So the medical model (thesis) that Mrs Grundy believes in is at the bottom of the barberpole, the social model (antithesis) is in the middle and the interactionist model (synthesis) is right at the top being discussed by academics.

Sounds like pretty normal trendyness-dialectics to me.

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From CleverBeast's cited comment:

> I tend to agree, physical disabilities are “mere difference.” There is nothing inherently better about being sighted versus being blind.

I have a blind friend who would be the first to tell you otherwise. The thought experiment about "civilization designed for" blind people can jump right out the window, because before you can even begin to design a civilization you have to get past a bunch of earlier steps. And out in the uncivilized natural world of prerequisites, a sighted person has any number of advantages.

Just for starters, let's take one of the most fundamental attributes of animal life, locomotion. I can walk much more quickly than my blind friend. Not because I'm particularly stronger or more physically fit than her, but simply because *I can see where I'm going,* whereas she has to take special care to not run into things or trip over them. By any measure, that's an inherent, objective advantage.

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> One could imagine, for example, a world where deaf people are the norm. 99% of people are deaf, whereas 1% of people are sighted.

Contra-Contra, Contra; Contra, Contra=Contra the social theory of disability.

What if some things are entirely social like left handed or entirely real like a society of deaf people with a minority sighted who will basically have super powers and rob all them blind. What is a deaf bank guard going to when the person with hearing and sight walks around them will unbelievable skill, and knows when to start and stop lock picking.

I really dont get this argument, how can society oppress a sighted person so hard they cant just run circles around everyone else.

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I wrote my own somewhat-inspired-by-the-original post (which is over here at https://noiseinmysignal.substack.com/p/the-antisocial-model-of-disability , although I disclaim that it is less a reasoned argument and more a rant inspired by a lingering urge to punch one of its more persistent advocates elsenet), but one thing I talk about there that seems worth mentioning over here is a certain fundamental problem with building wheelchair ramps up Everest.

Specifically, my lingering childhood ambition to climb Fuji, as wise men should once.

Which is, very specifically a desire to *climb* Fuji, which my spine won't let me do.

A wheelchair ramp up to the summit, or to pick the example that I seem to recall might actually be available, a helicopter ride up to the summit, can't give that to me, because what I want is *to climb* the mountain, the experience and the achievement, not *to sit at the top of the mountain*, the state.

The very large number of scenarios isomorphic to this one, while they obviously don't render accommodations valueless, do put a very distinct cap on exactly what they can do for anyone.

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Jul 25, 2023·edited Jul 25, 2023

Regarding wheelchair ramps and the like being sneaky charity, to the degree they are, aren't there also lots of other things that should be considered charity then? Roads, sidewalks, streetlamps are built in just the same way and accommodate most people, but no one considers them charity. Building out similar things that accommodate others, even if they're a minority, doesn't seem like it should be called charity then. Or to put it another way, yes it's something that society owes wheelchair users, to the same degree that society owes everyone.

There may be a discussion of how much it makes sense to spend for how many people, but at that point it's a different argument. (Yes I know those things are often tax funded, but everyone pays taxes.)

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>Humans can't fly (without machines), but we don't consider our flightlessness a problem, just a fact of life.

I think problems vs facts of life is a false dichotomy. Yes, flightlessness is a fact of life, but we spend a lot of money on planes and drones to get around this fact of life because it is a problem that we are mostly land bound, and we are able to complete novel tasks or current tasks much more easily by taking advantage of flight. In the other examples with blindness or wheelchair using admirals, likewise technology that expanded the capabilities of the user would change the facts of life such that not being able to use those abilities would become a problem

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I feel like I've seen the pattern a few times now where the absolute dumbest stuff happens in spaces one or two levels removed from academia. Actual academics are generally quite smart and extremely invested in their field. But then weird things happen when academic ideas escape containment and lose all their qualifiers and nuance and baggage. Or like, one academic with an axe to grind will make the rounds but leave out the gigantic pile of controversy that surrounds their particular position.

It sort of turns into an accidental motte and bailey, with a bunch of consultants and hangers-on occupying the bailey and academics vigorously working to fortify the motte.

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Re: the first comment, it seems to me that the thought experiment only works if you assume a post-industrial first-world country where functionally no-one has to do dangerous or strenuous manual labour. If you're living in a society of hunter-gatherers -- the form of organisation that prevailed for the majority of human history -- being deaf or blind or wheelchair-bound presents obvious problems. You can't hunt prey very well if you can't see, hear, or chase it, after all. Similarly, if you're a farmer in a peasant village -- the second-longest form of organisation -- you're going to find it much easier to sow, weed, and harvest crops if you can walk around and see what you're doing. The same applies, mutatis mutandis, if you're a factory worker operating heavy machinery, or a craftsman trying to produce something by hand.

I don't think, therefore, that the sort of society CleverBeast imagines could actually come about, because its members wouldn't be able to pass through the previous stages of social/economic/technological development necessary to reach it. Even if it did somehow happen, it would suffer greater constrains than ours does -- farming, manufacturing, and operating machinery are still vital to modern society, after all, even if we sometimes forget this because most of the work gets outsources to poorer countries.

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Jul 25, 2023·edited Jul 25, 2023

>I became more aware of the fact that it’s hard to define “disabled” in a sense where things we consider abled (eg hearing) wouldn’t be disabilities in some other society.

