Disability, Well-Being, and Intuition
By Daniel Tippens
In 2014, Elizabeth Barnes published a paper in Ethics with the title “Valuing Disability, Causing Disability.” Barnes is disabled herself and observes that there seems to be a striking difference between philosophers and disabled individuals, when it comes to their intuitions about the well-being of disabled people. Philosophers tend to hold what she calls the “bad-difference” view: that being disabled is bad for you per se; that being disabled automatically makes you worse off or more likely to be worse off.
Conversely, according to Barnes, disabled people (as well as disability-advocates and academics in other fields in the humanities) tend towards the “mere-difference” view: that to be disabled is merely to be different rather than worse off. On this view, disability is similar to homosexuality — it is a difference that doesn’t intrinsically make you worse off, but diminishes your well-being contingently, given the way our society is set up and treats the disabled population.
Barnes wants to show that two popular arguments against the mere difference view fail to provide good reasons for believing that being disabled, in itself, makes one’s life worse. The arguments involve two ideas: (1) if disability is a mere difference, then causing disability is morally permissible, and (2) if disability is a mere difference, then causing a non-disabled person to exist instead of a disabled person is morally impermissible. Barnes argues that the mere difference view is either compatible with these arguments or bad difference defenders end up begging the question (in a sense, as we will see later); relying on the intuition that being disabled, in itself, makes one’s life worse.
Barnes’ paper is thorough and well-argued. She does a great job at mapping the conceptual space of disability ethics and well-being discussions, and I came away feeling well-equipped to read further papers on these matters. I also found many of her points to be thoughtful and compelling. While most of the paper was devoted to addressing the aforementioned arguments, what interested me most about Barnes’ paper, and what I’d like to discuss, was a point she made about non-disabled people’s intuitions. To me, it was a case of metaphilosophy meeting politics (and I say that with intrigue, not derision). Let me return to this point after showing how she arrives at it.
The bad difference defenders cite that if something is a mere difference, then it entails a particular kind of symmetry in the moral permissibility of certain actions. Take having blonde hair vs. having black hair. Most would agree that your hair color being blonde and not black doesn’t make you intrinsically worse off. In a society accepting of all hair colors, then, it seems that if it is permissible to use gene editing to bring a blonde haired child into existence instead of a black haired child, then it is also permissible to select against a blonde haired child and for a black haired child.
However, the opponent of mere difference says, while it is intuitively true that a parent, Cara, has done something wrong if she intentionally takes a drug that causes her child, who would have been born non-disabled, to come out of the womb disabled, it also seems that it is at least permissible, if not obligatory, for Cara to intentionally take a drug to bring a non-disabled child into existence when it would have been disabled — to “cure” the child (Barnes would use scare quotes around this term, since it is quite value-laden).
Given that there is this asymmetry in moral permissibility, it would seem that disability cannot be a mere difference. However, Barnes points out that the mere difference defender could argue that this asymmetry can be explained by the fact that unlike having blonde or black hair, being disabled as opposed to non-disabled risks greater harm to the child, given the way that society is set up. So the mere difference view could also give a plausible explanation for this asymmetry, without conceding that disability per se makes one worse off.
However, Barnes thinks the better strategy is simply to deny the intuition that there is any relevant difference here. In other words, if society were fully accommodating of disabled individuals, then if it is permissible for Cara to cause a disabled person to be non-disabled, it is equally permissible to cause a non-disabled person to be disabled (like how in a fully accepting society, if it is permissible to bring into existence a heterosexual instead of a homosexual, it is permissible to do the converse as well).
Here is where things start to get really interesting. For Barnes, the mere difference defender seems to be in a position to reasonably hold the intuition that it is equally permissible to select for a non-disabled or a disabled person, because he thinks that being disabled, by itself, doesn’t make one worse off. The bad difference defender thinks that these two things are not equally permissible, because he has the intuition that being disabled, by itself, makes one worse off. In other words, the conclusion about whether or not there is symmetry in Cara’s actions seems to be determined by which starting intuition one holds. It would appear that the bad difference defender is begging the question.
But not quite. Barnes goes further and maintains that there are special epistemic reasons to be suspicious of the intuitions of abled (she at times uses the word “privileged”) people in these matters, and I take it that she thinks this implies some sort of epistemic privileging of disabled’ people’s intuitions about the moral permissibility of certain actions, when those intuitions hinge upon questions of the relative well-being of the disabled.
