1 00:00:00,000 --> 00:00:05,276 Hi,my name is Joseph Scamardo and I am an assistant professor of philosophy 2 00:00:05,276 --> 00:00:09,241 and associate Director of the Institute in Public Affairs 3 00:00:09,241 --> 00:00:11,449 at San Diego State University 4 00:00:11,449 --> 00:00:16,328 I specialized in philosophy of disability and bioethics. 5 00:00:16,581 --> 00:00:19,151 I also identify as disabled. 6 00:00:19,151 --> 00:00:22,259 I have a spinal cord injury, 7 00:00:22,259 --> 00:00:25,424 as well as a rare kind of dwarfism, and so 8 00:00:25,424 --> 00:00:28,567 you get two for the price of one with me. 9 00:00:28,809 --> 00:00:35,887 So, my first memory of discrimination was, 10 00:00:36,589 --> 00:00:40,589 well, it's hard to say... 11 00:00:43,296 --> 00:00:47,116 I have lots of memories as far as 12 00:00:47,116 --> 00:00:51,773 the experience of stigma or bigotry, 13 00:00:51,773 --> 00:00:54,819 mostly around my dwarfism, 14 00:00:54,819 --> 00:00:56,410 and so, you know, 15 00:00:56,410 --> 00:01:00,248 I have lots of early memories around that 16 00:01:00,248 --> 00:01:03,533 with children staring and laughing 17 00:01:03,533 --> 00:01:07,765 and that sort of thing from a very young age. 18 00:01:10,104 --> 00:01:13,498 Then as far as, sort of 19 00:01:13,498 --> 00:01:15,693 a more systematic discrimination 20 00:01:15,693 --> 00:01:18,580 that sort of excluded me from something 21 00:01:18,580 --> 00:01:22,343 that I wanted to do. 22 00:01:22,343 --> 00:01:25,849 I had a pretty good experience as a child, 23 00:01:25,849 --> 00:01:31,055 mostly because my parents really did a lot 24 00:01:31,055 --> 00:01:33,940 to make sure that I was included. 25 00:01:33,940 --> 00:01:37,254 I can remember being in boy scouts 26 00:01:37,254 --> 00:01:39,157 and cub scouts when I was a kid 27 00:01:39,157 --> 00:01:42,611 and my father, really doing a lot with me 28 00:01:42,611 --> 00:01:47,682 to ensure that the inclusion of my disability-- 29 00:01:48,509 --> 00:01:50,699 You know going on camping trips with me 30 00:01:50,699 --> 00:01:53,489 and sort of acting as a personal attendant 31 00:01:53,489 --> 00:01:56,501 kind of thing to make sure that I was able 32 00:01:56,501 --> 00:01:57,732 to go and participate, 33 00:01:57,732 --> 00:02:00,315 and that sort of thing. 34 00:02:00,551 --> 00:02:03,971 And so the first real experience 35 00:02:03,971 --> 00:02:06,023 of exclusion that I can remember 36 00:02:06,023 --> 00:02:07,799 happened when it was time 37 00:02:07,799 --> 00:02:09,349 to go to high school. 38 00:02:09,349 --> 00:02:10,988 I had gone to the public schools 39 00:02:10,988 --> 00:02:13,812 in my town up until through the 8th grade 40 00:02:13,812 --> 00:02:17,228 and then when it came to high school, 41 00:02:17,228 --> 00:02:21,228 I was supposed to go to the same 42 00:02:21,228 --> 00:02:25,131 private religiously sort of oriented 43 00:02:25,131 --> 00:02:27,837 school that my older siblings went to 44 00:02:27,837 --> 00:02:30,300 and I took the entrance exam and even got 45 00:02:30,300 --> 00:02:33,170 a small scholarship to go and everything, 46 00:02:33,170 --> 00:02:36,150 but it didn't have an elevator, 47 00:02:36,150 --> 00:02:39,847 and so I used a motorized scooter 48 00:02:39,847 --> 00:02:42,610 to get around, and it was 49 00:02:42,610 --> 00:02:44,260 going to be impossible for me to 50 00:02:44,260 --> 00:02:47,780 attend that school, because there was no 51 00:02:47,780 --> 00:02:49,810 elevator. Now this was actually 52 00:02:49,810 --> 00:02:51,960 after the passage of the ADA, 53 00:02:52,668 --> 00:02:55,448 but because it was 54 00:02:55,448 --> 00:02:58,288 a religiously oriented school, 55 00:02:58,288 --> 00:03:00,058 it was exempt from the requirements 56 00:03:00,058 --> 00:03:01,288 of the ADA. 57 00:03:01,288 --> 00:03:05,248 And so, I didn't have any leverage with 58 00:03:05,248 --> 00:03:06,696 that law. 59 00:03:06,696 --> 00:03:09,746 To be able to get them 60 00:03:09,746 --> 00:03:11,673 to make accommodations for me 61 00:03:11,826 --> 00:03:14,110 so I ended up going to the public school 62 00:03:14,173 --> 00:03:14,173 in my town, which actually, personally, 63 00:03:15,213 --> 00:03:19,213 I was pretty happy about anyway, 64 99:59:59,999 --> 99:59:59,999 because that's where all my friends were going. 65 99:59:59,999 --> 99:59:59,999 But it still sort of clued me in 66 99:59:59,999 --> 99:59:59,999 to the fact that... 67 99:59:59,999 --> 99:59:59,999 not everything is accessible, 68 99:59:59,999 --> 99:59:59,999 not everything is designed for me and that 69 99:59:59,999 --> 99:59:59,999 this was going to be something 70 99:59:59,999 --> 99:59:59,999 I was gonna have to figure out 71 99:59:59,999 --> 99:59:59,999 throughout my life. 72 99:59:59,999 --> 99:59:59,999 As far as remembering the ADA 73 99:59:59,999 --> 99:59:59,999 and sort of its passage 74 99:59:59,999 --> 99:59:59,999 and that sort of thing, 75 99:59:59,999 --> 99:59:59,999 I was pretty young when it was passed, 76 99:59:59,999 --> 99:59:59,999 I'm sometimes referred to as part of the 77 99:59:59,999 --> 99:59:59,999 ADA generation, which means that 78 99:59:59,999 --> 99:59:59,999 I sort of grew up with the ADA mostly, 79 99:59:59,999 --> 99:59:59,999 I was born in 1982, 80 99:59:59,999 --> 99:59:59,999 and so I was 8 or 9 years old when the ADA 81 99:59:59,999 --> 99:59:59,999 passed, and so I don't really have 82 99:59:59,999 --> 99:59:59,999 any kind of recollection of, "Aha!" 83 99:59:59,999 --> 99:59:59,999 That's the moment that it passed. 