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Very interesting post! Just a couple of thoughts:

1. You write: "Grant, for the sake of argument, that the social model is a better model of physical disabilities. On this view, whether or not a person is disabled depends on the environment. Disability is thus an extrinsic relation. A person could go from disabled to non-disabled, or vice versa, simply with a change in environment."

I get the sense (perhaps I'm wrong?) that you are thinking of this as a contrast with the medical model. I don't think it is (or at least, it doesn't have to be): the fitness of an organism is very much an extrinsic, environmentally-relative trait (polar bears are a lot more fit above the arctic circle than in Brazil), and the bio-medical model proponents often use fitness to cash out their notion of 'species-typical functioning.' (Maybe some actual, individual medical-model folks don't go this route; but it is at least open to them.)

2. You write: "There seems to be, then, something intrinsic about cognitive disability... that I think challenges the social model." One way someone might try to push back the claim that cognitive disabilities are intrinsic is by arguing that cognition is (maybe in just a thin/ minimal sense) extended.

Here's a toy example. Imagine that other people in my community are able to remember many more things than I can. If I live in a community that has no easy means of recording things (pens and notebooks, smartphones, whatever), then I could be "regarded as having" an "impairment that substantially limits one or more of the major life activities." But if I have some efficient memory aid outside the boundaries of my skin, then perhaps I would be able to engage in all major life activities.

Thus whether I count as cognitively disabled would be a function of my environment: if I lived in a society with widespread literacy, I would not be disabled; whereas if I lived in a pure oral society (and there were no other memory aids), then I would be cognitively disabled. And thus (at least this type of) cognitive disability would be extrinsic as well.

Jeremy Pierce

I don't see a disanalogy. It seems to me that if you define disability in terms of a lack in abilities that society expects us to have, then it follows that the social account is true. If you define disability in terms of a lack of abilities that a well-functioning human being would have (and with some Aristotelian account of that, this would be an objective notion), I think the social model is just false. If you deny any teleology in nature, the social model might make sense, but anyone who thinks there is an objective notion of what we ideally would be capable of should think the social model is just nonsense. It doesn't matter how accepting and accommodating my culture is. Even if they go out of their way to build someone an Iron Man suit to enable them to walk everywhere they want to, it's still not possible for someone without functioning legs to walk without such a suit. That's no different from your point about cognitive disability. It applies to physical disability as well. Both kinds of disability can't really be overcome just by people being accommodating.

And I would resist your disanalogy in the other direction as well. There are all manner of accommodations we can make to people with cognitive impairment that would allow non-verbal people to communicate with typing, sign language, and so on. Everyone could learn those methods and not assume someone is stupid just because they don't communicate at a high level. We could be more forgiving in public when someone shoves someone and not always assume that they knew what they were doing or were intending to harm someone. We might not expect parents have been terrible at parenting just because of a child's behavior. We might ensure that there are alternative ways to watch movies without a crowd, without as loud noise, without people around who would get mad at distracting noises. We could refund movie tickets if a person with a disability can't make it more than a third of the way through the movie or charge people with cognitive disabilities less, on the assumption that they often won't be able to watch the whole movie. We could do a lot more than we're doing, and maybe there are some ways we should.

It does involve a significant cost (e.g. never assuming someone who shoves someone is morally responsible until you know their disability status would be pretty unreasonable). But the same is true of a lot of the accommodations for physical disabilities. I don't see how either is necessarily any different.

The big question, in my mind, is: Is there teleology in nature? Is there an objective notion of well-functioning? If so, then disability is not just social. Even if it's entirely arbitrary which characteristics we will consider to be good for someone, and we adopt a complete relativism about it, it's still true though that there are objective facts about which abilities a person has. What's relative to our evaluative system will be whether lack of abilities is bad for someone. I don't think the contrast between the social model and the medical model really draws that line in the right place.

With particular conditions, we might conclude that they involve a mix of a disability and something else. Perhaps even a heightened ability, as often happens with autism (and this is one of the things people often mention with people who lack a sense, with other senses being more sensitive). With autism, I think this means that autism itself isn't a disability, but it involves a mix of disabilities and other modifications that are not typical. But I think it's a mistake to think it follows that autism is just a different way of being and doesn't involve disabilities. That might follow from the relativistic way of thinking about all this. It doesn't follow from the mere fact that the condition involves a mix of ways that people are affected. It also doesn't follow that autism isn't, on the whole, something that affects someone negatively more than it does positively. You could make that judgment, but you could also think that the particular mix is more negative than positive, or you could think that it's different for different particular people.

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