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Sunday, October 25, 2020

Autonomy

From Wikipedia, the free encyclopedia

The Åland Islands is a demilitarized autonomous region in Finland. Picture of Mariehamn, the capital of the Åland Islands.
 
The Republic of Karelia is an autonomous federal subject in Russia, close to borders of Finland. Picture of Petrozavodsk, the capital of the Republic of Karelia.

In developmental psychology and moral, political, and bioethical philosophy, autonomy is the capacity to make an informed, uncoerced decision. Autonomous organizations or institutions are independent or self-governing. Autonomy can also be defined from a human resources perspective, where it denotes a (relatively high) level of discretion granted to an employee in his or her work. In such cases, autonomy is known to generally increase job satisfaction. Self-actualized Individuals are thought to operate autonomously of external expectations. In a medical context, respect for a patient's personal autonomy is considered one of many fundamental ethical principles in medicine.

Sociology

In the sociology of knowledge, a controversy over the boundaries of autonomy inhibited analysis of any concept beyond relative autonomy, until a typology of autonomy was created and developed within science and technology studies. According to it, the institution of science's existing autonomy is “reflexive autonomy”: actors and structures within the scientific field are able to translate or to reflect diverse themes presented by social and political fields, as well as influence them regarding the thematic choices on research projects.

Institutional autonomy

Institutional autonomy is having the capacities as a legislator to be able to implant and pursue official goals. Autonomous institutions are responsible for finding sufficient resources or modifying their plans, programs, courses, responsibilities, and services accordingly. But in doing so, they must contend with any obstacles that can occur, such as social pressure against cut-backs or socioeconomic difficulties. From a legislator's point of view, to increase institutional autonomy, conditions of self-management and institutional self-governance must be put in place. An increase in leadership and a redistribution of decision-making responsibilities would be beneficial to the research of resources.

Institutional autonomy was often seen as a synonym for self-determination, and many governments feared that it would lead institutions to an irredentist or secessionist region. But autonomy should be seen as a solution to self-determination struggles. Self-determination is a movement toward independence, whereas autonomy is a way to accommodate the distinct regions/groups within a country. Institutional autonomy can diffuse conflicts regarding minorities and ethnic groups in a society. Allowing more autonomy to groups and institutions helps create diplomatic relationships between them and the central government.

Politics

In governmental parlance, autonomy refers to self-governance. An example of an autonomous jurisdiction was the former United States governance of the Philippine Islands. The Philippine Autonomy Act of 1916 provided the framework for the creation of an autonomous government under which the Filipino people had broader domestic autonomy than previously, although it reserved certain privileges to the United States to protect its sovereign rights and interests. Other examples include Kosovo (as the Socialist Autonomous Province of Kosovo) under the former Yugoslav government of Marshal Tito and Puntland Autonomous Region within Federal Republic of Somalia.

Philosophy

Autonomy is a key concept that has a broad impact on different fields of philosophy. In metaphysical philosophy, the concept of autonomy is referenced in discussions about free will, fatalism, determinism, and agency. In How to Make Good Decisions and Be Right All the Time, philosopher Iain King developed an 'Autonomy Principle', which he defines as "Let people choose for themselves, unless we know their interests better than they can." King argues it is not enough to know someone else's interests better than that person; their autonomy should only be infringed if that person is unable to know their own interests on a particular matter. In moral philosophy, autonomy refers to subjecting oneself to objective moral law.

According to Kant

Immanuel Kant (1724–1804) defined autonomy by three themes regarding contemporary ethics. Firstly, autonomy as the right for one to make their own decisions excluding any interference from others. Secondly, autonomy as the capacity to make such decisions through one's own independence of mind and after personal reflection. Thirdly, as an ideal way of living life autonomously. In summary, autonomy is the moral right one possesses, or the capacity we have in order to think and make decisions for oneself providing some degree of control or power over the events that unfold within one's everyday life.

The context in which Kant addresses autonomy is in regards to moral theory, asking both foundational and abstract questions. He believed that in order for there to be morality, there must be autonomy. He breaks down autonomy into two distinct components. "Auto" can be defined as the negative form of independence, or to be free in a negative sense. This is the aspect where decisions are made on your own. Whereas, "nomos" is the positive sense, a freedom or lawfulness, where you are choosing a law to follow. Kantian autonomy also provides a sense of rational autonomy, simply meaning one rationally possesses the motivation to govern their own life. Rational autonomy entails making your own decisions but it cannot be done solely in isolation. Cooperative rational interactions are required to both develop and exercise our ability to live in a world with others.

Kant argued that morality presupposes this autonomy (German: Autonomie) in moral agents, since moral requirements are expressed in categorical imperatives. An imperative is categorical if it issues a valid command independent of personal desires or interests that would provide a reason for obeying the command. It is hypothetical if the validity of its command, if the reason why one can be expected to obey it, is the fact that one desires or is interested in something further that obedience to the command would entail. "Don't speed on the freeway if you don't want to be stopped by the police" is a hypothetical imperative. "It is wrong to break the law, so don't speed on the freeway" is a categorical imperative. The hypothetical command not to speed on the freeway is not valid for you if you do not care whether you are stopped by the police. The categorical command is valid for you either way. Autonomous moral agents can be expected to obey the command of a categorical imperative even if they lack a personal desire or interest in doing so. It remains an open question whether they will, however.

The Kantian concept of autonomy is often misconstrued, leaving out the important point about the autonomous agent's self-subjection to the moral law. It is thought that autonomy is fully explained as the ability to obey a categorical command independently of a personal desire or interest in doing so—or worse, that autonomy is "obeying" a categorical command independently of a natural desire or interest; and that heteronomy, its opposite, is acting instead on personal motives of the kind referenced in hypothetical imperatives.

In his Groundwork of the Metaphysic of Morals, Kant applied the concept of autonomy also to define the concept of personhood and human dignity. Autonomy, along with rationality, are seen by Kant as the two criteria for a meaningful life. Kant would consider a life lived without these not worth living; it would be a life of value equal to that of a plant or insect. According to Kant autonomy is part of the reason that we hold others morally accountable for their actions. Human actions are morally praise- or blame-worthy in virtue of our autonomy. Non- autonomous beings such as plants or animals are not blameworthy due to their actions being non-autonomous. Kant's position on crime and punishment is influenced by his views on autonomy. Brainwashing or drugging criminals into being law-abiding citizens would be immoral as it would not be respecting their autonomy. Rehabilitation must be sought in a way that respects their autonomy and dignity as human beings.

According to Nietzsche

Friedrich Nietzsche wrote about autonomy and the moral fight. Autonomy in this sense is referred to as the free self and entails several aspects of the self, including self-respect and even self-love. This can be interpreted as influenced by Kant (self-respect) and Aristotle (self-love). For Nietzsche, valuing ethical autonomy can dissolve the conflict between love (self-love) and law (self-respect) which can then translate into reality through experiences of being self-responsible. Because Nietzsche defines having a sense of freedom with being responsible for one's own life, freedom and self-responsibility can be very much linked to autonomy.