84 99:59:59,999 --> 99:59:59,999 And the recall of where I was at the time 85 99:59:59,999 --> 99:59:59,999 or anything like this, 86 99:59:59,999 --> 99:59:59,999 but I do remember my father explaining 87 99:59:59,999 --> 99:59:59,999 it to me, around the time of my 88 99:59:59,999 --> 99:59:59,999 start of high school. 89 99:59:59,999 --> 99:59:59,999 When I experienced this with that 90 99:59:59,999 --> 99:59:59,999 private catholic school, and you know 91 99:59:59,999 --> 99:59:59,999 having that sort of systematic 92 99:59:59,999 --> 99:59:59,999 discrimination experience it explained 93 99:59:59,999 --> 99:59:59,999 that public schools, and other kinds of 94 99:59:59,999 --> 99:59:59,999 public places were accessible to me 95 99:59:59,999 --> 99:59:59,999 because of the ADA and that there was 96 99:59:59,999 --> 99:59:59,999 this law that said that things had to be 97 99:59:59,999 --> 99:59:59,999 accessible to people 98 99:59:59,999 --> 99:59:59,999 who use wheelchairs, and 99 99:59:59,999 --> 99:59:59,999 motorized scooters like I did at the time. 100 99:59:59,999 --> 99:59:59,999 And so, that was my first sort of 101 99:59:59,999 --> 99:59:59,999 awareness of the ADA, as well as my first 102 99:59:59,999 --> 99:59:59,999 awareness of discrimination, which is 103 99:59:59,999 --> 99:59:59,999 kind of cool. I think? 104 99:59:59,999 --> 99:59:59,999 Because it was neat to have 105 99:59:59,999 --> 99:59:59,999 that experience of, "Okay, well, 106 99:59:59,999 --> 99:59:59,999 this is something that's going to be a challenge for you, 107 99:59:59,999 --> 99:59:59,999 and here's how you're protected, and here's how you can do something 108 99:59:59,999 --> 99:59:59,999 about it." And so in a way, it was this sort of, 109 99:59:59,999 --> 99:59:59,999 my awakening into advocacy as well. 110 99:59:59,999 --> 99:59:59,999 Now, as far as the difference that the ADA has made in my life, 111 99:59:59,999 --> 99:59:59,999 or the life of others, I think that it's been, of course 112 99:59:59,999 --> 99:59:59,999 an incredibly important law that has opened up all sorts of opportunities 113 99:59:59,999 --> 99:59:59,999 to people, everything from public transportation, to be able to move around 114 99:59:59,999 --> 99:59:59,999 your community, the homestead decision is based on ADA, which says that people 115 99:59:59,999 --> 99:59:59,999 need to be--when they need any kind of long time care, 116 99:59:59,999 --> 99:59:59,999 they need to be served in the least restrictive environment, meaning that 117 99:59:59,999 --> 99:59:59,999 you can't just institutionalize or warehouse somebody because it's more 118 99:59:59,999 --> 99:59:59,999 convenient for you, you need to make sure that they're able to live in the community 119 99:59:59,999 --> 99:59:59,999 or somewhere that is going to be best for them. 120 99:59:59,999 --> 99:59:59,999 What else do the ADA do? Just the ability to you know an education, 121 99:59:59,999 --> 99:59:59,999 the ability to get a job, all of these things, for me and for others, 122 99:59:59,999 --> 99:59:59,999 were sort of caused by the ADA and I can't really imagine what it was like 123 99:59:59,999 --> 99:59:59,999 prior to the ADA, honestly. 124 99:59:59,999 --> 99:59:59,999 I mean, I can imagine it I guess, but I'm sure glad that I didn't have to 125 99:59:59,999 --> 99:59:59,999 experience it. 126 99:59:59,999 --> 99:59:59,999 The ADA makes a difference in a wide range of personal experiences 127 99:59:59,999 --> 99:59:59,999 and also a wide range of sort of disability politics issues. Right? 128 99:59:59,999 --> 99:59:59,999 So, my personal experience that I think most recently has been impacted by the ADA 129 99:59:59,999 --> 99:59:59,999 has been just my ability to live an independent life with my two kids. 130 99:59:59,999 --> 99:59:59,999 I think prior to the ADA, it would've been much harder to do that. 131 99:59:59,999 --> 99:59:59,999 You know raising kids means that I have to into lots of different public spaces and 132 99:59:59,999 --> 99:59:59,999 do different things that I might not have been 'required' to do, if you will, 133 99:59:59,999 --> 99:59:59,999 professionally, or just sort of in everyday life, if I didn't have them. 134 99:59:59,999 --> 99:59:59,999 So going to the zoo, or going to the grocery store, for that last minute item 135 99:59:59,999 --> 99:59:59,999 or you know, just whatever it might be, I think that, you know-- 136 99:59:59,999 --> 99:59:59,999 opening up the daycare centers, and so on and so forth. 137 99:59:59,999 --> 99:59:59,999 The ADA sort of opened all of that up to me, as a wheelchair user 138 99:59:59,999 --> 99:59:59,999 and so, that's where it's made a big personal impact in my life recently. 