

The Provision of Assistive Technology by Occupational Therapists Who Practice in Mental Health

The purpose of this study is to determine what assistive technology devices occupational therapists working in mental health settings use with their clients. Based on the literature, the authors expected that no tech and low tech assistive technology solutions are being used with clients in these settings even though high technology options are available for people with mental illness who have co-existing cognitive disabilities. The findings of the study reveal that indeed no tech and low tech interventions are most often used. Implications for professional development educational programs and further research are suggested.     

Restoring the Image: Spirituality, Faith, and Cognitive Disability

There is a great deal of theological confusion within the church as to the level of participation people with profound cognitive disabilities should be allowed within the orders of the church. For some, sacramental participation without intellectual comprehension is dishonoring to God, while for others, lack of cognitive ability precludes any kind of meaningful spiritual life. This paper sets out some of the various positions and argues that faith and spirituality are not intellectual concepts, but relational realities. It is only in and through our relationships that any of us can learn anything about the divine. A relational understanding of faith and spirituality as outlined here offers the church the freedom to avoid evaluating a person's spiritual life according to intellectual criteria and to begin to find new ways of preaching the Word to those who have no words.     

Reducing workplace bias toward people with disabilities with the use of imagined contact

In this research we test the effectiveness of imagined intergroup contact as an intervention that improves attitudes toward people with disabilities in organizational settings. We conducted two experimental studies with the aim of examining the bias‐reduction effects of imagined contact on attitudes toward people with disabilities. Furthermore, we examined how imagined contact can be most effective in improving attitudes in work situations. Both studies yielded evidence that the imagined contact intervention significantly impacted on two dependent variables: expected work‐related outcomes and support for the rights of people with disabilities, via enhancing the belief in performance level. We discuss the results in the context of developing effective and accessible intervention tools, which can be used in workplace trainings, and can promote anti‐discriminatory policies in organizations.     

Optimization and improvement

Agents face serious obstacles to making optimal decisions. For instance, their cognitive limits stand in the way. John Pollock’s book, Thinking about Acting, suggests many ways of revising decision principles to accommodate human limits and to direct limited, artificial agents. The book’s main proposal is to replace optimization, or expected-utility maximization, with locally global planning. This essay describes optimization and locally global planning, and then argues that optimization among salient options has the virtues of locally global planning without certain drawbacks. Although it does not endorse locally global planning, it recommends that decision theory incorporate some of the book’s ideas about settling for improvements when optimization among all options is unrealistic.     

Disability as diversity in Fortune 100 companies

To investigate the inclusion of people with disabilities in the diversity policies of the most successful businesses in the United States, we examined the publicly available workforce and supplier diversity policies of the top 100 companies on Fortune Magazine's 2003 list of the 500 most profitable companies in the nation. The majority of these companies have extensive information about their diversity policies and practices available on their corporate website. The information was used to categorize the policies into those that include people with disabilities, do not define diversity, and enumerate what is meant by diversity (e.g. in terms of race or gender) but do not expressly mention disability. In addition, we looked beyond the diversity policies to information available on corporate websites relating to a variety of diversity initiatives. Findings suggest that the majority of the companies that top the Fortune 500 list have developed and implemented diversity policies. Of these, 42% have diversity policies that include people with disabilities in the definition of a diverse workforce. Furthermore, 47% of companies with workplace diversity policies discuss diversity in a way that neither expressly includes nor excludes people with disabilities. Far fewer (15%) supplier diversity policies include disability in the definition of diversity, but a significant number of companies use criteria that allow a business owner with a disability to benefit from the company's supplier diversity program.     

A factor analysis for identifying people with disabilities’ mobility issues in built environments

Neighborhood built environments (BE) have been recognized as an important aspect that can, directly and indirectly, impact people with disabilities’ mobility. While many efforts have been made to improve the quality of BE, people with disabilities still perceive inequality in BE. The objective of this study is to identify the factors influencing people with disabilities’ attitudes toward BE that can facilitate or suppress their mobility, using exploratory factor analysis. This study specifically focuses on people with physical disabilities and people with visual impairments living in Austin, TX and Houston, TX metropolitan areas in USA. Data was gathered through an online survey. This study identified three factors from the sample: 1) barrier-free BE; 2) BE supporting safe travel; and 3) walkable BE. In addition, the factors were compared according to the respondents’ demographic information, such as income level, disability type, and private car use availability in households. Regarding income level, low-income individuals with disabilities perceived BE more negatively than their counterparts did. As for private car availability, people with disabilities who have no car in their households had a more negative perception of BE. However, no differences were found in the attitudes across disability types. This study contributes to understanding what BE factors are important for people with disabilities. The findings suggest the importance of establishing more targeted and prioritized strategies, considering people with disabilities’ neighborhoods and individual characteristics, for the improvement of their mobility.     

Freedom and Disability Rights: Dependence,Independence, and Interdependence

The increasing focus on disability rights—as found, for instance, in the U.N. Convention on the Rights of Persons with Disabilities (CRPD)—challenges philosophical imaginaries. This article broadens the philosophical imaginary of freedom by exploring the relation of dependence, independence, and interdependence in the lives of people with disabilities. It argues (1) that traditional concepts of freedom are rather insensitive to difference within humanity, and (2) that the lives of people with severe disabilities challenge philosophers to argue and conceptualize freedom not only as independence and interdependence but also as dependence. After tracing this need through a Hegelian understanding, via Julia Kristeva's work on disability, and finally the CRPD, it concludes that a unified solution might not be possible. Hence, it argues that disability issues necessitate philosophical modesty.     

Why Do People Join Groups? Three Motivational Accounts from Social Psychology

This paper describes and contrasts three contemporary social psychological theories that focus on why people join and identify with groups: the sociometer model, terror management theory, and uncertainty–identity theory. The sociometer model argues that people have a need to be socially included, and that self‐esteem is a meter of successful inclusion and group belonging. Terror management theory argues that people are motivated to reduce fear of the inevitability of their own death, and that the consensual belief–confirmation provided by groups drives people to belong. Uncertainty–identity theory argues that people have a basic need to reduce uncertainty about themselves, their attributes, and their place in the world, and that cognitive processes associated with group identification reduce such uncertainty. We critically contrast these three accounts to conclude that all three motivational processes may play a role, but that self‐uncertainty may have the benefit of wide generality to all groups and group contexts and of detailed specification of cognitive processes.