Justice Begins with the Question: Who Counts as Human?

When Some Lives Become Visible While Others Disappear

On Tuesday, 26 July 2016, a man entered Tsukui Yamayuri-en, an institution for people with cognitive disabilities in Japan. He killed nineteen people and wounded many more. The perpetrator had previously worked at the institution. He believed that people with severe disabilities should not live, and that society would be better off without them.

It was a mass killing, but it was also something more. It was an attack on the very idea that every human life has value. The killer did not merely take lives. He acted on the conviction that some lives should never have been lived.

Something happened afterwards that made the event even more disturbing. The public learned very little about who the victims were. They were not given names, faces and life stories in the way victims of other tragedies often are. We did not learn what they enjoyed, whom they loved, what they looked forward to, what they feared, or who missed them. Those who died remained largely anonymous.

They were described as disabled people, residents and victims. But not as particular human beings.

This raises a difficult question: Who is remembered as a human being when a life is lost? Who is given a name in public? Who is given a photograph, a story and a place in memory? And who disappears into a category?

Justice does not begin only with the question of how society’s goods should be distributed. It begins earlier and at a deeper level, with the question of who is counted at all. Who is seen as a human being whose life matters? Who is recognised as one of us?

Before asking what a person is entitled to, we must ask whom we recognise as a person with rights.

Lives Worth Grieving

The philosopher Judith Butler has written about which lives are regarded as worthy of grief. When a person dies, grief is never only private. It also has a public and political dimension. Memorial services, obituaries, photographs and names reveal something about whom society regards as belonging to it.

A life that is publicly mourned is at the same time recognised as a life that had value. Grief says that this person belonged among us. The death has created an absence. Someone has gone who should not have gone.

But not every death is met in the same way. Some lives are narrated in detail. Others are reduced to statistics. Some victims are given names. Others are referred to only as members of a group.

This does not mean that grieving families are obliged to make their grief public. People have a right to privacy, and there may be good reasons for protecting the identities of those who have lived vulnerable lives. Yet anonymity can also reveal society’s difficulty in seeing them as whole human beings.

When a person becomes visible only through a diagnosis, a disability or a need for support, a reduction takes place. The particular person disappears. What remains is the category: intellectually disabled, demented, mentally ill, addicted, service user, patient or client.

Categories are necessary. They make it possible to organise services, describe needs and develop knowledge. But they can also become hiding places. We may believe that we are seeing a person when in reality we see only the label we have given them.

A human being is always more than a category. Each person has a history that began before we met them, an inner life we can never fully know, and relationships with others that cannot be summarised in a case record.

The ethical challenge is therefore always the same: to see the person without denying the need, but also without reducing the person to that need.

The Invisible People

Societies reveal whom they value through whom they make visible. Monuments, history books, street names, memorial days and public narratives are not neutral. They tell us who is given a place in our shared memory.

In Berlin there are memorials to groups the Nazis attempted to destroy: Jews, Roma and Sinti, homosexuals and people with disabilities. These memorial sites give visibility to people who were first deprived of rights, then of names, and finally of life.

The murder of people with disabilities under Nazism did not begin in the gas chambers. It began in language and in theory. People were described as inferior, burdensome and unworthy of life. Their need for support was used as evidence that they did not contribute to society.

Before they were physically killed, they had already been morally expelled.

The Norwegian philosopher Harald Ofstad described Nazism as a contempt for weakness. What mattered was not only hatred directed at particular groups, but a view of humanity in which strength, achievement, obedience and usefulness became measures of value. The weak were not merely seen as weak. Weakness itself was interpreted as moral inferiority.

It is easy to place this way of thinking safely in the past. We may reassure ourselves that we live in another kind of society with different values. But the question remains whether contempt for weakness has entirely left us, or whether it still exists in more civilised forms.

It may appear when human value is measured by productivity. It may be heard when older people are spoken of as a burden. It may become visible when people with extensive support needs are described primarily through the costs they impose on society. It may be felt when illness and dependence are interpreted as personal failure.