139 99:59:59,999 --> 99:59:59,999 Now, I think that the one thing that I can sort of speak to, professionally, 140 99:59:59,999 --> 99:59:59,999 about the ADA and its impact or lack of impact is probably, two-fold: 141 99:59:59,999 --> 99:59:59,999 One, is the ways in which my privilege as a physically disabled-- 142 99:59:59,999 --> 99:59:59,999 there's a disability hierarchy of course, and so physical disability 143 99:59:59,999 --> 99:59:59,999 is usually at the top of that hierarchy, with psychiatric disabilities 144 99:59:59,999 --> 99:59:59,999 and intellectual developmental disabilities, 145 99:59:59,999 --> 99:59:59,999 are sort of lower down on the hierarchy. 146 99:59:59,999 --> 99:59:59,999 And so, as a physically disabled, cisgender, heterosexual white guy, 147 99:59:59,999 --> 99:59:59,999 I've benefited a lot more from the ADA than lots of other people 148 99:59:59,999 --> 99:59:59,999 that don't have those kinds of privileges. 149 99:59:59,999 --> 99:59:59,999 I think for instance about how the ADA is designed, really 150 99:59:59,999 --> 99:59:59,999 to promote what you'd think of as equality of opportunity, 151 99:59:59,999 --> 99:59:59,999 meaning that everybody has an equal opportunity to compete within sort of the 152 99:59:59,999 --> 99:59:59,999 economic life of the United States, and so, it allows you to enter into the 153 99:59:59,999 --> 99:59:59,999 workforce and enter into the educational system and so on and so forth 154 99:59:59,999 --> 99:59:59,999 then compete. 155 99:59:59,999 --> 99:59:59,999 But what it doesn't do is it doesn't address any of the other advantages 156 99:59:59,999 --> 99:59:59,999 or disadvantages that intersect with ableism. So that's sort of something 157 99:59:59,999 --> 99:59:59,999 that is I think, a real problem, with the ADA. 158 99:59:59,999 --> 99:59:59,999 I'm a well-educated person, I have a master's degree and a Ph.D. 159 99:59:59,999 --> 99:59:59,999 and that, I don't think would've been available to me as easily as it was 160 99:59:59,999 --> 99:59:59,999 if I didn't have these other privileges that I do have, 161 99:59:59,999 --> 99:59:59,999 that the ADA doesn't do anything to address, it just sort of treats 162 99:59:59,999 --> 99:59:59,999 all disabled people as if they were the same, and as if the only thing 163 99:59:59,999 --> 99:59:59,999 they have to deal with is structural ableism, and that's just not true, right? 164 99:59:59,999 --> 99:59:59,999 I think another thing about disability that the ADA doesn't address 165 99:59:59,999 --> 99:59:59,999 is economics, in that, I think that despite the ability to compete, 166 99:59:59,999 --> 99:59:59,999 a lot of disabled people still live in extreme poverty, because of other 167 99:59:59,999 --> 99:59:59,999 things that make it impossible for them to compete, 168 99:59:59,999 --> 99:59:59,999 other than just their disability. 169 99:59:59,999 --> 99:59:59,999 And so, the real sad part to me about that is you look at other systems 170 99:59:59,999 --> 99:59:59,999 that are designed to help disabled people get out of poverty, 171 99:59:59,999 --> 99:59:59,999 and even they don't recognize the way that privilege operates in these contexts. 172 99:59:59,999 --> 99:59:59,999 So, for instance, the vocational rehab system. 173 99:59:59,999 --> 99:59:59,999 I've benefited greatly from the vocational rehab system so I don't want to just 174 99:59:59,999 --> 99:59:59,999 sit here and talk smack on it, right? 175 99:59:59,999 --> 99:59:59,999 The vocational rehab system has helped me get a van that I could drive, 176 99:59:59,999 --> 99:59:59,999 so I could get back and forth from 177 99:59:59,999 --> 99:59:59,999 my place of employment, from school, which was huge, right? 178 99:59:59,999 --> 99:59:59,999 But the only reason why I had access to that van was: 179 99:59:59,999 --> 99:59:59,999 A. Because I could afford the van itself, which not a lot of disabled people can do, 180 99:59:59,999 --> 99:59:59,999 especially if they aren't working yet and 181 99:59:59,999 --> 99:59:59,999 B. Because the VOC rehab counselor thought 182 99:59:59,999 --> 99:59:59,999 that I was worth the investment right? 183 99:59:59,999 --> 99:59:59,999 Someone who didn't have the advantages that I had, as far as the kind of 184 99:59:59,999 --> 99:59:59,999 disability that I have, my family's resources and my skin color and gender and 185 99:59:59,999 --> 99:59:59,999 all those things, it's very likely that rehab counselor would've said, 186 99:59:59,999 --> 99:59:59,999 "You cant take the bus," right? 187 99:59:59,999 --> 99:59:59,999 "We're not going to invest all of this money into helping 188 99:59:59,999 --> 99:59:59,999 you learn how to drive." 189 99:59:59,999 --> 99:59:59,999 Because they wouldn't have believed that they would get this return on their 190 99:59:59,999 --> 99:59:59,999 investment that the person would be able to get a well paying job, 191 99:59:59,999 --> 99:59:59,999 and so on and so forth, and so, I think that that's also 192 99:59:59,999 --> 99:59:59,999 a big issue that the ADA doesn't address, is this kind of intersectionality 193 99:59:59,999 --> 99:59:59,999 that gives some disabled people advantages within even the system 194 99:59:59,999 --> 99:59:59,999 that is designed to help them, and other people, of course, disadvantages, which is 195 99:59:59,999 --> 99:59:59,999 a real issue. 