Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-27T19:50:35.109Z Has data issue: false hasContentIssue false

Autism, Neurodiversity and the Welfare State: The Challenges of Accommodating Neurological Difference

Published online by Cambridge University Press:  01 May 2013

Michael Orsini*
Affiliation:
University of Ottawa
*
Michael Orsini, School of Political Studies, University of Ottawa, 120 University Private (11002), Ottawa, ON K1N 6N5, email: [email protected]

Abstract

Abstract. In the last decade, autism has become one of the most hotly contested health policy issues in North America and beyond. From debates about the role of vaccines to the efficacy of therapeutic interventions, a range of civil society actors has been advocating for policy and societal change in the field, with mixed success. In Canada, this culminated in 2004 with a much-publicized Supreme Court decision—Auton v. British Columbia—that pitted parents of autistic children against the BC government, which was unwilling to cover the costs of behavioural treatment for autistic children. In contrast to parent-led advocacy groups, there has been a flurry of civil society activity waged by autistic self-advocates who decry the focus on curing autistic people and press instead for the recognition of neurological difference. Drawing on interviews with advocates in Canada and the US, this article highlights these contending perspectives and argues that both pose fundamental challenges to how we view the redistributive aims of the welfare state in Canada and beyond.

Résumé. Au cours de la dernière décennie, l'autisme est devenu l'un des enjeux les plus controversés dans le domaine de la santé au Canada et à l'étranger. Que ce soit lors de débats sur le rôle des vaccins ou encore sur l'efficacité des interventions thérapeutiques, plusieurs acteurs de la société civile ont milité, avec un succès mitigé, en faveur de changements dans politiques et sociaux par rapport à l'autisme. Au Canada, cet activisme résultera en une décision fort controversée de la Cour Suprême en 2004, Auton v. Colombie-Brittanique, portant sur un conflit entre les parents d'enfants autistes et le gouvernement de la Colombie-Britannique, qui refusait de payer le coût des traitements pour les enfants autistes. En parallèle au militantisme des parents d'enfants autistes, des individus autistes se sont aussi mobilisés pour dénoncer cette fois l'objectif même de guérir les personnes autistes. Ces derniers exigent plutôt que soient reconnues leurs différences et, de manière plus large, le principe de la diversité neurologique. Se basant sur des entrevues avec des militants et des militantes, cet article présente ces différentes perspectives et démontre qu'elles remettent en question la façon dont nous conceptualisons le modèle de redistribution associé à l'État-providence.

