Impairment of parts and wholes

Aristotelians tend to find the following argument plausible:

1. Every disability includes the impairment of the proper function of one or more body parts or aspects.

2. If a part or aspect is impaired, the whole is impaired.

3. It is bad for one to be impaired.

4. Hence, every disability includes something that is bad for one.

The argument is compatible with a disability not being on balance bad for one (e.g., because maybe it is instrumentally good, for instance because it might contribute to personal growth in various ways, or make one a member of a particularly valuable community, etc.), but it implies that a disability is always bad for one in some respect. I don’t know that I have seen the argument expressly formulated as above, but I think something like this argument has always been at the back of my mind when thinking about disability.

There is philosophical literature challenging premise (3). But (3) is central to Aristotelian eudaimonism, so challenges to it did not seem very plausible to me.

However, it occurred to me yesterday that premise (2) may well be false. Think about cases of redundancy. Suppose toothies are a species of organisms that, unlike humans, have a variable number of teeth. The minimum number of teeth for the first-order proper functioning of a toothy is 60. With fewer teeth, a toothy can’t chew its food sufficiently well to function properly. However, typical healthy toothies exhibit significant redundancy in their dentation, and have anywhere between 70 and 100 teeth. Toothies that have from 60 and 69 teeth either do not have any redundancy in their dentation (at 60) or have insufficient redundancy (from 61 to 69). We can think of redundancy as a second-order proper function. Furthermore, toothies that have more than 100 teeth have the teeth crowded too much in the jaw, which isn’t good for them.

Toothies constantly grow need teeth and wear out old teeth. The worn-out teeth become flaky and weak, and eventually break and fall out. Now suppose that Alice is a toothy with 85 teeth, one of which is well on its way to wearing out. That tooth is impaired. However, Alice is not impaired by virtue of having an impaired tooth, because any number of teeth between 70 and 100 is sufficient for proper first-order (chewing) and second-order (redundancy) functioning of the organism. When that tooth falls out completely, Alice won’t be impaired, and when the teeth has partial function, as it does now, she isn’t impaired either. This, premise (2) is false.

We might suppose that even if Alice isn’t impaired by having an impaired tooth, she would be better off if that tooth weren’t impaired. But that need not be true. For it need not be true that having more teeth is better for one. Having more teeth makes for more redundancy but it also makes for more crowding in the jaw. When the tooth is wearing out, crowding may be decreased (the tooth may be thinner), even though redundancy is also decreased. So it need not be the case that the tooth impairment is in any way bad for Alice.

Now, it may seem that typical impairments of human bodies or aspects are unlike Alice’s tooth impairment. However, this is not clear. Consider intellectual aptitudes. These include reasoning aptitudes in the domains of the spiritual, moral, emotional, intuitive, interpersonal, spatial, logical, arithmetical, artistic, linguistic, kinaesthetic, etc., etc. But different humans have different social roles. Perhaps what is normal for humans is proper functioning of a sufficient number of these aptitudes, not of all of them, so that each human being can find a good niche in society. Furthermore, the sufficient number of these aptitudes may be one that is sufficient to ensure redundancy. In that case, if someone has more than enough redundancy, a severe impairment of one of the aptitudes need not imply a lack of proper function of the human as a whole. But we might, nonetheless, count someone with such a severe impairment of an intellectual aptitude as disabled. If so, being disabled in that respect need not imply being impaired on whole, or badly off in any respect.

However, in the intellectual aptitude case, shouldn’t we say that having more of the aptitudes is better? It isn’t like teeth, where having too many can be harmful, is it? Well, that isn’t completely clear. After all, it can be harder for a kid with many talents to specialize. But even if we grant that one is better off for having more of the aptitudes, this does not mean that lacking one or more is bad. It can be just less good. If Alice’s having 70 teeth is enough for her toothy nature, but 71 is better, then having only 70 isn’t bad, just less good.

That said, there are doubtless some parts or aspects of a human being such that proper function of the part or aspect is necessary for the proper function of the whole. The most obvious cases are the moral and spiritual: someone whose moral or spiritual aspects are impaired is indeed impaired as a person.

Acknowledgment: I feel that some of what I say is influenced in various ways by conversations I had with my superb student Hilary Yancey, but where I have failed to absorb her ideas at the time.

Distancing oneself from one's brain

It can be quite useful for someone suffering from a variety of brain conditions, such as obsessive compulsive disorder, to deliberately distance themselves from their brain’s unfortunate doings, by saying to themselves things like: “That’s not me, just my brain.”

If physicalism is true, then brains are either identical with us or at least are the core of who we are. But “That’s not me, just me” is a contradiction while “That’s not me, just the core of my being” isn’t much of a distancing. A similar issue arises in second and third person contexts: if physicalism is true, one must admit brain problems to be grounded in that which is at the core of the other’s being.

The dualist, on the other hand, can pull off the distancing much more easily: “That’s not my soul, just my brain” makes perfect sense. An impairment in the brain is just an impairment of a body part, albeit one of the most important ones.

