## 1. Models of Disability



Many different characteristics have been considered disabilities.
Paraplegia, deafness, blindness, diabetes, autism, epilepsy,
depression, and HIV have all been classified as
"disabilities". The term covers such diverse conditions as
the congenital absence or adventitious loss of a limb or a sensory
function; progressive neurological conditions like multiple sclerosis;
chronic diseases like arteriosclerosis; the inability or limited
ability to perform such cognitive functions as remembering faces or
calculating sums; and psychiatric disorders like schizophrenia and
bipolar disorder.



Disabilities like these have been objects of study in sociology,
medicine, and policy debates for much longer than they have been
subjects of sustained interest in philosophy. These discourses do not
tend to define "disability" by way of the sort of rigorous
necessary and sufficient conditions philosophers often prefer. But
they have been centrally concerned with broadly definitional issues,
often discussed under the heading of "models" of
disability--that is, general theoretical perspectives concerned
to say what in the world social scientists are investigating when they
investigate disability. These models generally pick out, both (1) a
set of phenomenon as what needs explaining, when we explain
disability, phenomenon typically but not necessarily characterized as
*disadvantages*; and (2) an explanation of these
phenomenon--again, typically, but not solely, an explanation of
why disabled people experience the disadvantages they do.


### 1.1 Medical and Social Models



In their extreme forms, the *medical* and *social*
models serve to chart the space of possible relationships between
bodily difference and functional limitation more than to reflect the
actual views of individuals or institutions. (A variety of more formal
models, described in Altman 2001, graphically represent the causal
complexity of disability.)



The *medical model* explains disability disadvantage in terms
of pathological states of the body and mind themselves. It regards the
limitations faced by people with disabilities as resulting primarily
from their bodily differences. The medical model is rarely defended
explicitly, but aspects of it are often adopted unreflectively, when
health care professionals, bioethicists, and philosophers ignore or
underestimate the contribution of social and other environmental
factors to the limitations faced by people with disabilities.



In contrast, the *social model* explains the characteristic
features of disability in terms of a relation between an individual
and her social environment: the exclusion of people with certain
physical and mental characteristics, or "impairments",
from major domains of social life. Their exclusion is manifested not
only in deliberate segregation, but in a built environment and
organized social activity that preclude or restrict the participation
of people seen or labeled as having disabilities. A variety of social
models are embraced by disability scholars and activists in and
outside of philosophy. The "British social model"
associated with the Union of the Physically Impaired against
Segregation (UPIAS 1976) appears to deny any causal role to impairment
in disability:



> 
> 
> *In our view, it is society which disables physically impaired
> people.* Disability is something imposed on top of our impairments
> by the way we are unnecessarily isolated and excluded from full
> participation in society. Disabled people are therefore an oppressed
> group in society. Disability [is] the disadvantage or restriction of
> activity caused by a contemporary social organization which takes no
> or little account of people who have physical impairments and thus
> excludes them from participation in the mainstream of social
> activities.
> 
> 
> 



Two features of this influential statement are worth noting, although
we will only discuss the second at length. First, it limits itself to
*physical* impairments; second, it contrasts
*impairments*, individual characteristics or conditions, with
*disabilities*, disadvantages imposed by society on those with
impairments. The first feature inaugurates a long tradition in
disability activism and scholarship of focusing exclusively on
"physical" disability, to the neglect, if not the
exclusion, of intellectual, psychiatric, and other
"mental" disabilities. Both scholars and activists have
long criticized, and sought to broaden, this narrow focus, and even
those philosophers who continue to focus on physical disability
recognize that adequate models and definitions must include mental
disabilities as well. In the rest of this entry, we will not
distinguish between the two types of disability except when it is
relevant to a particular model or definition; we will note when an
account is limited to physical disabilities or criticizes other
accounts for that limitation.



The second feature, the distinction between impairment and disability,
will be more central to our discussion. It is through those terms that
the medical and social models have been distinguished, and it is this
"anatomy" of disability that several recent philosophical
definitions have rejected or significantly modified.



Implicit in the UPIAS understanding of disability are two ways that
society imposes limitations on disabled people, corresponding to two
distinct strands that might be a part of any social model. When the
UPIAS claims that society "excludes" people with
impairments, this suggests the *minority group model*, which
sees people with impairments as a minority population subject to
stigmatization and exclusion. On this view, the main reason people
with disabilities encounter hardship is because they suffer
discrimination along the same lines as racial or ethnic minorities.
Accordingly, civil rights protections and anti-discrimination laws are
the proper responses to disability (e.g., Hahn 1987 [1997] and Oliver
1990). Perhaps the most familiar expression of the minority-group
model is found in the preamble to the Americans with Disabilities Act
(ADA), which describes people with disabilities as "a discrete
and insular minority"--an explicit invocation of the legal
characterization of racial minorities.



The UPIAS also asserts that "contemporary social
organization" fails to "take into account" people
with disabilities. This suggests the *human variation model,*
according to which many of the challenges faced by disabled people do
not result from their deliberate exclusion, but from a mismatch
between their characteristics and the physical and social environment.
On this view, disability is



> 
> 
> an extension of the variability in physical and mental attributes
> beyond the present--but not the potential--ability of social
> institutions to routinely respond. (Scotch & Schriner 1997)
> 
> 
> 



This view of disabilities as the result of human variations is closely
related to the view that disability is a universal human condition
(Zola 1989) or shared human identity (L. Davis 2002: Ch. 1). The claim
that disability is universal can be taken as nothing more than a
prediction that we will all acquire familiar disabilities at some
point in our lives. But that claim is better construed as one about
the nature of disability; as maintaining that all human beings have
physical or mental variations that can become a source of
vulnerability or disadvantage in some settings.



These two versions of the social model are not incompatible, differing
mainly in emphasis. The discrimination stressed by the minority group
model generally leads to, and is expressed in, the societal failure to
accommodate people with various differences. In some contexts, it is
appropriate to analogize people with disabilities to racial or other
minorities; in others, it is important to reject a dichotomy between
disability and normality and treat impairments as continuous
variations. If one goal of social policy is to remove discrimination
and its enduring disadvantages, another is to encompass the full range
of human variation in the design of the physical environment and
social practices.