Type
Research Article
Copyright
Copyright © Canadian Political Science Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abu-Laban, Yasmeen and Gabriel, Christina. 2002. Selling Diversity: Immigration, Multiculturalism, Employment Equity and Globalization. Peterborough: Broadview Press.Google Scholar
Armstrong, Thomas. 2010. Neurodiversity: Discovering the Extraordinary Gifts of Autism, ADHD, Dyslexia and Other Brain Differences. Cambridge MA: Da Capo Press.Google Scholar
Arneil, Barbara. 2009. “Disability, Self Image, and Modern Political Theory.” Political Theory 37 (2): 218–42.Google Scholar
Autistic Self Advocacy Network. Website. “An Urgent Call to Action: Tell NYU Child Study Center to Abandon Stereotypes Against People with Disabilities,” Dec. 7, 2007. http://www.autisticadvocacy.org/modules/smartsection/item.php?itemid=21 (Jan. 13, 2012).Google Scholar
Baker, Dana Lee. 2011. The Politics of Neurodiversity: Why Public Policy Matters. Boulder CO: Lynne Rienner Publishers.Google Scholar
Banting, Keith, Johnston, Richard, Kymlicka, Will and Soroka, Stuart. 2006. “Do Multiculturalism Policies Erode the Welfare State? An Empirical Analysis.” In Multiculturalism and the Welfare State: Recognition and Redistribution in Contemporary Democracies, ed. Banting, Keith and Kymlicka, Will. Oxford: Oxford University Press.Google Scholar
Banting, Keith. 2010. “Is There a Progressive's Dilemma in Canada? Immigration, Multiculturalism and the Welfare State.” Presidential Address to the Canadian Political Science Association. Canadian Journal of Political Science 43 (4): 797820.Google Scholar
Banting, Keith and Kymlicka, Will. 2006. Multiculturalism and the Welfare State: Recognition and Redistribution in Contemporary Democracies. Oxford: Oxford University Press.Google Scholar
Baron-Cohen, Simon. 1997. Mindblindness: An Essay on Autism and Theory of Mind. Cambridge MA: MIT Press.Google Scholar
Brown, Phil, Zavestoski, Stephen, McCormick, Sabrina, Mayer, Brian, Morello-Frosch, Rachel, and Altman, Rebecca Gasior. 2004. “Embodied Health Movements: New Approaches to Social Movements in Health.” Sociology of Health and Illness 26 (1): 5080.Google Scholar
Bumiller, Kristin. 2008. “Quirky Citizens: Autism, Gender and Reimagining Disability.” Signs: Journal of Women in Culture and Society 33 (4): 967–91.Google Scholar
Carey, Allison C. 2009. On the Margins of Citizenship: Intellectual Disability and Civil Rights in Twentieth-Century America. Philadelphia: Temple University Press.Google Scholar
Centers for Disease Control and Prevention. 2012. “Prevalence of Autism Spectrum Disorders—Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2008.” Morbidity and Mortality Weekly Report 61 (31): 119.Google Scholar
Chamak, Brigitte. 2008. “Autism and Social Movements: French Parents' Associations and International Autistic Individuals' Organizations.” Sociology of Health and Illness 30 (1): 7696.Google Scholar
Cowen, Tyler. 2009. Create Your Own Economy: The Path to Prosperity in a Disordered World. New York: Dutton.Google Scholar
Davidson, Joyce and Henderson, Victoria L.. 2010. “‘Coming out’ on the spectrum: autism, identity and disclosure.” Social & Cultural Geography 11 (2): 155–70.Google Scholar
Davis, Lennard J. 2002. Bending over Backwards: Disability, Dismodernism and Other Difficult Positions. New York and London: New York University Press.Google Scholar
Dawson, Michelle. 2004a. “An Autistic at the Supreme Court, The Auton Case: The Intervener's Factum.” http://www.sentex.net/%7Enexus23/naa_fac.html (accessed Jan. 13, 2012).Google Scholar
Dawson, Michelle. 2004b. “The Many Varieties of Being Written Off: An Argument about Autism as Catastrophe.” http://www.sentex.net/~nexus23/naa_wro.html (Jan 13, 2012).Google Scholar
Dhamoon, Rita. 2009. Identity/difference politics: How difference is produced, and why it matters. Vancouver: University of British Columbia Press.Google Scholar
Eisenberg, Avigail, ed. 2006. Diversity and Equality: The Changing Framework of Freedom in Canada. Vancouver: University of British Columbia Press.Google Scholar
