The level of support available for people with disabilities differs widely around the world, and disability services provided by the government are often extremely controversial. Periodically, cases come up in Europe where some person with disabilities (so far, always a man) applies to have the government pay for a prostitute so that sexual needs can be met, and such cases predictably provoke a great deal of debate. An Ontario court recently ruled that severe alcoholism is a disability. This means that severe alcoholics, rather than being treated as though their alcoholism could be overcome with a little willpower, will be granted full disability payments in Canada. Some feel this is a victory for a legitimate medical problem; others feel that classifying alcoholism as a disability removes incentives for alcoholics to fight for greater functionality. Even those who agree that alcoholism can be a serious medical condition concede that it’s acquired by consistently abusing alcohol voluntarily over a long period of time. Some think anyone who felt alcoholism was their best available life choice deserved better opportunities than they had.

Four negotiations are central to almost all debates about disability services. First, what should be counted as a disability, and why; second, what people who have disabilities are really capable of; third, how society should deal with disabilities that people, to some degree or another, have created for themselves; and fourth, what things a human being really needs and/or should have a right to. All of these can be seen in the debate about alcoholism, and there are plenty of other examples as well. For instance, people who are extremely obese often receive extremely poor treatment at the hands of airline companies in the US. There’s no agreed upon set of standards about what to do with customers who don’t fit in those tiny seats, but although some are literally un-able to fly without some extra accommodation, there’s a great deal of resistance to applying the term “disabled” because–despite evidence that obesity is at least as genetic as heart disease–obese people are seen to have brought their condition on themselves.