Although the social model, in one version or another, is now the
dominant legislative, social-science, and humanities paradigm for
understanding disability, stronger versions of it - particularly
the British Social Model exemplified by UPIAS - have been
subject to extensive criticism. Some argue that an adequate
conceptualization of disability requires a recognition of impairments
as an objective basis for classification, to distinguish disability
discrimination from other types of discrimination (Bickenbach 1993).
Several critics argue that extreme versions of the model implausibly
deny or understate the role of impairment itself as a source of
disadvantage (Anastasiou & Kauffman 2013; Terzi, 2004, 2009;
Shakespeare 2006). Others, however, contend that this criticism is
misplaced, because the British Social Model does not deny the
importance of impairments but rather seeks to restrict the application
of the term "disability" to social exclusion and
oppression (Beaudry 2016).



Another objection is that the social as well as the medical model both
rest on a false dichotomy between biological impairments and social
limitations. There are two versions of this objection. One maintains
that disability is a complex phenomenon, in which biological
impairment and social exclusion are deeply interwoven and difficult to
tease apart (Martiny 2015; Anastasiou & Kauffman 2013). The other
version of this objection rejects the treatment of impairment as a
(strictly) biological phenomenon. "Impairment", the
argument goes, is no less a social construction than the barriers
faced by people so classified (more on this below). Claims that there
is a stable biomedical basis for classifying a variation as an
impairment are called into question by shifting classifications; by
the "medicalization" of some conditions (shyness) and
"demedicalization" of others (homosexuality). Moreover,
the social environment appears to play a significant role in
identifying and, arguably, in constituting some impairments (dyslexia)
(Cole 2007; Shakespeare 2006; L. Davis 2002: Ch 1; Tremain, 2001,
2017; Amundson 2000). What counts as an impairment may depend on which
variations appear to be disadvantageous in familiar or salient
environments, or on which variations are subject to social prejudice:
Less-than-average height may be more readily classified as an
impairment than greater-than-average height because the former is more
often disadvantageous in environments designed for people of average
height, or because it is generally seen as less desirable. For such
reasons, it is difficult to establish the objectivity of the
impairment classification by appeal to a clear and undisputed
biomedical norm. Amundson (2000), indeed, goes so far as to deny that
there is any biological basis for a concept of functional
normality--a claim emphatically rejected by Boorse (2010).


### 1.2 An Affirmative Model?



The debate between the medical and social model about the source of
the disadvantages disabled people experience has dominated academic
discourse about disability since the 1970s. More recently, however,
disability activists and disabled scholars have questioned the
apparent shared assumption of both models, that disability is
fundamentally a matter of disadvantage, exclusion, or functional
limitation. This to take a (partly) different view on what an account
of disability should explain; a view consistent in principle with
either a more medical or more social view of what does the explaining.
The *affirmative model* of disability and impairment, as
articulated by John Swain and Sally French (2000), holds that
disability is not in the first instance a problem--not simply or
solely a "personal tragedy", and implicitly, not simply or
solely a social injustice either. Rather, disability is a different
way of living in and experiencing the world, one not characterized by
its disadvantages any more than its advantages.



Note that this is not a claim about what causally explains disability;
rather, it is a claim about what aspects of the phenomena of
disability should serve as the object of explanation in social
scientific theories of disability. As such, the affirmational model is
*prima facie* consistent with either the medical or the social
model, and indeed tends to draw on considerations from both. The
diverse mix of advantages and disadvantages that characterize life
with disability can derive from biological factors, social factors, or
interactions between the two. On the side of advantage, a person with
a disability like blindness might celebrate the increased attention
sightlessness saves for hearing and other senses as well as the
solidarity they experience with other disabled people as they fight
together against ableism and for social justice. On the side of
disadvantage, the affirmational model will point to the considerations
some would regard as personal tragedies as, instead, a combination of
purely functional challenges to be overcome, and conditions of social
exclusion that can make life harder without thereby making it any less
valuable or worth living.



Still: though logically independent of claims about the evaluative
import of disability, the medical and social models suggest different
views about the impact of disability on well-being, and different
views about how disability is relevant to reproductive decisions,
medical interventions, and social policy. The affirmational model is
likely to be more in sympathy with social than medical models here.
Those who accept a social model of disability regard the association
between disability and well-being as highly contingent, mediated by a
variety of environmental and social factors (Campbell & Stramondo
2017). They also tend to question conceptions of well-being that give
a central role to the possession or exercise of the standard array of
physical and mental functions, as those conceptions imply, or are
often taken to imply, that well-being is precluded or diminished
merely by the absence or limitation of those functions (see entry
 disability: health, well-being, and personal relationships).
 As a result, they generally see the disadvantages of disability not
only as externally caused, but as less formidable than they appear to
people who view disability in largely biomedical terms. These
differences are reflected in the conflicting assessments of life with
disabilities found in the bioethics and public policy literature on
the one hand, and disability scholarship on the other (contrast Brock
2005 with Goering 2008).


### 1.3 Models, Decisions, and Policies



The different models of disability--and particularly, the medical
and social models--have always been interpreted as favoring
different responses to disability. The medical model appears to
support the correction of the biological condition (or some form of
compensation when that is impractical); the minority group model
appears to favor measures to eliminate exclusionary practices or at
least recognize their injustice; the human variation model appears to
favor reconstruction of the physical and social environment to take
into account a wider range of differences in human structure and
function (measures that could in turn make the social environment less
exclusionary).



But claims about the causal explanation of disadvantage do not always
yield straightforward prescriptions for their remediation (Wasserman
2001; Samaha 2007; Barclay 2018). In some cases, medical or surgical
"correction" may be the most effective way to escape
discrimination; if correction is not appropriate, that is because it
reinforces discriminatory attitudes and practices, not because it is
discriminatory *per se*. Even an affirmational model does not
straightforwardly imply that we should change society rather than
disabled bodies: that disabled people have reason to be proud of their
disabilities and/or impairments does not immediately entail claims in
justice on the rest of us to incur the costs of accommodating these
differences. This is to be expected: the proper response to the
disadvantages associated with disability depends not only on causal
attributions and prudential evaluations, the domains of the three
"models", but also on moral judgments about
responsibility, respect, justice.



