Marx's "Critique of the Gotha Programme" suggests that the principle of "equal rights" inevitably sacrifices differences, physical or otherwise, even under socialism. Marx's utopia, if we can call it that, is a future stage of human development ("communism") that would allow society to go beyond "the narrow horizon of bourgeois right" and "inscribe on its banners: From each according to his ability, to each according to his needs!" Moreover, for Marx, "work" doesn't exactly mean what we think it is: labor to produce goods and services necessary for human life. As a kind of Hegelian humanist, he uses the word "work" not only to refer to what we think of as "work," but also to signify what we often think is the antithesis of "work," for instance, free and creative exercise of all human faculties, including imagination, not necessarily to produce anything in particular, but more importantly for the sake of "culture" in one of the older senses of the word: "From eCl6 the tending of natural growth was extended to process of human development, and this, alongside the original meaning in husbandry, was the main sense until lC18 and eC19. Thus More: 'to the culture and profit of their minds; Bacon: 'the culture and manurance of minds (1605); Hobbes: 'a culture of their minds (1651); Johnson: 'she neglected the culture of her understanding (1759)" (Raymond Williams, _Keywords_, <http://pubpages.unh.edu/~dml3/880williams.htm>). Marx was not a philosopher of equality, nor was he a philosopher of utility who idealized "the body at work" producing useful stuff. He was a philosopher of freedom, freedom at work which is play, freedom that rests on the foundation of the world of necessity but goes beyond it, aiming for the free development of each individual with all her singular, concrete, incommensurable powers and needs for its own sake, without which the free development of all is impossible. In Marx's utopia, what is today an impairment -- e.g. deafness -- would be recognized as a unique power and need.
The difficulty of incorporating disablement into Marxism is not a theoretical difficulty. Rather, the difficulty is practical -- how to do so in current struggles, process of transition to socialism, and reconstruction of society on the socialist foundation. -- Yoshie
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