The language is of course different. But the underlying measure may be the same: What does this person contribute? What does this person produce? What does this person cost?

Human dignity then becomes conditional. A person gains value through what they do, rather than through what they are.

A Human Being Is Not an Account

A society must manage limited resources. Political authorities cannot avoid making priorities. Health and care services must be organised, budgets must be drawn up, and different needs must be weighed against one another.

But economic calculations must not be allowed to determine who counts as human.

There is a boundary between calculating what a service costs and calculating what a human being is worth. When that boundary becomes unclear, justice itself is placed at risk.

A person may, for much of life, need more help than they can return in measurable form. A child with extensive disabilities may require continuous care. A person with dementia may gradually lose the ability to work, plan and express their needs. Someone who is seriously ill may become completely dependent upon others.

Does this mean that the life has less value?

Modern society often celebrates independence. The ideal person is autonomous, efficient, rational and able to support themselves. They take responsibility, choose freely and place as little burden as possible on others.

This ideal may describe certain periods in certain people’s lives. It does not describe human life as a whole.

We all begin life in radical dependence. An infant cannot survive unless others carry, feed, protect and comfort it. Throughout life we become ill, wounded, frightened and uncertain. We need teachers, friends, doctors, neighbours and family. Many of us end life with a greater need for assistance than we had in the years before.

Dependence is therefore not a deviation from human life. It is part of human life.

The difference between people is not that some are dependent while others are entirely independent. The difference concerns how dependence appears, how extensive it is, and whether society has chosen to make it visible or to conceal it.

Martha Nussbaum’s Starting Point

Martha Nussbaum’s theory of justice begins with precisely this embodied and vulnerable human being. She criticises political theories built upon the idea of independent and rational people who enter into agreements with one another because doing so is mutually beneficial.

In many social contract theories, society’s citizens are imagined as more or less equal participants. They can reason, protect their interests and contribute to society’s production. They can then agree upon principles for how benefits and burdens should be distributed.

But what about those who cannot meet these assumptions? What about a person with severe intellectual disabilities, a young child or a person with advanced dementia? Should their rights be considered only after society’s basic principles have already been decided by others?

Nussbaum argues that this is not sufficient. People with extensive care needs cannot simply be added later to a theory originally constructed for independent citizens. Their lives must be included in the very starting point of a theory of justice.

If a theory of justice does not from the outset include people who depend upon the support of others, then it is not a theory for human beings as human beings actually are.

Nussbaum therefore does not begin by asking what a person can contribute to society. She asks what every person must have a genuine opportunity to do and to be in order to live a dignified life.

This is a decisive shift.

Human value does not come from achievement. Society’s responsibility is not determined by how profitable it is to invest in a person. Justice concerns the creation of conditions that make it possible for people to live in accordance with their dignity.

Who Is Allowed Inside the Circle?

Every society draws a moral circle around those regarded as full members. Inside the circle are those who are seen, heard and taken seriously. Their freedom counts. Their suffering receives attention. Their wishes are included in political deliberation.

Outside the circle, or near its edge, are people who are spoken about more often than they are spoken with. They are present in society, but they have less influence over how society is organised. Others interpret their needs, make decisions on their behalf and determine what should count as a sufficiently good life for them.

The history of people with intellectual disabilities is to a large extent a history of being placed outside this circle. They have been hidden in large institutions, deprived of legal agency and regarded as objects of care. Even when the care was well intended, the person could disappear behind the need for assistance.

An institution may be closed without the institutional gaze disappearing.

A person may live in an ordinary home and still live an institutionalised life. This happens when daily life is governed by staff schedules, staffing needs and administrative considerations. It happens when others decide when a person should get up, eat, socialise or go to bed. It happens when the home becomes, in practice, someone else’s workplace.

Society may have moved the person out of the institution without necessarily moving the institution out of the person’s life.

