Jill Stein, Autism, and Disability Liberation

by Sophia Burns on September 2, 2016

Jill Stein doesn’t reject mainstream medicine. Maybe she should.

During an interview with Jacobin last week, Stein received a question about vaccinations and the role of anti-science elements in her party. Much of the coverage she’s lately been getting from mainstream news has focused on her supposedly being anti-vaccination. Stein rightly rejected the accusation and confirmed her support for vaccinations, saying:

“One [issue] is whether or not vaccines are a threat. They’re not, not by any evidence we have.”

In the same interview, though, she indirectly alluded to the anti-vaccination conspiracy theory that vaccines cause autism. She denies thinking that vaccines lead to developmental disabilities (in context, she presumably means autism in particular). However, she then affirms the worries some people have about the number of autistic people:

“The other point that’s really important here is that people are really alarmed about developmental disabilities. There is compelling public health evidence that these are growing trends…You have to study a whole community and you have to study people before they develop disease. You’re tracking what are they eating, what medications are they taking, how much social stress are they under, what chemicals are they exposed to, etc. Do they smoke, do they exercise? You track all that. It’s called a prospective epidemiological study…This kind of study needs to be done about developmental disabilities.”

Now, “autism is on the rise” is a narrative that does not enjoy scientific consensus. However, the disputed nature of that particular claim of fact should concern socialists less than the deeper attitude she displays. Stein characterizes autism with the language of disease, treating it as a public health problem, and at one point implicitly comparing it to heart disease. She hints that “environmental toxins” (other than vaccines) might cause people to be autistic. The corollary seems to be that in a properly Green society, many fewer autistic people would exist (and Stein would appear to consider that a good thing).

Where does this particular concept of autism come from? Are there any legitimate alternatives? Most importantly, is Stein’s medical approach to autism compatible with the socialist values of communal economics, freedom, and human dignity?

Eugenics, Eugenics Everywhere

Talking about contemporary leftist and medical views of disability means talking about the history of eugenics.

Briefly, the eugenics movement in the US emerged in the late 19th century from a matrix of Victorian “scientific racialism,” social Darwinism, and the emerging field of genetics. Eugenicists believed that through selective breeding, progressively “superior” humans could be created each generation. This vision had little room for people of color, “degenerates,” and disabled people – and the eugenicists brought down the full coercive power of the state to enforce their agenda. The US government targeted poor women, women of color, and disabled women (and a smaller number of men) for nonconsensual sterilization, codified into the laws of more than 30 states. Further, eugenics was never an exclusively right-wing cause. It found support across the political spectrum, attracting not just reactionaries but also radicals such as W. E. B. Du Bois, Upton Sinclair, and Margaret Sanger. Sanger went so far as to declare:

“Today Eugenics is suggested by the most diverse minds as the most adequate and thorough avenue to the solution of racial, political and social problems. The most intransigent and daring teachers and scientists have lent their support to this great biological interpretation of the human race.”

After World War 2, open eugenics subsided in mainstream discourse. After all, Hitler’s explicit citation of US eugenics as a model for his own programs deeply undermined the ideology’s credibility. However, its disappearance as an organized political movement did not mean it went away. State-sponsored forced sterilizations continued into the 21st century, and Buck v. Bell – the Supreme Court’s endorsement of eugenics laws – still has not been overturned.

Additionally, the cultural and medical attitudes emerging from eugenics have remained strong. Certain pro-choice arguments and pop-culture artifacts like the film Idiocracy express strains of eugenicist logic, and recent genetic science sometimes facilitates disability-selective abortion. (To be clear, reproductive autonomy and reproductive justice are a sine qua non for any authentic socialism or feminism. Abortion should be provided free, on demand, no questions asked, and without apology – and abortion access matters because it’s part of feminist liberation and bodily self-determination, not because disabled people are somehow better off never living.)

Eugenics never really left. But what does that have to do with autism and Jill Stein?

“Nothing About Us Without Us”

Beginning in the 60s, the disability liberation movement identified two competing models of disability. On the one hand, there’s the medical model. The medical model defines disabled people’s bodies and/or brains as abnormal – disability, it claims, is basically a matter of having a diagnosable medical condition, analogous to any other illness or injury. To be disabled is to lack some of the capacities that normal people have, and to have a reduced quality of life as a result.

