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livThis is mainly because I want to draw a connection between two posts on related subjects, but you also get opinions because I can't resist.
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withasmoothroundstone posted Scarcity is not an excuse for ableism. And siderea posted something really brilliant about The Unjust Consequences of Scarcity.
withasmoothroundstone discusses some of the ways that lifesaving medical care, or even the right to existence at all, is too often defined as an unaffordable luxury for people who have long-term disabilities aside from an acute medical problem. Equally, when resources really are scarce (the example given is organ transplants), decision makers
Now, ableism is the kind of socially acceptable prejudice where sometimes people will outright declare that disabled people's lives are worth less. But most of the time I think it's a bit more subtle than that, andsiderea gives a good explanation of the underlying psychological process which may allow people to act as if that were true while still believing themselves to be good people who don't discriminate:
It's really widespread that disabled people are viewed as less worthy and less likeable than abled people. And that's bound up with the idea that disabled people's needs are "special", a luxury, in other words, beyond the basics that should be provided. (Regardless of who's doing the providing, whether it's the state or a private organization.) The basic, no-frills version of something might be inaccessible, and if there's resource (time, money, innovation, whatever) left over then maybe we'll think of including disabled people as well. And assiderea so astutely describes, only people who have high status are deserving of these extra luxuries. Disabled people have low status and people can actively resent it when accommodations are available to put disabled people on an equal footing with abled. It's not a special luxury to reserve disabled parking spaces near the entrance to a building; it's giving ambulatory and mobility-limited people the same access to that building.
It's sort of strange to me as a European to see that a large part of the US electorate seem to actively want healthcare to be an aspirational luxury, a status symbol, if you will, but when that's the case, making it very unequal in access is seen as a benefit, not a flaw. But the same bias and inequality applies to things that are not seen as luxuries: the right to live independently rather than being in an institution, usable transport for people who use mobility scooters rather than a combination of walking and cars, and so on.
My view that disabled people are people with the same rights as anyone else, not an afterthought to be generously helped if "we" have enough spare is the source of many of my unpopular opinions. Like, I can't get on board with the Effective Altruism idea that providing food, housing, medical care, opportunities for personal fulfilment etc for disabled folk is "expensive" so we should save money by just letting disabled people do without and prioritize buying cheap malaria nets and treatments for schistosomiasis. Effective Altruists don't expect abled people to go without necessities to support these charities; they ask abled people to donate their discretionary income. I can't agree with Liberal politicians who argue that disabled people should give up their homes in order to provide more space for cheaper tenants who don't need anywhere to store medical equipment or for a carer to stay. And I don't agree with the pro-choice movement who often argue that children expected to be born with disabilities should be aborted because it's too expensive and difficult for parents to raise disabled children1. Nor with the left wing factions that argue that euthanasia is somehow an equitable solution to the scarcity of medical resources.
One of the ways people justify what is effectively discrimination to themselves is that they tell themselves that a particular group of people don't really need the resources.siderea touches on it in her post when she talks about assuming that people from low status groups don't feel pain as acutely or don't really experience the symptoms they're describing. This problem is particularly acute when people are discussing allocating resources for disabled people, or even allowing them to live: it's often argued that selective abortion, or even existing humans being killed in a "humane" and "dignified" way is somehow for the benefit of the disabled people, because it's saving them from suffering by not allowing them to (continue to) exist at all. Suffering, too, is part of human existence, and courage and endurance and pure autonomy to experience all aspects of life to the full are also not a special luxury for high-status, abled people.
1]Yes, I know a lot of pro-choice advocates are primarily motivated by women's autonomy, if nothing else because loads of the pro-life movement don't care about "life" at all but want to control women. But ableism is still a factor when over 95% of pregnancies with a trisomy leading to Down syndrome are terminated, versus less than a quarter of pregnancies with no chromosomal abnormalities.<
siderea posted something really brilliant about The Unjust Consequences of Scarcity.just assume that disability is a quality that justifies instant disqualification, a reasoning which
only works at all if you accept that disability is a valid reason for people’s lives to not be worth as much.
Now, ableism is the kind of socially acceptable prejudice where sometimes people will outright declare that disabled people's lives are worth less. But most of the time I think it's a bit more subtle than that, and
siderea gives a good explanation of the underlying psychological process which may allow people to act as if that were true while still believing themselves to be good people who don't discriminate: It's when medical providers are allocating scarce resources at their personal discretion that accessing health care can slide towards being a popularity contest [... They] can fall prey to the bias to provide scarcities to those they like more over those they like less.
It's really widespread that disabled people are viewed as less worthy and less likeable than abled people. And that's bound up with the idea that disabled people's needs are "special", a luxury, in other words, beyond the basics that should be provided. (Regardless of who's doing the providing, whether it's the state or a private organization.) The basic, no-frills version of something might be inaccessible, and if there's resource (time, money, innovation, whatever) left over then maybe we'll think of including disabled people as well. And as
siderea so astutely describes, only people who have high status are deserving of these extra luxuries. Disabled people have low status and people can actively resent it when accommodations are available to put disabled people on an equal footing with abled. It's not a special luxury to reserve disabled parking spaces near the entrance to a building; it's giving ambulatory and mobility-limited people the same access to that building. It's sort of strange to me as a European to see that a large part of the US electorate seem to actively want healthcare to be an aspirational luxury, a status symbol, if you will, but when that's the case, making it very unequal in access is seen as a benefit, not a flaw. But the same bias and inequality applies to things that are not seen as luxuries: the right to live independently rather than being in an institution, usable transport for people who use mobility scooters rather than a combination of walking and cars, and so on.
