Session 10: Perspectives on Illness, Wellness and Disability
Chair: Paula Feder-Bubis

Health, Wellbeing, Potential and Capability
Iain Law
University of Birmingham, Birmingham, United Kingdom

How we conceive of the ‘well person’ depends upon how we conceive of health, disease and related concepts.  For example, for those who think of health as a ‘maximal’ standard, even relatively minor ailments and impairments will be seen as disease or disability.  Moreover, not only physical ailments but psychological, emotional and relational elements may also contribute to health.  On the other hand, those who see ‘disease’ as the primary concept will regard ‘curing’ as simply reaching a normal standard of functioning.
In order to address these issues, this paper will begin with the WHO definition of ‘health’ as ‘a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’ (WHO, 1948)  It will explore the three main criticisms of this definition, namely that making health a state of ‘complete’ wellbeing sets an implausibly high standard for health (Lewens & MacMillan, 2004); that in addition to defining health we need a separate definition of disease, since the two are not necessarily mutually exclusive and exhaustive (Hofmann, 2002); and that this definition merely collapses into an inadequately defined concept of wellbeing (Boorse, 1975).
In response to these criticisms, this paper will draw on the ‘capabilities’ approach to wellbeing proposed by Sen and Nussbaum (1985, 1993, 2000).  It will suggest that this approach has the resources to address these criticisms, and also utilises the best elements of other recent definitions of health in the literature (Kovacs, 1998, Bircher, 2005).  In particular, it offers a comprehensive and plausible account of wellbeing, which includes psychological, emotional and social elements while not requiring unrealistic and idealistic standards for health.  It also permits flexibility in accounting for related concepts of impairment, disability, disease and illness, since it is capable of accommodating differences in attitudes and circumstances.

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Physically Disabled People's Attitudes to End-of-Life Issues: Preparing for Fieldwork
Margo Milne
Open University, Milton Keynes, United Kingdom

This paper describes preparatory work for PhD fieldwork into physically disabled people’s attitudes to end-of-life issues, such as physician-assisted suicide and Do Not Attempt Resuscitation orders. National organisations attribute widely opposed opinions on end-of-life issues to “disabled people” as a whole. Polls have compared the opinions of “disabled people” with those of the general population , but only very limited work has been done attempting to identify whether sub-groups exist within the population of disabled people with different attitudes to these issues.
This paper will discuss the proposed methodology for the forthcoming fieldwork stage of the project, which aims to identify sub-groups of physically disabled people with different attitudes to end-of-life issues and examine some possible reasons for those differences. It will also consider some relevant ethical issues.
A mixed methodology design will be used. Qualitative data from a focus group, a useful method for accessing marginal groups, will inform the design of a questionnaire incorporating vignettes of end-of-life decision-making. Participants will indicate to what extent they agree with the decisions made in the vignettes. These responses will be correlated with respondents’ type and degree of disability, social class and other factors in an attempt to identify any differences in responses existing between sub-groups divided on these variables.

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Queering Illness: Issues of Stigma and Disclosure in Chronic Illness
Kimberly Myers
Department of English, Montana State University, Bozeman, MT, USA

Important parallels exist between coming out as a queer person and coming out as a person with illness:  both involve a norm (or norms) and varying degrees of deviance from that norm; both operate on a continuum ranging from denial to self-acknowledgment to self-disclosure; both potentially involve significant risks in personal, social, and professional spheres; and both can include internalized shame and guilt.  Utilizing both theoretical and experiential frameworks, this paper explores key concerns surrounding coming out as a person with chronic illness.

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