According to Piaget

The Swiss philosopher Jean Piaget (1896-1980) believed that autonomy comes from within and results from a "free decision". It is of intrinsic value and the morality of autonomy is not only accepted but obligatory. When an attempt at social interchange occurs, it is reciprocal, ideal and natural for there to be autonomy regardless of why the collaboration with others has taken place. For Piaget, the term autonomous can be used to explain the idea that rules are self-chosen. By choosing which rules to follow or not, we are in turn determining our own behaviour.

Piaget studied the cognitive development of children by analyzing them during their games and through interviews, establishing (among other principles) that the children's moral maturation process occurred in two phases, the first of heteronomy and the second of autonomy:

  • Heteronomous reasoning: Rules are objective and unchanging. They must be literal because the authority are ordering it and do not fit exceptions or discussions. The base of the rule is the superior authority (parents, adults, the State), that it should not give reason for the rules imposed or fulfilled them in any case. Duties provided are conceived as given from oneself. Any moral motivation and sentiments are possible through what one believes to be right.
  • Autonomous reasoning: Rules are the product of an agreement and, therefore, are modifiable. They can be subject to interpretation and fit exceptions and objections. The base of the rule is its own acceptance, and its meaning has to be explained. Sanctions must be proportionate to the absence, assuming that sometimes offenses can go unpunished, so that collective punishment is unacceptable if it is not the guilty. The circumstances may not punish a guilty. Duties provided are conceived as given from the outside. One follows rules mechanically as it is simply a rule, or as a way to avoid a form of punishment.

According to Kohlberg

The American psychologist Lawrence Kohlberg (1927-1987) continues the studies of Piaget. His studies collected information from different latitudes to eliminate the cultural variability, and focused on the moral reasoning, and not so much in the behavior or its consequences. Through interviews with adolescent and teenage boys, who were to try and solve "moral dilemmas," Kohlberg went on to further develop the stages of moral development. The answers they provided could be one of two things. Either they choose to obey a given law, authority figure or rule of some sort or they chose to take actions that would serve a human need but in turn break this given rule or command.

The most popular moral dilemma asked involved the wife of a man approaching death due to a special type of cancer. Because the drug was too expensive to obtain on his own, and because the pharmacist who discovered and sold the drug had no compassion for him and only wanted profits, he stole it. Kohlberg asks these adolescent and teenage boys (10-, 13- and 16-year-olds) if they think that is what the husband should have done or not. Therefore, depending on their decisions, they provided answers to Kohlberg about deeper rationales and thoughts and determined what they value as important. This value then determined the "structure" of their moral reasoning.

Kohlberg established three stages of morality, each of which is subdivided into two levels. They are read in progressive sense, that is, higher levels indicate greater autonomy.

  • Level 1: Premoral/Preconventional Morality: Standards are met (or not met) depending on the hedonistic or physical consequences.
    • [Stage 0: Egocentric Judgment: There is no moral concept independent of individual wishes, including a lack of concept of rules or obligations.]
    • Stage 1: Punishment-Obedience Orientation: The rule is obeyed only to avoid punishment. Physical consequences determine goodness or badness and power is deferred to unquestioningly with no respect for the human or moral value, or the meaning of these consequences. Concern is for the self.
    • Stage 2: Instrumental-Relativist Orientation: Morals are individualistic and egocentric. There is an exchange of interests but always under the point of view of satisfying personal needs. Elements of fairness and reciprocity are present but these are interpreted in a pragmatic way, instead of an experience of gratitude or justice. Egocentric in nature but beginning to incorporate the ability to see things from the perspective of others.
  • Level 2: Conventional Morality/Role Conformity: Rules are obeyed according to the established conventions of a society.
    • Stage 3: Good Boy-Nice Girl Orientation: Morals are conceived in accordance with the stereotypical social role. Rules are obeyed to obtain the approval of the immediate group and the right actions are judged based on what would please others or give the impression that one is a good person. Actions are evaluated according to intentions.
    • Stage 4: Law and Order Orientation: Morals are judged in accordance with the authority of the system, or the needs of the social order. Laws and order are prioritized.
  • Level 3: Postconventional Morality/Self-Accepted Moral Principles: Standards of moral behavior are internalized. Morals are governed by rational judgment, derived from a conscious reflection on the recognition of the value of the individual inside a conventionally established society.
    • Stage 5: Social Contract Orientation: There are individual rights and standards that have been lawfully established as basic universal values. Rules are agreed upon by through procedure and society comes to consensus through critical examination in order to benefit the greater good.
    • Stage 6: Universal Principle Orientation: Abstract ethical principles are obeyed on a personal level in addition to societal rules and conventions. Universal principles of justice, reciprocity, equality and human dignity are internalized and if one fails to live up to these ideals, guilt or self-condemnation results.

Child development

Autonomy in childhood and adolescence is when one strives to gain a sense of oneself as a separate, self-governing individual. Between ages 1–3, during the second stage of Erikson's and Freud's stages of development, the psychosocial crisis that occurs is autonomy versus shame and doubt. The significant event that occurs during this stage is that children must learn to be autonomous, and failure to do so may lead to the child doubting their own abilities and feel ashamed. When a child becomes autonomous it allows them to explore and acquire new skills. Autonomy has two vital aspects wherein there is an emotional component where one relies more on themselves rather than their parents and a behavioural component where one makes decisions independently by using their judgement. The styles of child rearing affect the development of a child's autonomy. Authoritative child rearing is the most successful approach, where the parents engage in autonomy granting appropriate to their age and abilities.

Autonomy in adolescence is closely related to their quest for identity. In adolescence parents and peers act as agents of influence. Peer influence in early adolescence may help the process of an adolescent to gradually become more autonomous by being less susceptible to parental or peer influence as they get older. In adolescence the most important developmental task is to develop a healthy sense of autonomy.

Religion

In Christianity, autonomy is manifested as a partial self-governance on various levels of church administration. During the history of Christianity, there were two basic types of autonomy. Some important parishes and monasteries have been given special autonomous rights and privileges, and the best known example of monastic autonomy is the famous Eastern Orthodox monastic community on Mount Athos in Greece. On the other hand, administrative autonomy of entire ecclesiastical provinces has throughout history included various degrees of internal self-governance.

In ecclesiology of Eastern Orthodox Churches, there is a clear distinction between autonomy and autocephaly, since autocephalous churches have full self-governance and independence, while every autonomous church is subject to some autocephalous church, having a certain degree of internal self-governance. Since every autonomous church had its own historical path to ecclesiastical autonomy, there are significant differences between various autonomous churches in respect of their particular degrees of self-governance. For example, churches that are autonomous can have their highest-ranking bishops, such as an archbishop or metropolitan, appointed or confirmed by the patriarch of the mother church from which it was granted its autonomy, but generally they remain self-governing in many other respects.

In the history of Western Christianity the question of ecclesiastical autonomy was also one of the most important questions, especially during the first centuries of Christianity, since various archbishops and metropolitans in Western Europe have often opposed centralizing tendencies of the Church of Rome. As of 2019, the Catholic Church comprises 24 autonomous (sui iuris) Churches in communion with the Holy See. Various denominations of Protestant churches usually have more decentralized power, and churches may be autonomous, thus having their own rules or laws of government, at the national, local, or even individual level.