This is not to say that these causal attributions, much less
prudential judgments, are morally irrelevant: to the extent that
social causation of disability disadvantage makes social institutions
*morally responsible* for the limitations disabled people face,
it may be unfair and disrespectful for society to ask disabled people
to change themselves rather than changing itself to be more inclusive
(Aas 2020). Moreover, "correcting" disability may (as the
affirmational model reminds) us involve destroying valuable forms of
life and reducing the vibrant diversity of human embodiment; or it may
not do not enough to counterbalance the benefits of uniformity
(Garland-Thomson 2012). *Contra* the sense that the social,
medical, and affirmational models each come bundled with obvious
policy consequences, it seems clear on reflection that there is much
yet to do to understand just what these different explanations of
disability imply as to how we should respond to it.


## 2.Definitions of Disability



Until relatively recently, there was little independent philosophical
discussion of definitions of disability. Instead, philosophers focused
primarily on developing and interpreting legal and regulatory
definition needed to implement disability policy. The legal
definitions, in turn, were heavily influenced by the two-part
"anatomy"--impairment and social response--of
the social model of disability, which was developed by activists
seeking to influence legislation and policy.


### 2.1 Philosophical discussion of Official Definitions of Disability



Thus, two familiar features are shared by most official definitions of
disability, such as those in the World Health Organization (1980,
2001), the Disability Discrimination Act (UK), and the Americans with
Disabilities Act (United States): (i) a physical or mental
characteristic labeled or perceived as an impairment or dysfunction
and (ii) some personal or social limitation associated with that
impairment. Impairments are generally seen as *traits* of the
individual that he or she cannot readily alter. Just what makes a
condition a trait or attribute of an individual is obscure and
debatable, but there seems to be agreement on clear cases. Thus,
poverty is not seen as an impairment, however disabling it may be, nor
is tasteless clothing, even if it is a manifestation of impaired
fashion-sense rather than scarce income. On the other hand, diseases
are generally classified as impairments, even though they are often
neither permanent nor static conditions. Diseases that are especially
transient, however, such as the flu and the measles, do not normally
count as impairments.



As in early philosophical debates about competing models, the most
controversial issue in defining disability is the relationship between
these two features. At one extreme are definitions that imply, or are
read to imply, that biological impairments are the sole causes of
limitation. The definitions in the World Health Organization's
1980 International Classification of Impairment, Disability, and
Handicap, and the Disability Discrimination Act (UK) have been
interpreted this way. At the other extreme are definitions that
restrict the limitations faced by disabled people (as such) solely to
"contemporary social organization", such as the definition
given by the Union of the Physically Impaired Against Segregation
(UPIAS 1976). In between are definitions which assert that individual
impairment and the social environment are *jointly* sufficient
causes of limitation. Perhaps the best-known example is the
WHO's International Classification of Functioning, Disability
and Health (World Health Organization 2001, referred to as ICF), which
emphasizes that disability is a "dynamic interaction between
health conditions and environmental and personal factors".



Through much of the first two decades of this century, philosophers
were largely content with this definitional approach to disability as
a relationship or interaction, disagreeing primarily on the
comparative contribution of the two elements and the policy relevance
of their contributions. As noted in the last section, dissenters
mainly focused on the characterization of one or both elements, as,
e.g., on the first as social vs. biological, rather than on the
"anatomy" itself. More recently, however, there has been
some movement away from reliance on these two-part approaches to
defining disability (e.g., Barnes 2016, and much of the literature
responding). One reason may be that in most settings, we do not think
of or refer to disabilities as relationships or interactions, but as
individual somatic or psychic traits, states or conditions (including
absences and deficiencies). These commonsense referents are hard to
find in, for example, the multifactorial charts by which the ICF
illustrates its definition of disability as a complex interaction of
health conditions with environmental, social, and personal
factors.



Some might argue that ordinary usage is ideological, shaped by false
failure to be conscious of the insights of social and interactionist
models. But defining "disability" in rough conformity to
ordinary usage hardly implies that its referents are selected by
biomedical criteria, let alone that the traits selected cause the
disadvantages faced by their bearers or dictate the appropriate social
response to those disadvantages. Rather, this view on what
"disability" and "people with disabilities"
refer to is compatible with a wide variety of positions on how those
referents are picked out: e.g., by biomedical criteria; by the rules
of a civil-rights movement; by the assumptions of the dominant
ideology about bodily dysfunction; or by the demands of justice. The
extent to which what counts as a disability, or a person with a
disability, varies with context will depend on the account adopted; on
biomedical accounts, the extension of "disability" will be
as stable as human biology; on other accounts, it will change with
changing social norms, economic needs, or political developments.
Further, on some accounts, the referents will have common features,
identifiable by inspection; on others, what they have in common can
only be understood in terms of an ideology or a theory of justice.



After discussing several types of accounts, we will address the claim,
inspired by the diversity of traits and conditions they pick out, that
"disability" has no core meaning, and that it may be
futile and distracting to search for one.


### 2.2 Philosophical Definitions of Disability



Outside of legal and policy interpretation, philosophers have made a
number of claims about the definition of
"disability"--at first, mostly only in passing,
during discussion of other matters, like "disease" and
"health"; later as an increasingly important philosophical
topic in its own right.


