Enhancement, disability and the riddle of the relevant circumstances.

The welfarist account of enhancement and disability holds enhanced and disabled states on a spectrum: the former are biological or psychological states that increase the chances of a person leading a good life in the relevant set of circumstances, while the latter decrease those chances. Here, I focus on a particular issue raised by this account: what should we count as part of an individual's relevant set of circumstances when thinking about enhanced and disabled states? Specifically, is social prejudice relevant to an individual's circumstances in regards to how disabled or enhanced they are? For instance, if an individual is discriminated against on the basis of their skin colour, and this leads to a reduction in their well-being, the welfarist account suggests that their skin colour is a disability. To avoid such a seeming mislabel, Savulescu and Kahane have argued for excluding social prejudice from counting as a relevant circumstance to their welfarist definition of disability. I argue, however, that this exclusion of social prejudice is unsatisfactory and incompatible with the goals of this account. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/