Disadvantage in Context: From Microaggressions to Healthcare Policy

Abstract

Many dimensions of applied ethics appeal to consequentialist moral theories to evaluate the moral permissibility of an action, practice, or policy. But such an approach risks obscuring other, non-consequentialist concerns. In line with this worry, this dissertation seeks to clarify and morally examine three phenomena that may compound the disadvantages that members of historically and currently disadvantaged groups face: microaggressions, the promotion of prenatal testing for selective abortion, and the allocation of scarce medical resources. Chapter 1, “Disadvantage in Context,” describes the notion of disadvantage that is relevant to this dissertation and explains the relation between Chapters 2-4. Chapter 2, “Microaggressions: What’s the Big Deal?” argues that the standard view of microaggressions, which holds that microaggressions are harmful because they express devaluing messages about members of disadvantaged groups, is too underdeveloped both for identifying microaggressions and for explaining why they are morally objectionable. I then offer an improved account of microaggressions according to which it is the content of what is expressed that determines when microaggressions are morally objectionable. Chapter 3, “When Is the Promotion of Prenatal Testing for Selective Abortion Wrong?” addresses the imprecisions of the expressivist objection to prenatal testing, which maintains that when medical professionals promote the use of prenatal testing for abortion on grounds of disability, they express a harmful, devaluing message to and about extant disabled people. I then offer an improved formulation of this objection according to which the promotion of prenatal testing for selective abortion is sometimes wrong. Chapter 4, “Indirect Benefits and Double Jeopardy in the Allocation of Scarce, Lifesaving Resources,” examines the question of whether or not benefits to third parties, e.g., saving their lives or improving socioeconomic conditions, should count when resources are scarce and not all can be saved. By recruiting the notion of ‘double jeopardy,’ which, as I argue, can be understood in two distinct ways, I aim to give a stronger foundation for the idea that counting indirect benefits such as social contribution would be wrong—at least given certain social conditions.