Of course, that something is a helpful way of thinking does not prove that it’s true. But it is an insight from the beginnings of Western philosophy that truth is generally better for us than falsehood, and so that something is a helpful way of thinking is some evidence that it is true. We may, thus, have some evidence for dualism here.

Impairment and saving lives

Bob and Carl are drowning and you can save only one of them. Bob is a human being in the prime of life, physically and mentally healthy, highly intelligent, and leading a happy and fulfilling life as a physicist committed to lifelong celibacy. To look at him, Carl is Bob’s identical twin. Carl has the same physical and mental powers as Bob, and leads a very similar happy and fulfilling life as a physicist committed to lifelong celibacy.

But there is one crucial difference that you know about, but Carl does not. Carl is actually a member of a superintelligent humanoid alien species. However, due to an unfortunate untreatable genetic condition, Carl suffers from a severe intellectual impairment, having merely the intelligence of a highly intelligent human. In order that Carl might avoid the stigma of the impairment, his parents had some highly sophisticated surgery done on him to make him fit into human society, and arranged for him to be adopted by a human family and raised as a human. No one except for you on earth will ever know that Carl isn’t human. You know because you happened to see the aliens arranging this (but you haven’t told anyone, because you don’t want people to think you are crazy).

Should you save Bob or Carl from drowning? My intuition is that if the above is all that you know, you have no reason to prefer saving one over the other. If one of them is slightly more likely to be saved by you (e.g., they are slightly closer to you), you should go for that one, but otherwise it’s a toss-up.

But notice that if you save Carl, there will be more natural evil in the world: There will be a severe intellectual impairment, which won’t be present if you choose to save Bob instead. It seems pretty plausible that:

1. If you have a choice between two otherwise permissible courses of action, which result in the same goods, but one of them results in exactly one additional evil, you have a moral reason to choose the course of action that does not result in the evil.

Thus, it seems, you should save Bob.

So there is something paradoxical here. On the one hand, there seems to be no reason to pick Bob over Carl. On the other hand, the plausible general ethical principle (1) suggests you should pick Bob.

How can we get out of this paradox? Here are two options.

First, one could say that impairment is not an evil at all. As long as Carl leads a fulfilling life—even if it is merely fulfilling by human standards and not those of his species—his impairment is no evil. Indeed, we might even take the above story to be a reductio ad absurdum of an Aristotelian picture of species as having norms attached to them with it being a harm to one to fall short of these norms.

Second, one argue that principle (1) does not actually apply to the case. For there is a difference of goods in saving Carl: you are saving a member of a superintelligent species, while in the case of saving Bob, you are saving a mere human. For this to fit with the intuition that it’s a toss-up whether to save Bob or Carl, it has to be the case that what the superintelligence of his species adds to the reasons for saving Carl is balanced by what his abnormally low intelligence subtracts from these reasons.

Of these options, I am more attracted to the second. And the second has an interesting and important consequence: "mere" membership in a natural kind can have significant value. This has important repercussions for the status of the human fetus.

Impairment and non-human organisms

Consider a horse with three legs, a bird with one wing, an oak tree without bark, and a yeast cell unable to reproduce. There is something that all four have in common with each other, and which they also have in common with the human who has only one leg. And it seems to me to be important for an account of disability to acknowledge that which all these five organisms have in common. If the right account of disability is completely disjoined from anything that happens in non-human organisms—or even from anything that happens in non-social organisms—then there is another concept in the neighborhood that we really should also be studying in addition to disability, maybe “impairment”.

Moreover, it seems clear the thing that the five organisms in my examples have in common is bad as far as it goes, though of course it might be good for the organism on balance (the one-winged bird might be taken into a zoo, and thereby saved from a predator).

Group impairment and Aristotelianism

Aristotelians have a metaphysical ground for claims about what is normal and abnormal in an individual: the form of a substance grounds the development of individuals in a teleological ways and specifies what the substance should be like. Thus a one-eyed owl is impaired—while it is an owl, it falls short of the specification in its form.

But there is another set of normalcy claims that are harder to ground in form: claims about the proportions of characteristics in a population. Sex ratios are perhaps the most prevalent example: if all the foals born over the next twenty years were, say, male, then that would be disastrous for the horse as a species. And yet it seems that each individual foal could still be a perfect instance of its kind, since both a male and a female can be a perfect instance of horsehood. Caste in social insects is another example: it would be disastrous for a bee hive if all the females developed into workers, even though each one could be a perfect bee.

The two cases are different. The sex of a horse is genetically determined, while social insect caste is largely or wholly environmental. Still, both are similar in that the species not only has norms as to what individuals should be like but also what the distribution of types of individuals should be. There is not only the possibility of individual but of group impairment. But what is the metaphysics behind these norms?

Infamously, Aristotle interpreters differ on whether forms are individual or common: whether two members of the same species have a merely exactly similar or a numerically identical form. Here is a place where taking forms to be common would help: for then the form could not only dictate the variation between the parts of each organism’s body but also the variation between the organisms in the species. But taking forms to be common would be ethically disastrous, because it would mean that all humans have the same soul, since the soul is the form of the human being.