#### 2.2.1 Normal-Function Views



Given the pervasiveness of medical models of disability in the
culture, one would think that at least some recent philosophers would
defend a view of disability on which it is defined in terms of
*pathology* or departure from normal functioning (see entry on
 concepts of health and disease).
 So far we can tell, however, no one has done so explicitly, in print.
Christopher Boorse, perhaps, comes closest, when he says:



> 
> 
> at first sight, one expects *disability* [...] to consist
> of a pathological condition severe enough to have certain morally and
> legally important effects. (Boorse 2010: 60-61)
> 
> 
> 



Though Boorse only broaches the possibility of such a definition,
without defending, his broader views about health and disease may seem
to support this approach. If, as Boorse argues there is a good
naturalistic sense of "pathology" as (statistically)
downward departure from species-typical functioning, then that notion
can be inputted into our moral and political thinking to produce a
definition of disability on the following pattern:




*S* is disabled, in a context *C*, iff


1. *S* has a pathology--that is, some part of their body
performs its normal function at statistically subtypical levels,
2. In *C*, that pathology causes effects that make a
difference, of kind *D*, to how *S* ought legally or
morally to be treated




To fully develop this view, of course, one would need to say what sort
of moral/legal difference pathology is supposed to make--not just
any difference will do, since it would not follow from the fact, say,
that everyone has a legal or moral right to treatment for transient
injuries or diseases that all these conditions are disabilities. Note
also that, though this view mentions the medical concept of pathology,
as a *definition* of disability it does not entail a medical
model, or indeed even the denial of the affirmational model. The
medical/social debate will turn on the extent to which it is pathology
*itself* that makes a moral difference, rather than pathology
in combination with social factors. The affirmational model debate
will turn on just which effects are definitive of disability; if these
are all negative or harmful, it will be harder to understand
disability as something to be proud of. But the bare fact that
disability arises from pathology, on this definition, does not
necessarily preclude pride in it, given Boorse's normatively
neutral definition of pathology.



That said, few philosophers seem inclined to defend this way of
defining disability. Many philosophers are skeptical of the analytic
division between facts about bodily function and social and ethical
norms, arguing that there is no way to define disease or pathology
independent of "normative" considerations (Wakefield 1992;
Kingma 2007; entry on
 concepts of health and disease).
 Those sympathetic to the claims of the disability may have more
specific qualms, as well. Those attracted to the "human
variation" version of the social model may be skeptical that all
of the bodily difference that make for disability are statistically
atypical in the required way, e.g., very common or universal
conditions like age-related hearing loss or atherosclerosis. Those who
tend more to a "minority group" model will tend to see the
bodily differences that matter to disability as *perceived* or
represented difference, rather than actual difference. And anyone with
any sympathy to the social model at all will tend to think that,
as-so-far stated, this definition puts its philosophical precision in
the wrong place: that it is at least as important to understand what
social, moral, and legal effects characterize disability as to
understand which sorts of causes these effects must have to count as
"disabling".


#### 2.2.2 The Welfarist View



Kahane and Savulescu (2009; Savulescu & Kahane 2011) propose a
reforming definition of disability that promises to avoid potentially
problematic references to pathology. Their basic idea is that a
disability is a (broadly) bodily condition that makes its bearer worse
off. To wit:



> 
> 
> "disability" should refer to any stable physical or
> psychological property of subject *S* that leads to a
> significant reduction of *S*'s level of wellbeing in
> circumstances *C*, *excluding* the effect that this
> condition has on wellbeing that is due to prejudice against *S*
> by members of *S*'s society. (Savulescu & Kahane
> 2011: 45.)
> 
> 
> 



This view adopts certain insights of the social model: in particular
in holding that disability is relative to circumstance and in
downplaying the role of pathology or biological abnormality in
defining disability (note there is no reference to
"impairment", not even records or appearance of
impairment).



In other ways, however, it seems to be significantly out of step with
both the letter and the spirit of social models of disability. On this
definition, a condition which is *only* harmful in virtue of
social prejudice would not be a disability. Even the softer social
model implicit in the Americans with Disabilities Act allows that
*some* people are disabled solely in virtue of being
"regarded as" impaired; those in that group who experience
discrimination as a result would still not be "disabled"
on Kahane and Savulescu's view. Just how out of step this
judgment is with the usual commitments of the social model, may depend
on the relative importance it places on prejudice as compared to other
factors in producing disability disadvantage. A social model that
cleaves closely to a "minority group" understanding of
ableist injustice may find that this definition excludes the paradigm
cases of disability, people who experience gross or net reductions in
advantage due to prejudicial phenomenon like stigma and intentional
exclusion. A "human variation" account of most disability
disadvantage would see more possibility for people to be disadvantaged
by non-prejudicial mismatches between atypical bodies and societies
built for typicality, since this account will say that many of the
welfare costs experienced by people with atypical bodies are not a
result of prejudicial attitudes *per se*, even if they often
reflect structurally unjust failures of inclusion.



It should be even more clear that the *affirmational* model of
disability is in substantial tension with this harm-requiring
definition of disability. Granted, affirmation of disability may not
be formally inconsistent with defining it in terms of harm, since it
is possible in principle to take pride in or otherwise be glad about
something that leads to a reduction in our well-being (since there are
things in life that matter, besides our own well-being). But
affirmational models generally hold that being disabled is not always
or in general a cost to our well-being (Swain & French 2000;
Barnes 2016). This would be a conceptual falsehood, on the welfarist
view: something which is not a cost to well-being in *some*
context is simply not a disability.



Are these decisive problems for defining disability in terms of
welfare? Much depends here on what we intend to do with definitions of
disability. If the goal is to capture ordinary usage, a welfarist view
may be on the right track. It might account, for instance, for the
broad appeal of slogans like "deafness is not a
disability" and euphemisms like "differently abled";
these expressions, on this view, would be ways of emphasizing some of
the substantive evaluative intuitions behind the affirmative model,
that most conditions we call disabilities are not so bad absent
prejudice. That said, disability scholars and activists have tended to
be skeptical of such expressions, on the grounds that they undermine
efforts to see disabled people as a politically salient group with
similar experience of ableism and strong reason to work together for
justice, rather than to simply commiserate. If a definition of
disability should advocate in favor of usages that produce a better or
more just world, this might be a reason to reject Kahane and
Savulescu's view, in favor of one that allows people to be
disabled due to prejudice and/or in the absence of harms to
well-being. Or at least, this will be so if the social and/or
affirmational models of disability have the moral and political
advantages proponents advertise for them.


#### 2.2.3 Social Constructionisms



Most philosophers who have considered the definition of disability in
recent years have written in sympathy with either or both of the
social or affirmational model of disability.