Esping-Andersen, Gosta. 1990. “Three Worlds of Welfare Capitalism.” In The Welfare State Reader, ed. Pierson, Christopher and Castles, Francis. Malden MA: Polity Press.Google Scholar
Esping-Andersen, Gosta (with Gallie, Duncan, Hemerijck, Anton and Myles, John). 2002. Why We Need a Welfare State. Oxford: Oxford University Press.Google Scholar
Eyal, Gil, Hart, Brendan, Onculer, Emine, Oren, Nita and Rossi, Natasha. 2010. The Autism Matrix: The Social Origins of the Autism Epidemic. Cambridge: Polity Press.Google Scholar
Families for Early Autism Treatment of British Columbia. 2007. “Ottawa's Ongoing Refusal to Provide Autism Health Care,” Media release, Feb. 26.Google Scholar
Frank, Arthur W. 2002. “Why Study People's Stories? The Dialogical Ethics of Narrative Analysis.” International Journal of Qualitative Methods 1(1): 109–17.Google Scholar
Ghaziuddin, Mohammad. 2010. Brief Report: Should the DSM V Drop Asperger Syndrome? Journal of Autism and Developmental Disorders 40: 1146–48.Google Scholar
Government of Canada. 2010. Federal Disability Report: The Government of Canada's Annual Report on Disability. Ottawa: Human Resources and Skills Development Canada. Cat. No HS61-1/2010.Google Scholar
Greschner, Donna and Lewis, Steven. 2003. “Auton and Evidence-Based Decision-Making: Medicare in the Courts.” Canadian Bar Review 82: 501–35.Google Scholar
Grinker, Roy Richard. 2010. “Disorder out of Chaos,” New York Times, February 10, op. ed.Google Scholar
Hacking, Ian. 2009. “Humans, aliens & autism.” Daedalus Summer: 4459.Google Scholar
Hankivsky, Olena. 2004. Social Policy and the Ethic of Care. Vancouver: University of British Columbia Press.Google Scholar
Harell, Allison and Stolle, Dietlind. 2010. “Diversity and Democratic Politics: An Introduction.” Canadian Journal of Political Science 43 (2): 235–56.Google Scholar
Jaarsma, Pier and Welin, Stellan. 2011. “Autism as a Natural Human Variation: Reflections on the Claims of the Neurodiversity Movement.” Health Care Analysis (February): 116.Google Scholar
Jenson, Jane. 1989. “‘Different’ but not ‘Exceptional’: Canada's Permeable Fordism.” Canadian Review of Sociology and Anthropology 26(1): 6994Google Scholar
Jenson, Jane and Papillon, Martin. 2000. Backgrounder: Citizenship and the Recognition of Cultural Diversity: The Canadian Experience. Ottawa: Canadian Policy Research Networks.Google Scholar
Jenson, Jane and Phillips, Susan D.. 1996. “Regime Shift: New Citizenship Practices in Canada.” International Journal of Canadian Studies 14 (Fall): 111136.Google Scholar
Jenson, Jane and Saint-Martin, Denis. 2003. “New Routes to Social Cohesion? Citizenship and the Social Investment State.” Canadian Journal of Sociology 28 (1): 7799.Google Scholar
Kershaw, Paul. 2005. Carefair: Rethinking the Rights and Responsibilities of Citizenship. Vancouver: University of British Columbia Press.Google Scholar
Kershaw, Paul. 2008. “Social Care.” In Recasting the Social in Citizenship, ed. Isin, Engin. Toronto: University of Toronto Press.Google Scholar
Kittay, Eva. F. and Carlson, Licia, eds. 2010. Cognitive Disability and Its Challenge to Moral Philosophy. London: Wiley-Blackwell.Google Scholar
Kymlicka, Will. 2007. Multicultural Odysseys: Navigating the New International Politics of Diversity. Oxford: Oxford University Press.Google Scholar
Lee, Theresa Man King. 2006. “Multicultural Citizenship: The Case of the Disabled.” In Critical Disability Theory: Essays in Philosophy, Politics, Policy and Law, ed. Devlin, Richard and Pothier, Dianne. Vancouver: University of British Columbia Press.Google Scholar
Lightman, Ernie, Vick, Andrea, Herd, Dean and Mitchell, Andrew. 2009. “Not Disabled Enough: Episodic Disabilities and the Ontario Disability Support Program.” Disability Studies Quarterly 29 (3) 116.Google Scholar
Linton, Simi. 2007. My Body Politics: A Memoir. Ann Arbor, MI: University of Michigan Press.Google Scholar
Manfredi, Chris and Maioni, Antonia. 2005. “Litigating Innovation: Health Care Policy and the Canadian Charter of Rights and Freedoms.” Paper presented at the annual meeting of the Canadian Political Science Association, London, Ontario.Google Scholar
