A Puzzle about Disability and Old Age

In this post, Kasper Lippert-Rasmussen discusses their recent article in Journal of Applied Philosophy on the connections between disability-related disadvantages and old-age-related disadvantages.

Many think that being disabled and being old are worse for a person than being able-bodied and being young respectively. However, many think differently about these two disadvantages. Specifically, they think that while the disadvantages of disabled people are (largely) due to ableism, the disadvantages of old age are not due to ageism, but simply reflects a regrettable, unavoidable fact of life. In a recent article, I argue that this view is untenable. More generally, I suggest in the light of how our thinking of one of these forms of disadvantages constrains our thinking about the other that much of the previous debate about the badness of disability and old is misdirected.

A few decades ago, most philosophers accepted something like the bad-difference view of disability (for a view that comes close to this see here). On this view, disabilities are kinds of bodily or mental dysfunction that are worse in themselves for the disabled person. However, nowadays many theorists reject this view. Instead, they embrace:

The mere-difference view of disability: Being disabled is no worse in itself for the disabled person than being able-bodied; it is merely different. To the extent that it is worse, this is due not to the disability itself, but to an ableist social environment.

An ableist social environment is one which matches the needs and abilities of able-bodied people significantly better than the needs and abilities of disabled people. An example of this is the, until recently, widespread absence of wheelchair access to public buildings. This example also provides considerable support for the mere-difference view of disability, since it brings out the fact that how accommodating our social environments are, makes a huge difference to how bad for the bearer these disabilities are.

Views about old age similar to these two views of disability are easily conceivable. Yet, our thinking has not undergone a similar transition from a bad-difference view of old age to a mere-difference view. Most accept (and most also accepted a few decades ago):

The bad-difference view of old age: Being old is worse in itself, and not merely different, for the older person than being young. To the extent that it is worse, this is due, in part at least, to old age in itself and not just to an ageist social environment.

As Michael Hauskeller puts it: ‘In ageing, we experience the gradual disintegration of our bodies and, often enough, our minds. Taken by itself this really is bad for us, that is, your ageing is bad for you and mine for me’. Suppose you were offered a pill at no cost at the age of 25 that would stop your body and mind ageing – meaning, for example, that your risk of Alzheimer’s would not double every five years of age after age 64. The pill would not affect the length of your life. Would you decline to take it on the ground that doing so would be pointless as it would not affect you for better or worse? I suspect virtually no one would – not even if, and here comes a crucial bit, they were credibly ensured that the social environment of the future is in no way ageist.

Consider now a third claim:

The biconditional claim: The mere-difference view of disability is true if, and only if, the bad-difference view of old age is false.

One supporting thought behind this claim is that old age generally involves developing disabilities or conditions similar to disabilities. Take deafness. Deafness is generally considered a disability in part because it prevents one from being able to take part in many social interactions – at least, when these takes place between people with no hearing impairments. But the same is true, albeit to a lesser extent, of reduced hearing. Generally, older people have worse hearing than young people. If the disadvantages experienced by deaf people are due to an ableist social world, it is difficult to see why the same is not true of nn-deaf older people with impaired hearing. Similarly, if the disadvantages involved in being disabled in a way that involves wheelchair use should be conceived in accordance with the mere-difference view, it is difficult to see why we should not similarly adopt a mere-difference view of the reduced mobility of non-wheel-chair-using, older people. Similar claims are true of many other conditions characteristic of old age, including slower reflexes, impaired memory, decreased muscle strength, poor balance and low oxygen consumption.

If the mere-difference view of disability, the bad-difference view of old age, and the biconditional claim are all plausible, we have a trilemma. Not all three claims can be true. Any pair of them logically entails the negation of the third. But if we are logically compelled to reject at least one of the three claims, which of them should that be?

Essentially, this is a hard choice. However, my main aim here is not to propose a particular solution to exit the age-disability trilemma. Rather, it is to point to the generally unacknowledged fact that how we think about mere-difference views in relation to disability constrains how we must think of similar views in relation to old age, and vice versa. Once we start taking this fact into account, I think many of us will see that we must revise the way in which we think about either the disadvantages of disability or old age. Or both.