Elizabeth Barnes's critique of definitional claims implicit in
the social model has been a signal moment in the recent debate. Barnes
is concerned that thinking of disability as a stigmatizing,
oppressive, and exclusionary response to bodily difference does not
distinguish disability from other properties grounded in responses to
the body, like (on many accounts) race, gender, and sexual orientation
identities.



Barnes develops an alternative view which still defines disability as
a social property--but in a way that fits the affirmational model
better than the definitions suggested by classic social models, doing
away with the distinction between disability and impairment and making
no direct reference whatsoever to injustice or disadvantage. Barnes
(2016) proposes to define disability in terms of the judgments of
disabled people themselves, not society as a whole. To wit, *S*
is (physically) disabled if and only if:


1. *S* is in some bodily state *x*; [such that]
2. The rules for making judgments about solidarity employed by the
disability rights movement classify *x* in context *C*
as among the physical conditions that they are seeking to promote
justice for.



This makes who is disabled a social construction--dependent on
the attitudes and commitments of a particular, self-identified group
of people in contemporary society, the "disability rights
movement", composed of self-identified disabled and nondisabled
members. It thus raises the concern that a disability movement might
seek justice for the wrong people. Couldn't some of those people
complain that they should be included in the aims of that movement,
precisely, because they are disabled? Barnes responds in two ways. The
first is to note that she appeals to the *rules* for
judgment-making, rather than judgments themselves; some people might
not *actually* be included in the disability rights
movement--say, because of internal prejudices on the part of
those within the movement--but if this is inconsistent with the
reasons for including others, then the excluded people will count as
disabled too, on Barnes' account. Still one might ask, what if
the rules themselves were bad rules, wrongly but consistently
excluding some people form the ambit of the struggle against ableism?
Barnes, in response to this, rigidifies, insisting that we judge
disability relative to the rules of the *actual* disability
movement, even when we are imagining situations where that movement
should use different rules than it actually does.



Some are not convinced by this last reply. For it can seem to give too
much weight to judgments of the actual disability rights movement. As
Jenkins and Webster point out, "rigidifying" to the actual
world in this way means that imagining a world with a different
disability rights movement isn't imagining a world with
different disabled people. But what if the disability rights movement
is different there because social conditions are different, warranting
a different set of rules for determining which people with
pathologized bodily difference to seek justice for? And indeed
isn't there a sense in which "there" could be
"here"? That is, couldn't the disability right
movement as it actually is, use rules that even when consistently
applied lead it to seek justice for the wrong people (Wasserman 2018;
Howard & Aas 2018; Lim 2018)?



This last concern can be generalized. Chong-min Lim, responding to
Barnes, questions why the disability movement alone should have the
authority to constitute disability. Where, we might ask, does this
leave the experience of disabled people not part of the movement, or
of those caregivers and/or non-disabled loved ones who advocate for
them? And couldn't the disability movement be overinclusive too,
in principle, attempting to expand solidarity beyond what makes sense
morally or politically. To address this problem (and in the process,
expand the account to cover cognitive and other
"non-physical" disabilities), Lim proposes that we make
the following modification to Barnes' account:




*S*, is disabled in context, *C*, if and only if:


1. *S* is in some state, *x*;
2. *x* is constitutive, in *C*, of some constraint on
*S*'s legitimate interests;
3. *x* is regarded, in *C*, as the subject of
legitimate medical interest;
4. the rules employed by the disability rights movement classify
*x* in *C* as among the traits that they are seeking to
promote progress and change for. (Lim 2018: 987)




Relative to Barnes, II and III are new restrictions, while IV is a
substantially broadened version of the main clause of Barnes'
approach--in effect, broadening the relevant goals to include any
improvement in the lives of putatively disabled people, whether that
comes from social change or bodily transformation. Relatedly, III
seems to bring back in medicalization--though now constrained by
the requirement that the medical interest in question be
"legitimate", meaning, not *apt* in the traditional
sense (not, *concerned with pathology*) but rather
*just* or *right*; morally legitimate in light of
whatever morally appropriate role medicine has to play in our society.
Lim introduces these conditions to reflect the fact that expert
communities outside of the disability rights movement have expertise
relevant to constituting the disability population; parents or
caregivers, even those not part of the movement itself, may have
insight into whether and how a condition affects legitimate interests,
while physicians will have important (though not exclusive) knowledge
of which limitations on function are legitimately subject to medical
interest.



The (intended) effect of Lim's modifications, then, would be to
limit the authority of the particular political judgments of the
actual disability rights movement in determining who is disabled. This
points to what may be a deeper problem for Barnes' account, and
the parts of Lim's that follow her in making recognition by the
rules that guide the disability movement determinative of disability.
If the disability movement ought to adopt rules that pick out a
certain group, isn't that precisely because that group shares
some other property, that makes that choice reasonable? That is,
isn't there something that those the disability rights movement
share, that explains why they ought to seek justice in solidarity
together? Wouldn't that thing, whatever it is, make a better
candidate definition of disability? To put the question for
Lim's account in particular: why would we want to deny that a
condition is a disability, it if were a medically interesting
constraint on legitimate interests, but not recognized as such by the
rules of the disability rights movement?



Howard and Aas (2018) respond to Barnes in a different way, developing
a definition that harkens back to the classic social model of
disability. Building on the work of Sally Haslanger (2000) on gender
and race, they define disability classically as a certain sort of
social response to impairment. On their view, person *S* is
disabled in a context *C*, iff


1. *S* is in some bodily or psychological state *x*
[such that]
2. *x* is regularly assumed in the ideology in *C* to
involve an impairment: a dysfunctional bodily state that limits a
major life activity, and
3. in the dominant ideology of *C*, that someone in *x*
has an impairment explains why they can be appropriately pitied,
stigmatized, and excluded from socially valued activities and
statuses.
4. The fact that *S* is in this state plays a role in
*S*'s systemic disadvantage: that is, (i)-(iii)
actually explains why *S* is involuntarily excluded from
certain valued activities or relegated to a marginal status along some
significant social dimension. (2018: 1128-1129)



Impairment is critical on this analysis. Disability is distinct from
other bodily-based social categories on this definition precisely
because it is a response, of a certain distinctive sort, to social
perception about bodily properties, namely *impairment*. Race,
gender, and orientation identity would be different (thought possibly
overlapping) responses to different (again, possibly overlapping)
bodily properties. Howard and Aas do not, however, defend the
biological reality of impairment; it suffices for their account that
society itself employs some notion of biological abnormality or
insufficiency, saying with the classic social model that disability is
a matter of being classified as impaired, and excluded on that
basis.



