Neurodiversity, epistemic injustice, and the good human life

In the paper

“What has been revealed is the systematic stifling of the voices and interpretive tools available to both ill and disabled persons: in particular, their information providing, testimonies, and interpretations.”

What the sources say

• Supported

  The Testimonial injustice section (p. 3) describes how stereotyping of illness or disability can constrain patients’ contributions to consultations. The Hermeneutical injustice section (p. 4) describes exclusion from shared interpretive resources, and the Evidence from patients section (p. 7) explains how patients’ testimony and interpretations can be minimised or disregarded. (LLM, conf=0.87)

  cites Blease et al., 2016 source
• Partly supported

  Section 1, “Testimonial and hermeneutical injustice” (page unavailable), describes how ill people’s testimony and interpretations can be ignored, downgraded, or treated merely as information. Section 2 gives an example involving a disabled person, but the paper does not establish systematic stifling across disabled people as a group; its broader analysis focuses on ill people. (LLM, conf=0.82)

  cites Carel & Kidd, 2014 sourceExperimental — accuracy not yet measured
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Crichton et al., 2016

In the paper

“Moreover, physically disabled persons' claims that they are happy and living good lives have also been dismissed due to prejudices about the possibility of living well whilst disabled (Blease et al., 2016;”

What the sources say

• Partly supported

  The Testimonial injustice section (p. 3) says that negative stereotyping of an illness or disability can constrain a patient's contribution to consultations. The Summary (p. 7) reports that stereotypes can lead to patients with CFS/ME having their testimony discounted. Neither passage addresses physically disabled people’s claims that they are happy or living good lives, or prejudice about whether living well with a disability is possible. (LLM, conf=0.84)

  cites Blease et al., 2016 sourceExperimental — accuracy not yet measured

In the paper

“as well as the widespread assumption noted by researchers (e.g., Bovell, 2015, p. 265;Verhoeff, 2012, p. 429) that autism causes autistic distress to the extent that autistic individuals are inherently disposed to lower wellbeing when compared to a neurotypical norm.”

What the sources say

• ?Not checked — no full text of the sourcecites Bovell, 2015 source
• ?Could not verify

  Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.

  cites Verhoeff, 2012 sourceExperimental — accuracy not yet measured

In the paper

“This is reflected in the DSM-5, where the notion of”

What the sources say

• Supported

  The Dysfunction section (p. 5) says DSM does not formally define dysfunction. The Etiological View of Dysfunction section (p. 6) says DSM criteria often infer dysfunction from folk intuitions and normative comparisons, while the validity of that inference remains to be demonstrated. Together, these support the paraphrase that DSM-5’s notion of dysfunction rests more on value judgments than established scientific findings. (LLM, conf=0.87)

  cites Aftab & Rashed, 2020 source

In the paper

“For instance, Milton and Sims found that a key reason autistic people attributed to hindering their wellbeing was barriers to belonging, rather than simply their being autistic (Milton & Sims, 2016).”

What the sources say

• Supported

  The Discussion of key points (pp. 19–20) identifies barriers to wellbeing and belonging and says that treating autistic people's challenges purely as deficits is limited and potentially counterproductive. The Conclusion (pp. 21–22) calls for less focus on remediation and more on reducing social isolation, supporting the paraphrase's contrast with autism itself as the cause. (LLM, conf=0.91)

  cites Milton & Sims, 2016 source

In the paper

“Their point is that dominant conceptions of the good life, including of flourishing, typically rely on species-typical intuitions regarding what is good or desirable, and so encounter a methodological issue when tasked with accounting for neurodivergent modes of flourishing that may be grounded in atypical intuitions.”

What the sources say

• Supported

  Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  cites Rodogno et al., 2016 source

In the paper

“Indeed, even significant illness and disability, such as cancer, renal failure, and paralysis, have been shown to have a surprisingly small intrinsic effect on levels of wellbeing as such.”

