Towards an Ethics of Autistic Meltdown, Part 2: Whose Disability Is It?


If you haven’t already done so, please read at least the disclaimer from Part 1. Here I will add that the following is intended for educational/conversational purposes only, and should absolutely not be misconstrued as any kind of serious advice or counsel — medical, psychological, legal, or otherwise. If you require any sort of serious advice or counsel, please find and work with a suitable expert.

Disability As External Cost

“…[W]e have analyzed the gains from trade that accrue to voluntary participants in transactions. However, many transactions involve involuntary participants as well. The neighbors who breathe the smoke from a polluting factory, the naturalist who deplores the “harvesting” of whales, the shoppers who enjoy the spectacle of department store Christmas displays — all are incurring costs or benefits from transactions in which they had no part. Such costs and benefits are said to be external and are collectively referred to as externalities. External costs (like the annoyance of breathing factory smoke) are called negative externalities, and external benefits (like the pleasure from seeing Christmas decorations) are called positive externalities.” — Steven E. Landsburg[1]

[Continued from Part 1]…I’ve argued elsewhere that instead of always seeing disability as a personal attribute, we are free to view it as characteristic of an environment (context, situation, etc.). For example, rather than view someone’s crawling as being due to “missing legs” (an attribute of the crawling person), we can view it as being due to a missing wheelchair (an environmental attribute). Similarly, rather than blaming a given misunderstanding on so-and-so’s “poor hearing”, we might explain it by a lack of a suitable hearing-aid. And instead of describing someone as “vulnerable to depression”, we might say rather that their current infosphere lacks adequate information about mood regulation — e.g. the efficacy and availability of psychotherapy and/or anti-depressant medication. In general, rather than view a given disabled person as the sole proprietor of the disability in question, we can rather view certain environments as being selectively disabling (those that lack a suitable wheelchair, a hearing aid, or information about mood regulation). In other words, instead of blaming features of a disabled person for their disabilities, we are free to blame features of the disabled person’s immediate environment.

L0037165 Artificial left arm

Image Credit: Wikimedia Commons

Perspectives aside, as a matter of practicality, the fact that we can make this sort of shift has almost always been accepted implicitly, as evidenced by the profusion of gadgets, widgets, devices, apparatuses, thingamajigs (or -mabobs), doohickeys, and whatchamacallits (e.g. crutches, eyeglasses, false teeth, prosthetic limbs, etc.) that human beings have designed, built and used for millennia[2] in order to help the disabled to function more or less independently. Aside from scientists who do cloning research and the most religiously faithful, and really as a matter of practical necessity, almost nobody wastes time on the fantasy, for example, that a paraplegic, diabetic, intellectually challenged child might simply grow a new spinal chord, pancreas, and neocortical tissue. By default we almost always attempt to make some environmental adjustment — build them a ramp, give them insulin shots, specialized education, etc.


The “Cairo Toe” is currently the oldest example found of a functional prosthetic device. Discovered on an Egyptian mummy, it has been dated to almost 3000 years ago. Image Credit: The University of Manchester.

And yet, why does this shift from a personal toward an environmental model of disability seem so unusual? If it is already our default strategy for coping with a disability in the first place, then how come it’s so normal to think and talk about disabilities as if they were strictly personal attributes? Why on Earth would anybody feel it necessary to point out the obvious: that these kinds of environmental adjustments imply that it’s the particular environment that’s broken, not the person?

A complete analysis of that question is probably beyond the scope of a single blog post, but here I can suggest that a key ponderable might be found in the economist’s idea of an external cost. A basic problem is that disabilities can be costly — not just financially, but also in terms of time, stress, etc. — and it seems intuitively obvious that these costs should be billed to and paid by the owner of the disability in question, whoever that may turn out to be. But each of these perspectives on disability implies potentially very different owners. On the one hand, the personal model suggests that these costs belong entirely to, and should be paid by the disabled person. In essence, it holds the disabled person accountable for having the wrong features and effectively tells that person “it’s your problem, so deal with it!” But the environmental model suggests that these costs should be paid by the owner or owners of the disabling environment. To the extent that the environment isn’t owned by the disabled person, then whoever does own the environment should pay to have the environment fixed. In effect, the environmental model holds to account the environment’s owners for causing disabilities in certain kinds of people and says to them “it’s your problem, so deal with it!”

Given that nobody chooses a disability, we can rightly wonder how any of us would dare to blame a disabled person for being disabled. Clearly we can’t hold people accountable for the whims of blind chance? Furthermore, given that environments are vastly more fixable than are the kinds of neurological and/or anatomical features that have been traditionally viewed as disabilities, why on Earth would we reject the more hopeful and optimistic environmental model of disability over the pessimistic and hopeless victim-blaming personal model?

Again, without trying to pronounce the last word on what is surely too complicated a problem to address in a single blog post, I hereby propose that this notion of external cost merits serious consideration. The upshot here, unfortunately, is the unflattering suggestion that we incline towards the personal model to the extent that we wish to avoid paying the costs of the disability. To the extent this is true, then adopting the personal model is in no small measure a strategy for externalizing onto disabled people costs that the rest of us ought to pay.

Continue with Part 3

Before you leave, you may wish to enjoy this YouTube video that debunks the myth that George Washington had wooden teeth:

[1] from Landsburg, Steven E., Price Theory and Applications, 9th edition, 2014, 2011, Cengage Learning, Stamford, CT., page 413

[2] The history of functional prosthetic devices (in contrast to the merely cosmetic) has been dated by archaeologists to roughly 3000 years ago. For a fascinating overview, see A Brief History of Prosthetic Limbs, JSTOR Daily, July 21, 2017, last accessed Feb. 3, 2018.

Image Credit (sprinter with prosthetic legs): Pixabay


  1. What always gets me is how the parents get blamed for their kid being autistic because they CLEARLY did something wrong–wrong diet, got them immunized, didn’t treat them with this or that essential oil, don’t do this, did do that…it’s always the parents’ fault somehow. And if they would just (insert thing here that makes no sense whatsoever) their kid would be fiiiiiiiiiine.

    Liked by 2 people


    1. I’m sorry to know that this kind of thing still happens. It was my understanding that the blame-the-parents theories have all been discredited. I guess that’s just among those who actually have expertise in the matter.



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