Most of the 'accomodations' demanded of social model advocates are literally impossible to provide without the ability of people considered non-disabled today. Blind people literally could not survive without sighted people, and any hypothetical society that somehow allowed the blind to live without the sighted could only be built...by the sighted. If all the sighted people were killed by a virus that spared blind people, 'society' would still be 'oppressing' blind people, but now 'society' is....just blind people!

If you cannot provide for yourselves in the absence of a certain category of abled people, then yes, you are inherently disabled. It is INHERENTLY better to be sighted because sighted people are capable of independent survival (i.e. as a group they can survive in the absence of any other group), blind people are not. If this does not count as 'inherently better', then 'inherently better' is a meaningless, useless term being used by someone trying to be 'technically right' in a way divorced from anything that actually matters. If the model doesn't account for reality as it is, as SOCIETY actually is, then it's not saying anything meaningful. If a hunter gatherer tribe literally cannot provide 'accommodations' to a disabled person, how is it possibly meaningful to blame 'society' for 'making' disabled people disabled? The social model purports to describe disability in the context of human society, but then appeals to an entirely abstract notion of 'society' divorced from the majority of societies that ever existed (and in some cases, may never exist).

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>Humans can't fly (without machines), but we don't consider our flightlessness a problem, just a fact of life.

Humans can survive without flight. Blind humans cannot survive without sighted humans. Quadraplegic humans cannot exist without mobile humans. THAT is the difference. This isn't anything 'social', it's the raw reality of human life. Unless you're saying 'preferring life to death is just a value judgement', then something like blindness is necessarily an inherent disability.

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Although I am still not a fan of the social model, I do appreciate the input of those in favor of its use. I honestly feel like I learned some things about potential disability accommodations that somewhat changed my view on them.

Ultimately I agree with the commenters who say that some accommodations would be incredibly inefficient in a society where very few people would need or use those accommodations.

I do also feel as though at least some proponents of the social model treat a certain standard of living as obviously possible no matter how we order society, when I don't think that's true. If we became inefficient enough, everyone would have a lower standard of living - including those that are asking for accommodations - such that even with an accommodation they are worse off than in a more efficient society that is more thoughtful about which things to accommodate and how.

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Paul Ingraham at PainScience.com on the widespread tendency of healthcare providers to BPS badly:


“[Consider] any poorly understood or hard-to-diagnose illness that causes malaise and pain (e.g fibromyalgia, Ehlers–Danlos syndrome, post-Lyme disease syndrome, endometriosis, celiac disease, and many more). Healthcare providers, often oblivious to the great diversity of ‘bio’ possibilities, shift the diagnostic burden onto the easier scapegoat of the ‘psychosocial,’ and pat themselves on the back for doing it. Worse, they often do this in an insidiously gaslighting way, e.g. ‘You’ve stressed yourself into chronic illness, it’s self-inflicted burnout, you poor self-sabotaging thing!’

“The pseudo-diagnosis of burnout just puts a coat of BPS paint on incompetence, but it’s so common that it’s the only influence of BPS that many patients have ever seen.“

I’ve even seen something as commonplace and “bio” as asthma “psychosocialed” as, “Maybe the asthma symptoms you describe as interfering with your sleep lately aren’t asthma but never-before-diagnosed anxiety pretending to be asthma.” (Spoiler: they weren’t.)

Ingraham concludes, “Rocket science is hard, but that doesn’t mean there’s anything wrong with rocket science, and I don’t think there's anything wrong with BPS itself. It’s a vision of really great healthcare; it would be weird if it was gracefully, consistently implemented across the land. It’s aspirational.”

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Unrelated but I think it would be preferable to avoid links to twitter-, I mean, X until they allow unregistered people to view stuff. Just in case people with accounts forgot this was still a thing.

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"Yes, this is false, but you don’t seem to understand that we’re using this false thing as propaganda"

The version of this that makes some sort of sense to me is something like:

The truth is a complex compromise between multiple models of disability (so the Social Model, the Medical Model, the Biophysical Model, the Charity Model, etc). Each of the models is individually pretty simple to explain and understand, so the best way to aid people's understanding is to emphasize the model(s) that that are non-dominant in order that the model in people's heads becomes a more accurate compromise.

I think that the dialectical argumentation style - reach for an opposite of something you don't like, then use it as a challenge, rather than trying to actually be right - tends to result in people getting locked in to the challenging (but inaccurate) idea and not accepting the synthesis when it emerges. Hegel did the best-known expression of the dialectic, and you can see how badly it worked because his most famous pupil, Marx, set up communism as an antithesis (opposing idea) to capitalism and then got locked in to the antithesis and never got to the synthesis that is the mixed economy or social democracy or whatever you want to call capitalism with a welfare state and some regulations of large corporations, and his successors started calling people who did support that "social fascists".

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I also read "Unspeakable Conversations" between the last post and this one and one thing I think that essay revealed is that behind the question of what's a disability is really a question as to the validity and nature of preference itself.

Specifically, Peter Singer and I share a lot of the same attitudes around what makes a person a person, and as a consequence of that is that infants don't really have more rights than fetuses, only their parents have rights. What I hadn't realized is that Peter Singer then goes on to make the perfectly logically consistent argument that there's really no ethical problem with killing disabled infants, provided the parents can demonstrate a legitimate preference for a non-disabled child.

In this specific case, I think disability advocates are upset by this argument as much because it seems a slippery slope to euthanizing all disabled people as to their vested interest in more disabled people being born, but if you take out the infantacide part and only frame it as the slightly less morally itchy question of "should an adult couple be able to abort a fetus just because of a disability and for no other reason" I can't see how you can get around this without a robust social model of disability.

