包容有什么好处?对严重智障和多重残疾人士社会包容理想的伦理分析

IF 1.8 3区 哲学 Q2 ETHICS Health Care Analysis Pub Date : 2023-12-11 DOI:10.1007/s10728-023-00470-y
Simon van der Weele, Femmianne Bredewold
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引用次数: 0

摘要

在全球北方的大多数国家,"社会包容 "是为智障人士提供服务和护理的主要理想。社会包容 "可以简单地指完全平等的权利,但更多时候它被认为是 "社区参与 "的意思。这种狭义的社会包容已经根深蒂固,几乎不受质疑。人们似乎假定,对社会包容的这种狭义理解是好的,这在道德上已形成明确的共识。然而,对于无法用语言表达自己的需求和偏好的深度智力残疾和/或多重残疾人士(PIMD)来说,这种道德共识并不明确。此外,事实证明,对深度智障和/或多重残疾人士来说,社会包容很难概念化和实施。因此,当务之急是要问一问对社会包容的狭隘理解的伦理依据是什么。我们为什么认为社会包容是好事?这些理由是否也适用于 PIMD 患者?本文针对这些问题,从伦理角度分析了社会包容对多发性情感障碍患者的理想意义。文章讨论了社会包容的四个伦理论点,并探讨了这些论点与 PIMD 患者的相关性。文章认为,这些论点都不能让人完全信服狭义的社会包容对 PIMD 患者的价值。文章最后倡导为多发性精神障碍患者提供一个想象美好生活的伦理空间。
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What’s Good About Inclusion? An Ethical Analysis of the Ideal of Social Inclusion for People with Profound Intellectual and Multiple Disabilities

‘Social inclusion’ is the leading ideal in services and care for people with intellectual disabilities in most countries in the Global North. ‘Social inclusion’ can refer simply to full equal rights, but more often it is taken to mean something like ‘community participation’. This narrow version of social inclusion has become so ingrained that it virtually goes unchallenged. The presumption appears to be that there is a clear moral consensus that this narrow understanding of social inclusion is good. However, that moral consensus is not clear in the case of people with profound intellectual and/or multiple disabilities (PIMD), who are not able to express their needs and preferences verbally. Moreover, social inclusion has proven to be difficult to conceptualize and implement for people with PIMD. Therefore, it becomes imperative to ask about the ethical rationale of the narrow understanding of social inclusion. For what reasons do we think social inclusion is good? And do those reasons also apply for people with PIMD? This article addresses these questions by providing an ethical analysis of the ideal of social inclusion for people with PIMD. It discusses four ethical arguments for social inclusion and probes their relevance for people with PIMD. The article argues that none of these arguments fully convince of the value of the narrow understanding of social inclusion for people with PIMD. It ends with advocating for an ethical space for imagining a good life for people with PIMD otherwise.

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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
3
期刊介绍: Health Care Analysis is a journal that promotes dialogue and debate about conceptual and normative issues related to health and health care, including health systems, healthcare provision, health law, public policy and health, professional health practice, health services organization and decision-making, and health-related education at all levels of clinical medicine, public health and global health. Health Care Analysis seeks to support the conversation between philosophy and policy, in particular illustrating the importance of conceptual and normative analysis to health policy, practice and research. As such, papers accepted for publication are likely to analyse philosophical questions related to health, health care or health policy that focus on one or more of the following: aims or ends, theories, frameworks, concepts, principles, values or ideology. All styles of theoretical analysis are welcome providing that they illuminate conceptual or normative issues and encourage debate between those interested in health, philosophy and policy. Papers must be rigorous, but should strive for accessibility – with care being taken to ensure that their arguments and implications are plain to a broad academic and international audience. In addition to purely theoretical papers, papers grounded in empirical research or case-studies are very welcome so long as they explore the conceptual or normative implications of such work. Authors are encouraged, where possible, to have regard to the social contexts of the issues they are discussing, and all authors should ensure that they indicate the ‘real world’ implications of their work. Health Care Analysis publishes contributions from philosophers, lawyers, social scientists, healthcare educators, healthcare professionals and administrators, and other health-related academics and policy analysts.
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