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自闭症的异质性是否破坏了神经多样性范式?

Does the heterogeneity of autism undermine the neurodiversity paradigm?

机构信息

School of Law, Keele University, Keele, Staffordshire, United Kingdom of Great Britain and Northern Ireland.

出版信息

Bioethics. 2021 Jan;35(1):47-60. doi: 10.1111/bioe.12780. Epub 2020 Jun 15.

Abstract

The neurodiversity paradigm is presented by its proponents as providing a philosophical foundation for the activism of the neurodiversity movement. Its central claims are that autism and other neurodivergent conditions are not disorders because they are not intrinsically harmful, and that they are valuable, natural and/or normal parts of human neurocognitive variation. This paper: (a) identifies the non-disorder claim as the most central of these, based on its prominence in the literature and connections with the practical policy claims that the paradigm is supposed to support; (b) describes the heterogeneity of autism at the behavioural and causal levels, and argues that at the behavioural level this encompasses ways of being autistic that are harmful in ways that cannot be not wholly attributed to discrimination or unjust social arrangements, challenging the claim that autism is not a disorder; (c) considers and rejects responses to this challenge based on separation of high- and low-functioning autism, separation of autism from co-occurring conditions, and viewing autism as part of an individual's identity. Two of these responses fail for reasons that are themselves connected with the behavioural and/or causal heterogeneity of autism.

摘要

神经多样性范式由其支持者提出,为神经多样性运动的行动主义提供了哲学基础。其核心主张是,自闭症和其他神经多样性状况不是障碍,因为它们本身没有伤害,而且它们是人类神经认知变异性的有价值、自然和/或正常的部分。本文:(a) 根据其在文献中的突出地位及其与该范式应支持的实际政策主张的联系,将非障碍主张确定为这些主张中最核心的主张;(b) 描述了自闭症在行为和因果层面上的异质性,并认为在行为层面上,它包括了以无法完全归因于歧视或不公正的社会安排的方式存在的自闭症方式,从而对自闭症不是一种障碍的说法提出了挑战;(c) 考虑并拒绝了基于高功能和低功能自闭症的分离、自闭症与共存状况的分离以及将自闭症视为个人身份的一部分的反应。其中两种反应失败的原因本身与自闭症的行为和/或因果异质性有关。

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