What the sources say

• ?Not checked — no full text of the sourcecites Riis et al., 2005 source
• ?Not checked — no full text of the sourcecites de Haes and van Knippenberg, 1985 source
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Brickman et al., 1978

In the paper

“People experiencing a wide range of illnesses and disabilities often report paradoxically high levels of [quality of life] and mood”

What the sources say

• ?Not checked — no full text of the sourcecites Ubel et al., 2005 source

In the paper

“and moreover that autistic empathic understanding does arise between autistics (Chapman, 2019b;Milton, 2012).”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Chapman, 2019b
• ?Not checked — no full text of the sourcecites Milton, 2012 source

In the paper

“a body of evidence has been accumulating which shows that neurotypicals equally struggle to understand autistics”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Chapman, 2019b
• ?Not checked — no full text of the sourcecites Milton, 2012 source

In the paper

“These types of epistemic injustice have been associated with the medical deficit model that dominates much of medical and psychiatric discourse (Kidd & Carel, 2018, 2019).”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Kidd & Carel, 2018, 2019

In the paper

“But it is also important for ethical theory more generally since it indicates that minority forms of human flourishing have been blocked from view.”

In the paper

“We will now argue that the issue here is in significant part one of epistemic injustice, whereby autistic persons are subject to an epistemic double-bind that culminates in being caught in a catch-22.”

In the paper

“We suggested that the neurodiversity movement's use of social models of disability, as well as issues noted with the reliance on species-norm accounts of functioning, gives initial reason to think that the medical deficit view regarding autism and the good life may be wrong.”

In the paper

“Autism is often associated with stereotypes that unjustly limit credibility, for example, viewing autistic persons as unreliable narrators and interpreters of social situations, lacking in understanding of social situations, or having”

In the paper

“On the one hand, there's more general testimonial injustice when it comes to autistic voices specifically due to prejudiced beliefs regarding autism.”

In the paper

“While the underlying biological mechanisms are complex and heterogenous, medical deficit accounts typically associate autism with empathy deficits alongside general cognitive and sensory processing issues that are in turn taken to have an underlying biological basis (Baron-Cohen, 2008;Frith, 2003).”

What the sources say

• ?Not checked — no full text of the sourcecites Baron-Cohen, 2008 source
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Frith, 2003

In the paper

“In practice, we show how this culminates in a catch-22 paradoxical situation whereby individuals are routinely seen as happy or autistic, but rarely both.”

In the paper

“Despite being widely assumed, however, it is worth considering how many disabled persons in fact report levels of wellbeing that are only slightly lower than average levels reported by those who are not disabled (Gilbert, 2006, p. 153).”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Gilbert, 2006

In the paper

“First, as we will cover in this section, they suffer unjust credibility deficits that stem from negative stereotypes commonly held about persons with autism.”

In the paper

“Many studies report no difference in levels of reported wellbeing between groups of people with a variety of medicalized conditions and healthy controls.”

In the paper

“For the neurodiversity paradigm, rejection of the species-norm is at odds not just with dominant medical accounts.It is also, we contend, at odds with both naturalist positions in the philosophical literature regarding human flourishing that exclude autistic individuals (Furman & Tuminello, 2015;Nussbaum, 2006),”

What the sources say

• ?Not checked — no full text of the sourcecites Furman & Tuminello, 2015 source
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Nussbaum, 2006

In the paper

“They conclude that”

What the sources say

• ?Not checked — no full text of the sourcecites Angner et al., 2009 source

In the paper

“The neurodiversity framing gets much of its force via its proponents drawing on social or relational models of disability.”

In the paper

“However, the notion of normal functioning has faced heavy criticism, insofar as the adaptive genetic diversity and plasticity found in humans render the idea that there is a restricted functional norm unconvincing (see, e.g., Amundson, 2000).”

What the sources say

• ?Not checked — no full text of the sourcecites Amundson, 2000 source

In the paper

“With this in mind, we here identify, in addition to the injustices noted by social model proponents, that epistemic injustice limits our capacity to recognize, understand, and cultivate autistic thriving and wellbeing.”

In the paper

“It is important to note that epistemic injustice itself is, like disabling barriers, another form of external harm that can lower wellbeing levels.”

In the paper

“Encountering prejudice and being unfairly accorded low credibility are additional external sources of harm that can impact on one's wellbeing and therefore need to be taken into account in our analysis.”

