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Thesis Barnes is right: being disabled is not in itself bad for you

Ethan Mercer Fellow
· 7 replies
DisabilityAnalyticElizabeth Barnes#adaptive-preferences#mere-difference#testimony#wellbeing
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Where it stands

I came to philosophy through effective altruism, where it's common to count disability as a reduction in wellbeing and to rank interventions accordingly. Elizabeth Barnes's The Minority Body changed my mind, and I want to defend her thesis.

Thesis: disability is a ‘mere difference’, not a ‘bad difference’. It may be bad for someone in a given society, through stigma, exclusion and inaccessible design, but it is not intrinsically bad for the person who has it. Being disabled is more like being gay or being a woman in a hostile society than like having a disease that can only diminish you.

The argument I find strongest is about testimony. Many disabled people report levels of wellbeing much higher than non-disabled people predict for them. The usual dismissal is ‘adaptive preferences’: they've lowered their expectations. But we don't treat non-disabled people's reports of their lives that way. If you discount disabled people's testimony about their own lives while trusting everyone else's, you owe an argument for the asymmetry, and the obvious candidate argument assumes disability is bad, which is the point in question.

I'm aware of the hard cases. Chronic pain. Degenerative conditions. Barnes discusses them. I think she can say some impairments involve intrinsic burdens while the category of disability is not a bad-difference category. But I'd like the objections, especially from people who know more than an undergraduate.

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7 replies

For the thesis 2

  1. Dima Nasser

    For Fellow

    For, mostly, and from experience. When I was fourteen everyone assumed my life was ruined. It wasn't. It was different, and the worst parts were other people and buildings. The testimony argument matters because for decades nobody asked us. I'd only add: some days my body is genuinely bad for me, and I resent being told that's off-message. So I'm for the category claim and against any version that requires me to pretend.

    Helpful · 2
  2. Nadia Haddad

    For Fellow

    For, cautiously, from palliative care. I've watched families decide what a patient's life was worth by what they themselves feared, and patients contradict them. The asymmetry Ethan describes is real and it does harm at the bedside. I'd want Barnes's view in the ear of every clinician deciding what treatments are worth offering.

    Helpful · 2

Against the thesis 3

  1. Omar Ragab

    Against Fellow

    Against. Barnes's thesis seems plausible for conditions like deafness, where a rich culture and language exist. It strains for conditions I see in the hospital every day: progressive neuromuscular disease, severe pain, organ failure. If ‘disability’ includes those, the claim that the category is not bad seems to rely on choosing examples. If it excludes them, the thesis becomes smaller than it sounds.

    Helpful · 3
    1. Ethan Mercer

      Fellow

      Omar, I think that's the strongest objection. Barnes's reply, as I read it, is that ‘mere difference’ is compatible with something being locally bad in many ways, as being a woman can involve real burdens without being a bad thing to be. But I agree the progressive cases test it hard.

  2. Priya Raghavan

    Against Fellow

    Against, on the testimony argument specifically. Adaptation isn't something we attribute only to disabled people. Psychologists find it everywhere: lottery winners, new parents, people after divorce. Everybody's reports of their wellbeing drift back toward baseline. That cuts both ways. It means the high reports can't be dismissed as adaptation peculiar to disability, but it also means self-reported wellbeing is a weak measure of whether something is good or bad for you in general.

    Helpful · 1
  3. Alistair Gow

    Against Fellow

    Against, but sympathetic. The thesis has real consequences: prenatal screening, resource allocation, how a GP talks to a new parent. If the view is right, much of what medicine does looks prejudiced. If it's overstated, people may be denied treatments they'd want. I'd rather hold it as a strong corrective than as a settled truth.

    Helpful · 3

Other replies

  1. Ethan Mercer

    Fellow

    I'll revise. I still think the testimony asymmetry is the decisive point against the default assumption that disability is bad. I'm less sure it establishes the strong thesis for every condition the word covers. Perhaps what Barnes wins is the burden of proof: anyone who says a disabled life is worse must now argue it, not assume it.