Duty, not gratuity: the ethics of social support for people with intellectual disabilities in the United States

Abstract

Many adults with intellectual disabilities require assistance with activities of daily life and life skills training. This support is provided by professional caregivers. Because of low wages, a shortage of caregivers in the United States is now threatening services for adults with intellectual disabilities. The gratuity view treats social support for adults with intellectual disabilities as an undeserved favor. Society owes them nothing as a matter of duty, and they have no right to services. I reject the gratuity view and defend the entitlement view: social care is deserved by adults with intellectual disabilities. Support services in the form of adequate professional caregiving are a human right and offering them a social duty.

Points of Interest

• This article examines the ethics of social support for people with intellectual disabilities by using a case study of the state of Illinois.

• In order to enjoy a good life, people with intellectual disabilities need day programs and residential services—both staffed by professional caregivers.

• Because of inadequate government funding, the United States is experiencing a shortage of professional caregivers who assist people with intellectual disabilities.

• There are two views of social care for people with intellectual disabilities: the gratuity view sees it as an undeserved favor, while the entitlement view sees it as a human right.

• This article argues that government-funded support services, including professional caregiving, are a matter of justice, not charity.

Keywords:

• charity
• direct service professionals
• David Hume
• intellectual disability
• justice
• rights
• well-being

Disclosure statement

No potential conflict of interest was reported by the author(s).