This Introduction sets out the book’s central aim, and it also provides an overview of the main arguments with summaries of subsequent chapters. The starting point for this book is that there is a need to test a common assumption about the widespread use of techniques and procedures used to prevent the birth of a disabled child: that in a modern liberal state this practice is mainly or solely a matter of individual choice, and that the state itself is neutral. Further, it might be assumed that this neutral stance would allow the modern liberal state to maintain its stated commitment to equality, and that it provides a shield against any charge of eugenics. The Introduction begins to explain how this common assumption will be tested, by reference to interpretations of a neutral state intention. It also emphasises the book’s original contribution: while there is already extensive literature on the ethics of selecting against disability, this book is distinctively centred on an analysis of the state’s position.

This chapter examines how state neutrality can be assessed by reference to the provision of certain information, with a particular focus on information provided through prenatal testing programmes. The information that parents receive about prenatal tests and procedures, and about disability, can be powerfully influential, and can shape the choices that are made. The chapter reviews a number of reasons why the provision of information might not reflect a neutral position: the information might be overly negative about disability, for example, and there is a risk that women will be blamed for any choice that they make. Although it must be acknowledged that it is not possible to have an entirely neutral framework, the chapter compares and evaluates different options that are thought to support autonomy. The chapter also considers nudge theory in order to critically assess both the state’s intention and some limits to individual choice. Although many of these limits are ones that the state cannot entirely avoid, it is important to consider how they put the parents in a particularly vulnerable position, where there is a risk of manipulation.

This Conclusion sums up the main arguments in the book, addresses some final questions, and suggests some future directions of travel. In particular, it returns to the eugenics question, and examines whether current practices in modern liberal states might be in line with a type of eugenics that does not involve state coercion, but that rather involves manipulation, and chiefly the manipulation of women. It also emphasises how an analysis of individual choice should be a secondary concern in our approach to the ethics of selecting against disability, and that the position of the state should be our starting point. The last part of the chapter offers additional reflections on the topic of starting points, and on the importance of thinking further about the nature of pregnancy.

This chapter examines some further difficulties in interpreting the meaning of state neutrality in the context of prenatal selection practices, and that are tied to the state’s approach to disability. A first set of difficulties relates to the challenging or impossible task of identifying a value-neutral definition or concept of disability. If such a definition cannot be found, it is certainly hard to see how the liberal and neutral state can act, although a review of liberal commitments can indicate that certain approaches are more neutral than others. A second set of difficulties is associated with the fact that many parents of disabled children feel that some of their most important values change after their child is born, though they could not have anticipated or understood this change in advance. This common experience, which could be a type of transformative experience, suggests that prospective parents might not be able to make an entirely rational and informed choice, and that the state’s supposed support for autonomy might need some qualification.

This chapter analyses the law in two areas that relate to prenatal selection, with the aim of critically evaluating what ‘messages’ the law might express about disabled lives, and about the state’s position: first, the law on abortion on the grounds of disability under the Abortion Act 1967, and second the law in the United Kingdom on preimplantation genetic testing (PGT). In the first case, it is argued that the disability ground in the law on abortion is not primarily protecting reproductive autonomy, but rather reflects a negative view about the value of disabled lives. In the second case, it is argued that the identification of approved conditions for PGT does not reflect a neutral approach to the definition of disability, and that the legal regime includes elements of state coercion. The chapter also examines a third area which does not relate to prenatal selection, but which might shed light on the state’s position about the latter: court decisions about the treatment of very ill infants. Here, there are reasons to think that interpretations of the best interests of the child do not, in fact, necessarily only take into account the interests of the child.

Chapter 5 focuses on racial disparities in the social security disability programs, commencing with examination of a much-discussed, extensive 1992 US General Accounting Office study of the topic documenting unexplained racial disparities in Social Security Act disability approval decisions, followed by other General Accounting Office reports and other studies revealing additional racial disparities in aspects of Social Security Act disability adjudication. The chapter then contextualizes the disability standards and their statutory elements and processes and explores the social construction of disability thereunder. It also examines the socially constructed, nonbiological concept of race, as differentiated from class, and also the intersectionality of race and disability, to provide a theoretical and substantive framework for examination of bias in pain and symptomology assessments. It includes studies of misevaluation, mistreatment, and undertreatment of Black patients’ pain and subjective symptomology, including psychiatric conditions, by doctors, therapists, and other treatment professionals, along with subsequent Social Security Act Administrative Law Judge bias in decision-making. It also examines the racial impact of misevaluation of claimants with Sickle Cell Disease – a pain-producing condition disproportionately afflicting African Americans. The chapter concludes with a series of remedial recommendations for monitoring and ameliorating racial bias and racially disparate decision-making in Social Security Act disability adjudications.

Inclusion is a term used frequently, but what does it really mean? Inclusion in its simplest term is ‘the action or state of including or of being included within a group or structure’ (Oxford Dictionary). This is a fundamental right of all people, but unfortunately when diversity exists, this is not a right afforded to everyone. The Oxford Dictionary has an alternate definition which elaborates on this initial one. Inclusion is also defined as ‘the practice or policy or providing equal access to opportunities and resources for people who might otherwise be excluded or marginalized, such as those who have physical or intellectual disabilities and members of other minority groups’. As recognised in this definition, inclusion is about opportunities for all, including those with disability, developmental delay, neurodivergence, mental health difficulties, cultural diversity, variations in socio-economic status, LGBTQIA+ people, gender diversity, people experiencing trauma, unique family structures, and Aboriginal and Torres Strait Islanders, just to name a few! While there are differences in what every individual needs to be included, the principles of inclusion and the foundation of everyone having the same rights, should not change.

