Friendship and Adults With Profound Intellectual and Multiple Disabilities and English Disability Policy

Abstract

The authors analyzed references to “friendship” in the documents that set out the policy vision for adults with intellectual disabilities living in England. Friendship is commonly identified as one of the human “goods”—those aspects of life that contribute to our flourishing. Disability ethicists have suggested that friendship is especially important for people with the most profound intellectual and multiple disabilities, as a means of establishing their social and moral standing. However, the idea of friendship with adults with profound disabilities is problematic if friendship is defined as it is commonly understood in the contemporary English context. Citizenship and rights have dominated policy discourse since the publication of the English intellectual disabilities strategy, Valuing People, in 2001. However, recent policy documents give greater prominence to friendship and frame it explicitly as a “good” in the lives of adults with profound disabilities. The language used in these policy documents signals but does not openly acknowledge the tensions and complexities entailed in the idea of friendship with adults with profound disabilities. The authors suggest that the failure to address these tensions and complexities is a recipe for failure in the implementation of policy recommendations. They note the need for policy in this area to be reconsidered and suggest that this process should be informed by both empirical research and conceptual analysis.

The Close Relationships of People with Intellectual Disabilities: A Qualitative Study

“…Related to this is the need for consideration for what friendship means for people with severe or profound intellectual disabilities and how their needs in this area are best addressed (Hughes et al . ).…”

“…There also needs to be a recognition in practice that PWID represent a heterogeneous population (Gates 2003) and that the concept of friendship as it is commonly understood and referred to in many policy documents may not be applicable for those with more profound intellectual disabilities (Hughes et al 2011). Likewise, the application of policy, rules and regulations that impact on social relationships in a blanket way to all PWID is likely to result in unnecessary restrictions for some and increased vulnerability to exploitation for others.…”

“…This issue was raised by the PFS Chairs Committee during their review of the current research project, which suggests that it is an area that PWID would like to see addressed. Related to this is the need for consideration for what friendship means for people with severe or profound intellectual disabilities and how their needs in this area are best addressed (Hughes et al 2011).…”

Attuning: A Communication Process between People with Severe and Profound Intellectual Disability and Their Interaction Partners

“…People with profound intellectual and multiple disabilities (PIMD) need extensive supports to engage meaningfully with life and to take up the daily activities that people without disabilities engage in ordinarily (Hughes et al 2011). Such supports are required because their disabilities often make it difficult to determine their capacities (Nakken & Vlaskamp 2007).…”

Reason and value: making reasoning fit for practice

“…Goldie argues against the strong claims of some philosophers about the level of psychological continuity needed for personal identity. Questions about the relationship between memory, a sense of self and what it is to be a person have profound implications for debates in neuropsychiatry and person‐centred medicine, and the answers given by some philosophers to these questions have caused serious concerns among professionals working with patients who have profound intellectual disabilities . Literary scholar Neil Vickers takes up the thread of Goldie's paper, focussing on the various ways in which illness may threaten one's personal continuity .…”