196 99:59:59,999 --> 99:59:59,999 Now, as far as my area of expertise, Bioethics, there's definitely been some 197 99:59:59,999 --> 99:59:59,999 ways in which the ADA has helped greatly, and other ways 198 99:59:59,999 --> 99:59:59,999 in which it hasn't really done much. 199 99:59:59,999 --> 99:59:59,999 So I'll start with the positivity, right? We'll start with the good news. 200 99:59:59,999 --> 99:59:59,999 One way in which I think, I can 201 99:59:59,999 --> 99:59:59,999 point to in a very concrete way in which 202 99:59:59,999 --> 99:59:59,999 the ADA has helped is 203 99:59:59,999 --> 99:59:59,999 when it comes to healthcare rationing so, 204 99:59:59,999 --> 99:59:59,999 The issue of healthcare in the United States of course is a very hot button 205 99:59:59,999 --> 99:59:59,999 topic and it's hot because there is sort of perceived lack of resources-- 206 99:59:59,999 --> 99:59:59,999 There's more need 207 99:59:59,999 --> 99:59:59,999 than there is supply for healthcare. 208 99:59:59,999 --> 99:59:59,999 And so, when we talk about expanding healthcare to a larger number of people, 209 99:59:59,999 --> 99:59:59,999 without also expanding the resources that are being devoted to healthcare, 210 99:59:59,999 --> 99:59:59,999 then that's gonna be a real problem, because some people aren't going to get 211 99:59:59,999 --> 99:59:59,999 as much as they need, right? 212 99:59:59,999 --> 99:59:59,999 You're going to have to sort of budget it, if you will. 213 99:59:59,999 --> 99:59:59,999 Or in the terms of bioethics, ration healthcare. 214 99:59:59,999 --> 99:59:59,999 Now this proved to be an issue because 215 99:59:59,999 --> 99:59:59,999 when it was done on smaller scale, for instance the state of Oregon, 216 99:59:59,999 --> 99:59:59,999 after the passage of the ADA-- I'm not sure exactly on the timeline, 217 99:59:59,999 --> 99:59:59,999 I'm not a historian--but the state of Oregon expanded their publicly provided 218 99:59:59,999 --> 99:59:59,999 healthcare to a larger number of people, and as they did that, they needed to 219 99:59:59,999 --> 99:59:59,999 make sure that they had a way of prioritizing what was covered 220 99:59:59,999 --> 99:59:59,999 and what was not covered. 221 99:59:59,999 --> 99:59:59,999 And so, as they did this, 222 99:59:59,999 --> 99:59:59,999 it became apparent that a lot of disabled people 223 99:59:59,999 --> 99:59:59,999 were being rationed out of the healthcare system. 224 99:59:59,999 --> 99:59:59,999 That a lot of things were not being covered for disabled folks 225 99:59:59,999 --> 99:59:59,999 that should be. 226 99:59:59,999 --> 99:59:59,999 And so, there was a series of lawsuits that were brought against 227 99:59:59,999 --> 99:59:59,999 the state of Oregon, that basically said that, "You couldn't discriminate 228 99:59:59,999 --> 99:59:59,999 against disabled people and not provide them with healthcare, 229 99:59:59,999 --> 99:59:59,999 based on their disability." 230 99:59:59,999 --> 99:59:59,999 That you couldn't sort of say, 231 99:59:59,999 --> 99:59:59,999 "Well, this person isn't going to get very much bang for their buck, 232 99:59:59,999 --> 99:59:59,999 they're not gonna end up being healthy anyway, 'cause they're still going 233 99:59:59,999 --> 99:59:59,999 to be disabled, so we're not going to give them this treatment option." 234 99:59:59,999 --> 99:59:59,999 Right? And so that was a big win within bioethics 235 99:59:59,999 --> 99:59:59,999 that was a direct result of the ADA. 236 99:59:59,999 --> 99:59:59,999 More recently, we've had a similar thing pop up 237 99:59:59,999 --> 99:59:59,999 because of the COVID-19 pandemic. 238 99:59:59,999 --> 99:59:59,999 Specifically, there are what are called "Emergency Healthcare Protocols" 239 99:59:59,999 --> 99:59:59,999 that are being developed for hospital systems and states that anticipate 240 99:59:59,999 --> 99:59:59,999 needing more intensive care unit beds, ventilators and so on and so forth, 241 99:59:59,999 --> 99:59:59,999 that aren't actually available. 242 99:59:59,999 --> 99:59:59,999 And so we need some way of figuring out who gets the ventilator, 243 99:59:59,999 --> 99:59:59,999 who gets the Intensive Care Unit bed, 244 99:59:59,999 --> 99:59:59,999 and so on and so forth, as the pandemic increases and goes on. 245 99:59:59,999 --> 99:59:59,999 And so there was some protocols that were developed 246 99:59:59,999 --> 99:59:59,999 that were very discriminatory against disabled people. 247 99:59:59,999 --> 99:59:59,999 There was one in Alabama specifically, that said that anybody 248 99:59:59,999 --> 99:59:59,999 with an intellectual disability or with dementia was going to be 249 99:59:59,999 --> 99:59:59,999 deprioritized from getting these life- saving resources if they got COVID-19. 