The medical model, with a human face

The Foundations of Autistic Flourishing

“…As efforts are made to broaden the range of issues that are taken to be constitutive of a good Autistic life-that is, away from narrow medical concerns to other elements that can 3 We note here that, with the rise of chronic diseases and evidencebased medicine, the ethical imperative of the medical model has broadened to include the cure, prevention, and management of health and biological disease [101]. 2 In traditional positivist research paradigms, the researcher attempts to be impartial, minimizing bias in the search for some objective "truth." Whatever the intent, however, the researcher's own expertise, experiences, and assumptions undeniably shape the process.…”

“…Yet, remarkably, the idea of flourishing lives has rarely been applied to Autistic 1 people. Its absence, we contend, is rooted in the field's historic commitment to the conventional medical model, in which a person's functional limitations or "impairments" are the source of any disadvantages experienced, which can be remedied by treatment or cure [1][2][3]. The absence of any meaningful discussion of flourishing could be because the challenges facing Autistic people can be substantial and lifelong [4••], with the fundamental idea of a "good life" thus seeming out of reach.…”

“…We suggest that such understanding will require us to step away from key assumptions that have structured autism science for decades now-and to acknowledge the ways in which both hidden biases and methodological errors too often obscure understanding the key elements of Autistic flourishing. 2 In what follows below, we outline five ways in which we, as an autism research community, need to reconsider Autistic flourishing, functioning almost as a toolkit for those seeking to have conversations about such flourishing well into the future.…”