Defining Disability in an Age of Enhancement

James J. Hughes Ph.D.Public Policy Studies

Trinity College

james.hughes@trincoll.edu

Union College – May 22, 2010

What is Ability/Disability?

Medical Model of Disability: there is an objective standard of disease/disability, health/ability (and enhancement)

Social Model of Disability: disability is created by how society treats varying levels of health and ability

Human Enhancement

Therapy/Enhancement

EnablementSome therapies already

enhanceBaseline is shiftingSocial construction of

normal, healthy, able

Therapeutic HETs

Under therapeutic model the sick and disabled will be first to receive HETs

Physical Ability

Prosthetics & Oscar Pistorius

Doping & gene dopingTissue engineering &

stem cellsDeclining senior disability and

changing expectations of the elderly

Skeleto-Muscular Therapies

Growth factor and follistatin genes inserted into muscle tissue increased muscle mass without exercise, and more with exercise.

A possible therapy for muscle wasting conditions such as Duchenne muscular dystrophy.

Health & Longevity

Therapies that slow aging will be therapies for aging-related diseases.

ObesityDiabetesHypertensionHeart diseaseDepressionImmune weaknessCancer

74 yr-old Tsumu Tosuka

Cochlear & Auditory Implants

Bluetoothed implants will permit implants to work with phones and MP3 players

Artificial Eyes

Today dots of lightTomorrow infrared and ultraviolet

Artificial Limbs

Artificial limbs could already be stronger than organic ones

bebionic fully articulating myo-electric prosthetic hand from RSLSteeper

Cognitive Ability

Therapies for developmental delay, brain damage and dementia

ADHD and stimulants

Flynn Effect

Mental Health & Mood

Diagnosis creep or increasing pathology

SSRIsIncreasing openness

but declining tolerance of untreated mental illness

Humans 1.0 Are All Disabled

In the future we will all be “disabled” in relation to the enhanced standard

Question will be how widespread access is to HETs

Victory of the Social Model?

HETs will gradually erode a medical model of disability

Ability will be defined by our access to technological enablement

Convergence of medicalization and social model

Unenhanced subject to:• Prejudice & stigma• Structural barriers

Literacy

Not required a hundred years ago

Expected todayEmployment

barriersStigmaMedicalization

Infertility

Are the infertile disabled or sick?

Infertility always a problem

Now that there are fertility treatments they have organized for access

Capabilities Approach

Sen-NussbaumNo naturalistic

fallacy or status quo bias

More capabilities are better

Capabilities determined by social and tech enablement