250 99:59:59,999 --> 99:59:59,999 And there was one in Washington state, that was pretty discriminatory against 251 99:59:59,999 --> 99:59:59,999 disabled folks that said that if you had a disability 252 99:59:59,999 --> 99:59:59,999 that meant that even after treatment you are still going to be disabled, 253 99:59:59,999 --> 99:59:59,999 that you would be deprioritized from getting the life-saving, life support 254 99:59:59,999 --> 99:59:59,999 treatment for COVID-19. 255 99:59:59,999 --> 99:59:59,999 So there was a variety of these all over the United States 256 99:59:59,999 --> 99:59:59,999 that were really problematic and that explicitly were discriminating 257 99:59:59,999 --> 99:59:59,999 against disabled people when it came to getting treatment for COVID 258 99:59:59,999 --> 99:59:59,999 and so in response, there were some folks from protection and advocacy agencies, 259 99:59:59,999 --> 99:59:59,999 which are sort of these-- Disability Rights California is one, 260 99:59:59,999 --> 99:59:59,999 and each state has protection and advocacy agencies that are federally funded, 261 99:59:59,999 --> 99:59:59,999 non-profit law firms that protect the rights of disabled people and so they 262 99:59:59,999 --> 99:59:59,999 sued these states and these hospital systems and got the federal government to 263 99:59:59,999 --> 99:59:59,999 provide guidelines for treatment ration protocols that basically say 264 99:59:59,999 --> 99:59:59,999 that you can't discriminate against disabled people in this way. 265 99:59:59,999 --> 99:59:59,999 That the only time that you can withhold treatment for COVID-19 is if there is 266 99:59:59,999 --> 99:59:59,999 sort of a very clear way in which the disability means that person would not 267 99:59:59,999 --> 99:59:59,999 benefit from the treatment, that, you know they have the kind of disability 268 99:59:59,999 --> 99:59:59,999 that would make it very, very unlikely that they would survive the virus 269 99:59:59,999 --> 99:59:59,999 even with some kind of ventilator or intensive care situation. 270 99:59:59,999 --> 99:59:59,999 And so, that's of course very different because something like needing 271 99:59:59,999 --> 99:59:59,999 an assistive device like a wheelchair or needing help dressing and bathing 272 99:59:59,999 --> 99:59:59,999 or having these things that would've meant that people would be rationed out 273 99:59:59,999 --> 99:59:59,999 of these protocols... 274 99:59:59,999 --> 99:59:59,999 So of course this is a really good thing that these protocols were changed because 275 99:59:59,999 --> 99:59:59,999 there were a lot of them that would have rationed people out 276 99:59:59,999 --> 99:59:59,999 for reasons that had nothing to do with whether or not they would survive the 277 99:59:59,999 --> 99:59:59,999 the virus with treatment, Right? 278 99:59:59,999 --> 99:59:59,999 So whether you use a wheelchair, or need a personal attendant for things 279 99:59:59,999 --> 99:59:59,999 like dressing and bathing, whether or not 280 99:59:59,999 --> 99:59:59,999 you have an intellectual disability 281 99:59:59,999 --> 99:59:59,999 These are reasons that were being used to deny people treatment for COVID-19 that 282 99:59:59,999 --> 99:59:59,999 have nothing to do with whether or not they would survive the disease. So, 283 99:59:59,999 --> 99:59:59,999 This advocacy efforts that were based on the American with Disabilities Act 284 99:59:59,999 --> 99:59:59,999 sort of made that illegal to do, which is of course a really important thing it's 285 99:59:59,999 --> 99:59:59,999 literally saved peoples lives presumably. 286 99:59:59,999 --> 99:59:59,999 So that the good news as far as my field of work and the ways of which ADA has 287 99:59:59,999 --> 99:59:59,999 made an impact, but of course that isn't the only story. 288 99:59:59,999 --> 99:59:59,999 There are lots of ways in which 289 99:59:59,999 --> 99:59:59,999 bioethics can and has been discriminatory towards disabled people in ways that isn't 290 99:59:59,999 --> 99:59:59,999 addressed by the ADA and that can't really be addressed by the ADA because of the way 291 99:59:59,999 --> 99:59:59,999 it's written and the kinds of problems it was designed to solve. 292 99:59:59,999 --> 99:59:59,999 For instance, there is a lot of controversy over the development of 293 99:59:59,999 --> 99:59:59,999 different reproductive technologies 294 99:59:59,999 --> 99:59:59,999 that are designed to prevent the birth of disabled children. 295 99:59:59,999 --> 99:59:59,999 With intellectual disabilities, with down syndrome, 296 99:59:59,999 --> 99:59:59,999 with disabilities like mine, dwarfism. 297 99:59:59,999 --> 99:59:59,999 with disabilities like certain kinds of genetically linked deafness, and so on. 298 99:59:59,999 --> 99:59:59,999 And so we have an entire industry aimed 299 99:59:59,999 --> 99:59:59,999 at genetic testing for these kind of 300 99:59:59,999 --> 99:59:59,999 disabilities and the prevention of the 301 99:59:59,999 --> 99:59:59,999 birth of children 302 99:59:59,999 --> 99:59:59,999 with these disabilities with 303 99:59:59,999 --> 99:59:59,999 selective abortion or, now, selective implantation, 304 99:59:59,999 --> 99:59:59,999 which is when you test embryos 305 99:59:59,999 --> 99:59:59,999 and then pick the one that you want 306 99:59:59,999 --> 99:59:59,999 to give birth to. 307 99:59:59,999 --> 99:59:59,999 And then coming down the pipeline 308 99:59:59,999 --> 99:59:59,999 is CRISPR, which will be a technology 309 99:59:59,999 --> 99:59:59,999 that doesn't select a particular embryo 310 99:59:59,999 --> 99:59:59,999 but rather modifies the embryo itself. 