Because essentially, the argument has to be that the preference for a non-disabled child is sort of nonsensical in a world where we agree all disabilities are social constructs created by various cultural and economic forces. There's no such "thing" as disability to create a valid preference, it would be like aborting a child because you wanted one to have blue eyes instead of brown.

Of course, perhaps one day the technology will exist to easily tell what eye color your baby will have and some small percentage of people will want to have abortions based slowly on such considerations, and then, as I said at the top, advocates and opponents of such things will be applying all of the same arguments to the very nature of preference itself. How much of wanting a tall child is because tallness conforms to real medical benchmarks of what healthy looks like, and how much of it is structured by arbitrary economic and cultural forces that make it easier to navigate the world in a tall body?

I can't stress how deep a rabbit hole this sent me down. I've always known that I would be uncomfortable (although not necessarily unable) to provide parental care for a disabled child, and I've also always been comfortable with people having abortions for basically any reason. I hadn't thought about the intersection of these two ideas, nor about how if you abort a potential life solely on the basis of them being disabled, at least part of what you are acknowledging is that the world is not shaped as well for disabled people. Which might not be unjust in itself, but it is certainly an acknowledgement that the world could be built better than it is. When we imagine a utopian future, what's the difference between imagining one where everyone is tall and symmetrical and contain no genetic disorders that impact their ability to navigate, vs one where basically everyone, regardless of the circumstances of their biology, has the kind of miraculous personal accommodations that allow them to live a full and happy life? Because the first one seems more enactable to me, but the second one seems in a weird way, more beautiful. But that itself is a preference and I don't know where it comes from.

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"I became more aware that some people think “Yes, this is false, but you don’t seem to understand that we’re using this false thing as propaganda” is some kind of extenuating factor that makes it okay. I’m against this, but I understand there’s lots of very convincing-sounding propaganda arguing I should be for it."

It feels like you're still not getting it. People aren't saying that it's an unalloyed good, they're saying that it's a lesser evil that's justified in the circumstances. I understand that the rationalist movement had normative issues with this from the start, first with "dark arts" rhetoric and then with "asymmetric weapons", but, well, the real world just doesn't work that way. Maybe it's because, like you said in that post, "ignorant armies" haven't yet seen the light and there's actually a better way, but so far it's purely aspirational and theoretical.

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Late-stage enlightenment.

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Jul 25, 2023·edited Jul 26, 2023

I don't get the examples in the first few comments... at all. In a world designed for people with wheelchairs, a person who can walk normally wouldn't be "disabled", they would be the equivalent of Usain Bolt and Mike Tyson rolled into one. That's *why* there isn't a civilization where most people use wheelchairs to begin with -- because being able to walk is such a major advantage for any organism living in a human-like way that it will inevitably evolve to be the dominant phenotype. The same applies for the people who can see/hear in the other thought experiments mentioned.

The only way I can see these arguments having any validity is if I'm meant to be imagining something like a society of blind cave trolls that never venture up to the surface or something like that. If that's what's meant by "a society where 99% of people are blind", then sure, being able to see wouldn't be much of an advantage there. But then the conclusion just reduces to the claim that our understanding of disabilities is rooted in human biology, which is clearly true but not an especially interesting or useful claim.

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More generally I can't endorse literally saying false things in the service of some social cause, but I do think this is a more complex issue than the rationalist community treats it as.

Zvi Mowshowitz did a series of posts about this - people use statements for a variety of reasons, only one of which is "conveying truth." A common reason to say true things, perhaps more common than conveying truth, is persuasion.

I'm bad at persuasion! I have a compulsive need to point out weaknesses in my own arguments, explain that there are exceptions to general rules, and otherwise undermine myself at every turn. A world of people who think and argue like me would be directionless. We need zealous soldiers *and* thoughtful debaters.

Consider a case where an issue has two sides - one if which tends to attract debaters and the other of which appeals to soldiers. Almost certainly the debaters are right! They're the ones who actually want to be right more than they want to win, after all. But the soldiers will be more convincing.

So a worldview that says "only say true things and do not mislead" is a worldview where we have correct people and winning people and they're often on opposite sides.

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Just wanted to note that the last section was great, and if you could include it whenever possible and appropriate it would be amazing.

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From the quoted comments:

> There is nothing inherently better about being sighted versus being blind. There is nothing inherently better about walking versus using a wheelchair.

Of course there is. A sighted person can choose to put on a blindfold if they wish. A blind person cannot choose to see no matter how much they want to. A person who can walk can sit in a wheelchair if they wish and wheel around. A paraplegic cannot walk no matter how much they want to. One of the pair in each example is simply _more able_ to do things and can do _more things_.

That's at the root of the conventional understanding of disability - there is a common ability which is lacking. All things being equal, more ability is better than less because you are more likely to be able to do the things you would like to do, it's easier for you to be self-actualized and flourish, etc. And that's without even getting into some of the most pernicious disabilities like chronic pain of various kinds which can literally be a living hell with no possible argument for any upside.

Does society have an obligation to enable everyone to lead a life of dignity and purpose, and help them to be their best self? Of course. But let's not pretend that being not-disabled isn't strictly superior to being disabled, and that any disabilities which can be removed, should be.

I'm sure there are and will be a lot of comments dunking on this take but I just had to be one of them because wow is it wrong...

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None of the plus points of the social model people have set out seem to require the social as opposed to biopsychosocial (holistic?) model. Apart from those about fighting being a good thing.