Barnes (2018) responds that, because of this last feature, this
account does not after all give sufficiently central place to bodily
difference. In particular, she thinks it makes it hard to see how the
bodily differences characteristic of disability could be, as the
affirmation model has it, *something to be proud* of. They are,
after all, picked out negatively, by reference to disadvantage and
social exclusion. Bodily features picked out for their role in the
struggle for disability justice seem to be a better candidate source
of joy, identification, and pride. The success of Barnes'
response depends on how exactly disability pride is supposed to work,
and on how exactly definitions like these are supposed to serve the
interests of the struggle against injustice. Among other things,
reflection on related cases involving racialized body features
suggests that it is possible to take pride in something that others
respond to in oppressive and stigmatizing ways. On this understanding,
the pride is not in the oppression, but in the oppression-triggering
feature itself or in a skillful or solidaristic response to
oppression.



Jenkins and Webster (2021) propose a different sort of
social-construct definition of disability--or actually, three
different but closely related definitions. Like Barnes, Howard, and
Aas, they are interested in understanding what bodily differences are
centrally relevant to disability. But they cleave closer to the human
variation model than the minority group model in understanding these
differences. Their key notion is what they call **marginalized
functioning**: having a body that does not work in the way that
our socially constructed world expects. Each of their three
definitions of disability presuppose this notion; to wit:




**MF1**: A subject *S* is [physically] disabled if
they have marginalized functioning relative to a context, *C*,
where this is the case iff:


1. there is a set of social norms *N*, comprising \(n\_1,\)
\(n\_2,\) ...\(n\_n,\) each of which serves as a default for the
purposes of constructing common social environments and structuring
common social interactions in *C*; and
2. there is some norm in *N*, \(n\_x,\) such that *S*
cannot physically function in a way that satisfies it. (2021: 8)




It might seem that this account, and indeed Howard and Aas's,
implies that there could be no disability in a just society. Though
this is a classic claim of the traditional British social model of
disability (UPIAS 1976), some find it implausible. Note, however, that
neither of these views in fact implies the impossibility of disability
in a just society (even if their language sometimes suggests it). For
neither view, in itself, implies that the social responses that
constitute most disabled people as such are *necessarily*
unjust (though surely all four authors would agree that in the actual
world, they usually are). If it is morally legitimate to set society
up in a way that is designed for the functioning of most but not all
its members--and it may well be, given how costly it would be to
get anywhere near complete and comprehensive inclusion (Barclay
2018)--then some forms of functioning could be marginalized or be
a source of disadvantage, even in a just society. And, thus, those
that function in those marginalized ways, could be disabled.



A more significant *prima facie* concern for MF1 is that it
seems to include amongst the disabled people with merely transitory
mismatch between body and society--say, someone who broke one or
both arms, and therefore cannot open doors or otherwise do what
society expects people to be, physically, able to do. These people do
not normally identify and are not normally identified as disabled. To
capture this, Jenkins and Webster propose that we might move, simply,
to:




**MF2:** someone is disabled in a context if and only if
they have lasting marginalized functioning in that context; OR



**MF3:** someone is disabled in a context if and only if
they experience disability-characteristic oppression because they have
marginalized functioning in that context




MF2 solves the problem of temporary conditions by stipulation. This
may or may not be good enough here, depending on whether we think
temporary conditions (e.g., post-concussion syndrome or pregnancy) can
be disabilities. MF3 faces some of the same problems as other
social-model-inspired definitions--particularly, that it seems to
define disability in terms of a kind of oppression, and therefore in
terms of something bad, something that is therefore (arguably)
difficult to be proud of or happy about. Further, by requiring that
oppression be caused by functioning that *actually* fails to
fit going norms and expectations, it does not clearly classify as
disabled people who are disadvantaged by *false* perceptions
regarding their bodily differences--again, failing to follow the
ADA in its well-considered inclusion of people "regarded
as", but not, impaired, in its definition of disability (Francis
2018). It remains to be seen whether the advantages of this definition
are great enough to justify excluding such "regarded" as
people as disabled.


#### 2.2.4 Inability Views



In their influential book *From Chance to Choice*, Buchanan,
Brock, Daniels, and Wikler (2000) propose the following definition,
meant as an explication of the legal and policy decisions considered
above.



> 
> 
> To have a disability is to be unable to perform some significant range
> of tasks or functions that individuals in someone's reference
> group (e.g., adults) are ordinarily able to do, at least under
> favorable conditions, where the inability is not due to simple and
> easily corrigible ignorance or to lack of the tools or means
> ordinarily available for performing such tasks or functions. (2000:
> 286)
> 
> 
> 



This defines disability colloquially, in terms of ability; disability
is, roughly, an unusual inability. Barnes and others object, however,
that this definition is too broad. It seems to make it the case, for
instance, that someone who cannot "roll their tongue" or
do mental subtraction is disabled; since most people can do this under
favorable conditions. Conversely, this sort of view also seems to
undergenerate disabilities, since some (fibromyalgia or depression for
instance), only make it more difficult to do things, without making
any particular task or function straightforwardly unachievable. And it
is not entirely clear how this account avoids the obviously
problematic implication that identity categories like race, gender,
and sexual orientation imply disability; someone subject to social
prejudice in virtue of their gender or the color of their skin might
be, for that reason, unable to do things others can do.



Alex Gregory (2020) takes a different approach to defining disability
in terms of inability:



> 
> 
> The Inability Theory: To be disabled is to be less able to do
> something than is typical, where this degree of inability is partly
> explained by features of your body that are atypical. (2020: 26)
> 
> 
> 



This definition of disability brings the body into the definition, but
it is meant to be neutral between more-medical and more-social ways of
seeing disability. "Atypical" features need not be
"abnormal" in a medicalizing sense; they are simply
different, not necessarily worse. To say that an inability that comes
to disability must be at least partly explained by bodily features is
consistent, both, with saying that it is entirely explained by them (a
la the medical model) and that it is also partly explained by social
factors. This in itself rejects the medical model as a general claim,
as well as the less nuanced statements of the social model, that would
definitionally exclude non-social inabilities from the ambit of
"disability".