Negating the medical model is the social model. According to the social model, human brains and human bodies have a legitimate existence as they are, and they are not all the same. Some bodies walk. Others don’t. Some people communicate through spoken words. Others do so through sign languages, or through other means entirely. None of that is necessarily “damaged.” No brain and no body is inherently disabled. Rather, the physical and cultural structures of any given society are built to be used by some bodies and not others. “Normal” brains and bodies are the ones for which physical and social environments are built. “Abnormal” ones aren’t intrinsically defective – rather, it’s the environment that isn’t sufficiently accessible. Disabled people don’t “have a disability” (much less “suffer from a handicap”); instead, they are disabled by the inaccessible features of the society around them. It’s the context that disables them, not their embodiment.

The medical model says a wheelchair user is disabled by their legs. The social model says they’re disabled by the steps.

The current medical model grew from medicine’s historical alignment with eugenics. Eugenics is an ideology of human “betterment,” emerging from the use of coercive medicine to control the most oppressed working-class communities in the deepest possible way. The medical model treats contextually-determined standards of “normalcy” as objective biological facts; many of its most direct political implications continue the eugenicist practice of violence “for people’s own good.” For instance, physician-assisted suicide laws give cover to doctors enforcing the notion that disabled lives lack dignity, lack quality, and are not worth living. In some cases, they prioritize doctors’ assessments that some disabled people should die over those individuals’ stated desire to continue living, as documented by disability rights groups such as Not Dead Yet and the Disability Rights Education & Defense Fund.

At the root, though, both the medical and social models beg the question: what, exactly, does “normal” mean?

“High-Funtioning” Autism: Who Benefits?

“The ideas of the ruling class are in every epoch the ruling ideas…”

–   Karl Marx, The German Ideology

In the case of autism, the dominant model of relative normalcy centers on the level-of-functioning spectrum. Autistic people who require help with the activities of daily living, who don’t use spoken words, and who cannot hold paid jobs get designated “low-functioning.” Conversely, those who can sometimes pass as non-autistic, who need less direct personal care, and who can make money in the capitalist workplace are “high-functioning” (with a range of intermediate levels for everyone else). What determines which abilities count as highly functional, though? What qualifies certain activities as integral to “normalcy,” but not others?

As autistic self-advocates have pointed out, the standards behind high and low function seem fairly arbitrary. If you choose to prioritize one set of abilities, an individual might seem extremely high-functioning; if you choose a different set, the same person might seem to barely function at all. However, the medical profession – and, in tandem, state agencies such as the Social Security Administration – pick one kind of functioning and treat it as definitive. For them, high function means not needing a caregiver, being able to maintain workplace-appropriate hygiene, having the capacity to show up to work on time, and (most of all) getting and holding a job. The last one determines, in the end, all the others.

What function does a high-functioning autistic person have, specifically? The same as every other working-class person: generating value to enrich the capitalist ownership class. Healthcare infrastructure and government agencies don’t somehow float around outside capitalism. They administer it. Part of that task is getting disabled people to work (and official standards of normalcy and function largely serve to determine who gets basic survival services and who just gets told to get a job). That also involves developing, and sometimes forcibly imposing, methods to mold disabled people into more easily exploitable workers. As the likelihood that a disabled person can be so molded drops, mainstream medicine becomes increasingly comfortable letting them die or actively killing them.

Nonprofits that oppose a disability liberation stance, such as Autism Speaks, consistently reinforce that policy. (Autism Speaks itself tends to mask its extreme anti-autism with quixotic calls for a “cure.” According to the neurodiversity paradigm, which applies the social model to psychological and neurological conditions, autism is a way of being, not an injury or illness. So, “curing” it is as nonsensical and impossible as curing one’s shoe size, and the techniques Autism Speaks endorses are inherently violent and abusive. Applied Behavioral Analysis, for instance, simply repurposes the methods originally developed for anti-gay conversion therapy to suppress mannerisms that many autistic people share.) Sometimes, this includes publicly fantasizing about murdering people for being autistic. That’s all part of the ideological and political superstructure that props up the enforcer roles of medicine and the state.

The dominant medical model, like its eugenicist ancestor, weaponizes medicine to coerce disabled people into the capitalist workforce. Part of that mission involves punishing disabled people who can’t be integrated into employment. That deters some disabled people from seeking assistance even if they actually need it; after all, the ruling class doesn’t care if your job damages your health as long as you show up for work. The elaborate eligibility restrictions for public assistance have only intensified under neoliberal austerity, despite the massive harm that causes. Of course, austerity also keeps the government’s medical budgets down. Capitalism doesn’t want to spend any more resources than it has to on the social reproduction of the working class, especially when it involves unemployable disabled people.

But what does this have to do with Jill Stein, whose opposition to neoliberalism is central to her platform?