Even the meta point about the model itself being more dignified - disabled advocates in favour of disability ramps are also generally in favour of disability benefits, in other words of a holistic model, and don't consider that dignity is undermined by realism, any more than a monarch will accept homage but disdain taxpayer support.

In addition to the fighting, it could also be about the irrationality - a display of power, the deadening effect of paying lip service to the ludicrous, the deliberate strengthening of the kind of people who like controlling the thoughts of others, that sort of thing. Easier for a king to take people's money if they're all having to say in public and private that his rule is anointed by God, when everyone knows his grandfather was a peasant and he's only in charge because someone else got unlucky with a blacksmith. That might be overthinking it, though.

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I just had my aversion to Continental philosophy refreshed by Tyler Cowen linking to Kevin Munger's critique of him. Hard to give a fair shake to others bringing it up now.

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Another issue with the Social Model is that it can be quite non-compassionate to people whose lives are dominated by *other people's* disabilities. For example, I have a teenage relative who is severely autistic. He can barely speak to indicate his needs; he throws violent self-harming tantrums; he can only eat three things; he cannot deal with a large and random array of sensory stimuli, which must be kept out of the home; etc, etc, etc. His parents' lives completely revolve around trying to meet his needs. When disability advocates say "autism is not a problem! it's just a different way of being!", this can feel like gaslighting to a family that has to accept numerous and constant limitations on their own lives due to their child's condition.

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Quite a bit of pearl-clutching at the idea that the model could be wrong but still useful. It's a model, that's the point, there's a whole aphorism about it :)

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I believe the tendency until the mid twentieth century to force children in schools to learn to write with their right hand was mostly to make life more convenient for them in a world with slow drying ink. With a pencil or a ball point pen, there is no problem writing left-handed, but if you are dipping a steel pen into an inkwell things are not so easy.

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Insisting on truthfulness above all things is very deontological of you, Scott.

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I started toying with these ideas in the last comment section, but: Some version of the medical model is pretty much universal and uncontroversial in cases where we can actually reliably fix the problem medically. I don't hear anybody, even the staunchest proponent of the social model, who say that we should stop surgically fixing cleft palates in infancy and instead accommodate people with that condition. There are plenty of things that were once debilitating disabilities that we now medically correct as a matter of course, and approximately nobody has any problem with that. (the opposition of some deaf people to the use of cochlear implants being an interesting exception.) Even something like a wheelchair ramp presupposes the use of a medical device (the wheelchair) to ameliorate the disability.

I guess I would boil my thoughts on this down to: Medically correct disability whenever possible. Also understand that every accommodation, no matter how trivial, has a nonzero cost, and sometimes hard choices need to be made about whether the cost is actually worth it. And at least in the case of government action, non-disabled people do in fact get a say in this conversation, seeing as it's (largely) their money being spent.

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Tinnitus is one of the most common causes of disability in US combat veterans. It also seems to be a uniquely difficult condition to shoehorn into the Social Model.

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"But it sounds like some people in the field of chronic pain have focused on the “psycho-” part and are using it to insist on therapy and prevent people from getting their chronic pain medications."

I interpret this as more directly a result of the overcorrection to the opioid crisis than as a specific reliance on a model. In other words, the rationale is not driving the practice of withholding opioids. It's the other way around: the desire to withhold opioids latches onto any available rationale, however tenuous. But you can always fabricate a justification when working from motivated reasoning. I don't think getting rid of the biopsychosocial rationale would have any impact on people seeking to withhold opioids. They'd just turn to something else - like bureaucracy.

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Jul 25, 2023·edited Jul 26, 2023

The commenters that are cool with propaganda, or retreating to meta positions regarding "what's politically effective is more important than what's true" are badly underestimating how corrosive those positions are to society. Yes, it's socially inept to take people literally all the time, or to prefer truth over friendship. But people hate being bullshitted, and they really really hate being obviously, brazenly bullshitted, to the point where they stop trusting not just the bullshitter, but all their friends, then all the people that ever said anything nice about them, and then eventually everyone that refuses to condemn them.

I'd hoped the experience of COVID would have dampened enthusiasm for this style of thinking for a generation. I get there's an is/ought crux, but seeing people talk about the "is" like there's no downside is unsettling.

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Yeah, how to react to 'we are using this false thing for propaganda' is one tactic that always got under my skin. I'm still not sure how to react to it, but my native instinct is to try to deny a place at the intellectual bargaining table to anyone who uses it.

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Gonna be honest. I didnt have "scott alexander comes out against metaphors" on my bingo card for the day.

To be charitable, maybe he is just reading some of these not the same way I am reading them. Like i am reading a lot of people trying to emphasize that the distinction between medical-2 and social-2 model is in the ought viewpoint of where primary locus of solutions to any impairment should be. So the social model would include people who hold the social-1 model described in the article but also include people who hold the interaction-1 model. Meanwhile while Kaplan holds the social-1 model he actually almost certainly holds the medical-2 model

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> I suppose the boring real explanation is that left-handers were never that discriminated again and there’s no left-hander genocide or anything to memorialize.

This... can't be right. Left-handedness was viewed in extremely negative terms. That's the reason everyone who was left-handed was forced to act as if they were right-handed. "Sinister" is the Latin word for "left".

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Jul 26, 2023·edited Jul 26, 2023

> I became more aware of the fact that it’s hard to define “disabled” in a sense where things we consider abled (eg hearing) wouldn’t be disabilities in some other society.