The initial statement of the Inability Theory would still seem to be
overinclusive; someone who cannot get a good job because of the color
of their skin, or marry the person they love because of their sexual
orientation, has an atypical inability explained by an atypical bodily
feature. To rule these cases out, Gregory moves to:



> 
> 
> The Final Inability Theory: To be disabled is to be less able to do
> something than is typical, where this degree of inability (1) is
> partly explained by features of your body that are atypical, and (2)
> is not explained by anyone's attitudes toward those bodily
> features. (2020: 33)
> 
> 
> 



This does plausibly avoid the problem of classifying sexual and
racialized minorities at least as disabled; any inability engendered
by color of skin is explained entirely by prejudicial attitudes. (Or
so it may seem; more below). But in the process it also raises a
recurring problem--where an atypical feature is only
inability-generating because of attitudes *specifically about
whether it is inability-generating*. If people think that people
with, say, Down syndrome, cannot benefit from education, they will not
be educated; when they do not develop the skills they could have
developed, that lack of skill is, then, explained by a combination of
atypical bodily features and attitudes towards those features. It can
seem plausible to say, with the ADA, that discrimination rooted in a
pathologized understanding of a trait *is* a kind of disability
discrimination.



Moreover, this analysis also raises some of the same concerns as those
Barnes and others pressed against Buchanan *et alia*'s
explication of disability as biologically abnormal limitation. For
here even more than there it seemed like not every limitation on
ability, not even every one explained by atypicality or abnormality,
is a disability properly-so-called. Gregory, however, has a novel
response here--insisting that these are, really, disabilities,
but just not normally worth calling attention to as
"disabilities", since the aptness of this ascription in
conversational context depends on the significance of the abilities at
issue.



This proposal raises other problems, however.. Recall race and sexual
orientation. A person with light-colored skin cannot work in even
relatively moderate sun all day without getting a sunburn. Someone
with exclusively same-sex orientation cannot have procreative sex with
someone for whom they have romantic and sexual feelings. These are
inabilities explained by bodily difference, not by attitudes, and they
are not insignificant or trivial ones: yet it seems they are not
disabilities, not even a little bit.



Why not? The social constructionist views considered above would give
one kind of answer--pointing to the facts that (depending on the
view):


1. the disability rights movement is rationally unconcerned with
properties like race and orientation; or
2. that race and orientation are not targeted by *ableist*
ideology for exclusion and stigmatization; or
3. that our actual social norms do not marginalize these
configurations of bodily function, in the way they marginalize
paradigm impairments.



An alternative, more positive approach, which remains focused squarely
on ability, would hold that these inabilities, like the minor
inabilities considered above, are not relevant to disability because
their absence does not place claims on others, in justice. To wit,
Jessica Begon (2021)



> 
> 
> Thus, I define disability as the restriction in the ability to perform
> those tasks human beings are entitled to be able to perform as a
> matter of justice, as the result of the interaction between an
> individual's impairment, their social and political context, and
> the resources they have available to them. (2021: 936-937)
> 
> 
> 



It turns out that by impairment Begon simply means "atypical or
unusual functioning", not pathological or life-limiting
functioning; so, this account is actually structurally more similar to
Gregory's than to Buchanan et alia. The difference is that the
specific absence of ability that constitutes a disability is the
atypicality-caused absence of abilities *we ought to have*, or
anyway that our societies ought to provide for us.



This account has a natural response to the problems of non-disability
inabilities. No one is entitled to roll their tongue (at least in any
social environment remotely like our own); thus, nobody is disabled
because they cannot do so. Nor, in most circumstances, are we entitled
to sit unprotected all day in the sun without paying the consequences.
We might be entitled to protection by sunscreen, or to the opportunity
to escape the sun, but we are not entitled to have the ability to
withstand the sun if we choose to forgo these protections. Similarly,
it seems plausible to deny that anyone is entitled to procreate
sexually with their romantic partner; there may be entitlements to
become a parent, perhaps even a genetic parent, but they need not be
realized in this way. Thus, Begon's account appears at first
glance not to overgenerate disabilities, as other inability-based
accounts seem to.



That said, the account still faces some of the problems we see with
other ability-limitation-based accounts. The non-pathologizing sense
of impairment as "functional difference" may not in the
end be specific enough to distinguish disability from other kinds of
unjust absence of ability. Begon addresses this in the case of sex
difference, arguing--in effect, with Boorse--that
differences in the "reference class" or appropriate
functional norms applying to males and females of the species make for
differences in what counts as an impairment between males and females.
So, for instance, an inability to get a good-paying job resulting from
possession of the capacity to menstruate is not a disability, because
that capacity is not atypical *for female human beings*. Such a
way to address the problem may not cover all forms of oppression since
much oppression seems to be evoked by differences that are functional
in some sense--sexual orientation relates to the function of our
dispositions to sexual attraction; absence of athletic ability (within
the normal range) to the function of the musculature; even
pigmentation, to the function of the epidermis in protecting the
organism from the environment.



Begon's view could avoid classifying inabilities down to these
differences by further multiplication of "reference
class", so that, say, being unable to get a job because you are
gay is not a disability because gay people function typically
"for gay people". But as Elselijn Kingma has argued, in
response to similar maneuvers in the health literature, this kind of
specificity seems problematically arbitrary--in the limit,
threatening to trivialize the relevant notion of "functional
typicality" (Kingma 2007). These concerns seem to press back in
the direction of Lim's restriction of disability to responses to
"medically significant interests", or Howard and
Aas's definition in terms of traits *perceived* or
represented as functional deficits in the reigning biomedical
ideology.



