“I’d Rather Be Dead Than Disabled”—The Ableist Conflation and the Meanings of Disability

Despite being assailed for decades by disability activists and disability studies scholars spanning the humanities and social sciences, the medical model of disability—which conceptualizes disability as an individual tragedy or misfortune due to genetic or environmental insult—still today structures many cases of patient–practitioner communication. Synthesizing and recasting work done across critical disability studies and philosophy of disability, I argue that the reason the medical model of disability remains so gallingly entrenched is due to what I call the “ableist conflation” of disability with pain and suffering. In an effort to better equip healthcare practitioners and those invested in health communication to challenge disability stigma, discrimination, and oppression, I lay out the logic of the ableist conflation and interrogate examples of its use. I argue that insofar as the semiosis of pain and suffering is structured by the lived experience of unwelcome bodily transition or variation, experiences of pain inform the ableist conflation by preemptively tying such variability and its attendant disequilibrium to disability. I conclude by discussing how philosophy of disability and critical disability studies might better inform health communication concerning disability, offering a number of conceptual distinctions toward that end

Disabled Autonomy

Disability law is still undertheorized. In 2007, Ruth Colker wrote that disability law was undertheorized because it conflated “separate” with “unequal,” and because disability was largely ignored or poorly understood within theories of justice. The solution for Colker was to attach the anti-subordination perspective, which was developed to apply to race and sex, directly to disability. This Article argues that this transportation from the race and sex contexts was a partial solution, but is not sufficient to give full substance to disability law theory. Concepts from critical race theory and feminist jurisprudence have long been simply transported into the disability context, acting as an imperfect facsimile. The primary purpose of those concepts was to describe, analyze, and remedy problems primarily related to race and gender, not disability. While disability law has benefitted to some extent from inclusion in these legal theories, many of the unique features and complexities of disability law have been left on the table. This Article explores those complexities. Autonomy, usually thought of as an uncomplicated social good for other groups, is challenged in disability theory by two competing values. The value of anti-subordination is critical because it seeks to address, and redress, discrimination, sigma, and stereotyping. An anti-subordination perspective gives a voice and supplies resources to people with disabilities, and will counsel against choices that support stigma and stereotyping. An anti-subordination perspective might seek to limit a right to physician-assisted suicide, for example, because of concerns about exploitation and the messaging that disabled lives are not worth living. This runs counter to an autonomy-focused perspective, which would support the choice to end one’s life in the end stages of a terminal disease. An anti-eliminationism perspective advocates for the preservation of, and resources for, disabled lives. This comes to mean that not only are people with disabilities valued, but their disability is valued too. Instead of seeking to end Autism, for example, an anti-elimination perspective seeks to support Autistics. However, an anti-eliminationism perspective might also support the restriction of choice, and therefore come into conflict with autonomy, where there is a choice that results in the end of a disability. An anti-elimination perspective could seek to restrict the ability to selectively terminate pregnancies when a disability is found, for example. Anti-eliminationism inherently challenges the notion that getting rid of disability is a good thing. Parts I, II, and III of this Article describe the values of autonomy, anti-subordination, and anti-eliminationism in the disability context, and argue that these values are each critical components of disability law and theory. Part IV of this article provides an overview of some real-world examples where these values come into immediate conflict

Paralympic cultures: disability as paradigm

This is an article about the Paralympic Games of summer 2012 and the experience of watching them. It rehearses the use of disability as political and cultural identity in relation to theatre and performance studies. Disability identity is not an identity based on similitude, but is a complex and nuanced relationship between singularity of embodied social experience and glimmers of common ground. Taking the works of Rod Michalko and Petra Kuppers as a representative foundation of disability studies, the article offers disability as an epistemological standpoint, a way of thinking, and not an object of thought. The argument works through close readings of three examples to introduce the theatre and performance studies reader to the notion of disability as a paradigm for the consideration of ideas of difference, similitude and identity. The process of reading the Paralympics from the perspective of a disabled person, bike riding sports fan and disability performance scholar gestures to the scope and potential of disability performance studies. The article accumulates three examples of one disabled person navigating a complex set of positions, all of which are iterations of disability. Whilst this critical approach might imply solipsism, the article also considers disability as community

Poverty and Disability: The Endless Loop

[Excerpt] Disability is a critical dimension of poverty in developing countries because poverty contributes to disability and disability leads to poverty. Poverty alleviation measures are unlikely to help poor disabled people who are insulated from information and isolated from opportunities and services by a de facto apartheid enforced by informational, physical and social obstacles. To be fully effective, poverty programs must take disability explicitly into account. The World Bank has noted that without paying attention to the rights and needs of people with disabilities (PWDs), Millennium Development Goals are unlikely to be achieved

