Shea Matthew
Kennedy Inst Ethics J. 2019;29(4):333-366. doi: 10.1353/ken.2019.0029.
This paper explores the relationship between disability and quality of life and some of its implications for bioethics and healthcare. It focuses on the neglected perfectionist approach that ties well-being to the flourishing of human nature, which provides the strongest support for the common view of disability as a harm. After critiquing the traditional Aristotelian version of perfectionism, which excludes the disabled from flourishing by prioritizing rationalistic goods, I defend a new version that prioritizes the social capacities of human nature and the goods of personal relationship. This relationship-centered perfectionism is able to accommodate and explain disabled thriving. I also show how these issues have important implications for specific bioethical debates and clinical practices, using a cluster of issues related to Down syndrome as timely illustrations. My goal is to sketch a perfectionist theory that gives a more plausible account of the relationship between disability and well-being and that provides better practical guidance in cases involving judgments about the quality of disabled lives.
本文探讨了残疾与生活质量之间的关系及其对生物伦理学和医疗保健的一些影响。它聚焦于被忽视的完美主义方法，这种方法将幸福与人性的蓬勃发展联系起来，为将残疾视为一种伤害的普遍观点提供了最有力的支持。在批判了传统的亚里士多德式完美主义版本（该版本通过优先考虑理性主义的善而将残疾人排除在蓬勃发展之外）之后，我捍卫了一个新版本，该版本优先考虑人性的社会能力和人际关系的善。这种以关系为中心的完美主义能够包容并解释残疾人的茁壮成长。我还通过一系列与唐氏综合征相关的问题作为及时的例证，展示了这些问题如何对具体的生物伦理辩论和临床实践产生重要影响。我的目标是勾勒出一种完美主义理论，该理论能更合理地解释残疾与幸福之间的关系，并在涉及对残疾人生活质量进行判断的案例中提供更好的实践指导。