Sartre brings the concept of the Cartesian god being totally free and autonomous. He states that existence precedes essence with god being the creator of the essences, eternal truths and divine will. This pure freedom of god relates to human freedom and autonomy; where a human is not subjected to pre-existing ideas and values.

According to the first amendment of the United States of America, the federal government is restricted in building a national church. This is due to the first amendment's recognizing people's freedom's to worship their faith according to their own belief's. For example, the American government has removed the church from their "sphere of authority" due to the churches' historical impact on politics and their authority on the public. This was the beginning of the disestablishment process. The Protestant churches in the United States had a significant impact on American culture in the nineteenth century, when they organized the establishment of schools, hospitals, orphanages, colleges, magazines, and so forth. This has brought up the famous, however, misinterpreted term of the separation of church and state. These churches lost the legislative and financial support from the state.

The disestablishment process

The first disestablishment began with the introduction of the bill of rights. In the twentieth century, due to the great depression of the 1930s and the completion of the second world war, the American churches were revived. Specifically the Protestant churches. This was the beginning of the second disestablishment when churches had become popular again but held no legislative power. One of the reasons why the churches gained attendance and popularity was due to the baby boom, when soldiers came back from the second world war and started their families. The large influx of newborns gave the churches a new wave of followers. However, these followers did not hold the same beliefs as their parents and brought about the political, and religious revolutions of the 1960s.

During the 1960s, the collapse of religious and cultural middle brought upon the third disestablishment. Religion became more important to the individual and less so to the community. The changes brought from these revolutions significantly increased the personal autonomy of individuals due to the lack of structural restraints giving them added freedom of choice. This concept is known as "new voluntarism" where individuals have free choice on how to be religious and the free choice whether to be religious or not.

Medicine

In a medical context, respect for a patient's personal autonomy is considered one of many fundamental ethical principles in medicine. Autonomy can be defined as the ability of the person to make his or her own decisions. This faith in autonomy is the central premise of the concept of informed consent and shared decision making. This idea, while considered essential to today's practice of medicine, was developed in the last 50 years. According to Tom Beauchamp and James Childress (in Principles of Biomedical Ethics), the Nuremberg trials detailed accounts of horrifyingly exploitative medical "experiments" which violated the subjects' physical integrity and personal autonomy. These incidences prompted calls for safeguards in medical research, such as the Nuremberg Code which stressed the importance of voluntary participation in medical research. It is believed that the Nuremberg Code served as the premise for many current documents regarding research ethics.

Respect for autonomy became incorporated in health care and patients could be allowed to make personal decisions about the health care services that they receive. Notably, autonomy has several aspects as well as challenges that affect health care operations. The manner in which a patient is handled may undermine or support the autonomy of a patient and for this reason, the way a patient is communicated to becomes very crucial. A good relationship between a patient and a health care practitioner needs to be well defined to ensure that autonomy of a patient is respected. Just like in any other life situation, a patient would not like to be under the control of another person. The move to emphasize respect for patient's autonomy rose from the vulnerabilities that were pointed out in regards to autonomy.

However, autonomy does not only apply in a research context. Users of the health care system have the right to be treated with respect for their autonomy, instead of being dominated by the physician. This is referred to as paternalism. While paternalism is meant to be overall good for the patient, this can very easily interfere with autonomy. Through the therapeutic relationship, a thoughtful dialogue between the client and the physician may lead to better outcomes for the client, as he or she is more of a participant in decision-making.

There are many different definitions of autonomy, many of which place the individual in a social context. See also: relational autonomy, which suggests that a person is defined through their relationships with others, and "supported autonomy" which suggests that in specific circumstances it may be necessary to temporarily compromise the autonomy of the person in the short term in order to preserve their autonomy in the long-term. Other definitions of the autonomy imagine the person as a contained and self-sufficient being whose rights should not be compromised under any circumstance.

There are also differing views with regard to whether modern health care systems should be shifting to greater patient autonomy or a more paternalistic approach. For example, there are such arguments that suggest the current patient autonomy practiced is plagued by flaws such as misconceptions of treatment and cultural differences, and that health care systems should be shifting to greater paternalism on the part of the physician given their expertise.  On the other hand, other approaches suggest that there simply needs to be an increase in relational understanding between patients and health practitioners to improve patient autonomy.

One argument in favor of greater patient autonomy and its benefits is by Dave deBronkart, who believes that in the technological advancement age, patients are capable of doing a lot of their research on medical issues from their home. According to deBronkart, this helps to promote better discussions between patients and physicians during hospital visits, ultimately easing up the workload of physicians. deBronkart argues that this leads to greater patient empowerment and a more educative health care system. In opposition to this view, technological advancements can sometimes be viewed as an unfavorable way of promoting patient autonomy. For example, self-testing medical procedures which have become increasingly common are argued by Greaney et al. to increase patient autonomy, however, may not be promoting what is best for the patient. In this argument, contrary to deBronkart, the current perceptions of patient autonomy are excessively over-selling the benefits of individual autonomy, and is not the most suitable way to go about treating patients. Instead, a more inclusive form of autonomy should be implemented, relational autonomy, which factors into consideration those close to the patient as well as the physician. These different concepts of autonomy can be troublesome as the acting physician is faced with deciding which concept he/she will implement into their clinical practice.

Autonomy varies and some patients find it overwhelming especially the minors when faced with emergency situations. Issues arise in emergency room situations where there may not be time to consider the principle of patient autonomy. Various ethical challenges are faced in these situations when time is critical, and patient consciousness may be limited. However, in such settings where informed consent may be compromised, the working physician evaluates each individual case to make the most professional and ethically sound decision. For example, it is believed that neurosurgeons in such situations, should generally do everything they can to respect patient autonomy. In the situation in which a patient is unable to make an autonomous decision, the neurosurgeon should discuss with the surrogate decision maker in order to aid in the decision making process. Performing surgery on a patient without informed consent is in general thought to only be ethically justified when the neurosurgeon and his/her team render the patient to not have the capacity to make autonomous decisions. If the patient is capable of making an autonomous decision, these situations are generally less ethically strenuous as the decision is typically respected.

It is important to note that not every patient is capable of making an autonomous decision. For example, a commonly proposed question is at what age children should be partaking in treatment decisions. This question arises as children develop differently, therefore making it difficult to establish a standard age at which children should become more autonomous. Those who are unable to make the decisions prompt a challenge to medical practitioners since it becomes difficult to determine the ability of a patient to make a decision. To some extent, it has been said that emphasis of autonomy in health care has undermined the practice of health care practitioners to improve the health of their patient as necessary. The scenario has led to tension in the relationship between a patient and a health care practitioner. This is because as much as a physician wants to prevent a patient from suffering, he or she still has to respect autonomy. Beneficence is a principle allowing physicians to act responsibly in their practice and in the best interests of their patients, which may involve overlooking autonomy. However, the gap between a patient and a physician has led to problems because in other cases, the patients have complained of not being adequately informed.

The seven elements of informed consent (as defined by Beauchamp and Childress) include threshold elements (competence and voluntariness), information elements (disclosure, recommendation, and understanding) and consent elements (decision and authorization). Some philosophers such as Harry Frankfurt consider Beauchamp and Childress criteria insufficient. They claim that an action can only be considered autonomous if it involves the exercise of the capacity to form higher-order values about desires when acting intentionally. What this means is that patients may understand their situation and choices but would not be autonomous unless the patient is able to form value judgements about their reasons for choosing treatment options they would not be acting autonomously.

