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Before I sold out to become a rich and powerful philosophy professor in Dubuque, Iowa, I spent several years working at group homes for people with disabilities both physical and intellectual. My wife, who has even more experience in that field, has at various times in her life been severely disabled, due to her multiple sclerosis. The two of us have also worked together as in-house caregivers for a couple with dementia, up until the end of their lives.

It was therefore with more than academic interest that I read Melanie Howard’s two-part series on “Disabling Ableism.” I don’t want to rest on my bona fides, such as they are, and the philosopher in me resists the notion that the quality of a person’s experiences has anything to do with the cogency of their arguments. But I do want the reader to know that what follows is not bloodless armchair logic-chopping. I hope my critique is motivated by the same compassion for the excluded, the same concern for human flourishing, the same attention to the brokenness of our culture, and the same biblical tradition that so clearly motivate Prof. Howard’s own arguments.

In other words, I hope I’m not being pedantic when I say it matters that we think clearly about what “disability” is. Prof. Howard herself says as much: “Although it may seem like a strange or even unnecessary place to begin, defining the models of disability . . . has real consequences . . . .” I agree not only with this point, but with her claim that the consequences of a bad model of disability can be and have been no less serious than a systemic failure to recognize the imago Dei in each person. The group homes I worked in are full of people who have been ignored, slighted, insulted, and isolated. But I don’t think Prof. Howard’s preferred “cultural” model brings the clarity that might prevent such misrecognition.

Consider the question of cochlear implants for deaf children of hearing parents. Most parents, working with the medical model of disability, want these devices for their children. Some Deaf activists, working with the cultural model, have argued that it is morally wrong to do this, and some have even equated it to “genocide.” The logic is clear in both cases. For the parents, deafness is a medical problem that hinders the inclusion of their children in social life, and to fix that problem (so far as is possible) is to enable inclusion. For the activists, Deafness is an identity – it is not a “problem” at all, medical or otherwise – and the real problem is the cultural ideal that keeps parents from accepting it. The parent sees deafness as a deviation to be corrected; the activist sees it as a difference to be celebrated.

Differences of opinion such as these force us to reckon with the full implications of a cultural model. You cannot take refuge in “individual choice,” since in this case, the children cannot make the choice for themselves. Nor can you retreat to quibbling about whether a medical fix really “works” – the question is, what should we do assuming we could do it? Which is the right way to foster inclusion? Who’s preferred policy would promote human flourishing? What does it mean to recognize the imago Dei of the deaf child?

The cultural model implies, as Prof. Howard notes in a footnote, that “no body is inherently an able one. All bodies are abled and disabled by their environments, cultures, and contexts.” If this means that our environments, cultures, and contexts help to shape our bodies in good and bad ways, and that therefore we should aim to build environments that shape them in good ways, so that we can flourish, then it would make sense. But it cannot mean that: the whole point of the cultural model is that what counts as a “good” – what counts as “normal functioning” – is itself a cultural construction, and the constructed distinction between “good” from “bad,” functioning and malfunctioning, is what causes or justifies exclusion. But how then can we talk about “flourishing”? How can we recognize “flourishing,” including the flourishing of the body, without recognizing impediments to it?

Prof. Howard wants us to pursue the same “cultural redefinitions in which Jesus normalizes individuals previously perceived as disabled.” But what do we mean here? Do we mean that the blind man that Jesus healed was only perceived to be disabled and that Jesus’ real work was not to heal his blindness, but to change our perceptions so that we no longer think of his blindness as something in need of healing? That is precisely what the cultural model implies our work should be.

