1. Defining Disability in an Age of Enhancement James J. Hughes Ph.D. Public Policy Studies Trinity College james.hughes@trincoll.edu Union College – May 22, 2010

2. What is Ability/Disability? Medical Model of Disability: there is an objective standard of disease/disability, health/ability (and enhancement) Social Model of Disability: disability is created by how society treats varying levels of health and ability

3. Human Enhancement Therapy/ Enhancement Enablement Some therapies already enhance Baseline is shifting Social construction of normal, healthy, able

4. Therapeutic HETs Under therapeutic model the sick and disabled will be first to receive HETs

5. Physical Ability Prosthetics & Oscar Pistorius Doping & gene doping Tissue engineering & stem cells Declining senior disability and changing expectations of the elderly

6. Skeleto-Muscular Therapies Growth factor and follistatin genes inserted into muscle tissue increased muscle mass without exercise, and more with exercise. A possible therapy for muscle wasting conditions such as Duchenne muscular dystrophy.

7. Health & Longevity Therapies that slow aging will be therapies for aging- related diseases. Obesity Diabetes Hypertension Heart disease Depression Immune weakness Cancer 74 yr-old Tsumu Tosuka

8. Cochlear & Auditory Implants Bluetoothed implants will permit implants to work with phones and MP3 players

9. Artificial Eyes Today dots of light Tomorrow infrared and ultraviolet

10. Artificial Limbs Artificial limbs could already be stronger than organic ones bebionic fully articulating myo- electric prosthetic hand from RSLSteeper

11. Cognitive Ability Therapies for developmental delay, brain damage and dementia ADHD and stimulants Flynn Effect

12. Mental Health & Mood Diagnosis creep or increasing pathology SSRIs Increasing openness but declining tolerance of untreated mental illness

13. Humans 1.0 Are All Disabled In the future we will all be “disabled” in relation to the enhanced standard Question will be how widespread access is to HETs

14. Victory of the Social Model? HETs will gradually erode a medical model of disability Ability will be defined by our access to technological enablement Convergence of medicalization and social model Unenhanced subject to: Prejudice & stigma Structural barriers

15. Literacy Not required a hundred years ago Expected today Employment barriers Stigma Medicalization

16. Infertility Are the infertile disabled or sick? Infertility always a problem Now that there are fertility treatments they have organized for access

17. Capabilities Approach Sen-Nussbaum No naturalistic fallacy or status quo bias More capabilities are better Capabilities determined by social and tech enablement