In the paper

“Most relevantly, Merriam has noted that the notion that static or even temporary snapshot conceptions of species-standard norms can show us how we should live may be both arbitrary and epistemically violent toward minority disabled modes of flourishing (Merriam, 2009, p. 135).”

What the sources say

• ?Not checked — no full text of the sourcecites Merriam, 2009 source

In the paper

“Unless we dismiss not just the voices of those autistic individuals (and carers) who report being happy, but also the evidence indicating that diminished autistic wellbeing can be explained in reference to stigma, exclusion, and societal disablement, there's good reason to think that a tenet of the dominant view, that autism and wellbeing are inherently at odds, is itself a prejudice.”

In the paper

“Importantly, autism slightly differs from many cases of disability insofar as autistic people do tend to have low levels of wellbeing.”

In the paper

“The over-proliferation of neurotypical signposts may even leave autistic people”

What the sources say

• ?Not checked — no full text of the sourcecites Jackson 2018 source

In the paper

“Beyond this, there are also many instances of autistic persons, all along the spectrum, publicly stressing that they are fully capable of living good and happy lives.”

In the paper

“On the one hand, Aristotleian conceptions of flourishing have tended to exclude members of marginalized groups who may need to develop specific virtues such as defiance or anger in order to resist their unjust situation, leading to the pathologisation of the very virtues made necessary by the social context (Potter, 2016;Tessman, 2005).”

What the sources say

• ?Not checked — no full text of the sourcecites Potter, 2016 source
• ?Not checked — no full text of the sourcecites Tessman, 2005 source

In the paper

“Although their argument is more centrally about the underlying methodology, our contention is that the outcome they point to can also be understood as a matter of epistemic injustice: they indicate that our typical conceptions of human flourishing, due to the intuitions that such conceptions implicitly rely on, always already exclude neurodivergent modes of flourishing.”

In the paper

“and their low quality of life is presumed to be caused by the autism even if they declare otherwise.”

In the paper

“Rather, he begs the question by presupposing that they are intimately related.”

What the sources say

• ?Not checked — no full text of the sourcecites Baron-Cohen, 2008 source

In the paper

“it also means that attempts to thrive by autistic individuals will be misled by neurotypical signposts, for example, those focusing on high cognitive and reflective achievement (e.g., Aristotle; cf.Carel, 2017) or other species-specific characteristics, such as having a family, gaining societal recognition, or accessing mainstream culture.”

What the sources say

• ?Not checked — no full text of the sourcecites Carel, 2017 source

In the paper

“However, as was noted above, specific disabilities are associated with low wellbeing if they are associated with high levels of stigma or greatly impaired functioning.”

In the paper

“Not only does this mean that autistic thriving is harder to identify or understand”

In the paper

“if a person who identifies as autistic and who fulfills the diagnostic criteria is living a good life, they are denied recognition of their autism.”

In the paper

“Such lacuna can, although they do not necessarily, give rise to reduced levels of wellbeing as a result of a lack of an interpretative framework that can express the richness and diversity of autistic experience.”

In the paper

“While it is highly plausible that what we are like will delineate what's good for us, associating species-normality with flourishing has been criticized as being unduly restrictive.”

In the paper

“We can now see how the situation we have identified will be harmful for autistic individuals.”

In the paper

“While Baron-Cohen purports here to simply be clarifying the harm aspect of mental disorder as traditionally conceived, he does not establish a necessary or even dispositional causal link between autism and increased suffering in any of the forms he identifies.”

What the sources say

• ?Not checked — no full text of the sourcecites Baron-Cohen, 2008 source

In the paper

“But it is also vital to consider how these forms of injustice combine and interlock in practice.”