There are also questions about how we are to understand the set of
entitlements relevant to determining when the absence of ability is
unjust. Begon discusses these issues only briefly (2021: 954, n30); a
more fully developed version of the view would have to do more. It
seems important to abstract from resource constraints, since we would
not want to say that someone is only disabled if habilitating them is
cost-effective relative to other priorities justice gives us, given
what resources we happen to have. But this abstraction threatens to
make too many of us disabled, since justice might, absent resource
constraints, give us powerful reasons to enable one another to do all
sorts of things--to give those of below-average height the
ability to dunk a basketball, say; or to give women well-past
childbearing age the ability to conceive and gestate children. Perhaps
we should do these things in response to these functional
atypicalities; that does not make people disabled, until we are rich
enough to do them.


#### 2.2.5 Skepticism about Defining Disabilities



Two sorts of skeptical responses have greeted the effort to define
disabilities as individual traits, conditions, or functions, selected
by some set of rules or criteria. The first critique is inspired by
the work of Michael Foucault on biopower as a form of control
exercised by modern states over the bodies of their populations
(Tremain 2017). This critique argues that to focus on individual
characteristics in defining disability is to miss the forest for the
trees. "Disability" refers not to a set of individual
characteristics, or to a concept that encompasses such a set, but to a
mechanism that identifies various types of individual characteristics
for the purpose of social control. Notably, Shelley Tremain analyzes
disability as a mechanism constructed and maintained by laws, informal
norms, cultural understandings and other exercises of biopower.
Impairments and disabilities only exist within this culturally and
historically contingent apparatus that arose in part as a means for
people who saw themselves as "normal" to regulate those
they labeled as "deviants".



> 
> 
> [D]isability is not a metaphysical substrate, a natural, biological
> category, or a characteristic that only certain individuals embody or
> possess, but rather is a historically contingent network of force
> relations in which everyone is implicated and entangled and in
> relation to which everyone occupies a position. That is, to be
> disabled or non-disabled is to occupy a certain subject position
> within the productive constraints of the apparatus of
> disability.... (2017: 22).
> 
> 
> 



At first glance, Tremain's Foucauldian claim can seem to be
talking past the interlocutors considered above; no more a distinctive
analysis of disability to compete with the foregoing than was
Foucault's famous claim that "knowledge is power" a
competitor to Plato's or Goldman's or Sosa's
analytic definitions of knowledge (see entry on
 the analysis of knowledge).
 As in that case, however, a recognition of the role the concept of
disability plays in reproducing unjust social conditions can cast
doubt on reliability of the commonsense judgments and linguistic
intuitions appealed to by rival analytic definitions. Such judgments
and intuitions are, so the Foucauldian could argue, products of the
apparatus, not an independent basis for assessing or understanding its
assignment of positions. However, several of the analytic accounts
discussed in the preceding action were developed with awareness of and
due skepticism towards the ideological roots of prevailing convictions
about disability and do not explain disability as a natural,
biological category. It is unclear then, if a Foucauldian challenge
could undermine the evidence used to develop these accounts.



The second critique, rather than dismiss the value of philosophical
definitions, emphasizes their multiplicity, maintaining that different
definitions are appropriate in different contexts and for different
purposes. On this view, the problem with these definitions is that
they see themselves as competitors in pursuing a goal that is both
unattainable and undesirable: a single unified or core definition of
disability:



> 
> 
> Many philosophical disagreements about disability simply overlook the
> fact that the disputants are talking about different phenomena
> (impairment vs. oppression; care vs. justice; legal vs. extra-legal
> obligations, etc.). Some of those disagreements are more productively
> articulated as disagreements on how to handle the polysemy of
> disability. (Beaudry 2020: 5; see also Beaudry 2016).
> 
> 
> 



Though certain ethical or political contexts might call for specifying
or stipulating a definition, this view holds that we have little
reason to think we can find, or should seek, a definition of
"disability" as a general matter. We are unlikely to find
one because these different definitions will have conceptual and
practical advantages in different contexts; we should not seek one
because adopting a canonical definition would foreclose our
recognition of other characteristics and phenomena with moral and
practical affinities to what we have decided to call
"disabilities". An open-ended approach, in contrast,
"can create avenues for new kinds of emancipatory
self-understandings" (Beaudry 2020: 13).



Beaudry acknowledges that even open-ended approaches have evidentiary
constraints, but these constraints are far looser than any which a
single definition, however nuanced and complex, would impose:



> 
> 
> Disability remains a term that at least denotes or connotes
> "abnormal embodiments", including phenomena entirely
> external to the bodies of "disabled persons" (such as
> prejudices directed at imagined abnormal embodiments or strictly
> cultural artifacts). It is a useful commonality between a
> constellation of discourses that relate to objects that are at least
> united by this family resemblance and may overlap or interact with
> each other, even though it is unlikely that a "master
> theory" would neatly choreograph all such interactions. (Beaudry
> 2020: 17)
> 
> 
> 



This deflationary pluralism, however, arguably overlooks the value of
continuing to seek a single unified or core definition of disability,
however unlikely we are to agree on one. Most philosophers who have
taken this tack do so not on the supposition that
"disability" or even "impairment" are natural
kinds--objective properties that legal and regulatory definitions
ought to track. Rather, they are largely motivated by a belief that
there is a set of personal experiences and social responses that
people with disabilities have in common, and that ways of precisifying
the meaning of "disability" and "impairment"
are likely to work better than others for purposes of framing policies
and building political movements to address the needs and claims of
individuals those sharing such personal experiences and aimed at
addressing the moral and political of this group.



Whether and to what extent the practical aims these various models of
disability seek to serve are best accomplished by many separate
contextual definitions, or one sophisticated one is, in the final
analysis itself likely to be a difficult ethical, even political,
question. Proponents of social constructionist, ameliorative views of
disability, like proponents of similar views of race and gender, have
tended to think that there are good practical reasons to define these
notions broadly, to draw attention to forms of injustice that many
experience, together, as a means for building larger and thus more
powerful coalition to push for positive change. And they have, or
anyway could, argue that the flexibility and inclusiveness pluralist
call for can be accommodated by an open-minded and sensitive debate
over just what this one solidaristic definition should or should not
include. They might be right, or they might be wrong, but if they are
wrong, it is not because the philosophical and political project of
offering a unifying definition is *a priori* misguided.