Justice therefore requires more than physical inclusion. It is not enough to be placed in the local community. A person must also be allowed to belong to it. They must be able to develop relationships, influence their environment and be regarded as a participant in shared life.

From Service User to Citizen

Language reveals how we think. In the welfare state, the term “service user” has acquired a remarkable position. Originally, it described an action: a person uses a service. Gradually, the action became an identity. The person became a user.

The term may appear neutral. Yet it tells us who the person is in relation to the system. This is someone who receives or makes use of a service. The whole identity of the person is viewed from the perspective of the service apparatus.

A person does not merely use services. They are a neighbour, friend, daughter, son, parent, colleague and citizen. They have interests, memories, hopes, resistance and attachments. They live a life that extends far beyond the part of life in which professional services are involved.

When a person is described as a citizen, something different happens. The citizen is not merely a recipient. The citizen has a place in the political and social community. The citizen has rights, but also a voice. They should be able to influence the society that shapes their life.

The transition from service user to citizen is therefore not merely a linguistic improvement. It represents a different view of the human being.

Yet the word “citizen” is not sufficient if society’s practices remain unchanged. A person may be called a citizen and still be treated as an object. What matters is whether that person has real opportunities to decide, participate, belong and be heard.

Here Nussbaum shows the difference between formal rights and actual opportunities. It is not enough for a door to be open in principle if a person cannot get through it. It is not enough to have the right to vote if information, polling places or necessary support are inaccessible. It is not enough to have a right to participation if no one has time to listen.

A right that cannot be exercised is only partly real.

Equality Is Not the Same as Treating Everyone Alike

We often say that justice means treating everyone equally. Yet equal treatment can in practice create profound inequality.

Imagine a bus that is, in principle, open to everyone. Tickets cost the same. The timetable is the same. No rule states that wheelchair users are forbidden to travel.

Yet the transport is not just if the ramp does not work, luggage fills the wheelchair space, or the driver believes that the passenger should have given notice in advance.

Everyone was met with the same rule, but not everyone had the same opportunity to travel.

Justice must therefore be assessed by what people are genuinely able to do, not merely by whether a system has formulated equal rules.

A person who needs additional support in order to participate on equal terms should not be regarded as someone demanding special treatment in the sense of an unreasonable advantage. The support is the very condition that makes equality real.

This can be difficult to understand in a culture where independence is regarded as the ideal. Assistance may be interpreted as privilege. Adaptation may be viewed as giving some people more than others.

But there is a difference between receiving the same and having genuine opportunities.

Two people may have the same formal right to education, employment, transport or political participation, but very different possibilities of using that right. Justice requires us to see these differences, not to pretend they do not exist.

Dignity Without Conditions

The most powerful element in Nussbaum’s thinking is that dignity does not have to be earned. It is not a prize for autonomy, intelligence or social usefulness.

A human being has dignity because theirs is a human life.

This may sound self-evident. Most modern democracies affirm human dignity and equal rights. Yet it is only when the principle encounters concrete differences that we see how demanding it truly is.

Do we believe that human dignity is equal when a person cannot express their wishes through speech? When they need assistance with intimate personal care? When they cannot work? When they make choices we do not understand? When they do not show gratitude? When care is demanding and expensive?

It is easy to recognise humanity in the abstract. It is more difficult to recognise the concrete person when they challenge our routines, ideals and interests.

Justice is therefore tested not primarily in solemn declarations, but in everyday life. It is revealed in how we speak about a person when they are not present. In how much time we give. In who is allowed to decide. In whether a refusal is respected. In whether a person’s habits and relationships are treated as meaningful.

Human dignity must have practical consequences. Otherwise, it remains only a beautiful word.

The Particular Human Being

To say that all human beings have equal value does not mean that people are the same. On the contrary, human dignity requires that each person be allowed to be different.

Hannah Arendt wrote about human plurality. Humanity never exists only in the singular. We exist as human beings among other human beings, and we are both equal and different. We are similar enough to understand one another, yet different enough that no one can ever be completely replaced by someone else.