In certain unique circumstances, government may have the right to temporarily override the right to bodily integrity in order to preserve the life and well-being of the person. Such action can be described using the principle of "supported autonomy", a concept that was developed to describe unique situations in mental health (examples include the forced feeding of a person dying from the eating disorder anorexia nervosa, or the temporary treatment of a person living with a psychotic disorder with antipsychotic medication). While controversial, the principle of supported autonomy aligns with the role of government to protect the life and liberty of its citizens. Terrence F. Ackerman has highlighted problems with these situations, he claims that by undertaking this course of action physician or governments run the risk of misinterpreting a conflict of values as a constraining effect of illness on a patient's autonomy.

Since the 1960s, there have been attempts to increase patient autonomy including the requirement that physician's take bioethics courses during their time in medical school. Despite large-scale commitment to promoting patient autonomy, public mistrust of medicine in developed countries has remained. Onora O'Neill has ascribed this lack of trust to medical institutions and professionals introducing measures that benefit themselves, not the patient. O'Neill claims that this focus on autonomy promotion has been at the expense of issues like distribution of healthcare resources and public health. 

One proposal to increase patient autonomy is through the use of support staff. The use of support staff including medical assistants, physician assistants, nurse practitioners, nurses, and other staff that can promote patient interests and better patient care. Nurses especially can learn about patient beliefs and values in order to increase informed consent and possibly persuade the patient through logic and reason to entertain a certain treatment plan. This would promote both autonomy and beneficence, while keeping the physician's integrity intact. Furthermore, Humphreys asserts that nurses should have professional autonomy within their scope of practice (35-37). Humphreys argues that if nurses exercise their professional autonomy more, then there will be an increase in patient autonomy (35-37).

International human rights law

After the Second World War there was a push for international human rights that came in many waves. Autonomy as a basic human right started the building block in the beginning of these layers alongside liberty. The Universal declarations of Human rights of 1948 has made mention of autonomy or the legal protected right to individual self-determination in article 22.

Documents such as the United Nations Declaration on the Rights of Indigenous Peoples reconfirm international law in the aspect of human rights because those laws were already there, but it is also responsible for making sure that the laws highlighted when it comes to autonomy, cultural and integrity and land rights are made within an indigenous context by taking special attention to their historical and contemporary events

The United Nations Declaration on the Rights of Indigenous Peoples article 3 also through international law provides Human rights for Indigenous individuals through its third article by giving them a right to self-determination meaning they have all the liberties to choose their political status, and are capable to go and improve their economics social, and cultural statuses in society by developing it. Another example of this is article 4 of the same document which gives them autonomous rights when it comes to their internal or local affairs and how they can fund themselves in order to be able to self govern themselves.

Minorities in countries are also protected as well by international law; the 27th article of the United Nations International covenant on Civil and Political rights or the ICCPR does so by allowing these individuals to be able to enjoy their own culture or use their language. Minorities in that manner are people from ethnic religious or linguistic groups according to the document.

The European Court of Human rights, is an international court that has been created on behalf of the European Conventions of Human rights. However, when it comes to autonomy they did not explicitly state it when it comes to the rights that individuals have. The current article 8 has remedied to that when the case of Pretty v the United Nations which was a case in 2002 involving assisted suicide where autonomy was used as a legal right in law. It was where Autonomy was distinguished and its reach into law was marked as well making it the foundations for legal precedent in making case law originating from the European Court of Human rights

The Yogyakarta Principles, a document with no binding effect in international human rights law, contend that "self-determination" used as meaning of autonomy on one's own matters including informed consent or sexual and reproductive rights, is integral for one's self-defined or gender identity and refused any medical procedures as a requirement for legal recognition of the gender identity of transgender. If eventually accepted by the international community in a treaty, this would make these ideas human rights in the law. The Convention on the Rights of Persons with Disabilities also defines autonomy as principles of rights of a person with disability including "the freedom to make one's own choices, and independence of persons".

Celebrity culture on teenage autonomy

A study conducted by David C. Giles and John Maltby conveyed that after age effecting factors were removed a high emotional autonomy was a significant predictor of celebrity interest, as well as high attachment to peers with a low attachment to parents. Patterns of intense personal interest in celebrities was found to be conjunction with low levels of closeness and security. Furthermore, the results suggested that adults with a secondary group of pseudo-friends during development from parental attachment, usually focus solely on one particular celebrity, which could be due to difficulties in making this transition.

Various uses

  • In computing, an autonomous peripheral is one that can be used with the computer turned off.
  • Within self-determination theory in psychology, autonomy refers to 'autonomy support versus control', "hypothesizing that autonomy-supportive social contexts tend to facilitate self-determined motivation, healthy development, and optimal functioning."
  • In mathematical analysis, an ordinary differential equation is said to be autonomous if it is time-independent.
  • In linguistics, an autonomous language is one which is independent of other languages, for example, has a standard variety, grammar books, dictionaries or literature, etc.
  • In robotics, "autonomy means independence of control. This characterization implies that autonomy is a property of the relation between two agents, in the case of robotics, of the relations between the designer and the autonomous robot. Self-sufficiency, situatedness, learning or development, and evolution increase an agent's degree of autonomy.", according to Rolf Pfeifer.
  • In spaceflight, autonomy can also refer to manned missions that are operating without control by ground controllers.
  • In economics, autonomous consumption is consumption expenditure when income levels are zero, making spending autonomous to income.
  • In politics, autonomous territories are States wishing to retain territorial integrity in opposition to ethnic or indigenous demands for self-determination or independence (sovereignty).
  • In anti-establishment activism, an autonomous space is another name for a non-governmental social center or free space (for community interaction).
  • In social psychology, autonomy is a personality trait characterized by a focus on personal achievement, independence, and a preference for solitude, often labeled as an opposite of sociotropy.

Limits to autonomy

Autonomy can be limited. For instance, by disabilities, civil society organizations may achieve a degree of autonomy albeit nested within––and relative to––formal bureaucratic and administrative regimes. Community partners can therefore assume a hybridity of capture and autonomy––or a mutuality––that is rather nuanced.

Semi-autonomy

The term semi-autonomy (coined with prefix semi- / "half") designates partial or limited autonomy. As a relative term, it is usually applied to various semi-autonomous entities or processes that are substantially or functionally limited, in comparison to other fully autonomous entities or processes.

Quasi-autonomy

The term quasi-autonomy (coined with prefix quasi- / "resembling" or "appearing") designates formally acquired or proclaimed, but functionally limited or constrained autonomy. As a descriptive term, it is usually applied to various quasi-autonomous entities or processes that are formally designated or labeled as autonomous, but in reality remain functionally dependent or influenced by some other entity or process. An example for such use of the term can be seen in common designation for quasi-autonomous non-governmental organizations.

Saturday, October 24, 2020

Disability rights movement

From Wikipedia, the free encyclopedia
Alternative access to the subway in Japan
 
Floor marker for visually impaired people in Narita Airport, Japan

The Disability Rights Movement is a global social movement to secure equal opportunities and equal rights for all people with disabilities.