311 99:59:59,999 --> 99:59:59,999 It sort of-- what's sometimes referred to 312 99:59:59,999 --> 99:59:59,999 as gene editing or genetic engineering. 313 99:59:59,999 --> 99:59:59,999 And that isn't a reality yet, but 314 99:59:59,999 --> 99:59:59,999 scientists are certainly working toward 315 99:59:59,999 --> 99:59:59,999 the use of that technology to prevent 316 99:59:59,999 --> 99:59:59,999 disability. 317 99:59:59,999 --> 99:59:59,999 Now it's something that of course makes 318 99:59:59,999 --> 99:59:59,999 a lot of people with these disabilities 319 99:59:59,999 --> 99:59:59,999 very uncomfortable because of 320 99:59:59,999 --> 99:59:59,999 the message that it might send, right? 321 99:59:59,999 --> 99:59:59,999 It might send the message that, 322 99:59:59,999 --> 99:59:59,999 "People like you aren't wanted 323 99:59:59,999 --> 99:59:59,999 in the world." Right? Meaning "we don't 324 99:59:59,999 --> 99:59:59,999 need more like you." 325 99:59:59,999 --> 99:59:59,999 And so, it is sorta of based on, largely, 326 99:59:59,999 --> 99:59:59,999 stigma around disability, around ideas 327 99:59:59,999 --> 99:59:59,999 about quality of life with disabled people 328 99:59:59,999 --> 99:59:59,999 that, "if you have a disability, you must 329 99:59:59,999 --> 99:59:59,999 be miserable, and so we must do everything 330 99:59:59,999 --> 99:59:59,999 we can to prevent more like you from 331 99:59:59,999 --> 99:59:59,999 coming into existence," and so on and so 332 99:59:59,999 --> 99:59:59,999 forth. 333 99:59:59,999 --> 99:59:59,999 Now, this is a real problem because, 334 99:59:59,999 --> 99:59:59,999 of course, it comes into conflict with 335 99:59:59,999 --> 99:59:59,999 values a lot of people hold around 336 99:59:59,999 --> 99:59:59,999 reproductive liberty, around women being 337 99:59:59,999 --> 99:59:59,999 able to make choices for themselves 338 99:59:59,999 --> 99:59:59,999 about their own bodies, and about their 339 99:59:59,999 --> 99:59:59,999 own lives, and so on and so forth. 340 99:59:59,999 --> 99:59:59,999 And so, this has created a tension between 341 99:59:59,999 --> 99:59:59,999 disability bioethics and other kinds of 342 99:59:59,999 --> 99:59:59,999 progressive groups that are wanting to 343 99:59:59,999 --> 99:59:59,999 promote freedom and justice for everybody. 344 99:59:59,999 --> 99:59:59,999 And so the ADA, you know, isn't designed 345 99:59:59,999 --> 99:59:59,999 to handle something like this because 346 99:59:59,999 --> 99:59:59,999 it's not about overt discrimination 347 99:59:59,999 --> 99:59:59,999 against people, but rather it's about 348 99:59:59,999 --> 99:59:59,999 attitudes about beliefs, about disability, 349 99:59:59,999 --> 99:59:59,999 that drive personal decisions. 350 99:59:59,999 --> 99:59:59,999 And so it's really really hard to address 351 99:59:59,999 --> 99:59:59,999 this as a policy problem because you know 352 99:59:59,999 --> 99:59:59,999 people aren't going to be very keen on 353 99:59:59,999 --> 99:59:59,999 restricting the kind of decisions women 354 99:59:59,999 --> 99:59:59,999 and families can make about reproduction. 355 99:59:59,999 --> 99:59:59,999 But at the same time, we want to promote 356 99:59:59,999 --> 99:59:59,999 good beliefs, and true beliefs, and good 357 99:59:59,999 --> 99:59:59,999 attitudes about disability, and the ways 358 99:59:59,999 --> 99:59:59,999 in which it contributes to the world, 359 99:59:59,999 --> 99:59:59,999 in the ways in which disabilities form 360 99:59:59,999 --> 99:59:59,999 a diversity that's important that we 361 99:59:59,999 --> 99:59:59,999 don't want to eliminate. 362 99:59:59,999 --> 99:59:59,999 And so that's, I think, a task for folks 363 99:59:59,999 --> 99:59:59,999 like myself and bioethics that are writing 364 99:59:59,999 --> 99:59:59,999 about these issues, that are trying to 365 99:59:59,999 --> 99:59:59,999 make arguments that are able to walk this 366 99:59:59,999 --> 99:59:59,999 very thin line between saying, 367 99:59:59,999 --> 99:59:59,999 "Okay, you know disability is the kind of 368 99:59:59,999 --> 99:59:59,999 thing that is not a horrible life sentence 369 99:59:59,999 --> 99:59:59,999 of misery, and so we don't want to make 370 99:59:59,999 --> 99:59:59,999 that assumption and we don't want to base 371 99:59:59,999 --> 99:59:59,999 the technologies that we develop or the 372 99:59:59,999 --> 99:59:59,999 decisions that we make on that assumption. 373 99:59:59,999 --> 99:59:59,999 But at the same time, we don't want to 374 99:59:59,999 --> 99:59:59,999 tell people what they can or can't do 375 99:59:59,999 --> 99:59:59,999 with their bodies." 