My view that disabled people are people with the same rights as anyone else, not an afterthought to be generously helped if "we" have enough spare is the source of many of my unpopular opinions. Like, I can't get on board with the Effective Altruism idea that providing food, housing, medical care, opportunities for personal fulfilment etc for disabled folk is "expensive" so we should save money by just letting disabled people do without and prioritize buying cheap malaria nets and treatments for schistosomiasis. Effective Altruists don't expect abled people to go without necessities to support these charities; they ask abled people to donate their discretionary income. I can't agree with Liberal politicians who argue that disabled people should give up their homes in order to provide more space for cheaper tenants who don't need anywhere to store medical equipment or for a carer to stay. And I don't agree with the pro-choice movement who often argue that children expected to be born with disabilities should be aborted because it's too expensive and difficult for parents to raise disabled children1. Nor with the left wing factions that argue that euthanasia is somehow an equitable solution to the scarcity of medical resources.
One of the ways people justify what is effectively discrimination to themselves is that they tell themselves that a particular group of people don't really need the resources.
siderea touches on it in her post when she talks about assuming that people from low status groups don't feel pain as acutely or don't really experience the symptoms they're describing. This problem is particularly acute when people are discussing allocating resources for disabled people, or even allowing them to live: it's often argued that selective abortion, or even existing humans being killed in a "humane" and "dignified" way is somehow for the benefit of the disabled people, because it's saving them from suffering by not allowing them to (continue to) exist at all. Suffering, too, is part of human existence, and courage and endurance and pure autonomy to experience all aspects of life to the full are also not a special luxury for high-status, abled people.1]Yes, I know a lot of pro-choice advocates are primarily motivated by women's autonomy, if nothing else because loads of the pro-life movement don't care about "life" at all but want to control women. But ableism is still a factor when over 95% of pregnancies with a trisomy leading to Down syndrome are terminated, versus less than a quarter of pregnancies with no chromosomal abnormalities.<
(no subject)
Date: 2017-07-03 10:00 pm (UTC)I think you are in my age group. How often do you see doctors in a typical year and for how long? Are your contacts with your physicians long enough to create meaningful relationship, and do you feel like your doctors care about your health outcomes?
(no subject)
Date: 2017-07-04 11:39 am (UTC)I imagine that my American counterpart would have pretty positive healthcare experiences too, though. I mean, I'm not only white and middle-class and earn about twice the median salary, I work in a medical field and I know how to convince doctors to treat me as a peer. And I don't have any complex or chronic health conditions (very mild and easily medicated asthma hardly counts). I am overweight by BMI, but my appearance is socially valued curvy so I don't usually get immediate anti-fat prejudice when I walk in the door.
I'm thinking that a tenured professor at a mid-range university would have reasonably solid health insurance. She might pay a bit more for it in terms of insurance premiums and copays than I do in tax, especially since I imagine she'd have to pay out-of-pocket for anything related to the pre-existing asthma, which is most of what I need healthcare for. But she would have access to good quality healthcare from doctors who respected her and cared about her health. Or am I too optimistic and that sort of thing is only for millionnaires?
(no subject)
Date: 2017-07-04 11:53 am (UTC)I think the amount of time that I spend with the doctor is about the same as the amount of time you spend with one more appointment for a bug that won't go away or allergies. I just don't necessarily get the sense that the doctors care much about anything other than a) not over prescribing antibiotics and b) billing.
Three Gold Stars!🌟🌟🌟
Date: 2017-07-03 10:06 pm (UTC)It's really widespread that disabled people are viewed as less worthy and less likeable than abled people. And that's bound up with the idea that disabled people's needs are "special", a luxury, in other words, beyond the basics that should be provided.
I've hated "special" for a long time, and this is the first time I've understood why.
(no subject)
Date: 2017-07-04 11:57 am (UTC)GIP
Date: 2017-07-04 10:22 pm (UTC)(no subject)
Date: 2017-07-04 06:05 am (UTC)Pauline Hanson (the Australian right-wing racist politician) recently had a public rant about how disabled kids shouldn't be in mainstream education because they're holding everyone else back. Meanwhile, the government voted through a huge education budget and, to satisfy various wealthy pressure groups, gave extra millions to the Catholic education sector, and kept most funding in place for wealthy private schools. It's not the kids who are a problem, it's the low valuation of their education and the staff to help them.
(no subject)
Date: 2017-07-04 12:05 pm (UTC)I hadn't realized dreadful Pauline Hanson was still around. My condolences. Education disparities are exactly the sort of thing I'm thinking of; I think it's hugely unjust to say that the state will pay for education for physically and cognitively abled people only, because anyone else is too expensive. Whatever budget is going to be set, it needs to include providing the same level of facilities to all.