It is made up of organizations of disability activists, also known as disability advocates, around the world working together with similar goals and demands, such as: accessibility and safety in architecture, transportation, and the physical environment; equal opportunities in independent living, employment equity, education, and housing; and freedom from discrimination, abuse, neglect, and from other rights violations. Disability activists are working to break institutional, physical, and societal barriers that prevent people with disabilities from living their lives like other citizens.

Disability rights is complex because there are multiple ways in which a person with a disability can have their rights violated. It is a form of discrimination in which others fail to address a person with disability needs. More specifically, in the 21st century a noteworthy barrier for employment is an employers’ unwillingness or inability to provide the necessary accommodations. When having a discussion about the needs of persons with disabilities, solutions include persons with disabilities as active participants to some extent. Current systems exist that involve third party involvement, such as mental rehabilitation and legal advocacy, but few of these methods include empowering this group to be self-sufficient.

History

United States

American disability rights has evolved significantly over the past century. Before the disability rights movement, Former President Franklin Delano Roosevelt's refusal to be publicized in a position of vulnerability demonstrated and symbolized the existing stigma surrounding disabilities. While campaigning, giving speeches, or acting as a public figure, he hid his disability, which perpetuated the ideology that “disability equates to weakness”. At this point, disability in the United States was a personal issue, and not many political or governmental organizations existed to support these groups. In the 1950s, there was a transition to volunteerism and parent-oriented organizations, such as the March of Dimes. While this was the beginning of activism and seeking support for these groups, children with disabilities were largely hidden by their parents out of fear of forced rehabilitation. When the Civil Rights Movement took off in the 1960s, disability advocates joined the Civil Rights Movement and women’s rights movements in order to promote equal treatment and challenge stereotypes or generalizations. It was at this time that disability rights advocacy began to have a cross-disability focus. People with different kinds of disabilities (physical and mental disabilities, along with visual and hearing disabilities) and different essential needs came together to fight for a common cause.

It was not until 1990 that the Americans with Disabilities Act was passed, legally prohibiting discrimination on account of disability, and mandating disability access in all buildings and public areas. The American Disability Act is historically significant in that it defined the meaning of reasonable accommodation in order to protect employees and employers. Today, disability rights advocates continue protecting those who are discriminated against, and also work towards more niche issues like law enforcement and treatment of people with disabilities. On a global scale, the United Nations has established the Convention on Rights of Persons with Disabilities, specifically discussing indigenous people with disabilities (Lockwood 146).

Disability barriers

The social model of disability suggests disability is caused by the way society is organized, rather than by a person’s impairment. This model suggests barriers in society are created by ableism. When barriers are removed, people with disabilities can be independent and equal in society.

There are three main types of barriers:

  1. Attitudinal barriers: are created by people who see only disability when associating with people with disabilities in some way. These attitudinal barriers can be witnessed through bullying, discrimination, and fear. These barriers include low expectations of people with disabilities. These barriers contribute to all other barriers. Attitudes towards people with disabilities in low and middle-income countries can be even more extreme.
  2. Environmental barriers: inaccessible environments, natural or built, create disability by creating barriers to inclusion.
  3. Institutional barriers: include many laws, policies, practices, or strategies that discriminate against people with disabilities. For example, a study of five Southeast Asian countries found that electoral laws do not specially protect the political rights of persons with disabilities, while ‘some banks do not allow visually disabled people to open accounts, and HIV testing centers often refuse to accept sign language interpreters due to confidentiality policies’. Restrictive laws exist in some countries, particularly affecting people with intellectual or psychosocial disabilities.

Other barriers include: internalised barriers (low expectations of people with disabilities can undermine their confidence and aspirations), inadequate data and statistics, lack of participation and consultation of disabled people.

Issues

People with physical disabilities

Access to public areas such as city streets, public buildings, and restrooms are some of the more visible changes brought about in recent decades to remove physical barriers. A noticeable change in some parts of the world is the installation of elevators, automatic doors, wide doors and corridors, transit lifts, wheelchair ramps, curb cuts, and the elimination of unnecessary steps where ramps and elevators are not available, allowing people in wheelchairs and with other mobility disabilities to use public sidewalks and public transit more easily and safely.

People with visual disabilities

Code Signs for People with CVD

People with color vision deficiency (CVD) regularly deal with implicit discrimination due to their inability to distinguish certain colors. A system of geometrically shaped code signs known as Coloradd was developed by Professor Miguel Neiva of the University of Minho, Portugal in 2010 to indicate colours to people who have difficulty discerning them.

People with developmental disabilities

Advocates for the rights of people with developmental disabilities focus their efforts on gaining acceptance in the workforce and in everyday activities and events from which they might have been excluded in the past. Unlike many of the leaders in the physical disability rights community, self-advocacy has been slow in developing for people with developmental disabilities. As a result, much of the work done by the Disability Rights Movement was completed by allies, or those without disabilities but with a strong connection to someone with disabilities. Parents, friends, and siblings fought for education and acceptance when their loved ones with cognitive disabilities could not. Public awareness of the civil rights movement for this population remains limited, and the stereotyping of people with developmental disabilities as non-contributing citizens who are dependent on others remains common. Today, the movement has a more social focus to increase this public awareness, as evidenced by the "R-Word" Campaign, in which they try to eliminate the colloquial use of the word "retard."

Autism rights movement

The autism rights movement is a social movement that emphasizes the concept of neurodiversity, viewing the autism spectrum as a result of natural variations in the human brain rather than a disorder to be cured. The autism rights movement advocates for several goals, including greater acceptance of autistic behaviors; therapies that focus on coping skills rather than imitating the behaviors of neurotypical peers; the creation of social networks and events that allow autistic people to socialize on their own terms; and the recognition of the autistic community as a minority group.

Autism rights or neurodiversity advocates believe that the autism spectrum is primarily genetic and should be accepted as a natural expression of the human genome. This perspective is distinct from two other views: the medical perspective, that autism is caused by a genetic defect and should be addressed by targeting the autism gene(s), and fringe theories that autism is caused by environmental factors such as vaccines.

The movement is controversial. A common criticism against autistic activists is that the majority of them are "high-functioning" or have Asperger syndrome and do not represent the views of "low-functioning" autistic people.

People with mental health issues

Advocates for the rights of people with mental health disabilities focus mainly on self-determination, and an individual’s ability to live independently.

The right to have an independent life, using paid assistant care instead of being institutionalized, if the individual wishes, is a major goal of the disability rights movement, and is the main goal of the similar independent living and self-advocacy movements, which are most strongly associated with people with intellectual disabilities and mental health disorders. These movements have supported people with disabilities to live as more active participants in society.

Access to education and employment

Access to education and employment have also been a major focus of the disability rights movement. Adaptive technologies, enabling people to work jobs they could not have previously, help create access to jobs and economic independence. Access in the classroom has helped improve education opportunities and independence for people with disabilities.