You cited a bunch of examples that assumed without argument that hearing in a world of deaf people would be disadvantageous. This is not actually true. Being around big industrial machines (we have those in reality!) is unpleasant because of the noises they make. But being deaf around them is still worse, not better; those noises carry important information about what the huge, dangerous machines are doing, and you can use that information to improve your own safety.

On the assumption that you don't care about your safety and neither does anyone else, you can also use that information to detect both problems in - and the normal operation of - the machinery, which will make you more productive in your job supervising and/or operating it.

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Jul 26, 2023·edited Jul 26, 2023

> I appreciate this explanation, but I hope I’m not being too hostile by summarizing it as “Yes, it may be false, but people are promoting the false thing for propaganda purposes.” How is that an extenuating factor?

I'm so confused when you do this. You quote it and use language as though you are being generous and charitable, in the very same sentence as being basically totally ungenerous and uncharitable. Can you just.. not tell you're doing it? It is confusing the same way it is confusing when you aggressively fail to steelman or pull a motte-and-bailey, which you do a lot despite having as far as I know coined the terms.

Yes, that is a hostile summary. Their whole reply was full of points like "there's a spectrum" "it has a lot of value" "you can't really understand it without the political history" "it's not entirely false or true but it is somewhat absolutist" etc. The words 'false' and 'propaganda' are just totally wrong ways to summarize any of it.

Time and time again this blog plays the trick of "pretending to understand a subject in order to pass negative judgment on it", and time and time again it fails to understand or sympathize any opposing viewpoints, but cleverly *pretends* to understand them which is, I guess, good enough for the readership. The people who know about this blog but *don't* read it are the ones who can see through this pattern of deception.

Seriously, if you can't understand where other people are coming from, you're not in a position to credibly disagree with them. You can try but you're just going to fail, because your disagreement doesn't *encompass* the other view. Instead it just fails to notice it entirely. The result sounds like a parody, and that's what having a debate with a few static articles on your own blog sounds like. If you want to find out what the point of this other model of disability is for, go argue with some actual people and then demonstrate that you understand their positions and that yours somehow supersedes theirs. Here you have demonstrated that you physically can't comprehend other positions, but are eager to pretend to so that, presumably, you sound more credible to a bunch of people who already agree with you.

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"If every human was born with the same level of physical ability that I now live with, everything would be shaped differently and it wouldn’t be a handicap. "

If every human was born with the same level of physical ability that she now lives with, the last human would have been eaten by wolves not long after the first human was born.

If we imagine that some alien civilization with approximately our level of technology were to stop by and take pity on the differently-abled protohumans, building them the technological infrastructure to survive, I doubt they'd be able to keep the machinery running more than a century or two. And if they could, I expect it would be a Vaal-like Servants of the Machine dystopia. If we set it at early industrial technology or before, then I'm even more confident of that.

We live in meatspace. And approximately the full "normal" set of human abilities, is required for humans to *keep* living in meatspace, to establish dominance over the wolves, to build and maintain industrial civilization, to grow food, etc. Because, we basically didn't do any of those things, had a much more precarious existence, until we got the full modern set of human abilities, and then we went and doggified the wolves, built that industrial civilization, etc, in an incredibly short time once we did. "Normally abled" is not an arbitrary social choice, it's a minimum requirement for survival without dependency.

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Scott, I don't think you can simultaneously claim that you have used the terms correctly according to Social Model of Disability, and also that you refuse to participate in the annoying game of redefining words which you accuse SMD of doing.

Also I'd like to push back on the “what if we force you to use a new word for the common-sense definition of the term and restrict the word you already have strong connotations with to a new definition”

People were not using "disability" to mean what SMD now means by "impairment". People were using the "disability" to mean the amalgamation of both biological and environmental factors, often without realizing it. It's not immediately clear whether biological related use was more often than environmental and even how to properly compare them. That's why it's helpful to have two different words for this kind of thing - more accuracy and more awareness of what you actually mean. Now is it annoying that in the transitional period their may be ambiguity between old and new definitions? Sure. But that's the way that language evolves and I don't think there is much utility in trying to oppose it.

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The common thought experiment seems to be to imagine a sighted or hearing person in a world of blind or deaf people, which is certainly interesting. I can imagine a very stressed out hearing person who never gets any sleep because night time is the obvious time to complete road works (/similar). However, I also suspect the reality may be less akin to disability and more akin to 'every superpower has it's kryptonite'.

We can also reverse this by imagining a future or alien society where everyone has an ability we don't, and whether the lack of that ability would constitute a disability/impairment.

Imagine you woke from cryonic sleep to be informed that your illness had been treated. However, they also inform you that they were unable to do anything about your impairment: you will never be able to fly. It turns out that humans have since evolved to fly, and it's just a normal ability that everyone is assumed to have. You then find yourself in a society and urban landscape where you are unable to live a normal life without a 24-hour carer who carries you from place to place.

We would of course hope that the new society we find ourselves in might make 'reasonable accommodations' for the flightless, which might involve installations of stairs and ladders where space and cost allows, but would we really go so far as to say that society is at fault for designing itself around the near-universal ability to fly? Yes, we might want to discuss what measures could be taken to work around this problem, but the problem is very obviously related to our inability to fly.

The idea of a left-handed world seems stronger, because that seems symmetrical to the actual situation: a right-handed person in a world of left-handed people would be in the exact same position as the inverse, so it's genuinely a case of being differently-abled rather than more or less abled. However, I also suspect that's why we tend to think of being left-handed as a difference rather than a disability.

