The last weekend school of the academic year was entitled Disability and the Right to Life: Would the Disabled be better off Dead? This got us off to a rather bad start – lots of people objected to the words after the colon. I used those words because this is what people often say when justifying the abortion of a disabled foetus, or the discarding of a disabled embryo produced through IVF. I apologise to anyone who is/was offended.
The speakers, both of whom were excellent, were Dr. Ben Wood from the University of Chester, and Jeff McMahan, the (relatively) new White’s Professor of Moral Philosophy at the University of Oxford. Jeff stepped in at the last minute to stand in for a speaker who had to pull out. Not bad eh? Getting the White’s Professor of Moral Philosophy as a last-minute stand-in!? I was so relieved and very pleased.
Ben, who is himself disabled, argued that the way we treat the ‘costly’ among us is best considered through the lens of Aristotelian Virtue Ethics, rather than by means of the language of rights, or Utilitarianism cost-benefit analyses. The language of rights, he said, has a tendency to focus on concepts like autonomy and freedom – on individualistic language often not well applied to the disabled, who by reason of their disability, are often less free or autonomous than the able-bodied. Evaluating the utilitarian cost-benefit analysis, on the other hand, depends hugely on the values that are used to determine costs and benefits. If our values accord with the myth of the atomistic individual so prevalent in contemporary thinking, we are likely to think that costly people are just a waste of resources.
But he pointed out, in thinking about the ‘costly’, we usually neglect the fact we were all once babies whose needs had to be satisfied by others, and we will all (with luck) become elderly, again relying on others to satisfy our needs. Each of us is, at some point in our lives, a costly individual. We also neglect to consider the benefits that many who have become carers have perceived only as a result of having become carers.
I can testify to the latter. Until I cared for my parents (both of whom had dementia), I had never given much thought to caring, or to those who do the caring. Having become a carer myself I realised that there was a whole wealth of experience to which I had previously been oblivious. I admit to being glad my caring days are over. But I wouldn’t have missed them for the world. (see my book: Keeping Mum: Caring for Someone with Dementia: On the other hand, we wouldn’t want to produce people with disabilities in order to provide the rest of us with someone to care for would we? That really would be using others as nothing more than means to our own ends.
Jeff considered whether it would be desirable completely to eliminate physical disability should this be possible. He first considered types of screening from pre-conception genetic testing to amniocentesis, with the thought of aborting any child found to be physically disabled . In doing so he distinguished between substituting one person for another (which doesn’t involve killing anything), and replacing one person with another (which does). We substitute one person for another when we hold off conception until we have screened ourselves genetically. Whether replacing one embryo for another involves killing a person depends, of course, on when you believe personhood starts.
Jeff next considered the arguments against the various types of screening for physical disability. There is, of course, the argument that abortion is wrong. This rules out any form of screening that might lead to abortion. Next comes the argument that screening for disability leads to fewer disabled people isolating those who are left and reducing their political clout. Then there is the idea that screening for disability expresses the view that the disabled are of lesser value than the able-bodied, that they are somehow not worth the resources that will be spent on them. Finally there is the idea that screening for disability is likely to reduce diversity which is, in itself, a bad thing.
Jeff suggested that it is a problem for all these objections that if they are correct they seem equally to be arguments for intentionally creating physically disabled people. He mentioned in this regard the Deaf Community, who have explicitly argued that they should be allowed to have IVF in order to discard embryos that can hear in favour of embryos that are, like their parents, deaf.
The following day Jeff discussed screening for cognitive as opposed to physical disability. He emphasised that he would be talking only about severe cognitive disabilities such as anencephaly, not disabilities such as Down’s Syndrome, which are consistent with a high quality of life. Jeff argued that screening for severe cognitive impairment is less controversial than screening for physical disability. This is because those who are severely cognitively impaired have a greatly diminished capacity for well-being. Jeff asked us to reflect on the extent to which our own well-being depends on the fact that we matter to ourselves, something that depends entirely on our cognitive abilities. He noted that whilst objections to screening for physical disabilities have force (though not, as he argued earlier, conclusive force), arguments against screening for severe cognitive impairment seem to lack a corresponding force.
The weekend was hugely stimulating. I suspect that many of us went away to reflect on prejudices that we hadn’t even realised we had.