Freedom from discrimination and abuse

Freedom from abuse, neglect, and violations of a person's rights are also important goals of the disability rights movement. Abuse and neglect includes inappropriate seclusion and restraint, inappropriate use of force by staff and/or providers, threats, harassment and/or retaliation by staff or providers, failure to provide adequate nutrition, clothing, and/or medical and mental health care, and/or failure to provide a clean and safe living environment, as well as other issues which pose a serious threat to the physical and psychological well-being of a person with a disability. Violations of patients' rights include failure to obtain informed consent for treatment, failure to maintain the confidentiality of treatment records, and inappropriate restriction of the right to communicate and associate with others, as well as other restrictions of rights.

As a result of the work done through the disability rights movement, significant disability rights legislation was passed in the 1970s through the 1990s in the U.S.

Major Events

Canada

Canada's largest province, Ontario created legislation, Accessibility for Ontarians with Disabilities Act, 2005 with the goals of becoming accessible by 2025.

In 2019, the Accessible Canada Act became law. This is the first national legislation on accessibility that affects all government departments and federally regulated agencies.

India

The Rights of Persons with Disabilities Act, 2016 is the disability legislation passed by the Indian Parliament to fulfill its obligation to the United Nations Convention on the Rights of Persons with Disabilities, which India ratified in 2007. The Act replaces the existing Persons with Disabilities Act, 1995. It came into effect on 28 December, 2016. This Law recognizes 21 disabilities.

United Kingdom

Disability rights activist outside Scottish Parliament, 30 March 2013

In the United Kingdom, following extensive activism by people with disabilities over several decades, the Disability Discrimination Act 1995 (DDA 1995) was passed. This made it unlawful in the United Kingdom to discriminate against people with disabilities in relation to employment, the provision of goods and services, education and transport. The Equality and Human Rights Commission provides support for this Act. Equivalent legislation exists in Northern Ireland, which is enforced by the Northern Ireland Equality Commission.

Following the introduction of the Bedroom Tax (officially the Under-occupancy penalty) in the Welfare Reform Act 2012, disability activists have played a significant role in the development of Bedroom Tax protests. A wide range of benefit changes are estimated to affect disabled people disproportionately and to compromise disabled people's right to independent living.

United States

In 1948, a watershed for the movement was the proof of the existence of physical and program barriers. The proof was provided as a specification for barrier free usable facilities for people with disabilities. The specifications provided the minimum requirements for barrier free physical and program access. An example of barriers are; providing only steps to enter buildings; lack of maintenance of walkways; locations not connected with public transit; lack of visual and hearing communications ends up segregating individuals with disabilities from independent, participation, and opportunities. The ANSI - Barrier Free Standard (phrase coined by Dr. Timothy Nugent, the lead investigator) called "ANSI A117.1, Making Buildings Accessible to and Usable by the Physically Handicapped", provides the indisputable proof that the barriers exist. The standard is the outcome of physical therapists, bio-mechanical engineers, and individuals with disabilities who developed and participated in over 40 years of research. The standard provides the criteria for modifying programs and the physical site to provide independence. The standard has been emulated globally since its introduction in Europe, Asia, Japan, Australia, and Canada, in the early 1960s.

One of the most important developments of the disability rights movement was the growth of the independent living movement, which emerged in California in the 1960s through the efforts of Edward Roberts and other wheelchair-using individuals. This movement, a subset of the disability rights movement, postulates that people with disabilities are the best experts on their needs, and therefore they must take the initiative, individually and collectively, in designing and promoting better solutions and must organize themselves for political power. Besides de-professionalization and self-representation, the independent living movement's ideology comprises de-medicalization of disability, de-institutionalization, and cross-disability (i.e. inclusion in the independent living movement regardless of diagnoses). Similarly, The Architectural Barriers Act was passed in 1968, mandating that federally constructed buildings and facilities be accessible to people with physical disabilities. This act is generally considered to be the first ever-federal disability rights legislation. Unfortunately for those with cognitive disabilities, their disability made it more difficult to be the best expert of their own needs, hindering their ability to self-advocate as their wheelchair-using counterparts could. Self-representation was much more difficult for those who could not articulate their thoughts, leading to their dependence on others to carry on the movement.

In 1973 the (American) Rehabilitation Act became law; Sections 501, 503, and 504 prohibited discrimination in federal programs and services and all other programs or services receiving federal funds. Key language in the Rehabilitation Act, found in Section 504, states “No otherwise qualified handicapped [sic] individual in the United States, shall, solely by reason of his [sic] handicap [sic], be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance.” This was the first civil rights law guaranteeing equal opportunity for people with disabilities.

Another crucial turning point was the 504 Sit-in in 1977 of government buildings operated by the United States Department of Health, Education, and Welfare (HEW), conceived by Frank Bowe and organized by the American Coalition of Citizens with Disabilities, that led to the release of regulations pursuant to Section 504 of the Rehabilitation Act of 1973. On April 5, 1977, activists began to demonstrate and some sat-in in the offices found in ten of the federal regions including New York City, Los Angeles, Boston, Denver, Chicago, Philadelphia, and Atlanta. One of the most noteworthy protests occurred in San Francisco. The protesters demanded the signing of regulations for Section 504 of the Rehabilitation Act of 1973.The successful sit-in was led by Judith Heumann. The first day of protests marked the first of a 25-day sit-in. Close to 120 disability activists and protesters occupied the HEW building, and Secretary Joseph Califano finally signed on April 28, 1977. This protest was significant not only because its goal was achieved, but also because it was the foremost concerted effort between people of different disabilities coming together in support of legislation that affected the overall disability population, rather than only specific groups.

In 1978 disability rights activists in Denver, Colorado, organized by the Atlantis Community, held a sit-in and blockade of the Denver Regional Transit Authority buses in 1978. They were protesting the fact that city’s transit system was completely inaccessible for the physically disabled. This action proved to be just the first in a series of civil disobedience demonstrations that lasted for a year until the Denver Transit Authority finally bought buses equipped with wheelchair lifts. In 1983, Americans Disabled for Accessible Public Transit (ADAPT) was responsible for another civil disobedience campaign also in Denver that lasted seven years. They targeted the American Public Transport Association in protest of inaccessible public transportation; this campaign ended in 1990 when bus lifts for people using wheelchairs were required nationwide by the Americans with Disabilities Act.

Another significant protest related to disability rights was the Deaf President Now protest by the Gallaudet University students in Washington, D.C. in March 1988. The 8-day (March 6 – March 13) demonstration and occupation and lock-out of the school began when the Board of Trustees appointed a new hearing President, Elisabeth Zinser, over two Deaf candidates. The students’ primary grievance was that the university, which was dedicated to the education of people who are Deaf, had never had a Deaf president, someone representative of them. Of the protesters’ four demands, the main one was the resignation of the current president and the appointment of a Deaf one. The demonstration consisted of about 2,000 student and nonstudent participants. The protests took place on campus, in government buildings, and in the streets. In the end, all the students’ demands were met and I. King Jordan was appointed the first Deaf President of the university.

In 1990, the Americans with Disabilities Act became law, and it provided comprehensive civil rights protection for people with disabilities. Closely modeled after the Civil Rights Act and Section 504, the law was the most sweeping disability rights legislation in American history. It mandated that local, state, and federal governments and programs be accessible, that employers with more than 15 employees make “reasonable accommodations” for workers with disabilities and not discriminate against otherwise qualified workers with disabilities, and that public accommodations such as restaurants and stores not discriminate against people with disabilities and that they make reasonable modifications to ensure access for disabled members of the public. The act also mandated access in public transportation, communication, and in other areas of public life.

