Why is it Bad to Have a Disability?

Abstract

The contrast between public views regarding the impact of a disability on human well-being, also aired in scientific discourse, and the views of disabled people regarding their own well-being is considerable. Disabled people often report a high level of subjective well-being, whilst the outside assumption is that they have little reason to feel like this, or that they are rationalising their situation, distorting their perception or degrading themselves (Albrecht and Devlieger 1999). The assumption endorsed in public perception and in scientific discourse—including philosophy and ethics—is that disability generally involves a drastic reduction in overall well-being and that disability not only implies relative disadvantage or affects certain aspects of well-being (e.g. health, mobility or education) but is overall a standard example of a serious detriment in absolute well-being. In what follows I will challenge this assumption. The problem I see in it is twofold. Firstly, disability is often used as a generalisation, without further specification of which disability is meant. I will indicate which disabilities indeed result in a serious detriment in human well-being or even make it impossible to apply the very concept of well-being. Secondly, the assumption that disability leads to a reduction in well-being in absolute terms—again without further specification—is problematic. Even if it is plausible to argue that it is better not to be disabled than to be disabled, and that the impairment to a bodily function or structure does affect elements of a good life (e.g. health), it does not immediately follow that overall well-being is affected in serious ways (Schramme 2013). Again, it is plausible to argue that impairments affect overall well-being. But this alone does not tell us how much and in what ways well-being is affected. If it did directly follow that overall well-being is affected in severe ways, then every affect on a single element of a good human life would lead to an absolute detriment of wellbeing. Human well-being is affected by various relative disadvantages and is far from being perfect. However, in order to understand the most pressing questions of justice concerning disability on a theoretical and a practical level, it is necessary to develop an understanding as to which disabilities pose a serious detriment to a human well-being. The impact of disability on human well-being has a clear significance in two regards. Firstly, the significance is of a theoretical nature. Assumptions about the impact of disability on human well-being shape the form and content of justice theories, for example (Nussbaum 2006). Secondly, a practical significance comes to light when attempts at clarification of the impact of disability on wellbeing are made on a cultural and social basis, affecting dealings with, and treatment of people with disabilities. Two points are important. Firstly, I shall concentrate on the issue of which disabilities are detrimental to human well-being, and for which reasons. As in the following part of the paper I concentrate mainly on the bio-statistical side of disability and thus the impairment of bodily functions and structures and their influence on human well-being, I mainly speak of impairments instead of disabilities. I thus highlight the descriptive side of the concept of disability.