The particular person becomes visible through action, speech and relationships. But what about the person who cannot express themselves in the ways society usually expects? What about the person who communicates slowly, unclearly or without speech?

Then it becomes the responsibility of others to listen in more than one way.

Listening is not only hearing words. It is attending to the body, expressions, habits, joy, anxiety, withdrawal and attachment. It is allowing enough time for a perspective to emerge.

Yet there is a danger here as well. When others interpret a person’s needs, they may replace that person’s voice with their own. Care may become paternalism. Protection may become control.

There is no simple solution. People sometimes need others to act on their behalf. But the helper must continually ask: Am I protecting this person’s life, or the order of the system? Am I trying to understand this person’s wishes, or making life easier for those of us who provide the service?

Justice requires humility because we can never fully know another person’s inner world.

When a Person Becomes a Burden

In political debate, care is often described as an expense. We speak of ageing populations, dependency burdens and the sustainability of the welfare state. Such questions are real. But the language can gradually shape how we see the people concerned.

When a group is repeatedly described as a burden, the people within it may begin to experience themselves as burdens. The economic category enters their understanding of themselves.

A person may then begin to ask: Am I worth what I cost? Am I taking up too much space? Should I manage with less help? Is my life a burden to my family or society?

These are dangerous questions when they arise from a society that values people primarily according to their contribution to the economy.

A just society cannot promise that no one will ever feel dependent or vulnerable. But it can refuse to make vulnerability shameful. It can organise care in ways that prevent the person from being reduced to a cost.

Care is not merely something the strong provide for the weak. It is a practice that holds the human world together. It reminds us that no one has created themselves and that no one lives entirely by their own strength.

Expanding the Imagination

Injustice does not always arise from cruelty. It may also arise from a failure of imagination. We find it difficult to imagine lives that are very different from our own.

The person who moves freely may not see the staircase as a barrier. The person who understands complex information may not notice that language excludes others. The person surrounded by family and friends may underestimate the importance of stability and attachment for someone who depends on constantly changing staff.

Throughout much of her work, Martha Nussbaum has been concerned with the role of emotion and imagination in moral life. Literature, stories and art can help us see the world from another standpoint. They can make what is unfamiliar less alien.

Yet imagination must not become a substitute for listening to people themselves. We cannot merely imagine what others need. We must create spaces in which they can express it, using whatever forms of expression are available to them.

Justice needs both empathy and institutions. It needs warmth, but also rights. It needs good people, but it cannot depend upon every person happening to meet an unusually good helper.

A just society builds arrangements that protect the person even on bad days, when staff are busy, resources are limited and empathy fails.

The Question That Is Never Finished

Who counts as human?

Most people will answer: Everyone.

But the real answer is not found first in words. It is found in society’s practices.

It is found in which lives we protect, which voices we hear, and which needs we are willing to spend resources on. It is found in who is allowed to participate in shaping their own life. It is found in how we speak about people who depend upon others.

It is also found in whom we grieve.

The nineteen people killed in Japan were not merely members of a vulnerable group. They were nineteen different human beings. Each had a particular life that cannot be replaced. The fact that we know little of their names does not make the loss smaller. But their anonymity reminds us how easily a human being can disappear behind a category.

Justice therefore begins in recognition: This is a human being. This life is real. This body, this voice, this joy and this vulnerability belong in our shared world.

Then comes the question of what society owes this person.

Nussbaum’s answer is that every human being must be given real opportunities to live a life consistent with human dignity. Not because the person has proved useful. Not because they can repay the care they receive. Not because they can argue for their own rights.

It is enough to be human among other human beings.

This may be the simplest sentence of justice. At the same time, it is one of the most difficult to realise.

For every time we organise a society, a service or an encounter, we must ask the question again:

Who becomes visible here?

Who is heard?

Who is left outside?

And whom have we not yet learned to see as one of us?