The Minority Body by Elizabeth Barnes (review)

Professor Elizabeth Barnes has produced a tightly and carefully reasoned philosophical examination of the significance of disability. It provides a clear defense of certain core principles of the disability rights movement in contrast to the many professional philosophers (those which I will term [End Page E-5] 'mainstream bioethicists') who consider that movement to be ill-conceived. An example of this tradition can be seen in the volume From Choice to Chance: Genetics and Justice, coauthored by four of the most prominent bioethicists of the turn of the century (Buchanan, Brock, Daniels, and Wikler 2000). (For discussion see Amundson and Tresky 2007; 2008.) I confess to the prejudice implied by my label of 'mainstream bioethicists' as those beset by the prejudice of ableism. The late Adrienne Asch considered herself a mainstream bioethicist even though her progressive views of disability were rare among her colleagues.

Disability rights is a serious civil rights movement, equal in significance to gay rights, feminism, resistance against discrimination on the basis of 'race,' and a number of other such movements. Just as earlier generations of philosophers assumed the legitimacy of the social prejudices of their own times, mainstream bioethicists have assumed the correctness of prevailing assumptions about disability. In this tradition, disabilities are conceptualized as inimical to well-being, they essentially involve suffering, and any civic ameliorations of the problems of disability are seen to result only in slight improvements to the essentially low quality of a disabled life. Barnes argues the contrary. Disabilities should be conceived as mere differences, not bad differences. Her neutral model of disability comports with a great deal of testimony from disabled people themselves. But such testimony is vulnerable to principled dismissals from their philosophical critics (few of them disabled). Barnes proceeds to argue against those dismissals, concluding that they are cases of testimonial injustice. I will sketch aspects of these two conclusions: first her neutral model of disability, and second her defense of the contrary testimony of disabled individuals against dismissal.

The Value-Neutral Model. Barnes acknowledges that individual cases of disability often co-occur with lowered well-being. However she argues that it is a mistake to conclude that disability is itself the cause of lowered well-being. Arguments in favor of the conceptual linkage between disability and lowered life quality are common in the literature. For example: Disability is abnormal function, normal life opportunities require normal function, sub-normal life opportunities therefore imply reduced well-being, which proves that disability implies reduced well-being. (This argument is reconstructed from Buchanan et al. 2000.) How does Barnes refute this inference? She begins by distinguishing between local 'bads' and global 'bads.' Global bads are things that are bad for you on the whole, largely without respect to your situation. Local bads are bad for you only with [End Page E-6] respect to certain contexts or situations. This is nearly all she needs to reveal the value-neutrality of disability. Using a list of individual cases of 'goods' and 'bads' she shows (a) that many things that are highly valued by individuals also have serious 'bads' associated with them and (b) that many people who have significant disabilities also find important 'goods' associated with their disabling conditions. To weaken our assumptions of the bad-making properties of disabilities, Barnes cites some important examples of conditions that have recently been socially reclassified from 'assumed to be bad-making' to 'assumed to be neutral.' One of these is gayness. She reports gayness to be a neutral trait, even though it can surely be associated with very low well-being when it occurs in a social context that is heavily prejudiced against gayness. Our own society has only recently come to hold that gayness is a neutral trait. Not long ago, and certainly within my lifetime, gayness was classified as a psychiatric illness by medical authorities and deemed (by typical Americans) to cause very low well-being. We must notice that majority agreement with Barnes's assessment that gayness is a neutral trait is not necessary for the strength of her argument. Even if...