The first Disability Pride March in the United States was held in Boston in 1990. A second Disability Pride March was held in Boston in 1991. There were no subsequent Disability Pride Marches/Parades for many years, until Chicago on Sunday, July 18, 2004. It was funded with $10,000 in seed money that Sarah Triano received in 2003 as part of the Paul G. Hearne Leadership award from the American Association of People with Disabilities. According to Triano, fifteen hundred people attended the parade. Yoshiko Dart was the parade marshal.

Exhibitions and collections

To mark the 10th anniversary of the Americans with Disabilities Act, the Smithsonian Institution National Museum of American History opened an exhibition that examined the history of activism by people with disabilities, their friends, and families to secure the civil rights guaranteed to all Americans. Objects on view included the pen President George H.W. Bush used to sign the Act and one of the first ultralight wheelchairs. The exhibition was designed for maximum accessibility. Web-based kiosks - prototypes for a version that will eventually be available to museums and other cultural institutions - provided alternate formats to experience the exhibition. The exhibition was open from July 6, 2000 to July 23, 2001.

Debates and Approaches

A key debate in the disability rights movement is between affirmative action for persons with disabilities versus fighting for equitable treatment. According to a 1992 polling organization, many fear that integrating people with disabilities into the workplace may affect their company image, or it may result in decreased productivity. This coincides with the 1992 parliamentary review of the Employment Equity Act, which stated that employers should look to implement equity without having an official quota system. This remains an ongoing debate.

An additional debate is between institutionalizing persons with disabilities versus supporting them in their homes. In 1963 during John F. Kennedy’s presidency, he transformed the national view of mental health by boosting funding for community-based programs and drafting legislation for mental health care. He also created the President's Panel on Mental Retardation, which created recommendations for new programs that governments can implement on a state level, therefore moving away from "custodial institutions". This shift away from institutionalization has generated a long-lasting stigma against mental health institutions, which is why in politics there is often not enough funding for this concept.

According to the US Supreme Court case Humphrey v. Cady, civil commitment laws and eligibility for intervention exist only in the instance when the person is ruled an immediate danger to themself or others. The difficulty of proving "immediate danger" has led to the unexpected outcome that it is harder to commit mentally ill patients to hospital and easier to send them to prison. According to the National Alliance on Mental Illness, about 15% male inmates and 30% female inmates have some kind of serious mental illness, which remains untreated.

Another ongoing debate is how to cultivate self-determination for persons with disabilities. Article 1 of the United Nations Charter asserts that "All peoples have the right to self-determination" with free will. 

Because this highlights the concept of free and autonomous choice, one argument is that any government interference deters self-determination, thus leaving it to persons with disabilities to seek out any help they need from charities and nonprofit organizations. Charitable organizations such as Christian or Catholic dominations believe in helping persons with disabilities with nothing in return. On the other hand, another approach is a participatory, symbiotic relationship, which include methods like professional development and resource provisions. More specifically, one approach is to allow persons with disabilities to self-articulate their needs and generate their own solutions and analyses. Instead of passive participation, which is participation by being told what to do or what has been done, this approach proposes to allow this group to be self-sufficient and make their own decisions. Barriers to this include defining who is a self-sufficient individual with a disability, circling back to the concept of self-determination.

Ableism

From Wikipedia, the free encyclopedia

Ableism (/ˈbəlɪzəm/; also known as ablism, disablism (Brit. English), anapirophobia, anapirism, and disability discrimination) is discrimination and social prejudice against people with disabilities or who are perceived to have disabilities. Ableism characterizes persons as defined by their disabilities and as inferior to the non-disabled. On this basis, people are assigned or denied certain perceived abilities, skills, or character orientations.

There are stereotypes, generally inaccurate, associated with either disability in general, or with specific disabilities (for instance a presumption that all disabled people want to be cured, that wheelchair users necessarily have an intellectual disability or that blind people have some special form of insight). These stereotypes, in turn, serve as a justification for ableist practices and reinforce discriminatory attitudes and behaviors toward people who are disabled. Labeling affects people when it limits their options for action or changes their identity.

In ableist societies, people with disabilities are viewed as less valuable, or even seen as expendable. The eugenics movement of the early 20th century would be considered an example of widespread ableism.

Ableism can also be better understood by reading literature published by those who experience disability and ableism first-hand. Disability Studies is an academic discipline that is also beneficial to explore to gain a better understanding of ableism.

Etymology

Originated from -able (in disable, disabled) and -ism (in racism, sexism); first known use in 1985–1990. 

History

Canada

Ableism in Canada refers to a set of discourses, behaviors, and structures that express feelings of anxiety, fear, hostility, and antipathy towards people with disabilities in Canada.

The specific types of discrimination that have occurred or are still occurring in Canada include the inability to access important facilities such as infrastructure within the transport network, restrictive immigration policies, involuntary sterilization to stop people with disabilities from having offspring, barriers to employment opportunities, wages that are insufficient to maintain a minimal standard of living, and institutionalization of people with disabilities in substandard conditions.

Austerity measures implemented by the government of Canada have also at times been referred to as ableist, such as funding cuts that put people with disabilities at risk of living in abusive arrangements.

Nazi Germany

In 1939 Hitler signed the secret euthanasia program decree, Aktion T4, which authorized the killing of selected patients diagnosed with chronic neurological and psychiatric disorders. This program killed about 70,000 people with disabilities before it was officially halted by Hitler in 1941 under public pressure, and it was unofficially continued out of the public eye, killing a total of 200,000 or more by the end of Hitler's reign in 1945.

United Kingdom

A poster in gold colors and line art, showing three people: a large menacing man, a small frail man, and a woman in academic robes; the wording is "She. It is time I got out of this place. Where Shall I Find The Key? Convicts Lunatics and Women! Have no vote for Parliament"
A poster of the British suffrage movement, attacking the fact that women were placed next to "lunatics" and convicts in being unable to vote. Ableist and eugenicist ideas were often found in suffrage rhetoric.

In the UK, disability discrimination became unlawful as a result of the Disability Discrimination Act 1995, and the Disability Discrimination Act 2005. These were later superseded, retaining the substantive law, by the Equality Act 2010. The Equality Act 2010 brought together protections against multiple areas of discriminatory behavior (disability, race, religion and belief, gender, sexual orientation, gender identity, age and pregnancy – the so-called 'protected characteristics').

Under EA2010 there are prohibitions addressing several forms of discrimination: direct discrimination (s.13(1) Equality Act 2010), indirect discrimination (s.6 and s.19 Equality Act 2010, harassment (s.26 Equality Act 2010), victimisation (s.27(2) Equality Act 2010), discrimination arising from disability (s.15(1) Equality Act 2010 and failure to make reasonable adjustments (s.20 Equality Act 2010).

Part 2, Chapter 1, Section 6, of the Equality Act 2010 states that:

“A person P has a disability if

(a) P has a physical or mental impairment, and

(b) the impairment has a substantial and long-term adverse effect on P's ability to carry out normal day-to-day activities.“

(Please note that as with any English, for the purposes of the interpretation of the Equality Act 2010, and, for the purposes of righteousness, both phonetically and otherwise derived undertones apparently implied by the nomenclature and numbering manifest in the phrase “Part 2, Chapter 1, Section 6” as well as in the abbreviated “P” which takes the place of “person” in the document, are irrelevant.)