In the paper

“If they are not currently living a good life, they are recognized as autistic”

In the paper

“As autistic scholar Nick Walker has proposed, since”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Walker, 2015

In the paper

“In fact, once we accept that humanity is neurodiverse-which even critics of the neurodiversity movement concede is true to some extent (Jaarsma & Welin, 2012;Wakefield et al., 2020)and that there are many different, yet equally legitimate, ways of functioning, then it is not too far a step to consider that humanity will likely be similarly diverse in terms of routes to, and forms of, flourishing.”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Jaarsma & Welin, 2012
• ?Not checked — no full text of the sourcecites Wakefield et al., 2020 source

In the paper

“However, this does not mean we must give up on objectivist notions of flourishing as such.”

In the paper

“The cost for this hermeneutical lacuna is borne by autistic persons seeking ways to express their wellbeing, comfort with being autistic, or another narrative that interprets autism as a form of neurodivergence.”

In the paper

“The assumption that autistic unhappiness is natural and unavoidable itself”

In the paper

“We established above that objectivist conception of the good life that are based on the species norm are part of the problem.”

In the paper

“It is therefore important to note that epistemic injustice is implicated in lower levels of wellbeing, as it exacerbates and increases the silencing of minority groups suffering its effects.”

In the paper

“Adhering to such a model can lead to an inability to properly distinguish between inherently inhibited flourishing on the one hand, and societally disabled minority ways of being on the other (ibid., pp.134-5)”

What the sources say

• ?Not checked — no full text of the sourcecites Merriam, 2009 source

In the paper

“In day-to-day life, prejudiced stereotypes regarding autistic flourishing and wellbeing culminate in autistic individuals encountering a”

In the paper

“Just as a location that has been removed from all maps will be much harder to find, so too will autistic individuals find it harder to aim at autistic thriving than neurotypicals do, because such thriving is not (yet) “on the map.””

In the paper

“We are not against comparisons across the species as such, but we do suggest that using this as the core basis of how we understand human flourishing is likely, not compatible with recognizing autistic and other neurodivergent forms of flourishing.”

In the paper

“With this in mind, it is vital to consider that how autistic voices have consistently argued that any impediment to autistic wellbeing and functioning is best understood in terms of social barriers, marginalization, stigma, and exclusion (Booth, 2016;Robertson, 2010).”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Booth, 2016
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Robertson, 2010

In the paper

“On the other, Aristotleian accounts tend to be at odds with the natural variation in a given species.”

In the paper

“there has to be evidence that the person is “suffering” in some way (e.g., they are being bullied, or are becoming depressed, or have high levels of anxiety, or are not fulfilling their academic or occupational potential).(2008, p. 29)”

What the sources say

• ?Not checked — no full text of the sourcecites Baron-Cohen, 2008 source

In the paper

“in recent years the concept has been applied to other neuro-cognitive disabilities (Armstrong, 2010, Chapman, 2019a).”

What the sources say

• ?Not checked — no full text of the sourcecites Armstrong, 2010
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Chapman, 2019a

In the paper

“While it is true that autistics do often struggle to interpret the neurotypical social world”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Chapman, 2019b
• ?Not checked — no full text of the sourcecites Milton, 2012 source

In the paper

“especially since neurotypicals often display patronizing attitudes toward neurodivergent people (Jackson, 2017)”

What the sources say

• ?Not checked — no full text of the sourcecites Jackson, 2017 source

In the paper

“What those views have in common is the focus on what is typical of a species, from which an account of normal function is built, against which atypical functioning would become abnormal.”

In the paper

“Beyond neo-Aristotelians, this requirement to fix individuals who fall outside the norm is also reflected in the work of Norman Daniels, who has been highly influential in theorizing healthcare justice.”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Daniels, 1981

In the paper

“the presupposition [that] suffering is a structural part of the evaluative process of autism produces a working version of the condition that has an assumed negativity and a normalized value judgment built into its medical/ diagnostic baseline”

What the sources say

• ?Not checked — no full text of the sourcecites Murray, 2012 source

In the paper

“other philosophers who are not neo-Aristotelian, such as the utilitarian philosopher Peter Singer, have excluded cognitively disabled people from conceptions of the good human life on further grounds still.”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites Singer

In the paper

“As we have highlighted, the very conceptual commitments espoused by the medical deficit framing and the species-standard norm that it shares with species-norm-based conceptions of flourishing, is a key part of the issue when it comes to autism.”