I have tried to find out what the social implications of classical hedonistic utilitarianism are with respect to different kinds of disability: mere disability, simple disability, problematic disability, and tragic disability. The implications seem to be, once we rid ourselves of prejudice with respect to disability, rather commonplace. Very roughly, the implications are as follows.
First of all, there are reasons, within a publicly-financed health care system, to try to cure disabilities. This is true even of some mere disabilities, where people very much want to get rid of them—in spite of the fact that, as such, they do not mean any threat to their level of felt happiness. Here society must surrender to the perversity/futility-mechanism identified in this paper. People with disabilities have a rather strong claim on scarce medical resources, given utilitarianism. Somewhat unexpectedly, they have, in many cases, an even stronger claim than the one they would have had, if instead some kind of egalitarianism or prioritarianism had been the point of departure of the assessment of their needs.
Secondly, when people suffering from problematic disabilities cannot be cured, these people have a right to compensation from society, once a publicly financed health care system has been established. The need for compensation, mainly in the form of personal assistance, is no less urgent than the need for a cure, when a cure exists. Somewhat unexpectedly, it has also been concluded that people suffering from intractable pain (but no disability) have a similar right to compensation.
Finally, even if there are good utilitarian reasons, in the individual case, to avoid the birth of people with costly simple disabilities, as well as people with problematic and tragic disabilities, through the use of prenatal genetic diagnosis and selective abortion, as well as through IVF and PGD, it would not be a good idea to make the use of these techniques obligatory. This would be to give rise to speculation among people living with these disabilities that they should not really be where they are; they pose a burden to society. Hence, it is wise utilitarian policy to avoid any concession to eugenics whatever. We may safely assume that, if society is neutral with respect to the question what sort of people there should be, individual couples are capable, in most cases, to arrive at wise answers to this question.
Classical hedonistic utilitarianism seems to give the "right" answer to how society should react to disability, then. This does not mean that we have come across any positive evidence in favor of classical hedonistic utilitarianism. Other moral views, when applied to the same problem, may give rise to similar implications. We have evidence for a moral theory only where it gives the best explanation of the data at hand. However, the fact that classical hedonistic utilitarianism gives answers in conformance with our considered moral intuitions does at least show that it has not, in this field, been disconfirmed.
Dordrecht: Springer , 2010.