United States

Before the 1800s, the perspective of disability was often from a religious point of view. Individuals with disability were seen as evil or possessed by the devil. Much like many minority groups, disabled Americans were often segregated and denied certain rights for a majority of American history. In the 1800s, a shift from a religious view to a more scientific view took place and caused more individuals with disabilities to be examined. Public stigma began to change after World War II when many Americans returned home with disabilities and physical handicaps. In the 1960s, following the civil rights movement in America, the world began the disabled rights movement. The movement was intended to give all individuals with disabilities equal rights and opportunities. Until the 1970s, ableism in the United States was often codified into law. For example, in many jurisdictions, so-called "ugly laws" barred people from appearing in public if they had diseases or disfigurements that were considered unsightly.

Rehabilitation Act of 1973

Section 504 and other sections of the Rehabilitation Act of 1973 enacted into law certain civil penalties for failing to make public places comply with access codes known as the ADA Access Guidelines (ADAAG). These laws prohibit direct discrimination against disabled people in government programs, employment, public transit, and public accommodations like stores and restaurants.

Voting Accessibility for the Elderly and Handicapped Act of 1984

The Voting Accessibility for the Elderly and Handicapped Act was passed to promote the fundamental right to vote by improving access for handicapped and elderly individuals to registration facilities and polling places for Federal elections by requiring access to polling places used in Federal elections and available registration and voting aids, such as instructions in large type. 

Fair Housing Amendments Act of 1988

The federal Fair Housing Amendments Act of 1988 prohibits housing discrimination on the basis of mental or physical disability and requires that newly constructed multi-family housing meet certain access guidelines while requiring landlords to allow disabled persons to modify existing dwellings for accessibility. The law also protects people with mental disabilities by prohibiting discrimination in housing and allowing people with mental illness or any other disability to live where they choose.

Americans with Disabilities Act of 1990

The Americans with Disabilities Act of 1990 (ADA) was passed on July 26, 1990, during the George H. W. Bush administration and amended on January 1, 2009. The act gave individuals with disabilities civil rights protections.

Individuals with Disabilities Education Act

The Individuals with Disabilities Education Act (IDEA) is a four-part (A-D) piece of American legislation that ensures students with a disability are provided with Free Appropriate Public Education (FAPE) that is tailored to their individual needs. IDEA was previously known as the Education for All Handicapped Children Act (EHA) from 1975 to 1990. In 1990, the United States Congress reauthorized EHA and changed the title to IDEA (Public Law No. 94-142). Overall, the goal of IDEA is to provide children with disabilities the same opportunity for education as those students who do not have a disability.

Workplace

In 1990, the Americans with Disabilities Act was put in place to prohibit private employers, state and local government, employment agencies and labor unions from discrimination against qualified individuals with disabilities in job applications, when hiring, firing, advancement in workplace, compensation, training, and on other terms, conditions and privileges of employment. The U.S. Equal Employment Opportunity Commission, also known as the EEOC also plays a part in fighting against ableism by being responsible for enforcing federal laws that make it illegal to discriminate against a job applicant or an employee because of the person's race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age (40 or older), disability or genetic information. Despite legislation to reduce disability discrimination, roughly 13.3 million Americans with disabilities report difficulty finding a job.

Healthcare

In England, Scotland and Wales it is permitted for an abortion to be performed on the basis of the foetus having physical or mental abnormalities.

Schools

Ableism often makes the world unwelcoming, and inaccessible to people with disabilities - especially in schools. An ableist would assert that children with disabilities need to assimilate to the normative culture. For example, a student who experiences a disability needs to read text instead of listening to a tape recording of the text. In the past, schools have focused too much on fixing the disability, but due to progressive reforms, schools are now focused on minimizing the impact of a student’s disability, and giving support, skills, and more opportunities to live a full life. Moreover, schools are required to maximize access to their entire community. In 2004, Congress made into law the Individuals with Disabilities Education Act, which states that free and appropriate education is eligible to children with disabilities with insurance of necessary services. Congress later amended the law, in 2015, to include the Every Student Succeeds Act, which guarantees equal opportunity for people with disabilities full participation in society, and the tools for overall independent success.

Media

Disabilities are not only misrepresented in the media but often underrepresented as well. These common ways of framing disability are heavily criticized for being dehumanizing and failing to place importance on the perspectives of persons with disabilities. While roughly 20 percent of the population is disabled, only 2 percent of characters played in television and film have a disability. 95 percent of the time, disabled characters are played by actors and actresses who are not disabled.

Disabled villain

One common form of media depiction of disability is to portray villains with a mental or physical disability. Lindsey Row-Heyveld notes, for instance, "that villainous pirates are scraggly, wizened, and inevitably kitted out with a peg leg, eye patch, or hook hand whereas heroic pirates look like Johnny Depp's Jack Sparrow." The disability of the villain is meant to separate them from the average viewer and dehumanize the antagonist. As a result, stigma forms surrounding the disability and the individuals that live with it.

Inspiration porn

Inspiration porn is the use of people with disabilities performing ordinary tasks as a form of inspiration. Criticisms of inspiration porn say that it distances people with disabilities from individuals who are not disabled and portrays disability as an obstacle to overcome or rehab.

Pitied character

In many forms of media such as films and articles a person who experiences disability is portrayed as a character who is viewed as less than able, different, and an "outcast." Hayes & Black (2003) explore Hollywood films as the discourse of pity towards disability as a problem of social, physical, and emotional confinement. The aspect of pity is heightened through the storylines of media focusing on the individual's weaknesses as opposed to strengths and therefore leaving audiences a negative and ableist portrayal towards disability.

Supercrip stereotype

The supercrip narrative is generally a story of a person with an apparent disability who is able to "overcome" their physical differences and somehow accomplish an impressive task. In Thomas Hehir's "Eliminating Ableism in Education," he uses the example of a blind man who climbs Mount Everest as an example of the supercrip narrative. The Paralympics are another example of the supercrip stereotype, since they generate a large amount of media attention, and demonstrate disabled people doing extremely strenuous physical tasks. Although at face value, this may appear inspiring, Hehir explains that many people with disabilities can view these news stories as setting unrealistic expectations. Additionally, Hehir mentions that supercrip stories imply that disabled people are required to overcome their disabilities by performing these impressive tasks to be seen as an equal and avoid pity from those without disabilities.

Sports

A runner in the Rio 2016 Paralympic Games

Sports are often an area of society in which ableism is evident. In sports media, athletes with disabilities are often portrayed to be inferior. When athletes with disabilities are discussed in the media, there is often an emphasis on rehabilitation and the road to recovery, which is inherently a negative view on the disability. Oscar Pistorius is a South African runner who competed in the 2004, 2008, and 2012 Paralympics and the 2012 Olympic games in London. Pistorius was the first double amputee athlete to compete in the Olympic games. While media coverage focused on inspiration and competition during his time in the Paralympic games, it shifted to questioning whether his prosthetic legs gave him an advantage while competing in the Olympic games.

Butane

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