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Defining Disability in an Age of Enhancement
James J. Hughes Ph.D.Public Policy Studies
Trinity College
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