Marshall, T.H. 1950. Citizenship and Social Class, and Other Essays. Cambridge, UK: Cambridge University Press.Google Scholar
Murray, Stuart. 2012. Autism. London and New York: Routledge.Google Scholar
Novas, Carlos. 2006. “The Political Economy of Hope: Patients' Organizations, Science and Biovalue.” BioSocieties 1: 289305.Google Scholar
Orsini, Michael. 2009. “Contesting the Autistic Subject: Biological Citizenship and the Autism/Autistic Movement.” In Critical Interventions in the Ethics of Health Care, ed. Murray, Stuart and Holmes, Dave. London: Ashgate.Google Scholar
Orsini, Michael and Smith, Miriam. 2010. “Social Movements, Knowledge and Public Policy: The Case of Autism Activism in Canada and the US.” Critical Policy Studies 4 (1): 3857.Google Scholar
Ortega, Francisco. 2009. “The Cerebral Subject and the Challenge of Neurodiversity.” BioSocieties 4: 425–45.Google Scholar
Pothier, Dianne and Devlin, Richard. 2006. “Introduction: Toward a Critical Theory of Dis-Citizenship.” In Critical Disability Theory: Essays in Philosophy, Politics, Policy, and Law, ed. Pothier, Dianne and Devlin, Richard. Vancouver: University of British Columbia Press.Google Scholar
Prince, Michael J. 2009. Absent Citizens: Disability Politics and Policy in Canada. Toronto: University of Toronto Press.Google Scholar
Rabinow, Paul. 1996. Essays on the anthropology of reason. Princeton NJ: Princeton University Press.Google Scholar
Rose, Nikolas. 2006. The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-First Century. Princeton NJ: Princeton University Press.Google Scholar
Rose, Nikolas and Novas, Carlos. 2005. “Biological citizenship.” In Global assemblages: Technology, politics and ethics as anthropological problems, ed. Ong, Aihwa and Collier, Stephen J.. London: Blackwell.Google Scholar
Shakespeare, Tom. 2006a. Disability Rights and Wrongs. New York and London: Routledge.Google Scholar
Shakespeare, Tom. 2006b. “The Social Model of Disability.” In The Disability Studies Reader, ed. Davis, Lennard J.. 2nd ed. New York and London: Routledge.Google Scholar
Silverman, Chloe. 2012. Understanding Autism: Parents, Doctors, and the History of a Disorder. Princeton NJ: Princeton University Press.Google Scholar
Smith, Miriam. 2009. “Diversity and Canadian Political Development.” Presidential Address to the Canadian Political Science Association. Canadian Journal of Political Science 42 (4): 831–54.Google Scholar
Somers, Margaret. 2008. Genealogies of Citizenship: Markets, Statelessness and the Right to Have Rights. Cambridge: Cambridge University Press.Google Scholar
Sparrow, Robert. 2005. “Defending Deaf Culture: The Case of Cochlear Implants.” The Journal of Political Philosophy 13 (2): 135–52.Google Scholar
Standing Senate Committee on Social Affairs, Science and Technology. 2003. First Meeting on Mental Health and Mental Illness, Proceedings, issue 9, February 26.Google Scholar
Standing Senate Committee on Social Affairs, Science and Technology. 2007. Pay Now or Pay Later: Autism Families in Crisis, Final Report, March.Google Scholar
Statistics Canada. 2007. Participation and Activity Limitation Survey 2006: Tables. Ottawa: Statistics Canada (Cat. No. 89-628-XIE - No. 003).Google Scholar
Tiedemann, Marlisa. 2008. Health Care at the Supreme Court of Canada: Auton (Guardian Ad Litem of) v. British Columbia (Attorney General). Ottawa: Parliamentary Information and Research Service.Google Scholar
Valentine, Fraser and Vickers, Jill. 1996. “Released from the Yoke of Paternalism and Charity: Citizenship and the Rights of Canadians with Disabilities.” International Journal of Canadian Studies 14 (fall): 155–77.Google Scholar
Wikler, Daniel. 2010. “Cognitive Disability, Paternalism and the Global Burden of Disease.” In Cognitive Disability and Its Challenge to Moral Philosophy, ed. Kittay, Eva. F. and Carlson, Licia. London: Wiley-Blackwell.Google Scholar
Wolff, Jonathan. 2010. “Cognitive Disability in a Society of Equals.” In Cognitive Disability and Its Challenge to Moral Philosophy, ed. Kittay, Eva F. and Carlson, Licia. London: Wiley-Blackwell.Google Scholar