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This chapter explores the ethical responsibilities of those who make medical decisions on behalf of individuals with intellectual and/or developmental disabilities that result in lifelong decisional incapacity. Standard accounts argue that because these patients have never had the capacity to make their own decisions, surrogates should make decisions based solely on what best promotes the patients’ welfare. On such accounts, the preferences, values, and decisions of those with impaired consent capacity are still relevant to decision making but only instrumentally: to the extent that soliciting them is conducive to or can provide an indicator of the patients’ general interests. Such accounts fail to ensure that such patients are properly respected. Rather than emphasize the importance of respect for autonomy, this chapter explores the more inclusive question of how decision making can be done in a way that does not insult the existent agential capacities of individuals. Trustees need to recognize that a patient’s unique evaluative perspective possesses intrinsic normative significance, and giving moral weight to their preferences, values, and decisions provides a way to respect that perspective.

This chapter explores disability-based criticism against what is here called selective reproductive technology (SRT) such as prenatal screening programs in light of recent calls for disability theory, as well as political activism based on that, to accommodate for an intersectional turn across all types of critical social identity studies (class, disability, gender, LGBT, queer, race, etc.). Applying intersectionality to the disability SRT critique generates complex and provoking implications, not invalidating it but radically transforming its shape and direction. Most notably, it inserts a wedge between the identity-based experience that SRT unjustly discriminates and oppresses disabled people and the identity political call for SRT programs to be shut down or at least not publicly supported. Intersectionality steers the justification toward politically addressing structural factors explaining injustice independently of identity-based experience, and SRT programs may have to be allowed for such action to be sustainable also from a disability identity standpoint.

This chapter argues that critical disability theory and an ethics of care, rather than offering opposing ways to think about disability, can be allies in crafting a theoretical foundation for providing care and assistance for disabled people. It recognizes the importance of taking seriously objections to care theory and to thinking of disabled people as dependents. Yet it urges that disability theorists forgo adopting the dominant liberal conceptions of the value of independence and the stigma of dependence and embrace a robust fully normative ethic of care that is compatible with the rights and dignity of disabled people.

This article argues in defence of the application of an empathy-based approach to moral education. It describes the nature of care ethics as it has developed in recent years in the work of many authors and shows the relevance of empathy to care ethics and to moral education based on such ethics. It discusses Carol Gilligan's In a Different Voice: Psychological Theory and Women's Development and Nel Noddings recent work to highlight some ways in which the relevance of caring to moral education may be relatively independent of questions of empathy.

It may seem obvious that causing disability in another person is morally problematic in a way that removing or preventing a disability is not. This suggests that there is a moral asymmetry between causing disability and causing non-disability. This chapter investigates whether there are any differences between these two types of actions that might explain the existence of a general moral asymmetry. After setting aside the possibility that having a disability is almost always bad or harmful for a person (a view that we have critiqued at length elsewhere), seven putative differences are considered. Ultimately, it is concluded that none of these seven factors can ground a general moral asymmetry between causing disability and causing non-disability, though each factor can provide some moral reason to avoid causing disability in certain particular cases.

This chapter develops a civic republican approach to disability justice. It begins by articulating a republican account of liberty as nondomination before showing how such domination can shape the relationships of people with disabilities. This leads to a consideration of whether disability justice can be defined in terms of maximizing or sufficient nondomination. Instead, the chapter provides a civic framework within which republican disability justice can be understood, encompassing both the absence of oppressive relationships and the presence of capabilities of special egalitarian concern. It also considers some specific normative implications of a republican account of disability justice—doubting the suitability of contestatory democracy but pointing toward the merits of self-education and universal basic income. Finally, the objection that this republican approach to disability justice unreasonably denigrates dependence is rebutted.

This chapter explores the ethical dimensions of diplomatic efforts to form a global agreement on climate change. It offers a brief historical background on the core multilateral climate negotiation body, the United Nations Framework Convention on Climate Change, and highlights some contentious moral elements of these negotiations. In particular, it explores the complex ways in which the principle of “common but differentiated responsibilities” (CBDR) has driven debates on how burdens for mitigation, adaptation, and finance should be distributed between developed and developing countries. It then considers the transformation in these climate negotiations since 2009, including the move toward a bottom-up architecture as part from the Copenhagen Accord to the Paris Agreement. Finally, it assesses the current state of climate diplomacy in relation to broader diplomatic priorities, arguing that climate diplomacy must be elevated alongside other top-tier foreign policy issues today in order to eventually achieve some level of climate stability.

Many models of cognitive ability and disability rely on the idea of cognition as abstract reasoning processes implemented in the brain. Research in cognitive science, however, emphasizes the way that our cognitive skills are embodied in our more basic capacities for sensing and moving, and the way that tools in the external environment can extend the cognitive abilities of our brains. It is important to address the implications of research in embodied cognition and extended cognition for how we think about cognitive impairment and rehabilitation, how cognitive reserve mitigates neural impairment, and the distinction between medical and social models of disability.

This chapter provides a roadmap of ongoing conversations about cognitive disability and moral status. Its aim is to highlight the political stakes of these conversations for advocates for the cognitively disabled while at the same time bringing out how a fundamental point of divergence within the conversations has to do with what count as appropriate methods of ethics. The main divide is between thinkers who take ethical neutrality to be a regulative ideal for doing empirical justice to the lives of people with cognitive disabilities and those who reject this methodological precept as unduly restrictive. What results is a debate between, on the one hand, fans of various familiar forms of moral individualism and Kantian approaches in ethics and, on the other, a range of disability scholars and activists who implicitly or explicitly make use of philosophically more radical methods.

Conscientious objection in health care generally involves conflicts between health care providers asserting authority not to provide certain goods and services such as emergency contraception or abortion and patients seeking them. The conflict is may be exacerbated by objectors’ refusal to cooperate with others performing these actions. Equitable resolution of this conflict depends on the role responsibilities of health care providers and the availability of alternatives for patients. Protection of the integrity of providers should not substabtially limit patients’ access to needed goods and services, especially because of the power and knowledge differential between health care professionals and patients and the restrictions on patients obtaining goods and services through other means. Although professional obligations entail clear duties such as notification, informed consent, and emergency treatment, there is contining debate about obligations to refer and what constitutes discrimination. Organizations may make analogous claims regarding their integrity and similar systems should be developed to assure patient access.

Consciousness, understood as an awareness of what is going on that helps shape one’s experiences, is one of the ways that scholars have distinguished animal life from the rest of the natural world. Beings that have interests in having good experiences and avoiding bad ones deserve our moral attention, and this quality is an important feature of ethical engagement with other sentient beings, both human and nonhuman. What interests matter and why they matter is a subject of disagreement that has affected what we judge to be permissible or impermissible treatment of other animals. Empathy toward and respect for other animals takes us beyond attention to their suffering and has us focus on what counts as well-being for others, by their own lights.

This chapter considers why social contract accounts may seem particularly ill-suited to address justice for all persons with impairments or illnesses. Two variants of social contract theory are discussed: contractarianism and contractualism. It is argued that while contractarian theories may be able to address certain basic needs and interests of persons with impairments or illnesses, such theories are, nonetheless, unacceptable if one holds that (nearly all) human beings are owed justice because of their own value or intrinsic worth. Although Rawls did not address justice for those with impairments in his theory in any detail, it is argued that contractualists can develop quite inclusive theories. Two strategies for developing an inclusive contractualism are discussed, both of which focus on a capacity for cooperative contribution possessed by nearly all human beings and in which we can understand the intrinsic value of persons as inhering.