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I'm glad to see from Adesh Thapliyal's comments that we do not have the situation I feared: Nobody actually believes the Social Model but everybody is required to publicly proclaim their belief in it or be pilloried.

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I would expect a deeper analysis along these lines: Some people have disabilities, but that class depends on what society generally expects/requires of people. So one alternative is to alter society so that the people with a particular limitation aren't disabled, and the other is for those people to be disabled. Assuming that the problem is "large", an important question is which course of action is "more expensive": losing the productivity of the disabled or society paying the costs of adaptation.

Of course, that's a heartless, capitalistic way of looking at it. But the societies that will be around in a century or two are descended from the societies today that are most productive. There is a continuous competition between societies for the allegiance (physical presence, really) of humans, and it's clear that a major determinant of which societies humans choose is material prosperity.

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The left-handed catchers in MLB since 1989 has a decent explanation which seems obvious after it's been explained. 1st, there are catchers in MLB that bat left handed (e.g. Tyler Soderstrom of Oakland); the fact that needs to be explained is that there are now left throwing catchers. This was explained to me as down to comparative advantage. A catcher needs to be able to throw the ball quickly, hard, and accurately from home to 2nd base to prevent runners on first from stealing. However, if someone could do that with their left hand, they will almost certainly be more valuable to the team as a left handed pitcher than they would be as a catcher. This is because left handed pitchers have an advantage against right handed hitters, which are more common in the game.

This explanation doesn't really leave any mystery on the table except for "why were there ever left throwing catchers?" If I'm taking a guess, I think its down to the increasing competitiveness at the little-league and college level. If players start the game as kids mostly outside of organized leagues and choose their positions without input from coaches, it's not impossible for a catcher who throws left handed to develop their skills as catcher to the point that it's no longer a good move to convert them to LHP. But if adults are running the show from the get-go, everyone who's good enough at throwing left handed to be a catcher will be asked to pitch instead.

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I reject the example of the hearing-capable person born into a deaf world.

I mean, yes, that person would face challenges in life, and would require accommodations (i.e. earplugs) a lot of the time. But what everyone seems to be missing is that he possesses a bona fide superpower. He has an entirely new (to the deaf denizens) sense that can detect all kinds of things that normal (i.e. deaf) humans cannot. So, yes, in the short term it makes sense to provide accommodations; in the long term, however, the reasonable thing to do would be to embark on an accelerated research program to give everyone in this society air-vibration-detection superpowers.

The opposite is true of a deaf person born into a hearing-capable society. Yes, he would also require accommodations and special consideration; but it would not make sense to embark on a research program to deprive everyone of their hearing (not unless you're some kind of a Bond-type supervillain, that is). The need for accommodations and disability are correlated, but not identical; and objectively, having more powers -- enhanced senses, higher physical strength, faster mental calculation speed, etc. -- is always (meaning, 100% of time +- epsilon) better than the alternative.

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The 1 trillion estimate is probably closer than the 1 billion one, even before accounting for regular maintenance. Extrapolating costs from lower elevations is not fruitful, because as the latter comment indicates, costs increase rapidly with elevation. Given how much time entities like the Colorado DOT spend repairing roads (the possible work season is short), I'm not even sure an outdoor road like that is physically possible with current technology. It would degrade faster than it could be repaired.

Many machines don't work properly at those altitudes. If you try to build only a narrow path, not wide enough to support them, then are you doing all of the work by hand? Carrying bags of cement up and down? Not to mention specific sections where people have to take ladders over ice chasms, which move regularly, or thin ridges where you can't fit a path let alone workers, or steep slopes requiring technical climbing... by the time you were done, if it were even possible, you would have destroyed the very thing you are trying to make accessible.

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A striking aspect of Cleverbeast's response is that time starts with advanced human society. Human evolution on Earth's environment is presumed to have been successful without the advantage of hearing, so important that at least most vertebrates have it. Is this not a deal-breaking omission? Psychologically, it is intriguing. I wonder how many people do diminish our animal nature.

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The problem with the "not being deaf would be a handicap in a world where most people were deaf" argument is that the downside of being able to hear can be eliminated at the trivial cost of wearing hearing protection, as people at gun ranges commonly do, and the advantages when hearing was useful would remain. There is no comparable way to eliminate the disadvantage of being deaf. I take the fact that people defending the model fall back on such a weak example as evidence that the model is not defensible.

A number of the comments come down to "the model is a lie that can be used to persuade people to do things we want them to do," which does not strike me as a defense.

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one point that I have not seen addressed _at all_ is the fact that everyone will be disabled/impaired/whatever at some point in their lives. When we are born, we are unable to walk and society accommodates us by carrying us around until things improve.

Live long enough, and you will regress to the point where you are

- unable to walk

- hard of hearing/completely deaf

- vision impaired/blind

- in chronic pain

... so the accommodations that we build _now_? There's a minority who uses them all the time, but they're for _everyone_.

Ignoring that fact seems extremely short-sighted to me.

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“Personally, while I'm not a full-on continental philosophy fan I do think there's a time and place for saying things that are obviously not literally true on reflection, as provocative correctives to a complacent status quo.”

Are there any examples where that was actually a good idea?

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The meta point seems to be "Is it allowable to lie (or if you want to shade over the issue) to exaggerate, omit, and mislead" for political purposes (ie what I claim to be a good cause). It seems that plenty of people seem to think so.

I don't know what we do about this. The flaws in this logic are so obvious.

1) We can no longer have any sort of useful conversation if I don't trust a word out of your mouth.

