Parental Autonomy, Children with Disabilities, and Horizontal Identities

Abstract

Ordinarily, parents have broad authority to make medical decisions for their children. This chapter explores whether a child’s disability may sometimes provide a basis for deviating from the legal presumption of parental authority. Drawing on the concept of “horizontal identities” and highlighting the potential roles of disability bias and conflicts of interest, the chapter examines how several concerns may undermine justifications for parental authority to pursue elective medical interventions for their disabled children. After arguing that the presence of several of these concerns in a particular case justifies skepticism regarding the parents’ unfettered discretion to pursue elective interventions, the chapter suggests some ways that parental authority might be constrained or guided in such cases.