The cultural model leads to an inability to say that anything is wrong with a world like that depicted in the movie WALL-E, for example. In WALL-E, everyone is obese, but obesity has been culturally normalized. According to the cultural model, the humans in WALL-E are flourishing. The social model also comes into play in this example: because of the built environment, which makes it unnecessary to walk, obesity is not an impairment. Just as a person in a wheelchair is “not disabled until the lack of a ramp disables them from entering a building,” so the obese people in WALL-E are not disabled until the lack of a hoverchair disables them from moving around. Of course, WALL-E is a dystopia. But this argument is not a reductio ad science fiction. The current politics of obesity are full of the same logic. Virginia Sole-Smith, author of Fat Talk, says “the solution to racism is not to make everyone white. The solution to homophobia is not to make everyone straight. This is not how we as a culture want to be proceeding on [anti-fat bias].”1 Instead, she says, we ought to normalize fatness.

The cultural model conflates two things: the mere description of something as a problem, as an impediment to human flourishing (as in a disability), and the use of that description as an excuse for treating people with disrespect. The model implies that to describe a person’s condition as a problem simply is to show that person disrespect. But this concern with showing respect leads to a strange discursive environment in which showing compassion by trying to fix people’s disabilities meets the definition of “ableism.” That is certainly not Prof. Howard’s intention. I am simply talking about the logic of the model itself: our goal here is clear thinking. The cultural model produces a confusion that short-circuits efforts to help, not just in philosophy seminars but in real life, and in public policy. It tells parents who wish to give their children cochlear implants that they are failing to celebrate diversity – if not committing “genocide.”

The cultural model (along with the social model it incorporates) does not help us to “define the models of disability” so as to avoid moral and practical consequences that are inimical to human flourishing. But this argument is not a brief for the medical model, which is if anything even less helpful than the cultural model.

If the weakness of the cultural model is that, rhetoric aside, it actually forbids us from defining anything as a “problem,” (there are no real disabilities, only different abilities), the weakness of the medical model is that it assumes problem-definitions can be established by scientific facts. But this is false, and extremely dangerous. Science can explain why someone is deaf; but those facts tell us nothing about whether being deaf is a problem – something in need of fixing. This matter is not a question of fact, but of value. Consider the antebellum idea of “drapetomania” – the “disease causing Negros to run away.” The claim was that a problem in the enslaved person’s brain had disabled them from accepting their natural condition of servitude. This was, of course, nonsense. But it was moral nonsense, not medical nonsense. If MRIs had been available in the 19th century, the source of this “disability” might have been located, and possibly fixed (perhaps by a lobotomy). The question is not about the facts; the question is about what the facts mean. And the cultural model gets this right. The question “what is a disability?” is a question of values, not facts.

But in the cultural model, all the values – the judgments that tell us what is and is not conducive to human flourishing – are “culturally constructed” in the interests of excluding some and including others. This point is of course true in many, many cases. We do live in a broken culture. So often we make judgments in order to exclude. But the solution of the cultural model is to ban all such judgments about the actual content of human flourishing, and this cannot be right, since we cannot pursue human flourishing for ourselves and with others without making judgments about what flourishing is – and what it is not. We can try to avoid making those judgments, but eventually, we will be forced to do so, as in the case of the cochlear implant.

The question, then, is about the source of our visions for human flourishing. Where do we find the standard that allows us to distinguish ability from disability, which we must be able to do if we are going to treat the disabled with both compassion and respect? Well, we are Christians: it is at this point that we will have to start talking about Scripture and Christian tradition. And here there is plenty of room for disagreement. The activist’s charge of “genocide” is unconscionable, but unlike many critics of the cultural model, I actually have a great deal of sympathy for their more reasonable claim that Deafness is at least as much of a cultural identity as it is a disability, and cannot be entirely reduced to a medical problem.

But I do not think there is infinite room for disagreement. I found Prof. Howard’s example of the eunuch especially strange. While some eunuchs were “congenital” (i.e., born that way), most were boys who had been made into eunuchs, by having their testicles and sometimes their penises destroyed or removed before they reached puberty. When Isaiah welcomes eunuchs into the Kingdom of God, he is not celebrating diversity; he is welcoming people who have been maimed. Prof. Howard’s argument would seem to imply that, if it simply produces a difference to be celebrated, there is no intrinsic problem with castrating someone. I assume she would oppose castrating boys against their will, but I assume she would not object to a man’s decision to castrate himself. I do not see what sense remains of Isaiah’s welcome if we do not emphasize that he is welcoming people who have been hurt – people who have been disabled, not just “born different.”