Moral wrongs, disadvantages, and disability: a critique of critical disability studies

Critical disability studies (CDS) has emerged as an approach to the study of disability over the last decade or so and has sought to present a challenge to the predominantly materialist line found in the more conventional disability studies approaches. In much the same way that the original development of the social model resulted in a necessary correction to the overly individualized accounts of disability that prevailed in much of the interpretive accounts which then dominated medical sociology, so too has CDS challenged the materialist line of disability studies. In this paper we review the ideas behind this development and analyse and critique some of its key ideas. The paper starts with a brief overview of the main theorists and approaches contained within CDS and then moves on to normative issues; namely, to the ethical and political applicability of CDS

Clinical Pathways to Disability

This paper examines the pathways by which individuals transition from healthy to disabled. Because of the high prevalence and costs associated with disability, understanding these pathways is critical to developing interventions to prevent or minimize disability. We compare two estimates of disabling conditions: those observed in medical claims and conditions indicated by the disabled individual. A small number of conditions explain about half of incident disability: arthritis, infectious disease, dementia, heart failure, diabetes, and stroke. These conditions show up in medical claims and self reports. A large number of elderly also attribute disability to old age and various symptoms. Because so many of the most disabling conditions do not have clear medical treatments, the outlook for major reductions in disability might be limited.

Tragic but brave or just crips with chips? Songs and their lyrics in the Disability Arts Movement in Britain

Disability culture is a site within which social and positional identities are struggled for and dominant discourses rejected; in which mainstream representations of people with impairments – as victims of personal tragedy – are held to the light and revealed as hegemonic constructions within a disabling society. Drawing upon styles that range from jazz, blues and folk to reggae, performance poetry and punk, disabled singers and bands in the Disability Arts Movement in Britain have been central to the development of an affirmative disability discourse rooted in ideas of pride, anger and strength. Examining lyrics by Johnny Crescendo, Ian Stanton and the Fugertivs – performers emerging as part of this movement in the 1980s and 1990s – this article considers the dark humour which runs through much of this work. It is suggested that these lyrics' observational reflections on everyday experiences of being oppressed as disabled people have been overlooked within critical disability studies to date, but are important in developing an understanding of positive disability identity as a tool available to disabled people in order to make sense of, and express themselves within, the world in which they find themselves

Disability pensions and social security reform : analysis of the Latin American experience

This paper describes the disability pension arrangements prevailing in ten Latin American countries that reformed their pension systems. The analysis is limited to the topic of disability pensions, without attempting to evaluate other critical aspects such as the available infrastructure: handicapped access generally (ramps, blind cues), medical and nursing support, home care, and so on. The relative significance of disability pensions is highly dependant on these factors and, however, they are really limited in most countries of Latin America.Gender and Law,Social Protections&Assistance,Pensions&Retirement Systems,Gender and Law,Social Cohesion

Return-of-Premium Endorsements for Living-Benefits Insurance Policies: Rational or Irrational?

Insurance companies selling Critical Illness, Disability, and Long-Term Care insurance policies typically offer consumers the option to purchase an endorsement that returns the nominal value of all premiums paid (over the life of the policy) if the policy is not used during the policy term. The endorsement costs the policyholder extra money. Simple calculations show that it is prima facie irrational to purchase the endorsement since the conditional implied rate-of-return on the asset (return-of-premium endorsement) is almost twice as worse as a market index; the unconditional rate of return is even worse. Behavioral explanations for the purchase of these otherwise irrational endorsements are considered.Behavioral Economics, Insurance, Critical Illness Insurance, Disability Insurance, Long-Term Care Insurance

'Caught Between a Rock and a Hard Place': Anti-discrimination Legislation in the Liberal State and the Fate of the Australian Disability Discrimination Act

This article offers a critical analysis of some of the practical implications for disabled people of the Disability Discrimination Act of 1992. Specifically, it raises questions about politics and the role of the law as an instrument of social change?taking greater account of the interests of disabled people?on the one hand, and of the reliance of the social model of disability on a strategy based upon legal rights on the other. The article also suggests that the constraining effects of Australia's constitutional protections of rights and its federal system of government hinder the mildly progressive elements of the Disability Discrimination Act. To illustrate this, the paper employs empirical evidence to suggest that these effects have been exacerbated by the passage of the Human Rights Legislation Amendment Act in 1999