Edwards S D
University College Swansea, U.K.
Theor Med Bioeth. 1998 Jan;19(1):89-100. doi: 10.1023/a:1009942512459.
This paper is an attempt to provide a critical evaluation of the theory of disability put forward by Lennart Nordenfelt. The paper is in five sections. The first sets out the main elements of Nordenfelt's theory. The second section elaborates the theory further, identifies a tension in the theory, and three kinds of problems for it. The tension derives from Nordenfelt's attempt to respect two important but conflicting constraints on a theory of health. The problems derive from characterisation of the goals of persons; the difficulty which Nordenfelt has in respecting the plausible view that there is a distinction between illness and disability; and the presence in the theory of other strongly counterintuitive implications. In section three a defence of Nordenfelt is attempted from within the resources available within his own theory. This defence seeks to exploit his distinctions between a person who is ill and one who is 'generally disabled' and that between first- and second-order disabilities. However, it is concluded that there are insufficient resources within Nordenfelt's theory to fend off the criticisms developed in section two. The fourth section of the paper attempts a defence of Nordenfelt. It is claimed that introduction of the concept of capacity helps to explain differences between problem cases in the theory. Finally, it is shown that at least two important constraints on any theory of disability emerge from the preceding discussion.
本文旨在对伦纳特·诺德费尔特提出的残疾理论进行批判性评价。本文共分为五个部分。第一部分阐述了诺德费尔特理论的主要内容。第二部分进一步阐述该理论，指出其中的一个矛盾之处以及该理论存在的三类问题。这种矛盾源于诺德费尔特试图兼顾对健康理论的两个重要但相互冲突的限制条件。这些问题源于对人的目标的描述；诺德费尔特难以认同疾病与残疾存在区别这一合理观点；以及该理论存在的其他严重违背直觉的含义。在第三部分，尝试从诺德费尔特自身理论所提供的资源内部为其进行辩护。这种辩护试图利用他对患病者与“一般残疾者”的区分以及一阶残疾和二阶残疾的区分。然而，得出的结论是，诺德费尔特的理论中没有足够的资源来抵御第二部分中提出的批评。本文的第四部分尝试为诺德费尔特辩护。有人认为引入能力概念有助于解释该理论中疑难案例之间的差异。最后，表明在前述讨论中至少出现了对任何残疾理论的两个重要限制条件。