Collaboration is essential to inclusive practice, ensuring that children with disabilities, developmental differences and neurodivergence receive holistic, coordinated and high-quality support. A collaborative, team-based approach allows children to experience inclusive, responsive learning environments where interventions are seamlessly integrated into their everyday experiences. Research has demonstrated that when educators, allied health professionals, and families work together, children’s learning and development are enhanced, leading to greater participation, engagement and wellbeing.

When we think about inclusion in early childhood education, our minds often turn immediately to children with disabilities. While supporting children with diverse abilities remains crucial, true inclusion extends far beyond this single lens. Inclusion is fundamentally about creating environments where every child, regardless of their cultural background, family circumstances, language or life experiences, can belong, participate and thrive.

Since the 19th century, the U.S. military has grown increasingly adept at saving the lives of troops injured in combat. Yet rising survivability rates, coupled with social attitudes linking disability to diminished manhood and economic dependency, contributed to a perceived national crisis about what came to be known as the “problem of the disabled veteran” (PDV). What is U.S. federal policy toward disabled veterans? What is its aim—to keep veterans alive or to help them reintegrate into postwar society? And how might the U.S. military curb disability in future conflicts? Drawing upon works in disability studies, military history, and war and society studies, this chapter surveys the evolution of U.S. efforts to solve the PDV, from the colonial era to the present. In World War I, when the term originated, anxieties about war disability prompted the federal government to embrace the policy of veterans’ rehabilitation. In later years, the military would explore other ways to limit U.S. wartime casualties, disabled or otherwise. Ultimately, this chapter argues that the PDV stems from the United States’ failure to come to terms with the violence and trauma of military conflict.

Throughout human history, individuals with impairments have encountered significant challenges, often living in hardship with limited opportunities for social, economic and cultural participation. Societies have responded to impairment with superstition and prejudice, which have contributed to marginalisation and exclusion. Disability identity is a complex concept; for some, it is a personal journey, while for others, it represents a political statement. Māori do not typically identify with the Western biomedical notion of disability. Instead, they prefer to frame their experiences through a cultural lens, using terms such as whānau hauā or Mana whaikaha. However, it is important to acknowledge that the term Mana whaikaha was introduced without broad consultation within the Māori disabled community. Other iwi and hapū may have their own terms; Māori should be free to self-identify in ways that align with their lived realities, without imposed terminology.

This chapter offers readers perspective on ideals and practices that shaped health-related treatment of former service members from the Revolutionary period through the end of the Cold War. Studying how veterans fought for and accessed health services over two centuries offers a compelling view of the wide-ranging impacts of military endeavors on policy and politics and on the individual lives of service members and civilians. It also brings into sharp relief the extent to which norms of civilian society – for example, changing perceptions of how diseases are classified and what constitutes proper care – influence wars and perceptions of them. Broadly, the chapter shows that, while veterans’ care became more bureaucratized and institutionalized over time, some realities were constant: the nature and extent of available services, and the ways people interpreted them, were dictated by former service members’ advocacy, as well as prevailing notions about governmental responsibility, illness and disease, disability, and medical practice. Most broadly, the history of veterans’ experiences related to health care reveals that war and society are inextricably and intricately linked.

Human flourishing is a fundamental goal of most societies, and various theories have approached this concept, including the International Classification of Functioning, Disability, and Health (ICF), the job demands-resources (JD-R) model, self-determination theory (SDT), and the integrative model of behavioural prediction (IMBP). These theories focus on different aspects of well-being and the factors that influence an individual’s ability to lead a fulfilling life. This chapter aims to explore the capability approach (CA) and examines how it complements and connects with these existing theories. This chapter demonstrates how, by emphasising the importance of individual capabilities and human agency, the CA broadens the applicability of these theories. Unlike classical models that focus primarily on analysing situations, the CA highlights the broader context, aiming to enhance flourishing by considering situational determinants and the impact of contextual factors on an individual’s ability to make meaningful choices. This chapter contributes to a more nuanced understanding of human flourishing by illustrating the synergies between the CA model and other theoretical models. It argues that to be truly comprehensive and effective in the real world, theories must embrace the transformative potential of the CA.

The judge delegate system continued throughout the late Middle Ages and into the early modern period. The documents examined in the chapter reveal it in operation in the fifteenth and sixteenth centuries: a marriage case; a request for the dispensation required for ordination; a dispute between an exempt monastery and the local bishop; a case in which the plaintiff feared violence if the trial were held in his home town; an administrative innovation designed to facilitate demand for delegated justice; and the system of synodal judges established by the Council of Trent.

This chapter argues that throughout his prose works, Wilde demonstrates ambivalence regarding the significance of fashion in relation to flesh, and this chapter traces that ambivalence through texts including The Picture of Dorian Gray, De Profundis, and “The Birthday of the Infanta.” Treating ugliness and beauty, monstrosity and martyrdom, this chapter demonstrates Oscar Wilde’s continued fascination with beautiful flesh that is betrayed as such flesh decays, rots, and becomes loose and baggy, like an ill-fitting garment. Wilde writes against the backdrop of eugenicist discourse, which proves a foil to his aesthetic project while simultaneously animating his response to criminal charges against him for gross indecency. But Wilde also looks to an earlier precedent to work out questions of flesh and fashion, particularly that of baroque painting and sculpture by artists such as Guido Reni and Gianlorenzo Bernini in their representations of the flesh of martyrs. The world remains unsure whether Wilde was a monster or a martyr; this chapter shows that Wilde himself shared those concerns.