376 99:59:59,999 --> 99:59:59,999 I think that, if I were to pick one thing 377 99:59:59,999 --> 99:59:59,999 to change, to try to give people with 378 99:59:59,999 --> 99:59:59,999 disabilities more access, and to remove 379 99:59:59,999 --> 99:59:59,999 remove barriers to a life of flourishing 380 99:59:59,999 --> 99:59:59,999 and opportunity for disabled people. 381 99:59:59,999 --> 99:59:59,999 I think I would go back to my birth story, 382 99:59:59,999 --> 99:59:59,999 my origin story if you will. 383 99:59:59,999 --> 99:59:59,999 When I was born, the doctor that delivered 384 99:59:59,999 --> 99:59:59,999 me looked at my body and he had never 385 99:59:59,999 --> 99:59:59,999 seen somebody with my kind of Dwarfism 386 99:59:59,999 --> 99:59:59,999 before, and didn't know much about it, 387 99:59:59,999 --> 99:59:59,999 and he told my parents, 388 99:59:59,999 --> 99:59:59,999 "he's not gonna do much, he's not gonna be 389 99:59:59,999 --> 99:59:59,999 able to walk, he's not gonna be able 390 99:59:59,999 --> 99:59:59,999 to talk, he's not gonna be able to go to 391 99:59:59,999 --> 99:59:59,999 school," and so on and so forth. 392 99:59:59,999 --> 99:59:59,999 "You should place him in a 393 99:59:59,999 --> 99:59:59,999 state institution and 394 99:59:59,999 --> 99:59:59,999 go about your lives, forget about him." 395 99:59:59,999 --> 99:59:59,999 And they didn't do that, obviously. 396 99:59:59,999 --> 99:59:59,999 They chose not to do that. 397 99:59:59,999 --> 99:59:59,999 They took me home, they raised me 398 99:59:59,999 --> 99:59:59,999 like their kid because I was their kid. 399 99:59:59,999 --> 99:59:59,999 And so I think a lot about how different 400 99:59:59,999 --> 99:59:59,999 my life would be if I had been 401 99:59:59,999 --> 99:59:59,999 institutionalized from birth, as that 402 99:59:59,999 --> 99:59:59,999 doctor recommended. 403 99:59:59,999 --> 99:59:59,999 And then I think about how these 404 99:59:59,999 --> 99:59:59,999 institutions still exist. 405 99:59:59,999 --> 99:59:59,999 That when I was-- before I entered 406 99:59:59,999 --> 99:59:59,999 academia full-time, I worked as an 407 99:59:59,999 --> 99:59:59,999 advocate for a protection and advocacy 408 99:59:59,999 --> 99:59:59,999 agency in the state of Texas, where they 409 99:59:59,999 --> 99:59:59,999 have what are called, 410 99:59:59,999 --> 99:59:59,999 "state supported living centers," 411 99:59:59,999 --> 99:59:59,999 which are-- sort of a euphemism for 412 99:59:59,999 --> 99:59:59,999 state institutions where they warehouse 413 99:59:59,999 --> 99:59:59,999 people with intellectual disabilities and 414 99:59:59,999 --> 99:59:59,999 psychiatric disabilities of various kinds. 415 99:59:59,999 --> 99:59:59,999 Basically the kind of place that the 416 99:59:59,999 --> 99:59:59,999 doctor was recommending my parents 417 99:59:59,999 --> 99:59:59,999 to put me. They still exist, almost forty 418 99:59:59,999 --> 99:59:59,999 year later. This is not okay. 419 99:59:59,999 --> 99:59:59,999 And it's not just these kind of places 420 99:59:59,999 --> 99:59:59,999 that are really problematic. 421 99:59:59,999 --> 99:59:59,999 Nursing homes, there's lots of disabled 422 99:59:59,999 --> 99:59:59,999 people in nursing homes. 423 99:59:59,999 --> 99:59:59,999 Even some group home systems 424 99:59:59,999 --> 99:59:59,999 that are corporate, that are designed to 425 99:59:59,999 --> 99:59:59,999 make money, and not to make sure that 426 99:59:59,999 --> 99:59:59,999 people living there are actually living 427 99:59:59,999 --> 99:59:59,999 good lives, right? 428 99:59:59,999 --> 99:59:59,999 This is a serious problem when you 429 99:59:59,999 --> 99:59:59,999 take people and you put them in 430 99:59:59,999 --> 99:59:59,999 a situation where they don't have control 431 99:59:59,999 --> 99:59:59,999 the basic decisions of their life: 432 99:59:59,999 --> 99:59:59,999 what they eat for their meals, when they 433 99:59:59,999 --> 99:59:59,999 wake up, when they go to bed, 434 99:59:59,999 --> 99:59:59,999 how they spend their time, what they wear. 435 99:59:59,999 --> 99:59:59,999 When I was working as an advocate going 436 99:59:59,999 --> 99:59:59,999 in to the state institutions in Texas, 437 99:59:59,999 --> 99:59:59,999 I remember sitting in a meeting where it 438 99:59:59,999 --> 99:59:59,999 was discussed about my clients eating 439 99:59:59,999 --> 99:59:59,999 habits. How apart of his behavioral 440 99:59:59,999 --> 99:59:59,999 support plan was that they had his helper 441 99:59:59,999 --> 99:59:59,999 try to get him to take a sip of water 442 99:59:59,999 --> 99:59:59,999 between every bite of food that he took 443 99:59:59,999 --> 99:59:59,999 during meal time. I thought to myself, 444 99:59:59,999 --> 99:59:59,999 "how absurd!" This is a grown adult 445 99:59:59,999 --> 99:59:59,999 person that they are trying to micromanage 446 99:59:59,999 --> 99:59:59,999 down to the very last detail of his life 447 99:59:59,999 --> 99:59:59,999 and trying to control everything about 448 99:59:59,999 --> 99:59:59,999 what he does. That's horrific I can't 449 99:59:59,999 --> 99:59:59,999 imagine living under that kind of 450 99:59:59,999 --> 99:59:59,999 condition. Where