The Concept of Disability: A Philosophical Analysis
Ralston, David Christopher
Engelhardt, H. Tristram, Jr.
Doctor of Philosophy
At the most general level, this project seeks to engage the question, "What is disability?" The conceptual exploration is undertaken against the background of the philosophical literature addressing the nature of disease, illness, and disability. This work contends that much of the literature bearing on the nature of disability fails to distinguish sufficiently between different domains of philosophical explanation and concern--ontological, non-moral normative, and moral normative, respectively. Specifically, this involves a failure to distinguish among (a) disputes regarding the proper ontological characterization of disability, particularly as expressed in medical-scientific explanations of the phenomenon; (b) disputes regarding the role of non-moral (aesthetic, epistemic, cultural) values or norms in the constitution of those explanations (i.e., non-moral normative concerns); and (c) disputes regarding moral and political considerations that shape the character of the social reality within which persons with disabilities live (i.e., moral normative concerns). This work advances the thesis that disabilities, like diseases, are "natural," in the sense that they are not mere social constructions, but that values of various sorts nevertheless do enter into the identification of states of affairs as disability, and that the "disability" designation has important socio-cultural implications that are inevitably the subject of ongoing political negotiation. Specifically, this work argues that "disability" involves a complex interplay of ontological realities, non-moral normative, and moral normative considerations or values. This interplay is captured well by a "biopsychosocial" (BPS) approach to disability, one which incorporates these various considerations into a single account, involving an integration of different levels of explanation (biological, psychological, social) of the disability phenomenon. This work first develops the theoretical underpinnings and rationale for a BPS approach to disability (Chs. 1-3), then explores in detail some of the relevant ontological (Ch. 4), non-moral and moral normative (Ch. 5), and sociological and political (Ch. 6) considerations that enter into the identification of states of affairs as "disability," concluding (in Ch. 7) with a brief consideration of some of the study's implications for understanding the nature of disability, the future of disability studies and the disability rights movement, and the relationship between the disabled and the broader society.