Hegemony, Common Sense, and Class Solidarity

Stein’s position on autism reflects the current medical model. She characterizes autism and other developmental disabilities in exclusively negative terms, and while she rightly criticizes the FDA’s blatant corruption, her line on autism still falls in line with mainstream ideas. Leftists, both abled and disabled, should reject and critique that position, even (perhaps especially) when their most prominent spokespeople endorse it. However, this isn’t an allyship-model call for support based on morality. Rather, adopting the social model of disability is the legitimate self-interest of the abled working class.

The Italian communist Antonio Gramsci’s theory of cultural hegemony is key here. The common sense shared across a society doesn’t necessarily reflect either material reality or most people’s self-interest. Common sense, instead, comes from the massive cultural clout of the ruling class. In the US, it’s common sense that hard workers do better. That’s factually false; most rich people inherited their wealth, and working class people do all the work and get very little out of it. The medical model seems intuitively true to most people, but that’s because of the same mechanism. It sounds self-evident only because it lines up with ruling-class cultural hegemony. The medical model, in practice, does not benefit anyone except the ruling class.

In fact, it actively hurts abled as well as disabled working-class people. Producerism – the notion that a “truly productive” working class is exploited by an unemployed underclass – has only ever served the ruling class. It breaks working-class unity by pitting working-class people against each other, and it subtly legitimates the imaginary “job creating” role of the ownership class. Additionally, it’s generally served to reinforce white supremacy, nativism, and antisemitism by appealing to stereotypes of “lazy” and “parasitic” people of color, immigrants, and Jewish people. Often, it’s racism’s primary method – it’s especially apparent in “immigrants will bankrupt social services” xenophobia and Reagan/Clinton style “welfare cheat” dog whistles. As the ruling class well knows, nothing undermines socialism like the socialism of fools.

The medical model of disability contains a subtle producerism. If disability is something that’s medically wrong with an individual, and if normalcy and functionality generally get defined according to one’s ability to hold capitalist employment, then to be disabled is to mooch off of others while giving little back. In reality, though, all cooperative human activity is work. Unemployed disabled people aren’t a parasitic burden on employed workers. They’re part of working class communities, and part of the process of social reproduction. Only the ruling class has a reason to think they’re “useless to society” – for the ruling class, “useful to society” means exploited by them!

To be clear, Jill Stein is not out there decrying “degenerate social parasites” and claiming that disabled people ought to be murdered. She isn’t calling for more nonconsensual sterilization or new eugenics laws. Rather, she’s incorporating hegemonic common sense and the medical model into her politics. In this case, common sense is only good for the ruling class. It’s bad for everyone else. The medical model of disability, in particular, is acutely dangerous for disabled people, more subtly so for abled workers, and not a very accurate description of reality in any case. Stein and the rest of the Left should disavow the dominant theory of disability, the medical model.

Instead, the Left should embrace the social model. It should reject value systems that equate functionality, human worth, and quality of life with having a capitalist job. “An injury to one is an injury to all” isn’t an ethical imperative. It’s a description of reality. Stein’s advocacy for the medical model undermines working-class solidarity. It gives capitalist anti-autism a progressive endorsement it does not deserve. Working-class self-liberation necessarily involves replacing the Protestant work ethic with an ethic of solidarity, support, and universal worth. The medical model belongs to the former and the social model to the latter. Without disability liberation and its refusal of producerism, doing away with capitalism cannot logistically be done.

So let’s all reject mainstream medicine (whenever it pushes the medical model of disability). Let’s fight for an application of medical science that recognizes that both disabled and abled lives carry the potential for meaning and deserve the same fundamental dignity. As Emma Lazarus said,

“Until we are all free, we are none of us free.”

 


Sophia Burns is a member of TNS’s editorial board and an officer in the Communist Labor Party. Their work can also be found at Gods&Radicals.

 

{ 1 comment… read it below or add one }

D.B. Cooper September 5, 2016 at 2:12 am

This is a good article, the only comment I have right now is to point out the mis-interpretation of “an injury to one is an injury to all”. It’s not at all a “description of reality”, it’s not meant to be.

From the IWW’s constitution (the origin of this version of the phrase): “These conditions can be changed and the interest of the working class upheld only by an organization formed in such a way that all its members in any one industry, or in all industries if necessary, cease work whenever a strike or lockout is on in any department thereof, thus making an injury to one an injury to all.”

An injury to one is not naturally and inherently an injury to all, not directly at least. Instead it’s a state of reality that we consciously decide to make.

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