Her argument is based on induction, and this is where metaphilosophy meets politics. Consider that for millennia, most heterosexuals have believed that homosexuality is intrinsically wrong; men believed that women are less intelligent; and whites believed that black people are less than entirely human. For Barnes, given that our society has deep-seated ableist prejudices against the disabled (things like feeling of disgust or discomfort around disabled people and the (by now largely abandoned) idea that disability indicates some kind of wrong-doing), we should be concerned about the privileged majority’s intuitions about disabled people’s well-being and should epistemically downgrade them, to the point that they cannot override the views of the disabled, on the subject of disability. The upshot of her discussion is that employing arguments that depend on intuitions about disability and well-being will not provide any independent traction on this debate.
First, I agree that when we have good reason to believe an individual or group has relevant biases, we should be suspicious of their intuitions. When a known racist tells me that he thinks black people are less intelligent, I have good grounds to be suspicious. I am troubled, however, by Barnes’ conclusion that we should not rely on arguments that depend on intuitions regarding well-being in this debate (if indeed I am reading her correctly), because I’m not sure how else a debate about the mere difference vs. bad difference view could proceed. It’s a conceptual matter, not an empirical one, and as such, arguments will ultimately bottom out in intuitions about whether being disabled makes one worse off. Beyond this, I wonder about her suggestion that we should epistemically downgrade non-disabled people’s intuitions on the subject of disability. Do we trust disabled people’s intuitions on this matter, then, by default? There are strong reasons for caution on this front.
Barnes claims that we should be suspicious about abled people’s intuitions, regarding disability, but a similar point can be made about the disabled. Human beings are remarkably adaptable. Under the most unfavorable conditions, people are capable of finding happiness. In a 2011 study, researchers found that locked-in syndrome patients — people who have full sensory and cognitive functioning, but cannot move a muscle — reported high levels of happiness and contentment (I realize these might not be equivalent with well-being). This is surprising and a testament to the remarkable ability of humans to adapt to difficult circumstances. Frequently, this is the result of subtle psychological mechanisms, and it wouldn’t be surprising to me if these, like implicit biases, were capable of influencing a disabled person’s intuitions about well-being. This argument, then, could be made in a similar inductive form to Barnes’: presently and historically, people’s intuitions about well-being have been influenced by coping mechanisms, and it is plausible that they are at work here, too.
Second, one can imagine cases where we would not accept a person’s intuitions, simply by virtue of their belonging to a relevant minority group. Consider the case of slavery. It is well-documented that a number of former slaves, after transitioning to a free life, reported that they preferred being a slave or at least thought that being a slave was just as good as being free. One said, “For myself and them, I will say again, slavery was a mighty good thing.” 
Barnes notes that while disabled people may automatically lose some intrinsic goods (like hearing in the case of deafness), they also may acquire unique goods that aren’t available to abled people (such as feeling music through tactile vibrations — something becoming increasingly popular with the deaf community). In a similar fashion, some slaves noted the unique advantages that came from being a slave, “Things sure better long time ago then they be now. I know it. Colored people never had no debt to pay in slavery time. Never hear tell about no colored people been put in jail before freedom.” 
Imagine, now, that we are in pre-Civil War times, and slavery is common in the South. You are a time traveler who has just read Barnes’ arguments, and you are trying to decide whether it is permissible to make someone a slave or to free someone from slavery. Slaves tell you that being a slave is a “mere difference,” pointing out the unique benefits of being a slave, how their society (plantation owners) treats them well, and they maintain that they are no worse off than a free person. Should you, as someone who lives in freedom (and lives in a society that contains racial prejudices), allow their intuitions to match or override yours? (Note that this isn’t to say you don’t consider their views seriously and with respect.) The answer to me is certainly not clear.
The point is that I suspect we will have to engage in arguments that deploy intuitions about the well-being of disabled individuals, in order to advance the debate. If this is the case, then while Barnes might think that we should epistemically downgrade privileged people’s intuitions, because they are likely influenced by ableism and other biases, the same argument might be applicable to the disabled. Additionally, it is at best unclear that a majority – even if considered privileged and subject to majority-based biases — should have their views epistemically downgraded, to the point that the minority’s position should simply be accepted by default.
- George P. Rawick, ed.,The American Slave: A Composite Autobiography; Westport, Conn.: Greenwood Press, 1972-79.