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Spring 2017 · Vol. 46 No. 1 · pp. 111–113 

Book Review

Reconsidering Intellectual Disability: L’Arche, Medical Ethics, and Christian Friendship

Jason Reimer Greig. Washington: Georgetown University Press, 2015. 293 pages.

Reviewed by Paul Doerksen

Jason Greig’s fine book, part of Georgetown University Press’s Moral Traditions series, is a welcome and constructive theological contribution to the expanding field of contemporary disability theory. The book might be seen as a vigorous attempt to change the focus within bioethics from seeing disability as an objective problem to be solved, to {112} embracing a vision which includes “being friends with a person with a cognitive impairment as part of the good life” (107), a vision grounded in God’s friendship with humanity. Internal to the latter theological understanding is Greig’s concern to develop an inclusive vision for all people with disabilities, not just those who retain the capacity for social relationships or who can claim rights. Put another way, Greig is also concerned about addressing the potential pitfalls of a “disability hierarchy” (105).

Greig’s book begins by setting out the infamous and “controversial case of ‘Ashley X,’ a girl with severe developmental disabilities who received interventionist medical treatment to limit her growth and keep her body forever small” (back cover). This case study illustrates many of the shortcomings Greig discerns as problematic dimensions of contemporary disability theory, problems which are generated by late modernity, or the “Baconian project” (50). Central to the problematic nature of the “Ashley Treatment” is the objectification and instrumentalization of the body (21), the totalizing gaze of technological medicine (3), and the further reduction of these issues to matters of individual human rights.

Greig shows that more recent disability theory embraces social models which, while promising, are also inadequate (86), especially insofar as these models push the specificity of the body into the background while putting forward a negative view of dependency (90, 91). Greig’s description and critique of modern disability theory is multidisciplinary in nature, drawing on a wide range of source material. Much of the heavy lifting of his critical work depends on Christian theology. This entire project is grounded in the work of L’Arche, that organization of Christian communities founded by Jean Vanier, where people with disabilities live alongside other people in mutually supportive and transformative relationships.

When Greig turns from analysis and critique to presenting his constructive vision (which begins in chapter 4) it is Christian theology which frames this creative, substantial, and interesting work. He argues for a “theology of receiving God’s friendship . . . and how those with profound cognitive disabilities fit within its framework. Christian scripture and the church’s theological tradition promise a universal vision of ethical relations and praxis which the social theory of disability cannot match” (107-8).

Greig’s book is an important contribution to disability studies, challenging as it does both contemporary disability theory and the church to cultivate a more inclusive vision of people with all kinds of disabilities. Especially strong here is Greig’s insistence that any adequate understanding and practice in this field must include dynamic recognition and indeed embrace of dependence, which is important especially for those who are able to be independent.

Further, while it is the case that Greig’s work draws primarily on {113} theology, there is a sense in which theology might have played an even more powerful role in the book. That is, starting with the theological vision, especially as it shapes ecclesiology and anthropology, would have allowed Greig’s constructive vision to provide a more obvious shape and impetus to his critiques of various dimensions of modern disability theory. This methodological shift, namely, starting with theology and moving from within that framework to analyze other approaches, is on display, for example, in John Swinton’s fine book, Dementia, wherein he does not begin with the problem and then move to theology. Rather, he constructs his robust theological vision first, which provides a way to read issues surrounding dementia theologically. Greig’s book would be strengthened by following a similar methodology.

In addition, Greig might also have applied appropriate critical analysis to his treatment of the thought and work of L’Arche. As it stands, once he turns to L’Arche for his alternative vision, Greig offers no questions, let alone direct critique, resulting in the passing over of important issues without adequate attention. For example, Greig describes L’Arche’s decentering of the Eucharist in favor of the practice of foot-washing. He supplies support for the embrace of foot-washing as a counter-politics, while largely ignoring an analysis of what might be lost in replacing one central practice with another. A replacement of this kind, after all, involves more than simply changing minor social habits.

Overall, Greig’s book constitutes an important contribution to theology, medical ethics, and disability studies.

Paul Doerksen
Associate Professor of Theology and Anabaptist Studies
Canadian Mennonite University, Winnipeg, Manitoba

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