The medical and social model of disability is discussed and debated among researchers, scholars, activists, and people in general. It is common to hold a mixed view and believe that some disabled people suffer more from social obstacles and others more from medical problems inherent in their bodies or minds. Rachel Cooper discusses possible ‘test environments’, making explicit an idea which likely plays an implicit part in many disability discussions. We place or imagine placing the disabled person in a range (...) of different environments. If there is a relevant test environment in which they do fine, their problem was societal/external; if there is not, it was medical/internal. Cooper admits that deciding on the appropriate range of test environments is an ethical and political question. In this chapter, I argue that we often ought to widen our scope when discussing psychiatric disabilities. (shrink)

Exemption from blameworthiness is often bound to implicit or explicit claims of diminished agency, or even non-agency. This poses a dilemma in navigating moral relationships affected by mental illness. While it is crucial for assessments of responsibility to be responsive to the significance of mental illness, must this responsiveness come at a cost to symmetrical moral relations? In this paper we argue, contra recent critiques, that Strawsonian accounts of responsibility are able to navigate this dilemma, and can accommodate significant exculpation (...) on the basis of mental illness while maintaining symmetrical relations. We understand this to be part of the larger recognition that while we have certain fundamental entitlements within our moral relationships, it is also possible to be over-entitled, and to expect too much of others. Our account draws, in particular, on the moral significance of difficulty. Difficulty is inherently scalar, and in drawing on this explanatory framework we explicate a theory of both excuse and exemption by degree. We argue for a significant realm of excuse on the basis of mental illness that is fully compatible with symmetrical relations. However, we also acknowledge the limits of this accommodation on Strawsonian grounds, and argue that these limits are justified and appropriate. (shrink)