Here’s my best solution to the puzzle. The form specifies the conditions of the flourishing of an individual. But these conditions can be social in addition to individual. Thus, a perfectly healthy and well-nourished male foal would not be flourishing if it lacks a society with potential future mates. And while each worker bee can internally be a fulfilled worker bee, it is not flourishing if its work does not in fact help support a queen. These social conditions for flourishing are constitutive. It’s not that the lack of a queen will cause the worker bee to die sooner (though for all I know, it might), but that the lack of a queen is constitutive of the worker bee being poorly off.

Once we see that there can be constitutive social conditions for flourishing, it is natural to think that there will be constitutive environmental conditions for flourishing. And this could be the start of an Aristotelian philosophy of ecology.

Are we all seriously impaired?

When I taught calculus, the average grade on the final exam was around 55%. One could make the case that this means that our grading system is off: that everybody’s grades should be way higher. But I suspect that’s mistaken. The average grasp of calculus in my students probably really wasn’t good enough for one to be able to say with a straight face that they “knew calculus”. Now, I think I was a pretty rotten calculus teacher. But such grades are not at all unusual in calculus classes. And if one didn’t have the pre-selection that colleges have, but simply taught calculus to everybody, the grades would be even lower. Yet much of calculus is pretty straightforward. Differential calculus is just a matter of ploughing through and following simple rules. Integral calculus is definitely harder, and exceling at it requires real creativity, but one can presumably do decently just by internalizing a number of heuristics and using trial and error.

I find myself with the feeling that a normal adult human being should be able to do calculus, understand basic Newtonian physics, write a well-argued essay, deal well with emotions, avoid basic formal and informal fallacies, sing decently, have a good marriage, etc. But I doubt that the average adult human being can learn all these things even with excellent teachers. Certainly the time investment would be prohibitive.

There are two things one can say about this feeling. The first is that the feeling is simply mistaken. We’re all apes. A 55% grade in calculus from an ape is incredible. The kind of logical reasoning that an average person can demonstrate in an essay is super-impressive for an ape. There is little wrong with average people intellectually. Maybe the average human can’t practically learn calculus, but if so that’s no more problematic than the facts that the average human can’t practically learn to climb a 5.14 or run a four-minute mile. These things are benchmarks of human excellence rather than of human normalcy.

That may in fact be the right thing to say. But I want to explore another possibility: the possibility that the feeling is right. If it is right, then all of us fall seriously short of what normal human beings should be able to do. We are all seriously impaired.

How could that be? We are, after all, descendants of apes, and the average human being is, as far as we can tell, an order of magnitude intellectually ahead of the best non-human apes we know. Should the standards be another order of magnitude ahead of that?

I don’t think there is a plausible naturalistic story that would do justice to the feeling that the average human falls that far short of where humans should be at. But the Christian doctrine of the Fall allows for a story to be told here. Perhaps God miraculously intervened just before the first humans were conceived, and ensured that these creatures would be significantly genetically different from their non-human parents: they would have capacities enabling them to do calculus, understand Newtonian physics, write a well-argued essay, deal well with emotions, avoid fallacies, sing decently, have a good marriage, etc. (At least once calculus, physics and writing are invented.) But then the first humans misused their new genetic gifts, and many of them were taken away, so that now only statistically exceptional humans have many of these capacities, and none have them all. And so we have more geneticaly in common with our ape forebears than would have been the case if the first humans acted better. However, in addition to genetics, on this story, there is the human nature, which is a metaphysical component of human beings defining what is and what is not normal for humans. And this human nature specifies that the capacities in question are in fact a part of human normalcy, so that we are all objectively seriously impaired.

Of course, this isn’t the only way to read the Fall. Another way—which one can connect in the text of Genesis with the Tree of Life—is that the first humans had special gifts, but these gifts were due to miracles beyond human nature. This may in fact be the better reading of the story of the Fall, but I want to continue exploring the first reading.

If this is right, then we have an interesting choice-point for philosophy of disability. One option will be to hold that everyone is disabled. If we take this option then for policy reasons (e.g., disability accommodation) we will need a more gerrymandered concept than disability, say disability^*, such that only a minority (or at least not an overwhelming majority) is disabled^*. This concept will no doubt have a lot of social construction going into it, and objective impairment will be at best a necessary condition for disability^*. The second option is to say only a minority (or not an overwhelming majority) is disabled, which requires disability to differ significantly from impairment. Again, I suspect that the concept will have a lot of social construction in it. So, either way, if we accept the story that we are all seriously impaired, for policy reasons we will need a disability-related concept with a lot more social construction in it.

Should we accept the story that we are all seriously impaired? I think there really is an intuition that we should do many things that we can’t, and that intuition is evidence for the story. But far from conclusive. Still, maybe we are all seriously impaired, in multiple intellectual dimensions. We may even be all physically impaired.