2) Historically this sort of behavior has not gone down well. Life is an iterated game, and sooner or later people catch on to what's being done. This happened to the Jesuits repeatedly (there is a reason they were expelled so often, even from Catholic countries).

We also see this today in America. America, since the late 50s has done more than any society on earth to try to improve itself. The only thing comparable is Britain's ending slavery and then spending years stopping the trade. And what has been the result of this ~70 years of self-improvement? Zero acknowledgement that it happened, zero gratitude, and an endless litany of complaints that America is the worst society in human history and that every little thing, no matter what the issue, is motivated not by personality conflicts, or mistakes, or genuine disagreements, but by some sort of -ism.

The consequence of this is exactly what any normal human who understands normal human emotions would predict. If I get exactly the same (hostile, non-empathic, furious) response no matter what I do, then fsck you, I'll do whatever is most convenient for me. That's the basic stance today of 50% of Americans, and that, more than anything else, is why Trump was popular.

Not his policies per se, but the fact that he is pretty much the only politician who is willing to say "America just is not as evil as you claim; and if you insist on this nonsense I don't feel I owe you an apology for anything".

In other words, is the poisoning of our politics worth it? Worth it to achieve something that would probably be achieved anyway (perhaps a few years later, but also perhaps a few years earlier)? Both ADA and Gay Marriage are probably the most "neutral" of current civil rights, the ones that generate the least fury and ongoing litigation – and they're both the ones that were achieved primarily by rational, honest persuasion, not by lies and demonization of opponents.

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In evolutionary terms, we are best adapted to our environment with our full faculties. It shouldn’t be seen as any sort of capitulation to say that folks with a disability are at a disadvantage - it clearly makes the world more difficult to navigate. We should support all reasonable accommodations to help them enjoy full lives, but we don’t have to accede to the social theorist’s denialism.

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Jul 27, 2023·edited Jul 27, 2023

Re. CleverBeast's claim that "There is nothing inherently better about being sighted versus being blind. There is nothing inherently better about walking versus using a wheelchair." :

Scott's answer was polite and reasonable. I feel, though, that we may be playing a sucker's game by responding politely and with an extended argument to claims that are obviously, objectively wrong. This has been happening often lately. We're told that black people can't be racist, that it's fair for cis women to have to compete with trans men in weightlifting, that printing money can't cause inflation (see Freddie deBoer's blog for a recent example), that it's racist not to capitalize Black but racist to capitalize white, that math is white, that every Black in America should receive $100 million in repayments, and that being able to hear and to walk isn't desirable.

I think this is just a tactic of the left to shift the Overton window, by centering debate around obviously insane ideas until only-slightly-insane ideas, like defunding the police or studying Marx in English Lit, seem almost reasonable. I don't know, but perhaps we should stop responding to utterly insane claims, or respond with laughter and derision rather than polite responses. Debating insane opinions seems only to legitimize them.

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Jul 27, 2023·edited Jul 27, 2023

>I appreciate this explanation, but I hope I’m not being too hostile by summarizing it as “Yes, it may be false, but people are promoting the false thing for propaganda purposes.” How is that an extenuating factor?

I still don't really understand why you say it is false... I don't think there are any empirical predictions that the social model would make that the biopsychosocial model wouldn't also make, or the medical model for that matter.

Given that the models have no empirical disagreements, it seems wrong to say that one is true and the other is false. Rather, they just disagree on framings, semantics, and recommendations - precisely the stuff that propaganda is made of.

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I'd suspect that we'd hear a lot more about the oppression of lefthanders in the past if there was a way to make money off lefthand identity politics. But handedness is not a protected category in American law and there are no checkboxes for handedness on government forms, so there are very few handedness discrimination attorneys feeding pre-cooked storylines to reporters.

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> Also you bring up the example of a blind person being disadvantaged on a desert island, but it’s not like there aren’t natural environments where blindness is advantaged, hence why blindness has evolved more times than sightedness has (though blindness is easier to evolve than sightedness)

I think there are two meanings of "blindness is advantaged", and this mixes them up.

* Blindness can (perhaps) be advantageous in an absolute sense, in environments where all visual signals are meant to impair and misdirect. I know of no such environments.

* Evolutionary, the costs of having eyes may be higher than the fitness benefit they provide. In such environments, mutations which do not maintain costly eyes will win out.

Blind humans still pay most of the costs of having eyes. And crucially, all of them live in habitats where having working eyes would actually be beneficial. This is not surprising: like most species, humans are ultimately dependent on photosynthesis for their energy, and there are only a few habitats where the products of photosynthesis exist but sunlight does not (like the deep seas, which is not well suited for humans). Most vertebrae species, as well as many other animal species have eyes of some sort.

If the reason most blind people were blind was that their ancestors were living near deep sea hydrothermal vents for generations and lost their useless eyesight in evolution, then the claim that "both sightedness and blindness are sometimes advantageous (given the costs of eyes)" might be fair to make. But that is just not the world we live in.

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It's dismaying to see you characterize "stating a position on one end of a spectrum when the truth is somewhere in the middle" as "deliberately lying for the sake of propaganda" when you yourself wrote a much better explanation of the relevant dynamics 10 years ago.


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I read the article that @HalfRadish linked to, "The Bad Patient". The author tells a philosophical story about any medical diagnosis being a result of some negotiation and round-table discussion where poor, oppressed and disadvantaged patients struggle to "have their voices heard" while Doctors fail to honestly listen to his authentic pain and are dimissive and impatient.

