The Ableism of Quality of Life Judgments in Disorders of Consciousness: Who Bears Epistemic Responsibility?

Abstract

In this peer commentary on L. Syd M. Johnson’s “Inference and Inductive Risk in Disorders of Consciousness,” I argue for the necessity of disability education as an integral component of decision-making processes concerning patients with DOC and, mutatis mutandis, all patients with disabilities. The sole qualification Johnson places on such decision-making is that stakeholders are educated about and “understand the uncertainties of diagnosis and prognosis.” Drawing upon research in philosophy of disability, social epistemology, and health psychology, I argue that this educational qualification is insufficient to address systemic ableism and other forms of epistemic bias in quality of life judgments.

Keywords: Minimally Conscious States, Ableism, Disability, Disability Rights