Of course, my argument implies that even those eunuchs who were born that way were still born disabled. But this judgment is not at odds with the Kingdom. Prof. Howard’s examples from the gospels are all stories in which Jesus acts on the moral common sense that it is bad to be blind, that it is good to see. I say this not because I have some scientific facts about how eyes work, or because my culture has “constructed” the idea for me, but because the created purpose of the eye is to see. It makes no sense so say it is good for Christ to heal the blind unless we can say that blindness is not just a “difference” but is rather a genuine dis-ability – something that interferes with the eye’s telos.

But whatever judgments we make, when we disagree, we need to be clear about what we are doing. We are making judgments about what is objectively good and bad for human as created beings, judgments that we hope are faithful to Christ’s teaching and example. That is very different from declaring that the solution is to make no judgments at all – to redefine every “disability” as mere “difference.”


  1. Mosley, T. (2023) Diet culture can hurt kids. this author advises parents to reclaim the word ‘fat’, NPR. Available at:’re,not%20to%20make%20everyone%20white. (Accessed: 26 October 2023).

Adam Smith

Adam Smith is Associate Professor of Political Philosophy and Director of the Honors Program at the University of Dubuque, and Associate Editor at Front Porch Republic.


  • Gordon Moulden says:

    Re: “We are making judgments about what is objectively good and bad for human as created beings, judgments that we hope are faithful to Christ’s teaching and example.”

    I agree strongly with the argument here that we cannot ignore disabilities; we must recognize them as they are and respond “Christianly’. But if we are to think and act “Christianly”, then we cannot think objectively, that is, without a subjective, value-based perspective.

    We are called to act on values, on those based on the Word of God, because as Christ quoted from Deuteronomy 8:3, we are not meant to “live on bread alone, but on every word that comes from the mouth of God.” (Matthew 4:4). Scripture is to be our manual for living, for viewing the world and all of creation. So, when asked to identify the most important commandment, Christ added a second which He said was “like it”, that second being to “love your neighbor as yourself”. He then, as Luke recounted, presented to His listeners the Parable of the Good Samaritan–a man who did not ignore a person clearly suffering and unable to help himself, but seeing with compassionate eyes and acting with a compassionate heart, preceded to attend to his wounds and then to take him to an inn where he could rest and heal. That is, he acted to do all he could to restore the beaten and injured man to health. Christ identified that as loving one’s neighbor. More generally, when Christ sent out his disciples to minister, He empowered them to cast out demons and heal diseases, to perform acts of compassion upon those suffering spiritual, mental, and physical infirmities to restore them in order to significantly improve the quality of each one’s life in a way that would allow them to participate as “able” members of society.

    To think Christianly about disability is therefore, I think, to apply the Biblical model of compassion that not only sees disabilities for what they are but acts, where possible, to restore those suffering so that they can live a quality of life equivalent to those who do not have the disability. That can achieve not only restoration but the social inclusion that we all wish for those who are suffering from disabilities.

  • Adam Smith says:

    I agree, Gordon – I’m probably using “objectively” in a too-technical way here. I don’t mean that we must be “objective,” in the sense of “detached,” of not subjectively feeling things (like compassion). In the sense I’m using the term, something is “objectively” good or bad for us when it’s good or bad for us regardless of how we feel about it – “whether we like it or not.” But this doesn’t mean our feelings don’t matter. Rather, the moral aim is to subjectively like what’s objectively good for us, and subjectively dislike what’s objectively bad for us.

    • Gordon Moulden says:

      Thanks for the clarification. This topic is . . . “big”. There is so much disability around, it appears, particularly mental illnesses during and since the pandemic, that knowing how to deal with the issue is a challenge. And it is connected to an infirmity clearly prevalent in the Bible but very difficult to discuss in the very secular west: demonic oppression/possession.