Actual language:

"Illness is a matter of testimony. You tell somebody else — generally, somebody who has more degrees than you — how you feel, and they, ideally, have the ability to recognize in your testimony something you lack the expertise to identify....Illness is also a social negotiation between what you have to say and what your doctor is willing to hear — and the diagnosis that results from this dynamic isn’t exactly your illness, but a mutually agreed-upon fiction."

This story is grounded and informed by his year of occasional, severe episodes of gastrointentinal pain and distress. He went to a lot of different MedPros, tests found nothing, he was blaming himself for a psychosomatic illness and musing on the illness fetishists of the Internet and the Chronic Everything shut-ins.

About 3/4 of the way through the piece, another severe attack sends him to the ER, and he learns:


GALLSTONES!!! But now, after a year of nobodody thinking of this well-known possibility, he has necrotizing damage to his pancreas, might not survive (as of the writing of the article.)

People, how in the name of God and science did 5+ doctors over a year not find this? How is it that highly educated, wealthy adult Americans in 2023 get so caught up in stories of "testimony" and "advocacy" and self-actualization that EXTREMELY BASIC MEDICAL SH!T is mysterious, never even occurs to you? Everybody is so introverted and narcissistic that the physical world is just a Plato's Cave? It's no wonder that ideas like "non-binary gender" and homeopathic medecine are widespread.

(What is the point of medical licensing ? I feel like a good old-school auto mechanic could have caught this if they were motivated, but somehow the "check engine" light and scanning OBD codes made them say, "Golly! It's a mystery!")

Something is very broken in medicine when stuff a GP in 1956 could have found and fixed for $100 tops gets imagined as a spectum of faddish disorders, tabled, and then the patient almost dies.


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I haven't seen it mentioned elsewhere, so I'll point it here:

If we observe that the issues of a fact itself are conflated with the issues of that fact being in a small minority, say 1%-99%, then more interesting than imagining a counterfactual world where the minority status is reversed, 99%-1%, is to imagine a counterfactual world where the minority status is abolished, 50%-50%.

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If you're refuting a motte and bailey argument, you need to be specific what you're denouncing and not get sucked into debating both at once. Because if you shout down the thing they're saying as a whole, they'll act as if you're arguing against the motte and draw in everyone else.

Sometimes that's hard to maintain if it's really obvious that they really want the bailey and the defensible motte is only there for cover. People arguing for the existence of God with the ontological argument are usually people who ARE really invested in the existence of God, and there's not a lot of people who innocently found a simple one-step logical inference to be profound and are genuinely shocked that some people pretending to be on their side replace "A" with "God" at the end.

"social model of disability" accidentally forms a motte and bailey between the extreme position "EVERY bad condition is bad because of how society treats people, chronic pain sufferers aren't relevant" and the defensible position "MANY conditions are bad because of how society treats people, it's worth pushing to improve this" . (I think it's a motte and bailey by accident, not on purpose, because the people pushing the extreme version of the argument seem to more be activists who want societal discrimination to be recognised, the people who want to use deaf people as cover to make people with chronic pain suffer I don't think have the lingo sufficiently yet.)

But I think it has the same effect as a motte and bailey. If you make an entirely legitimate argument against the extreme position, then whether or not we agree how many people believe it in reality, I understand we may differ in this and I don't have a very strongly held concept, if you used "social model" to mean only the extreme position (even with high-profile examples of people using it that way), and entitle it "SOCIAL MODEL IS BAD SOCIAL MODEL IS BAD" and you think but don't say "SOCIAL MODEL ALWAYS MEANS THE EXTREME VERSION THE MODERATE POSITION DOESN'T EXIST", then you will start a big pointless fight over terminological differences with people like me who believe the moderate version and who use "social model of disability" to mean the moderate version.

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Interesting point about left handed acceptance.


"I've long wondered if it wouldn't make more sense to simply offer some disabled individuals large sums of cash rather than ask people constructing buildings etc to accommodate them."

This is always a spectrum.

Plenty of people with sufficiently rare problems do get personalised accommodations (e.g. a full time carer) because that's cheaper than making everywhere possible to navigate by themselves.

But lots of universal accommodations are much more efficient. Do we say "why don't we pay everyone a water allowance, rather than having the government regulate or run water companies?" Well, we might, but even if it had some advantages we'd usually be wrong because almost everyone needs tap water and there are massive massive efficiencies of scale by having a specific organisation piping water to everyone rather than having everyone make separate arrangements with different water-carrying-taxis or whatever.

There's some sort of cut-off of "how common". Not 100% of people need ramps. But a lot of people benefit from them, most people under 2, many people over 60, everyone with pushchairs or carts, everyone who's temporarily impaired, not only people who can ONLY use them. Same for "plain text versions of things" or "ingredients lists" etc. The "average able bodied adult" might be barely a majority, if you design public spaces for the modal person, not the mean person.

Given the amount of coordinated effort necessary to get people to agree to any universal accommodations, I suspect that the ones that there are very much worth the investment in the long term and more would probably be better.

There's probably *some* errors in both directions for things which are mandated but shouldn't be as well as things that aren't mandated but should be, but I think those are probably more the exceptions, although there's probably some I've forgotten.

"if it would be easy to give disabled people a direct grant" I think is true in some cases, where accidentally unhelpful or non-existent accommodations are offered.

But I'm also leery of it because it's the sort of thing a lot of people would think about when they mainly just want less accommodations, and don't particular care whether these grants would exist or not.

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