not even being able to 451 99:59:59,999 --> 99:59:59,999 eat my meals in peace without someone 452 99:59:59,999 --> 99:59:59,999 telling me what to do and how to do it. 453 99:59:59,999 --> 99:59:59,999 Right? And so you know I think that this 454 99:59:59,999 --> 99:59:59,999 lack of control over basic decisions of 455 99:59:59,999 --> 99:59:59,999 your life is a real problem for a large 456 99:59:59,999 --> 99:59:59,999 number of disabled people still even you 457 99:59:59,999 --> 99:59:59,999 know 30 years after the passage of the 458 99:59:59,999 --> 99:59:59,999 ADA. So if there is one thing that I 459 99:59:59,999 --> 99:59:59,999 could sort of wave a magic wand and change 460 99:59:59,999 --> 99:59:59,999 it would be that. It would be developing 461 99:59:59,999 --> 99:59:59,999 systems where people are truly supported 462 99:59:59,999 --> 99:59:59,999 to be able to flourish as they are, but 463 99:59:59,999 --> 99:59:59,999 not controlled. Right? Not told what to 464 99:59:59,999 --> 99:59:59,999 do and when to do it every moment of their 465 99:59:59,999 --> 99:59:59,999 lives. Where they can make their own 466 99:59:59,999 --> 99:59:59,999 decisions and have agency over their own 467 99:59:59,999 --> 99:59:59,999 life. I think that's what is missing for a 468 99:59:59,999 --> 99:59:59,999 large number of disabled people still even 469 99:59:59,999 --> 99:59:59,999 after the ADA. And that we need to do 470 99:59:59,999 --> 99:59:59,999 something about that. I think that there 471 99:59:59,999 --> 99:59:59,999 is a few things that we can do. 472 99:59:59,999 --> 99:59:59,999 First, educate your self on the issues. 473 99:59:59,999 --> 99:59:59,999 Right? Educate your self on the issues 474 99:59:59,999 --> 99:59:59,999 beyond just how they effect you. Right? 475 99:59:59,999 --> 99:59:59,999 I think that within the disability 476 99:59:59,999 --> 99:59:59,999 movements there is sort of pockets of 477 99:59:59,999 --> 99:59:59,999 different people doing different things. 478 99:59:59,999 --> 99:59:59,999 And that's fine. But, I think we need to 479 99:59:59,999 --> 99:59:59,999 talk to each other more. We need to 480 99:59:59,999 --> 99:59:59,999 realize that disability issues go beyond 481 99:59:59,999 --> 99:59:59,999 our limited experience. Right? So we need 482 99:59:59,999 --> 99:59:59,999 to be aware of the ways in which 483 99:59:59,999 --> 99:59:59,999 disability disadvantages people 484 99:59:59,999 --> 99:59:59,999 differently. That the experience of 485 99:59:59,999 --> 99:59:59,999 disability is not an experience it's many 486 99:59:59,999 --> 99:59:59,999 experiences. And so, we need to listen to 487 99:59:59,999 --> 99:59:59,999 each other and hear from each other about 488 99:59:59,999 --> 99:59:59,999 the ways in which we are suffering and 489 99:59:59,999 --> 99:59:59,999 hurting. Because, of disability 490 99:59:59,999 --> 99:59:59,999 discrimination because it looks very 491 99:59:59,999 --> 99:59:59,999 different between different people. And so 492 99:59:59,999 --> 99:59:59,999 having a richer fuller understanding 493 99:59:59,999 --> 99:59:59,999 of the problem I think is the first step. 494 99:59:59,999 --> 99:59:59,999 Then beyond that sort of talking to people 495 99:59:59,999 --> 99:59:59,999 about strategies they have and learn from 496 99:59:59,999 --> 99:59:59,999 each other about you know maybe some 497 99:59:59,999 --> 99:59:59,999 strategy that works for you know the deaf 498 99:59:59,999 --> 99:59:59,999 community would work really well for the 499 99:59:59,999 --> 99:59:59,999 dwarf community and maybe haven't talked 500 99:59:59,999 --> 99:59:59,999 to each other very well about different 501 99:59:59,999 --> 99:59:59,999 political strategies to try to get where 502 99:59:59,999 --> 99:59:59,999 we need in order to live well. And maybe 503 99:59:59,999 --> 99:59:59,999 we should. Right? So, educate ourselves 504 99:59:59,999 --> 99:59:59,999 about the struggle of others you know 505 99:59:59,999 --> 99:59:59,999 because it's important to know and then 506 99:59:59,999 --> 99:59:59,999 share information and share strategies on 507 99:59:59,999 --> 99:59:59,999 how to effectively advocate and come 508 99:59:59,999 --> 99:59:59,999 together and fight together. Right? If you 509 99:59:59,999 --> 99:59:59,999 show up for someone on issue A that they 510 99:59:59,999 --> 99:59:59,999 are having then their more likely to show 511 99:59:59,999 --> 99:59:59,999 up for you on issue B that your having. 512 99:59:59,999 --> 99:59:59,999 And, so building solidary across the 513 99:59:59,999 --> 99:59:59,999 movement more effectively recognizing 514 99:59:59,999 --> 99:59:59,999 the ways in which other oppressions 515 99:59:59,999 --> 99:59:59,999 intersect with disability and change the 516 99:59:59,999 --> 99:59:59,999 nature of disability oppression. These 517 99:59:59,999 --> 99:59:59,999 would be my recommendations of what to do. 518 99:59:59,999 --> 99:59:59,999 Just basically raising your awareness 519 99:59:59,999 --> 99:59:59,999 of discrimination beyond just your own 520 99:59:59,999 --> 99:59:59,999 experience.